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TechRemove E-Waste Recycling Agreement 02-08-2023AGREEMENT BETWEEN THE CITY OF SALINA, KANSAS and TECHREMOVE, LLC for E-WASTE RECYCLING EVENT This Agreement is entered into f.ebl'~ 1>~, 2023 by and between the City of Salina, Kansas, (the "City") and TechRemove, LLC, a Missouri limited liability company (the "Contractor"). Recitals A. The City desires to contract for electronic waste recycling services for the purpose of a community-wide recycling event in compliance with federal, state, and local regulations. B. The Contractor has the requisite qualifications and experience to perform the services needed by the City and desires to perform those services pursuant to the terms of this Agreement. The parties, in consideration of the mutual promises set forth in thi s Agreement, agree and covenant: 1. Definitions. Capitalized words used in this Agreement shall have the following meanings: "Agreement" means this Agreement for E-Waste Recycling Event, as amended and supplemented from time to time. "City" means the City of Salina, Kansas. "Contractor" means TechRemove, LLC and its successors. 2. Exhibits. The following Exhibits are attached to and made a part of this Agreement (Mark with "X" if applicable): Exhibit A: Responsibilities of the Parties ~ Exhibit B: Term; Schedule ~ Exhibit C: Basis of Payment ~ Exhibit D: Insurance Requirements ~ 3. Responsibilities of the Parties. The parties agree to perform the responsibilities outlined in the attached and incorporated Exhibit A. 4. Term; Schedule. The Contractor agrees to perform its responsibilities during the term and according to the timeframe and schedule described in Exhibit B, subject to the potential for prior termination pursuant to the terms of this Agreement. 5. Payment. The City shall pay the Contractor for the performance of its responsibilities pursuant to this Agreement as set forth in Exhibit C. 6. Insurance Requirements. 6.1. Types and Amount of Coverage. The Contractor agrees to obtain insurance coverage as specified in Exhibit .Q, attached hereto, and shall not make any material modification or change from these specifications without the prior approval of the City. If the Contractor subcontracts any of its obligations under this Agreement, the Contractor shall require each such subcontractor to obtain insurance coverage as specified in Exhibit D. Failure of the Contractor or its subcontractors to comply with these requirements shall not be construed as a waiver of these requirements or provisions and shall not relieve the Contractor of liability. Contractor Services (2020-30-10) 6.2. Rating. All insurance policies shall be issued by insurance companies rated no less than A-Vil in the most recent "Bests" insurance guide, and admitted in the State of Kansas. Except as otherwise specified in Exhibit D, all such policies shall be in such form and contain such provisions as are generally considered standard for the type of insurance involved. 6.3. Certificate of Insurance. The parties acknowledge that the Contractor has provided the City with a certificate of insurance listing the City as the Certificate Holder and evidencing compliance with the insurance requirements in this Agreement. The City reserves the right to require complete certified copies of all insurance policies procured by the Contractor pursuant to this Agreement, including any and all endorsements affecting the coverage required hereunder. 7. Injury to Persons or Damage to Property. The Contractor acknowledges responsibility for any injury to person(s) or damage to property caused by its employees or agents in the performance of its duties under this Agreement and shall immediately notify the City's Risk Management Department at (785) 309-5705 in the event of such injury to person(s) or damage to property. 8. Indemnification. To the fullest extent permitted by law, the Contractor shall defend, indemnify and hold harmless the City, its agents, representatives, officers, officials and employees from and against all claims, damages, losses and expenses (including but not limited to attorney fees and court costs) attributable to bodily injury, sickness, disease, death, or injury to, impairment, or destruction of property, including loss of use resulting therefrom, to the extent that such claims, damages, losses, and expenses relate to, arise out of, or are alleged to have resulted from the wrongful acts, negligent acts, errors, omissions, or defective work or services of the Contractor, its employees, agents, or any tier of subcontractors in the performance of this Agreement. 9. Voluntarv Termination. The City may terminate this Agreement, with or without cause, upon thirty (30) days advance written notice to the Contractor. In the event of such termination, the Contractor shall be compensated for such services as have been satisfactorily performed through the date of termination, but no compensation shall be earned after the effective date of the termination. Within five (5) days of any such termination, all finished or unfinished documents, data, studies, surveys, drawings, maps, models, photographs, reports or other material prepared by the Contractor pursuant to this Agreement shall be delivered to the City. Notwithstanding the above, the Contractor shall not be relieved of any liability to the City for damages sustained by the City by virtue of any breach of this Agreement by the Contractor, and the City may withhold any payments to the Contractor for the purposes of set-off until such time as the exact amount of damages due the City from the Contractor may be determined. 10. Default. If either party fails to comply with any term of this Agreement within ten (10) days after written notice to comply has been mailed by the non-defaulting party to the defaulting party, such failure shall be deemed an immediate breach of this Agreement ("Event of Default"). 11. Remedies. Upon the occurrence of an Event of Default, the non-defaulting party shall have the following rights and remedies, in addition to any other rights and remedies provided under this Agreement or by law: 11 .l Termination. The non-defaulting party shall have the right to terminate this Agreement or terminate the defaulting pai1y's rights under this Agreement. 11.2 Other Remedies. The non-defaulting party may pursue any available remedy at law or in equity (including specific performance) by suit, action, mandamus or other proceeding to enforce and compel the performance of the duties and obligations set forth in this Agreement, to enforce or preserve any other rights or interests of the non-defaulting party under this Agreement or otherwise existing at law or in equity and to recover any damages incurred by the non-defaulting party resulting from such Event of Default. 12. Non-Assignable. Due to the unique qualifications and capabilities of the Contractor, neither the rights nor responsibilities provided for under this Agreement shall be assignable by either party, either in whole or in part. 13. Notices. All notices required or permitted to be given pursuant to this Agreement shall be in writing and delivered personally or sent by registered or certified mail, return receipt requested, or by generally recognized, prepaid, commercial courier or overnight air courier service. Notice shall be considered given when received on the date appearing on the return receipt, but ifthe receipt is not returned within five (5) days, then three (3) days after mailed, if sent by registered or certified 2 mail or commercial courier service; or the next business day, if sent by overnight air courier service. Notices shall be addressed as appears below for each party, provided that if any party gives notice of a change of name or address, notices to the giver of that notice shall thereafter be given as demanded in that notice. CITY: CONTRACTOR: Household Hazardous Waste Attn: Derek McKellips 412 E. Ash St. Salina, KS 67402-0736 TechRemove, LLC Attn: Kaloeb Salter 5661 Natural Bridge Ave. Saint Louis, MO 63120 14. Retention and Inspection of Records. The Contractor shall maintain complete, accurate, and clearly identifiable records with respect to all costs and expenses incurred under this Agreement. The records shall be maintained during the term of this Agreement, and for a period of three (3) years from the date of final payment under this Agreement (the "Retention Period"); provided, however, that if any litigation, claim or audit is commenced prior to the expiration of the Retention Period, then the Retention Period shall be extended until all litigation, claims or audit findings have been completely terminated or resolved, without right of further appeal. During the Retention Period, the Contractor shall allow a representative of the City during normal business hours to examine, audit, and make transcripts or copies of such records and any other documents created pursuant to, or arising under, this Agreement. The City agrees to responsibly utilize all information obtained pursuant to this paragraph for the purposes of reviewing, confirming, and verifying the nature and amount of all costs and expenses incurred under this Agreement. The City agrees to take reasonable precautions not to disclose such information outside the scope of those stated purposes, subject to the Kansas open records act or other applicable law. IS. Non-aoorooriation. The City is subject to Kansas budget and cash basis laws, and operates on a calendar fiscal year. ln the event that this Agreement involves financial obligations spanning multiple fiscal years for the City, it is subject to annual appropriation by the City's governing body for future fiscal years. If the City's governing body does not appropriate the funds necessary to fulfill the City's financial obligations pursuant to this Agreement, the City shall so notify the other parties to this Agreement and this Agreement shall be null and void for purposes of the fiscal year(s) affected by the decision of the governing body not to appropriate. 16. Relationship. It is expressly understood that Contractor in performing services under this Agreement, does so as an independent contractor. The City shall neither have nor exercise any control or direction over the methods by which Contractor performs its responsibilities as outlined in Exhibit A. The sole interest and responsibility of the City is to see that the services covered by this Agreement are performed and rendered in a competent, efficient, and satisfactory manner. Contractor shall be exclusively responsible for all taxes, withholding payments, employment-based benefits, deferred compensation plans, including but not limited to its workers compensation and social security obligations, and the filing of all necessary documents, forms, or returns pertinent to the foregoing. 17. Subcontracting. Contractor shall not subcontract any work or services under this Agreement without the City's prior written consent. 18. Compliance with Applicable Law. Contractor shall comply with all applicable federal, state, and local law in the performance of this Agreement. 19. Equal Opportunity. (a) In conformity with the Kansas act against discrimination and Chapter 13 of the Salina Code, the Contractor and its subcontractors, if any, agree that: 3 (1) The Contractor shall observe the provisions of the Kansas act against discrimination and Chapter 13 of the Salina Code and in doing so shall not discriminate against any person in the performance of work under this Agreement because ofrace, sex, religion, age, color, national origin, ancestry or disability; (2) The Contractor shall include in all solicitations, or advertisements for employees, the phrase "equal opportunity employer," or a similar phrase to be approved by the City's human relations director; (3) If the Contractor fails to comply with the manner in which the Contractor reports to the Kansas human rights commission in accordance with the provisions ofK.S.A. 44-1031 and amendments thereto, the Contractor shall be deemed to have breached this Agreement and it may be canceled, terminated or suspended, in whole or in part, by the City; ( 4) If the Contractor is found guilty of a violation of Chapter 13 of the Salina Code or the Kansas act against discrimination under a decision or order of the Salina human relations commission or the Kansas human rights commission which has become final, the Contractor shall be deemed to have breached this Agreement and it may be canceled, terminated or suspended, in whole or in part, by the City; (5) The Contractor shall not discriminate against any employee or applicant for employment in the performance of this Agreement because ofrace, sex, religion, age, color, national origin, ancestry or disability; and (6) The Contractor shall include similar provisions in any subcontract under this Agreement. (b) The provisions of this section shall not apply to this Agreement ifthe Contractor: (1) Employs fewer than four employees during the term of this Agreement; or (2) Contracts with the City for cumulatively $5 ,000 or less during the City's calendar fiscal year. 20. Administration of Agreement. All references in this Agreement requiring the City's participation or approval shall mean the participation or approval of the City Manager or his designee, unless otherwise provided herein. 21. Attorney Fees. If any suit or action is instituted by either party hereunder, including all appeals, the prevailing party in such suit or action shall be entitled to recover reasonable attorney fees and expenses from the non-prevailing party, in addition to any other amounts to which it may be entitled. 22. Right to Independent Legal Advice. The Contractor understands and acknowledges the right to have this Agreement reviewed by legal counsel of the Contractor's choice. 23. Applicable Law; Venue. This Agreement and its validity, construction and performance shall be governed by the laws of Kansas. In the event of any legal action to enforce or interpret this Agreement, the sole and exclusive venue shall be in the Saline County, Kansas District Court. 24. Interpretation. This Agreement shall be interpreted according to its fair meaning, and not in favor of or against any party. 25. Time. Time is of the essence of this Agreement. No extension will be granted unless in writing and signed by the parties. Should the end of a time period fall on a legal holiday that termination time shall extend to 5 :00 p.m. of the next full business day. 26. Severability. The unenforceability, invalidity, or illegality of any provision of this Agreement shall not render the other provisions unenforceable, invalid, or illegal. 27. Authoritv and Consent to Transaction. Each party represents to the other that the person executing this Agreement has full and legal authority to bind such party to the terms of this Agreement, and that the execution and delivery of this Agreement have been duly and validly authorized by the governing body of each party. 4 28. Persons Bound. This Agreement shall extend to and bind the heirs, executors, administrators, trustees, successors and authorized assigns of the parties hereto. 29. Counterparts. This Agreement may be executed in any number of counterparts, each of which shall be deemed an original, or in multiple originals, and all such counterparts or originals shall for all purposes constitute one agreement. 30. Amendments. Neither this Agreement nor any of its terms may be changed or modified, waived, or terminated except by an instrument in writing signed by an authorized representative of the party against whom the enforcement of the change, waiver, or termination is sought. 31. Waiver. No failure or delay by a party hereto to insist on the strict performance of any term of this Agreement, or to exercise any right or remedy consequent to a breach thereof, shall constitute a waiver of any breach or any subsequent breach of such term. No waiver of any breach hereunder shall affect or alter the remaining terms of this Agreement, but each and every term of this Agreement shall continue in full force and effect with respect to any other then existing or subsequent breach thereof. 32. Conflict Resolution. No interpretation of this Agreement shall be allowed to find the City has agreed to binding arbitration. 33. No Third Partv Beneficiaries. Solely the parties to this Agreement shall have rights and may make claims under this Agreement. There are no intended third party beneficiaries under this Agreement, and no thfrd parties shall have any rights or make any claims hereunder. 34. Typewritten or Handwritten Provisions. Typewritten or handwritten provisions inserted or attached, and initialed by all parties, shall supersede all conflicting printed provisions. 35. Feminine-Masculine, Singular-Plural. Wherever used, si ngular shall include the plural, plural the singular, and use of any gender shall include all genders. 36. Headings. The headings of the sections of this Agreement are included for the purposes of convenience only and shall not affect the interpretation of any provision hereof. 37. Merger Clause. These terms are intended by the parties as a complete, conclusive and final expression of all the conditions of their Agreement. No other promises, statements, warranties, agreements or understandings, oral or written, made before or at the signing thereof, shall be binding unless in writing and signed by all parties and attached hereto. IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by their authorized representatives. CITY OF SALINA, KANSAS Byo ~-/>-UJ21 JimeutSCh,PUbliCWs Director CONTRACTOR NAME HERE By: TECHREMOVE, LLC ?¢~ =-~ (nruno) \!.,AL.£)£(? tjAL-re°t2.. (title) 1""~.v-AC.-~1.-.. ('...t=."""'6~'1l.. 5 EXHIBIT A RESPONSIBILITIES OF THE PARTIES 1. Community Recycling Event. The Contractor agrees to organize, hold and faci litate a one-day recycling event within the City of Salina, Kansas, for the purpose of collecting, removing, and recycling electronic waste from individuals in the community in compliance with the Quote Specifications submitted by Contractor and attached and incorporated as page A-2 of this Exhibit A. The event shall be held at the Berkley Family Recreational Area on Markley Road, Salina, Kansas. 2. Materials. During the event, the Contractor shall accept recyclable materials including but not limited to microwaves, TVs, VCR players, DVD players, fax machines, answering machines, monitors, speakers, computers, printers, scanners, hard drives, laptops, keyboards, stereos, radios, pagers, cel l phones, kitchen appliances, furnaces, water heaters, air conditioners, power tools, camera equipment, restaurant equipment, medical equipment, lab eq uipment, machinery, most batteries, lawn and garden equipment (gas and oil must be removed prior to drop off). 3. Collection Fees. The Contractor shall be entitled to collect the following fees from individuals dropping off recyclable electronics and shall provide sufficient personnel to collect such fees. Acceptable forms of payment shall be cash or check: contr.ictor's All-inclusive Event cost to city: • see Bid Specific.atiortS for details s 4400 • Does not indude fees for specific items (i.e. CRTs) llJ C;ish Ill Check Specify <11ccepUble forms of p<11yment from event p.uticipants ~ CreditC.ard regarding fees for specific items lUted below (died all that apply]: Ill Debit card D PayPal Ill Venmo contriKt:Or's Fees for Specific Items {i..e. CRTsj: • complete list of ;ill items that require ii n <11dditioniil tee below • Items not specified will be il.dvertised <11s fru to reqde lt1!111 Description l'ee List by type and size, as applicable CRT TVs s 30.00 CRT Monitors s 5.00 LCD.LED, and Plasma TVs s 20.00 Projection TVs S45_QO Freon Containing Devices s 10.00 4. City's Responsibilities. The City shall provide the location, event advertising, restroom facilities, and traffic control. In addition, if the City wishes to operate a survey station on the premises to obtain information from individuals visiting the site, the City shall be responsible for providing any necessary personnel and survey materials. A-1 5. Contractor's Responsibilities. Electronic Waste Collection and Recyding Contractor Responsibilities: Organize, hold and facilitate a one day recycling event. Guarantee availability for Saturday, May 6, 2023. Shall collect dropped off material from 9:00 a.m. to 1:00 p.m. Provide alHnclusive event pricing. Provide R2 or E-Steward or other certification documentation. Please list how data destruction is certified for data storage devices such as CO ROMs/DVD, solid state drives, hard drives, floppy disks, data tapes, flash memory (USB sticks, SD cards, etc.). internal storage chips, desktop/laptop computers, DVRs, mobile phones, servers, tablets, copiers and imaging devices and higll-end Printers. NAID AAA or R2 Certified data destruction for Hard Drives, Media, Etc. R2 Compliant Destruction tor aH whole devices w/o removable stOrC1Qe. Acquire applicable permits and ensure compliance with all federal and state (KDHE} regulations. Provide all required equipment, supplies and tools necessary for completion of services, including clean-up. • Staged trudc(s} or trailer(s} to store recydable materials • Pallets • Boxes and Wraps • For1dift and/or hand truc:k(s) tor loading materials • Vehicles, equipment, supplies and tools necessary for removing all recydable materials from the premises immediately upon conclusion of the event. A-2 Electronic Waste Collection and Recyding Provide fully qualified, licensed drivers for truck{s) and/or D fOOdift(s). Provide sufficient persoooel for two lines of simultaneous e-waste collection (minimum of 10 le . ~ D ~ List number of personnel: 10 Provide sufficient personnel to collect fees for two ·nes of simultaneous e-waste collection (minimum of 2 people). ~ D i;zi List number of personnel: 12 J Provide city with a brief work plan outlining staffing, 181 D ~ shipping and equipment.. Ensure all persoooel are courteous and prepared to answer questions r~rding how the recyclable materials ~ D lill are handled following collection. Provide a list of acceptable material. ~ D ~ Provide a list of unacceptable material. ~ D lill Provide a list of materials subject to an additional fee to ~ D i;zi participants and the fee amounts. aean and remove all materials and debris from the l8l D i;zi premises at the conclusion of the event. Sweep if needed. Provide city with certificates of recycling and data ~ D i;zi destruction within 14 days of event. Provide city with the following inf()(mation within 14 days of the event: D • Total weight collected • #of CRTs collected A-3 EXHIBITB TERM; SCHEDULE 1. Term. The term of this Agreement shall commence upon execution of this Agreement by both parties, and shall remain in effect until completion of the services described in Exhibit A. 2. Schedule. The Contractor shall provide the recycling event services from 9:00 a.m. to I :00 p.m., on May 6, 2023. The Contractor wi ll arrive before 8:30 a.m. to set up for the event and clean and remove all materials and debris from the premises at the conclusion of the event. B-1 EXHIBIT C BASIS OF PAYMENT 1. Compensation. The City agrees to compensate the Contractor on a lump sum basis, in the amount of $4,400.00 with a single lump sum payment upon the satisfactory completion of all the Contractor's responsibilities set forth in Exhibit A. All of the Contractor's costs and expenses, including employee salaries, overhead, other direct costs subcontract expenses, and profit are included in the lump sum amount, and the City shall not be obligated to reimburse the Contractor for costs or expenses in excess of the total lump sum amount. 2. Invoices. Upon completion of all the Contractor's responsibilities set forth in Exhibit A, the Contractor shall invoice the City for the entire lump sum amount. 3. Payment. The Contractor's invoice will be due and payable within 30 days ofreceipt by the City. C-1 EXHIBITD INSURANCE REQUIREMENTS Pursuant to Section 6 of the Agreement, the Contractor shall obtain, pay for, and maintain - and shall require each of its authorized subcontractors to obtain and maintain -for the duration of the Agreement, policies of insurance meeting the following requirements: 1. General Requirements. A. Additional Insured. With the exception of the workers' compensation and professional liability policies to be obtained by the Contractor hereunder, all policies shall name the City of Salina ("City"), its agents, representatives, officers, officials, and employees as additional insured(s). Insurance for the additional insured shall extend to Products/Completed Operations and be as broad as the insurance for the named insured, including defense expense coverage, and, with respect to the commercial general liability policy required hereunder, shall be endorsed to apply as primary and non-contributory insurance before any other insurance or self-insurance, including any deductible, maintained by, or provided to, the additional insured(s). B. Waiver of Subrogation. Where allowed by law, all policies will include a waiver of subrogation in favor of the City, its agents, representatives, officers, officials, and employees. C. Claims Made Policies. If coverage is written on a claims-made basis for any of the policies required by this Agreement, the Contractor must maintain the coverage for a minimum of two (2) years from the date of final completion of all work under the Agreement. D. Premium and Deductible Expenses. The Contractor shall be responsible for all premiums and retention or deductible expense for any and all policies required by this Agreement. 2. Specific Coverage Requirements. A. Commercial General Liability ("CGL"). The Contractor shall maintain CGL coverage written on ISO Occurrence form CGOO 01 or an industry equivalent, which shall cover liability arising from Personal Injury, Bodily Injury, Property Damage, Premises and Operations, Products and Completed Operations, Contractual Liability, Independent Contractors and Advertising Injury. The policy limits shall not be less than the following: • Each occurrence • General aggregate • Personal and Advertising Liability $1 ,000,000 $2,000,000 $1,000,000 The policy shall contain an endorsement that modifies the general aggregate to apply separately to each project. The Contractor shall maintain the Products and Completed Operations liability coverage for a period of at least two (2) years after completion of all work under the Contract. D-1 B. Business Automobile Liability ("BAL"). The Contractor shall maintain BAL coverage written on ISO form CA 00 01 or an industry equivalent. Coverage shall be applicable to all autos and other vehicles subject to compulsory auto liability laws that are owned, hired, rented or used by the Contractor and include automobiles not owned by but used on behalf of the Contractor. The BAL policy limits shall not be less than the following: • Combined single limit $1 ,000,000 C. Workers' Compensation/Employer's Liability. workers' compensation and employer's liability coverage with following: • Workers' Compensation (Coverage Part A) o Statutory • Employer's Liability (Coverage Part B) o $100,000 each accident o $500,000 disease -policy limit o $100,000 disease-each employee The Contractor shall maintain policy limits not less than the D. Contractor's Pollution Liability. The Contractor shall maintain Pollution Liability insurance covering liability arising from Bodily Injury, Property Damage, Environmental Damage/Clean-up Cost, and Emergency Response Expense. The policy may be written on an occurrence or claims-made form, with limits of insurance not less than: • Each occurrence • General aggregate $1 ,000,000 $2,000,000 The policy shall include coverage for contractual liability, and shall apply to claims arising out of the liability of subcontractors, transit exposure, and non-owned disposal sites. D-2 Client#: 2298954 04TECHRLLC ACORD™ CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY) 1/26/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s). PRODUCER l:lli'~~~1.;T Commercial Client Center 888-743-2217 McGriff Insurance Services rA~gNJo Exll: 888 7 43-2217 I f.ti2 Nol: 8888279861 7701 Airport Center Dr ~oMDA~~ss: ClientServiceCenter@mcgriff.com Suite 1800 INSURER(S) AFFORDING COVERAGE NAIC # Greensboro, NC 27409 INSURER A : The Cincinnati Insurance Company 10677 INSURED INSURER B : Cincinnati Casualty Company 28665 TechRemove LLC INSURERC : 5661 Natural Bridge Ave INSURER D : St. Louis, MO 63120 INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR 1~~M%~1 11~~M%1MY1 LIMITS LTR INSR WVD POLICY NUMBER A X COMMERCIAL GENERAL LIABILITY x x ENP0675968 01/24/2023 01/24/202.:1 EACH OCCURRENCE s1 000 000 -D CLAIMS-MADE ~OCCUR ~~~~~H9E~~JJi.ncel s500 000 MED EXP (Any one person) s10 000 - PERSONAL & ADV INJURY s1 000 000 ~ GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE s2,000,000 R D PRO-[!] LOC PRODUCTS -COMP/OP AGG s2,000,000 POLICY JECT OTHER: $ A AUTOMOBILE LIABILITY x x EBA0675968 01/24/2023 01/24/202.:1 COMBINED SINGLE LIMIT s1,000,000 IEa accident\ ~ X ANYAUTO BODILY INJURY (Per person) $ -OWNED -SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ x HIRED x NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY !Per accident! -$ UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ -EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION x EWC0675969 ~1/24/2023 01/24/202~ X l~ffrnTF I l ~~H-AND EMPLOYERS' LIABILITY y I N s1 000 000 ANY PROPRIETOR/PARTNER/EXECUTIVE[YJ E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED? y N/A (Mandatory In NH) E.L. DISEASE -EA EMPLOYEE s1 000 000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT s1,000,000 A Pollution ENP0675968 ~1/24/2023 01/24/202~ $1,000,000 Per Incident Liability $2,000,000 Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Certificate Holder included as Additional Insured when required by contract or agreement. CERTIFICATE HOLDER CANCELLATION City of Salina, KS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Derek McKellips ACCORDANCE WITH THE POLICY PROVISIONS. 412 E Ash St Salina, KS 67402 AUTHORIZED REPRESENTATIVE I ~ © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S31479512/M31479093 D-3 QN THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY BROADENED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Endorsement-Table of Contents: Coverage: Begins on Page: 1. Employee Benefit Liability Coverage ....................................................................................... 2 2. Unintentional Failure To Disclose Hazards ............................................................................. 8 3. Damage To Premises Rented To You ...................................................................................... 8 4. Supplementary Payments ......................................................................................................... 9 5. Medical Payments ...................................................................................................................... 9 6. 180 Day Coverage For Newly Formed Or Acquired Organizations ...................................... 9 7. Waiver Of Subrogation ........................................................................................................... 10 8. Automatic Additional Insured -Specified Relationships: .................................................. 10 (a) Managers Or Lessors Of Premises (b) Lessor Of Leased Equipment (c) Vendors (d) State Or Governmental Agency Or Subdivision Or Political Subdivision - Permits Or Authorizations Relating To Premises (e) Mortgagee, Assignee Or Receiver 9. Property Damage To Borrowed Equipment ......................................................................... 13 10. Employees As Insureds -Specified Health Care Services And Good Samaritan Services ................................................................................................................................... 14 11. Broadened Notice Of Occurrence ......................................................................................... 14 12. Nonowned Aircraft .................................................................................................................. 14 13. Bodily Injury Redefined .......................................................................................................... 14 14. Expected Or Intended Injury Redefined ............................................................................... 14 15. Former Employees As Insureds ............................................................................................ 14 B. Limits Of Insurance: The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorse- ment, except as provided below: 1. Employee Benefit Liability Coverage Each Employee Limit: $1 ,000,000 Aggregate Limit: $3,000,000 Deductible Amount: $ 1,000 3. Damage To Premises Rented To You The lesser of: a. The Each Occurrence Limit shown in the Declarations; or b. $500,000 unless otherwise stated$ _____ _ 4. Supplementary Payments a. Bail Bonds: $ 2,500 b. Loss Of Earnings: $ 500 5. Medical Payments Medical Expense Limit: $10,000 9. Property Damage To Borrowed Equipment GA210 0920 Includes copyrighted material of Insurance Services Office, Inc., with its permission. D-4 Page 1 of 14 Each Occurrence Limit: $10,000 Deductible Amount: $ 250 C. Coverages 1. Employee Benefit Liability Coverage a. The following is added to Section I - Coverages: EMPLOYEE BENEFIT LIABILITY COVERAGE (1) Insuring Agreement (a) We will pay those sums that the insured becomes legally obligated to pay as damag- es caused by any act, error or omission of the insured, or of any other person for whose acts the insured is legally liable, to which this insurance applies. We will have the right and duty to defend the insured against any "suit" seeking those damages. However, we will have no duty to defend against any "suit" seeking damages to which this in- surance does not apply. We may, at our discretion, in- vestigate any report of an act, error or omission and settle any claim or "suit" that may result. But: (b) 1) The amount we will pay for damages is limited as described in C. Cov- erages, 1. Employee Benefit Liability Cover- age, c. Limits Of Insur- ance of this endorse- ment; and 2) Our right and duty to defend ends when we have used up the appli- cable limit of insurance in the payment of judg- ments or settlements. No other obligation or liabil- ity to pay sums or perform acts or services is covered unless explidtly provided for under Supplementary Pay- ments. This insurance applies to damages only if the act, er- ror or omission is negligently committed in the "admin- istration" of your "employee benefit program"; and 1) Occurs during the policy period; or 2) Occurred prior to the "first effective date" of this endorsement pro- vided: a) You did not have knowledge of a claim or "suit" on or before the "first ef- fective date" of th is endorsement. You will be deemed to have knowledge of a claim or "suit" when any insured listed under C. Coverages, 1. Employee Benefit Liability Coverage, b. Who Is An In- sured, (1) of this endorsement or any "employee" authorized by you to give or receive notice of a claim or "suit": i) Reports all, or any part, of the act, error or omission to us or any other insurer; ii) Receives a written or ver- bal demand or claim for dam- ages because of the act, er- ror or omis- sion; and b) There is no other applicable insur- ance. (2) Exclusions This insurance does not apply to: (a) Bodily Injury, Property Damage Or Personal And Advertising Injury "Bodily injury", "property damage" or "personal and advertising injury". GA 210 09 20 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2of14 0-5 GA 210 09 20 (b) Dishonest, Fraudulent, Criminal Or Malicious Act Damages arising out of any intentional , dishonest, fraudulent, criminal or mali- cious act, error or omission, committed by any insured, including the willful or reck- less violation of any statute. (c) Failure To Perform A Con- tract Damages arising out of fail- ure of performance of con- tract by any insurer. (d) Insufficiency Of Funds Damages arising out of an insufficiency of funds to meet any obligations under any plan included in the "employee benefit program". (e) Inadequacy Of Perfor- mance Of Invest- ment/Advice Given With Respect To Participation Any claim based upon: 1) Failure of any invest- ment to perform; 2) Errors in providing in- formation on past per- formance of investment vehicles; or 3) Advice given to any person with respect to that person's decision to participate or not to par- ticipate in any plan in- cluded in the "employee benefit program". (f) Workers' Compensation And Similar Laws Any claim arising out of your failure to comply with the mandatory provisions of any workers' compensation, un- employment compensation insurance, social security or disability benefits law or any similar law. (g) ERISA Damages for which any in- sured is liable because of li- ability imposed on a fiduci- ary by the Employee Re- tirement Income Security Act of 1974, as now or hereafter amended, or by any similar federal , state or local laws. (h) Available Benefits Any claim for benefits to the extent that such benefits are available, with reasonable effort and cooperation of the insured, from the applicable funds accrued or other col- lectible insurance. (i) Taxes, Fines Or Penalties Taxes, fines or penalties, in- cluding those imposed un- der the Internal Revenue Code or any similar state or local law. (j) Employment-Related Prac- tices Any liability arising out of any: 1) Refusal to employ; 2) Termination of employ- ment; 3) Coercion, demotion, evaluation, reassign- ment, discipline, defa- mation, harassment, humiliation, discrimina- tion or other employ- ment-related practices, acts or omissions; or 4) Consequential liability as a result of 1 ), 2) or 3) above. This exclusion applies whether the insured may be held liable as an employer or in any other capacity and to any obligation to share damages with or repay someone else who must pay damages because of the in- jury. (3) Supplementary Payments Section I -Supplementary Pay- ments -Coverages A and B also apply to this Coverage, however 1.b. and 2. of the Supplementary Payments provision do not apply. b. Who Is An Insured Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3of14 D-6 As respects Employee Benefit Liabil- ity Coverage, Section II -Who Is An Insured is replaced by the following: (1) If you are designated in the Dec- larations as: (a) An individual, you and your spouse are insureds, but on- ly with respect to the con- duct of a business of which you are the sole owner. (b) A partnership or joint ven- ture, you are an insured. Your members, your part- ners, and their spouses are also insureds but only with respect to the conduct of your business. (c) A limited liability company, you are an insured. Your members are also insureds, but only with respect to the conduct of your business. Your managers are in- sureds, but only with respect to their duties as your man- agers. (d) An organization other than a partnership, joint venture or limited liability company, you are an insured . Your "execu- tive officers" and directors are insureds, but only with respect to their duties as your officers or directors. Your stockholders are also insureds, but only with re- spect to their liability as stockholders. (e) A trust, you are an insured. Your trustees are also in- sureds, but only with respect to their duties as trustees. (2) Each of the following is also an insured: (a) Each of your "employees" who is or was authorized to administer your "employee benefit program"; (b) Any persons, organizations or "employees" having prop- er temporary authorization to administer your "employ- ee benefit program" if you die, but only until your legal representative is appointed; or (c) Your legal representative if you die, but only with re- spect to duties as such . That representative will have all your rights and duties under this Coverage Part. (3) Any organization you newly ac- quire or form, other than a part- nership, joint venture or limited liability company, and over which you maintain ownership or major- ity interest, will qualify as a Named Insured if no other similar insurance applies to that organi- zation. However, coverage under this provision: (a) Is afforded only until the 18oth day after you acquire or form the organization or the end of the policy period, whichever is earlier; and (b) Does not apply to any act, error or omission that was committed before you ac- quired or formed the organi- zation. c. Limits Of Insurance As respects Employee Benefit Liabil- ity Coverage, Section Ill -Limits Of Insurance is replaced by the follow- ing: (1) The Limits of Insurance shown in Section B. Limits Of Insurance, 1. Employee Benefit Liability Coverage of this endorsement and the rules below fix the most we will pay regardless of the number of: (a) Insureds; (b) Claims made or "suits" brought; (c) Persons or organizations making claims or bringing "suits"; (d) Acts, errors or omissions; or (e) Benefits included in your "employee benefit program". (2) The Aggregate Limit shown in Section B. Limits Of Insurance, 1. Employee Benefit Liability Coverage of this endorsement is the most we will pay for all dam- ages because of acts, errors or omissions negligently committed GA 210 09 20 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4of14 D-7 in the "administration" of your "employee benefit program". (3) Subject to the limit described in (2) above, the Each Employee Limit shown in Section B. Limits Of Insurance, 1. Employee Bene- fit Liability Coverage of this en- dorsement is the most we will pay for all damages sustained by any one "employee", including damages sustained by such "employee's" dependents and beneficiaries, as a result of: (a) An act, error or omission ; or (b) A series of related acts, er- rors or omissions, regard- less of the amount of time that lapses between such acts, errors or omissions; negligently committed in the "administration" of your "employ- ee benefit program". However, the amount paid under this endorsement shall not ex- ceed, and will be subject to the limits and restrictions that apply to the payment of benefits in any plan included in the "employee benefit program." (4) Deductible Amount (a) Our obligation to pay dam- ages on behalf of the in- sured applies only to the amount of damages in ex- cess of the Deductible Amount shown in Section B. Limits Of Insurance, 1. Em- ployee Benefit Liability Cov- erage of this endorsement as applicable to Each Em- ployee. The limits of insur- ance shall not be reduced by the amount of this de- ductible. (b) The Deductible Amount shown in Section B. Limits Of Insurance, 1. Employee Benefit Liability Coverage of this endorsement applies to all damages sustained by any one "employee", includ- ing such "employee's" de- pendents and beneficiaries, because of all acts, errors or omissions to which this in - surance applies. (c) The terms of this insurance, including those with respect to : 1) Our right and duty to defend the insured against any "suits" seeking those damag- es; and 2) Your duties, and the du- ties of any other in- volved insured, in the event of an act, error or omission, or claim; apply irrespective of the ap- plication of the Deductible Amount. (d) We may pay any part or all of the Deductible Amount to effect settlement of any claim or "suit" and, upon no- tification of the action taken, you shall promptly reim- burse us for such part of the Deductible Amount as we have paid. d. Additional Conditions As respects Employee Benefit Liabil- ity Coverage, Section IV -Commer- cial General Liability Conditions is amended as follows: (1) Item 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit is replaced by the following: 2. Duties In The Event Of An Act, Error, Omission, Claim Or Suit a. You must see to it that we are notified as soon as practicable of an act, error or omission which may result in a claim. To the extent possible, notice should include: (1) What the act, error or omission was and when it oc- curred; and (2) The names and addresses of any- one who may suf- fer damages as a result of the act, error or omission. GA 210 09 20 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5of14 D-8 b. If a claim is made or "suit" is brought against any insured, you must: (1) Immediately record the specifics of the claim or "suit" and the date received ; and (2) Notify us as soon as practicable. You must see to it that we receive written no- tice of the claim or "suit" as soon as practicable. c. You and any other in- volved insured must: (1) Immediately send us copies of any demands, notices, summonses or le- gal papers re- ceived in connec- tion with the claim or "suit"; (2) Authorize us to ob- tain records and other information; (3) Cooperate with us in the investigation or settlement of the claim or defense against the "suit"; and (4) Assist us, upon our request, in the en- forcement of any right against any person or organi- zation which may be liable to the in- sured because of an act, error or omission to which this insurance may also apply. d. No insured will, except at that insured's own cost, voluntarily make a payment, assume any obligation , or incur any expense without our consent. If other valid and collectible insurance is available to the insured for a loss we cover under this Employee Benefit Liability Coverage, our obli- gations are limited as fol- lows: a. Primary Insurance This insurance is prima- ry except when c. below applies. If this insurance is primary, our obliga- tions are not affected unless any of the other insurance is also prima- ry. Then, we will share with all that other insur- ance by the method de- scribed in Paragraph b. below. b. Method Of Sharing If all of the other insur- ance permits contribu- tion by equal shares, we will follow this meth- od also. Under this ap- proach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other in- surance does not permit contribution by equal shares, we will contrib- ute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insur- ers. c. No Coverage This insurance shall not cover any loss for which the insured is entitled to recovery under any other insurance in force previous to the effective date of this Employee Benefit Liability Cover- age. (2) Item 4. Other Insurance is re- placed by the following : e. Additional Definitions GA 210 09 20 4. Other Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. D-9 Page 6 of14 As respects Employee Benefit Liabil- ity Coverage, Section V -Definitions is amended as follows: (1) The following definitions are added: 1. "Administration" means: a. Providing information to "employees", including their dependents and beneficiaries, with re- spect to eligibility for or scope of "employee benefit programs"; b. Interpreting the "em- c. ployee benefit pro- grams"; Handling connection "employee grams"; or records in with the benefit pro- d. Effecting , continuing or terminating any "em- ployee's" participation in any benefit included in the "employee benefit program". However, "administration" does not include: a. Handling payroll deduc- tions; or b. The failure to effect or maintain any insurance or adequate limits of coverage of insurance, including but not limited to unemployment insur- ance, social security benefits , workers' com- pensation and disability benefits. 2. "Cafeteria plans" means plans authorized by applica- ble law to allow "employees" to elect to pay for certain benefits with pre-tax dollars. 3. "Employee benefit pro- grams" means a program providing some or all of the following benefits to "em- ployees", whether provided through a "cafeteria plan" or otherwise: a. Group life insurance; group accident or health insurance; dental, vision and hearing plans; and flexible spending ac- counts; provided that no one other than an "em - ployee" may subscribe to such benefits and such benefits are made generally available to those "employees" who satisfy the plan's eligibil- ity requirements; b. Profit sharing plans, employee savings plans, employee stock ownership plans, pen- sion plans and stock subscription plans, pro- vided that no one other than an "employee" may subscribe to such benefits and such bene- fits are made generally available to all "employ- ees" who are eligible under the plan for such benefits ; c. Unemployment insur- ance, social security benefits, workers' com- pensation and disability benefits; and d. Vacation plans, includ- ing buy and sell pro- grams; leave of ab- sence programs, includ- ing military, maternity, family , and civil leave; tuition assistance plans; transportation and health club subsidies. 4. "First effective date" means the date upon which cover- age was first effected in a series of uninterrupted re- newals of insurance cover- age. (2) The following definitions are de- leted in their entirety and re- placed by the following: 5. "Employee" means a person actively employed, formerly employed, on leave of ab- sence or disabled, or retired. "Employee" includes a "leased worker". "Employee" does not include a "tempo- rary worker". GA210 0920 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7of14 D-10 18. "Suit" means a civil proceed- ing in which money damag- es because of an act, error or omission to which this in- surance applies are alleged. "Suit" includes: a. An arbitration proceed- ing in which such dam- ages are claimed and to which the insured must submit or does submit with our consent; b. Any other alternative dispute resolution pro- ceeding in which such damages are claimed and to which the in- sured submits with our consent; or c. An appeal of a civil pro- ceeding. 2. Unintentional Failure To Disclose Haz- ards Section IV -Commercial General Liabil- ity Conditions, 6. Representations is amended by the addition of the following: Based on our dependence upon your rep- resentations as to existing hazards, if un- intentionally you should fail to disclose all such hazards at the inception date of your policy, we will not reject coverage under this Coverage Part based solely on such failure. 3. Damage To Premises Rented To You a. The last paragraph of 2. Exclusions under Section I -Coverage A -Bod- ily Injury And Property Damage Li- ability is replaced by the following: Exclusions c. through n. do not apply to damage by fire, explosion, light- ning, smoke or soot to premises while rented to you or temporarily occupied by you with permission of the owner, for which the amount we will pay is limited to the Damage To Premises Rented To You Limit as described in Section Ill -Limits Of Insurance. b. The insurance provided under Sec- tion I -Coverage A -Bodily Injury And Property Damage Liability applies to "property damage" arising out of wa- ter damage to premises that are both rented to and occupied by you . As respects Water Damage Legal Li- ability , as provided in Paragraph 3.b. above: The exclusions under Section I - Coverage A -Bodily Injury And Prop- erty Damage Liability, 2. Exclusions, other than i. War and the Nuclear Energy Liability Exclusion (Broad Form), are deleted and the following are added: This insurance does not apply to : (a) "Property damage": (i) Assumed in any contract or agreement; or (ii) Caused by or resulting from any of the following: 1) Wear and tear; 2) Rust or other corrosion, decay, deterioration, hidden or latent defect or any quality in proper- ty that causes it to damage or destroy it- self; 3) Smog; 4) Mechanical breakdown, including rupture or bursting caused by cen- trifugal force; 5) Settling, cracking, shrinking or expansion; 6) Nesting or infestation, or discharge or release of waste products or secretions, by insects, birds , rodents or other animals; or 7) Presence, growth, pro- liferation , spread or any activity of fungus, in- cluding mold or mildew, and any mycotoxins, spores, scents or by- products produced or released by fungi. (b) "Property damage" caused di- rectly or indirectly by any of the following: (i) Earthquake, volcanic erup- tion, landslide or any other earth movement; (ii) Water that backs up or over- flows or is otherwise dis- charged from a sewer, drain, sump, sump pump or related equipment; GA 210 09 20 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 8 of14 D-11 (iii) Water under the ground sur- face pressing on, or flowing or seeping through: 1) Foundations, walls , floors or paved surfac- es; 2) Basements, whether paved or not; or 3) Doors, windows or other openings. (c) "Property damage" caused by or resulting from water that leaks or flows from plumbing, heating, air conditioning, fire protection sys- tems, or other equipment, caused by or resulting from freezing, unless: (i) You did your best to main- tain heat in the build ing or structure; or (ii) You drained the equipment and shut off the water sup- ply if the heat was not main- tained . (d) "Property damage" to : (i) Plumbing , heating, air condi- tioning , fire protection sys- tems, or other equipment or appliances; or (ii) The interior of any building or structure, or to personal property in the building or structure, caused by or re- sulting from rain , snow, sleet or ice, whether driven by wind or not. c. Limit Of Insurance With respect to the insurance afford- ed in Paragraphs 3.a. and 3.b. above, the Damage To Premises Rented To You Limit as shown in the Declara- tions is amended as follows: (1) Paragraph 6. of Section Ill -Lim- its 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 -Bodily Injury And Property Damage Liability for damages be- cause of "property damage" to any one premises: a. While rented to you, or temporarily occupied by you with permission of the owner; b. In the case of damage by fire, explosion , light- ning, smoke or soot, while rented to you ; or c. In the case of damage by water, while rented to and occupied by you. (2) The most we will pay is limited as described in Section B. Limits Of Insurance, 3. Damage To Prem- ises Rented To You of this en- dorsement. 4. Supplementary Payments Under Section I -Supplementary Pay- ments -Coverages A and B: a. Paragraph 1.b. is replaced by the fol- lowing: Up to the limit shown in Section B. Limits Of Insurance, 4.a. Bail Bonds of this endorsement for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage ap- plies. We do not have to furnish these bonds. b. Paragraph 1.d. is replaced by the fol- lowing: All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to the limit shown in Sec- tion B. Limits Of Insurance, 4.b. Loss Of Earnings of this endorsement per day because of time off from work. 5. Medical Payments The Medical Expense Limit of Any One Person as shown in the Declarations is amended to the limit shown in Section B. Limits Of Insurance, 5. Medical Payments of this endorsement. 6. 180 Day Coverage For Newly Formed Or Acquired Organizations Section II -Who Is An Insured is amended as follows : Subparagraph a. of Paragraph 3. is re- placed by the following: GA 210 09 20 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 9of14 D-12 a. Coverage under this provrsron is af- forded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; 7. Waiver Of Subrogation Section IV -Commercial General Liabil- ity Conditions, 8. Transfer Of Rights Of Recovery Against Others To Us is amended by the addition of the following: We waive any right of recovery against any additional insured under this en- dorsement, because of any payment we make under this endorsement, to whom the insured has waived its right of recov- ery in a written contract, written agree- ment, written permit or written authoriza- tion. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such additional insured prior to loss. 8. Automatic Additional Insured -Speci- fied Relationships a. The following is added to Section II - Who Is An Insured: (1) Any person(s) or organization(s) described in Paragraph 8.a.(2) of this endorsement (hereinafter re- ferred to as additional insured) whom you are required to add as an additional insured under this Coverage Part by reason of a written contract, written agree- ment, written permit or written authorization. (2) Only the following persons or or- ganizations are additional in- sureds under this endorsement, and insurance coverage provided to such additional insureds is lim- ited as provided herein: (a) Managers Or Lessors Of Premises The manager or lessor of a premises leased to you you are required per Paragraph 8.a.(1) of this endorsement to provide insurance, but on- ly with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by you or those acting on your behalf in connection with the own- ership, maintenance or use of that part of the premises leased to you , subject to the following additional exclu- sions: This insurance does not ap- ply to: (i) Any "occurrence" which takes place after you cease to be a tenant in that premises; (ii) Structural alterations, new construction or demolition operations performed by or on be- half of such additional insured. (b) Lessor Of Leased Equip- ment Any person(s) or organiza- tion(s) from whom you lease equipment you are required per Paragraph 8.a.(1) of this endorsement to provide in- surance. Such person(s) or organization(s) are insureds 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 or- ganization(s). 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. However, this insurance does not ap- ply to any "occurrence" which takes place after the equipment lease expires. (c) Vendors Any person or organization (referred to below as ven- dor) you are required per Paragraph 8.a.(1) of this en- dorsement to provide insur- ance , but only with respect to liability for "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the ven- dor's business, subject to the following additional ex- clusions : GA 210 09 20 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 10of14 0-13 (i) The insurance afforded the vendor does not apply to : 1) "Bodily injury" or "property damage" for which the ven- dor is obligated to pay damages by reason of the as- sumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; 2) Any express war- ranty unauthorized by you; 3) Any physical or chemical change in the product made intentionally by the vendor; 4) Repackaging, ex- cept when un- packed solely for the purpose of in- spection, demon- stration , testing, or the substitution of parts under in- structions from the manufacturer, and then repackaged in the original con- tainer; 5) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normal- ly undertakes to make in the usual course of busi- ness, in connection with the distribution or sale of the products; 6) Demonstration, in- stallation, servicing or repair opera- tions, except such operations per- formed at the ven- Includes copyrighted material of Insurance GA 210 09 20 Services Office, Inc., with its permission. D-14 dor's premises in connection with the sale of the product; 7) Products which, af- ter distribution or sale by you, have been labeled or re- labeled or used as a container, part or ingredient of any other thing or sub- stance by or fo r the vendor; or 8) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omis- sions or those of its employees or anyone else acting on its behalf. How- ever, this exclusion does not apply to: a) The excep- tions contained in Paragraphs (c)(i)4) or 6) of this endorse- ment; or b) Such inspec- tions, adjust- ments, tests or servicing as the vendor has agreed to make or nor- mally under- takes to make in the usual course of business, in connection with the distri- bution or sale of the prod- ucts. (ii) This insurance does not apply to any insured person or organization : 1) From whom you have acquired such products, or any ingredient, part or container, enter- ing into, accompa- nying or containing such products; or Page 11of14 GA 210 09 20 2) When liability in- cluded within the "products- completed opera- tions hazard" has been excluded un- der this Coverage Part with respect to such products. (d) State Or Governmental Agency Or Subdivision Or Political Subdivision Permits Or Authorizations Relating To Premises Any state or governmental agency or subdivision or po- litical subdivision you are required per Paragraph 8.a.(1) of this endorsement to provide insurance, subject to the following additional provision: This insurance applies only with respect to the following hazards for which the state or governmental agency or subdivision or political sub- division has issued a permit or authorization in connec- tion with premises you own, rent or control and to which this insurance applies: (i) The existence, mainte- nance, repair, construc- tion, erection or removal of advertising signs, awnings, canopies, cel- lar entrances, coal holes, driveways, man- holes, marquees, hoist away openings, side- walk vaults, street ban- ners or decorations and similar exposures; (ii) The construction, erec- tion or removal of eleva- tors; or (iiQ The ownership, mainte- nance or use of any el- evators covered by this insurance. (e) Mortgagee, Assignee Or Receiver Any person or organization you are required per Para- graph 8.a.(1) of this en- dorsement to provide insur- ance, but only with respect to their liability as mortga- gee, assignee or receiver and arising out of the own- ership, maintenance or use of the premises by you. However, this insurance does not apply to structural alterations, new construction and demolition operations performed by or for that per- son or organization. (3) The insurance afforded to addi- tional insureds described in Par- agraph 8.a.(1) of this endorse- ment: (a) Only applies to the extent permitted by law; (b) Will not be broader than that which you are required by the written contract, written agreement, written permit or written authorization to pro- vide for such additional in- sured; and (c) Does not apply to any per- son , organization, vendor, state, governmental agency or subdivision or political subdivision , specifically named as an additional in- sured under any other provi- sion of, or endorsement added to, this Coverage Part, provided such other provision or endorsement covers the injury or damage for which this insurance ap- plies. b. With respect to the insurance afford- ed to the additional insureds de- scribed in Paragraph 8.a.(1) of this endorsement, the following is added to Section Ill -Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of in- surance: (1) Required by the written contract, written agreement, written perm it or written authorization described in Paragraph 8.a.(1) of this en- dorsement. For the purpose of determining the required amount of insurance only, we will include the minimum amount of any Um- brella liability or Excess Liability coverage required for that addi- tional insured in that written con- Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 12of14 D-15 tract, written agreement, written permit or written authorization; or (2) Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. c. Section IV -Commercial General Liability Conditions is amended to include the following : Automatic Additional Insured Pro- vision This insurance applies only if the "bodily injury" or "property damage" occurs, or the "personal and advertis- ing injury" offense is committed: (1) During the policy period ; and (2) Subsequent to your execution of the written contract or written agreement, or the issuance of a written permit or written authori- zation, described in Paragraph 8.a.(1). d. Section IV -Commercial General Liability Conditions is amended as follows: Condition 4. Other Insurance is amended to include: Primary And Noncontributory In- surance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured per Paragraph 8.a.(1) of this endorsement provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract, agreement, permit or authorization described in 8.a.(2) of this endorsement that this in- surance would be primary and would not seek contribution from any other insurance available to the additional insured. 9. Property Damage To Borrowed Equip- ment a. The following is added to Exclusion 2.j. Damage To Property under Sec- tion I -Coverage A-Bodily Injury And Property Damage Liability: Paragraphs (3) and (4) of this exclu- sion do not apply to tools or equip- ment loaned to you, provided they are not being used to perform operations at the time of loss. b. With respect to the insurance provid- ed by this section of the endorse- ment, the following additional provi- sions apply: (1) The Limits of Insurance shown in the Declarations are replaced by the limits shown in Section B. Limits Of Insurance, 9. Property Damage To Borrowed Equip- ment of this endorsement with respect to coverage provided by this endorsement. These limits are inclusive of and not in addi- tion to the limits being replaced. The Limits of Insurance shown in Section B. Limits Of Insurance, 9. Property Damage To Bor- rowed Equipment of this en- dorsement fix the most we will pay in any one "occurrence" re- gardless of the number of: (a) Insureds; (b) Claims made or "suits" brought; or (c) Persons or organizations making claims or bringing "suits". (2) Deductible Clause (a) Our obligation to pay dam- ages on your behalf applies only to the amount of dam- ages for each "occurrence" which are in excess of the Deductible Amount shown in Section B. Limits Of Insur- ance, 9. Property Damage To Borrowed Equipment of this endorsement. The limits of insurance will not be re- duced by the application of such Deductible Amount. (b) Section IV -Commercial General Liability Conditions, 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit, applies to each claim or "suit" irrespective of the amount. (c) We may pay any part or all of the deductible amount to effect settlement of any claim or "suit" and, upon no- GA 210 09 20 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 13of14 D-16 tification of the action taken, you shall promptly reim- burse us for such part of the deductible amount as has been paid by us. 10. Employees As Insureds -Specified Health Care Services And Good Samar- itan Services Paragraph 2.a.(1)(d) under Section II - Who Is An Insured does not apply to: 1) Your "employees" who provide pro- fessional health care services on your behalf as a duly licensed nurse, emergency medical technician or paramedic in the jurisdiction where an "occurrence" or offense to wh ich this insurance applies takes place; or 2) Your "employees" or "volunteer work- ers", other than an employed or vol- unteer doctor, providing first aid or good samaritan services during their work hours for you will be deemed to be acting within the scope of their employment by you or performing du- ties related to the conduct of your business. 11. Broadened Notice Of Occurrence Paragraph a. of Condition 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit under Section IV -Com- mercial General Liability Conditions is replaced by the following: a. You must see to it that we are notified as soon as practicable of an "occur- rence" or an offense which may result in a claim. To the extent possible, no- tice should include: (1) How, when and where the "oc- currence" or offense took place; (2) The names and addresses of any injured persons and wit- nesses; and (3) The nature and location of any injury or damage arising out of the "occurrence" or offense. This requirement applies only when the "occurrence" or offense is known to any insured listed under Paragraph 1. of Section II -Who Is An Insured or any "employee" authorized by you to give or receive notice of an "occur- rence" or offense. 12. Nonowned Aircraft The following is added to Exclusion 2.g. Aircraft, Auto Or Watercraft: under Sec- tion I -Coverage A -Bodily Injury And Property Damage Liability: This exclusion does not apply to an air- craft you do not own, provided that: a. The pilot in command holds a current effective certificate, issued by a duly constituted authority of the United States of America or Canada, desig- nating that person as a commercial or airline transport pilot; b. The aircraft is rented with a trained, paid crew; and c. The aircraft does not transport per- sons or cargo for a charge. 13. Bodily Injury Redefined Section V -Definitions, 3. "Bodily injury" is replaced by the following: 3. "Bodily injury" means bodily harm or injury, sickness, disease, disability, humiliation, shock, fright, mental an- guish or mental injury, including care, loss of services or death resulting from any of these at any time. 14. Expected Or Intended Injury Redefined The last sentence of Exclusion 2.a. Ex- pected Or Intended l!lury under Sec- tion I -Coverage A -Bodily Injury And Property Damage Liability is replaced by the following: This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect per- sons or property. 15. Fonner Employees As Insureds The following is added to Paragraph 2. under Section II -Who Is An Insured: 2. Each of the following is also an in- sured: Any of your former "employees", di- rectors, managers, members, part- ners or "executive officers", including but not limited to retired, disabled or those on leave of absence, but only for acts within the scope of their em- ployment by you or for duties related to the conduct of your business. GA 210 09 20 Includes copyrighted material of Insurance Services Office , Inc., with its permission. Page 14of14 D-17 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CinciPlus® BUSINESS AUTO XC+® {EXPANDED COVERAGE PLUS) ENDORSEMENT This endorsement modifies insurance provided by the following: BUSINESS AUTO COVERAGE FORM With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. A. Blanket Waiver of Subrogation SECTION IV -BUSINESS AUTO CONDI- TIONS, A. Loss Conditions, 5. Transfer of Rights of Recovery Against Others to Us is amended by the addition of the following: We waive any right of recovery we may have against any person or organization because of payments we make for "bodily injury" or "property damage" arising out of the operation of a covered "auto" when you have assumed liability for such "bodily injury" or "property damage" under an "insured contract", provid- ed the "bodily injury" or "property damage" oc- curs subsequent to the execution or the "in- sured contract". B. Noncontributory Insurance SECTION IV -BUSINESS AUTO CONDI- TIONS, B. General Conditions, 5. Other In- surance c. is deleted in its entirety and re- placed by the following: c. Regardless of the provisions of Par- agraph a. above, this Coverage Form's Liability Coverage is primary and we will not seek contribution from any other insurance for any lia- bility assumed under an "insured contract" that requires liability to be assumed on a primary noncontributo- ry basis. C. Additional Insured by Contract SECTION II -LIABILITY COVERAGE, A. Coverage, 1. Who is an Insured is amended to include as an insured any person or organi- zation for whom you have agreed in a valid written contract to provide insurance as af- forded by this policy. This provision is limited to the scope of the valid written contract. This provision does not apply unless the valid written contract has been: 1. Executed prior to the accident causing "bodily injury" or "property damage"; and 2. Is still in force at the time of the "accident" causing "bodily injury" or "property dam- age". D. Employee Hired Auto 1. Changes in Liability Coverage The following is added to the SECTION II -LIABILITY COVERAGE, A. Coverage, 1. Who is an Insured: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in that "employee's" name, with your permission , while performing duties related to the conduct of your business. 2. Changes in General Conditions SECTION IV -BUSINESS AUTO CON- DITIONS, B. General Conditions, 5. Other Insurance is deleted in its entirety and replaced by the following: b. For Hired Auto Physical Damage Coverage the following are deemed to be covered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in that individual "em- ployee's" name, with your per- mission, while performing duties related to the conduct of your business. AA288 06 20 Includes copyrighted material of ISO Properties, Inc., with its permission. Page 1of4 0-18 However, any "auto" that is leased , hired, rented or borrowed with a driver is not a covered "auto". E. Audio, Visual and Data Electronic Equip- ment SECTION Ill -PHYSICAL DAMAGE COV- ERAGE, C. Limit of Insurance is amended by add ing the following: 4. The most we will pay for all "loss" to au- dio, visual or data electronic equipment and any accessories used with this equipment as a result of any one "acci- dent" is the lesser of a. The actual cash value of the dam- aged or stolen property as of the time of the "accident"; b. The cost of repairing or replacing the damaged or stolen property with oth- er property of like kind and quality; or c. $2,500. Provided the equipment, at the time of the "loss" is : a. Permanently installed in or upon the covered "auto" in a housing, opening or other location that is not normally used by the "auto" manufacturer for the installation of such equipment; b. Removable from a permanently in- stalled housing unit as described in Paragraph 2.a. above; or c. An integral part of such equipment. F. Who is an Insured -Amended SECTION II -LIABILITY COVERAGE, A. Coverage, 1. Who is an Insured is amended by adding the following: The following are "insureds": 1. Any subsidiary which is a legally incorpo- rated entity of which you own a financial interest of more than 50% of the voting stock on the effective date of this cover- age form. However, the insurance afforded by this provision does not apply to any subsidiary that is an "insured" under any other au- tomobile liability policy or would be an "in- sured" under such policy but for termina- tion of such policy or the exhaustion of such policy's limits of insurance. 2. Any organization that is newly acquired or formed by you and over which you main- tain majority ownership. The insurance provided by this provision: a. Is effective on the date of acquisition or formation, and is afforded for 180 days after such date; b. Does not apply to "bodily injury" or "property damage" resulting from an "accident" that occurred before you acquired or formed the organization; c. Does not apply to any newly acquired or formed organization that is a joint venture or partnership; and d. Does not apply to an insured under any other automobile liability policy or would be an insured under such a policy but for the termination of such policy or the exhaustion of such poli- cy's limits of insurance. 3. Any of your "employees" while using a covered "auto" in your business or your personal affairs, provided you do not own, hire or borrow that "auto". G. Liability Coverage Extensions -Supple- mentary Payments -Higher Limits SECTION II -LIABILITY COVERAGE, A. Coverage, 2. Coverage Extensions, a. Sup- plementary Payments is amended by: 1. Replacing the $2 ,000 Limit of Insurance for bail bonds with $4 ,000 in (2); and 2. Replacing the $250 Limit of Insurance for reasonable expenses with $500 in (4). H. Amended Fellow Employee Exclusion SECTION II -LIABILITY COVERAGE, B. Ex- clusions, 5. Fellow Employee is modified as follows: Exclusion 5. Fellow Employee is deleted. I. Hired Auto -Physical Damage If hired "autos" are covered "autos" for Liability Coverage, then Comprehensive and Collision Physical Damage Coverages as provided un- der SECTION Ill -PHYSICAL DAMAGE COVERAGE of this Coverage Part are ex- tended to "autos" you hire, subject to the fol- lowing: 1. The most we will pay for "loss " to any hired "auto" is $50,000 or the actual cash value or cost to repair or replace, which- ever is the least, minus a deductible. 2. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage, or $1 ,000, whichever is less. 3. Hired Auto -Physical Damage coverage is excess over any other collectible insur- ance. AA288 06 20 Includes copyrighted material of ISO Properties, Inc., with its permission. Page 2 of 4 0-19 4. Subject to the above limit, deductible, and excess provisions we will provide cover- age equal to the broadest coverage appli- cable to any covered "auto" you own in- sured under this policy. Coverage includes loss of use of that hired au- to, provided it results from an "accident" for which you are legally liable and as a result of which a monetary loss is sustained by the leasing or rental concern . The most we will pay for any one "accident" is $3,000. If a limit for Hired Auto -Physical Damage is shown in the Schedule, then that limit replac- es, and is not added to, the $50,000 limit indi- cated above and the deductibles shown in the Schedule are applicable. J. Rental Reimbursement SECTION Ill -PHYSICAL DAMAGE COV- ERAGE is amended by add ing the following: 1. We will pay for rental reimbursement ex- penses incurred by you for the rental of an "auto" because of a "loss" to a covered "auto". Payment applies in addition to the otherwise applicable amount of each cov- erage you have on a covered "auto". No deductible applies to th is coverage. 2. We will pay only for those expenses in- curred during the policy period beginning 24 hours after the "loss" and ending, re- gardless of the policy's expiration, with the lesser of the following number of days: a. The number of days reasonably re- quired to repair the covered "auto". If "loss" is caused by theft, this number of days is added to the number of days it takes to locate the covered "auto" and return it to you; or b. 30 days. 3. Our payment is limited to the lesser of the following amounts: a. Necessary and actual expenses in- curred; or b. $50 per day. 4. This coverage does not apply while there are spare or reserve "autos" available to you for your operations. 5. We will pay under this coverage only that amount of your rental reimbursement ex- penses which is not already provided for under SECTION Ill -PHYSICAL DAM- AGE COVERAGE, A Coverage, 4. Coverage Extensions. K. Transportation Expense -Higher Limits SECTION Ill -PHYSICAL DAMAGE COV- ERAGE, A. Coverage, 4. Coverage Exten- sions is amended by replacing $20 per day with $50 per day, and $600 maximum with $1 ,500 maximum in Extension a. Transpor- tation Expenses. L. Airbag Coverage SECTION 111 -PHYSICAL DAMAGE COV- ERAGE, B. Exclusions, 3.a. is amended by adding the following: However, the mechanical and electrical breakdown portion of this exclusion does not apply to the accidental discharge of an airbag. This coverage for airbags is excess over any other collectible insurance or warranty. M. Loan or Lease Gap Coverage 1. SECTION Ill -PHYSICAL DAMAGE COVERAGE, C. Limit of Insurance is deleted in its entirety and replaced by the following, but only for private passenger type "autos" with an original loan or lease, and only in the event of a "total loss" to such a private passenger type "auto": a. The most we will pay for "loss" in any one "accident" is the greater of: (1) The amount due under the terms of the lease or loan to which your covered private passenger type "auto" is subject, but will not include: (a) Overdue lease or loan pay- ments; (b) Financial penalties imposed under the lease due to high mileage, excessive use or abnormal wear and tear; (c) Security deposits not re- funded by the lessor; (d) Costs for extended warran- ties, Credit Life Insurance, Health, Accident or Disabil- ity Insurance purchased with the loan or lease; and (e) Carry-over balances from previous loans or leases, or (2) Actual cash value of the stolen or damaged property. b. An adjustment for depreciation and physical condition will be made in de- termining actual cash value at the time of "loss". AA288 06 20 Includes copyrighted material of ISO Properties, Inc., with its permission. Page 3 of 4 D-20 2. SECTION V -DEFINITIONS is amended by adding the following, but only for the purposes of this Loan or Lease Gap Coverage: "Total loss" means a "loss" in wh ich the cost of repairs plus the salvage value ex- ceeds the actual cash value. N. Glass Repair -Waiver of Deductible SECTION Ill -PHYSICAL DAMAGE COV- ERAGE, D. Deductible is amended by adding the following: No deductible applies to glass damage if the glass is repaired in a manner acceptable to us rather than replaced. 0. Duties in the Event of an Accident, Claim, Suit or Loss -Amended SECTION IV -BUSINESS AUTO CONDI- TIONS, A. Loss Conditions, 2. Duties in the Event of Accident, Claim, Suit or Loss, a. is amended by adding the following: This condition applies only when the "acci- dent" or "loss" is known to: 1. You, if you are an individual; 2. A partner, if you are a partnership; 3. An executive officer or insurance manag- er, if you are a corporation; or 4. A member or manager, if you are a lim- ited liability company. P. Unintentional Failure to Disclose Hazards SECTION IV -BUSINESS AUTO CONDI- TIONS, B. General Conditions, 2. Conceal- ment, Misrepresentation or Fraud is amended by adding the following: However, if you unintentionally fail to disclose any hazards existing on the effective date of this Coverage Form, we will not deny cover- age under this Coverage Form because of such failure. Q. Mental Anguish Resulting from Bodily Inju- ry SECTION V -DEFINITIONS, C. "Bodily inju- ry" is deleted in its entirety and replaced by the following: "Bodily injury" means bodily injury, sickness or disease sustained by a person, including men- tal anguish and death sustained by the same person that results from such bodily injury , sickness or disease. "Bodily injury" does not include mental anguish or death that does not result from bodily injury, sickness or disease. R. Coverage for Certain Operations in Con- nection with Railroads With respect to the use of a covered "auto" in operations for or affecting a railroad: 1. SECTION V -DEFINITIONS, H. "Insured contract", 1.c. is deleted in its entirety and replaced by the following: c. An easement or license agreement; 2. SECTION V -DEFINITIONS, H. "Insured contract", 2.a. is deleted. AA288 06 20 Includes copyrighted material of ISO Properties, Inc., with its permission. Page4 of 4 D-21 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Blanket Waiver of Subrogation If you are required by a written contract or agreement, which is executed before a loss, to waive your rights of recovery from others, we agree to waive our rights of recovery. This waiver of rights applies to any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver, but shall not be construed to be a waiver with respect to any other operations in which the Insured has no contractual interest. Any person or organization for which the employer has agreed by written contract, executed prior to loss, may execute a waiver of subrogation. However, for purposes of work performed by the employer in Missouri, this waiver of subrogation does not apply to any construction group of classifications as designated by the waiver of right to recover from others (subrogation) rule in our manual. This endorsement changes the policy to which it is attached and is effective on the date issued unless other- wise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 01-24-2023 Policy No.Ewe 067 59 69-00 Endorsement No. Insured TECHREMOVE LLC Insurance Company THE CINCINNATI CASUALTY COMPANY Premium $INCL Countersigned by WC 00 0313 © 1983 National Council on Compensation Insurance. D-22