HomeMy WebLinkAboutFoggle Pump & Supply Inc - Desert Sunset Irrigation Well Cleaning & Rehabilitation (Agreement No. 21-006)CONTRACT
MRSC SMALL WORKS ROSTER
Desert Sunset Irrigation Well Cleaning and Rehabilitation
Agreement No. 21-M6
THIS CONTRACT is made and entered into this day of202_1 by
and between the City of Pasco, Washington, a Municipal Corporation, hereinafter referred to as
"City", and Fogle Pump and Supply Inc., hereinafter referred to as "Contractor."
WHEREAS, the Project qualifies under RCW 39.04.155 as a small works roster contract,
or a limited public works contract; and
WHEREAS, the City having sought and secures quotations from its small works roster,
and the Contractor being duty qualified as a Contractor on the small works roster having submitted
a quotation acceptable to the City.
NOW, THEREFORE, in consideration of the mutual covenants contained herein, the
parties agree as follows:
1. Description of Work. The Contractor shall furnish all equipment, labor, tools, materials
and appurtenances and perform all services in a workmanlike manner and in accordance
with the pians and specifications as provided in the Project Description and Specifications,
attached hereto as Exhibit A.
2. Compensation. Compensation for the performance of the service and materials as
described in Exhibit A, and shall be:
That amount set in the quotation attached hereto as Exhibit D subject to any retainage
or withholdings as provided below.
3. Time of Completion. The work covered by this Contract shall be completed with all
respects within 60 calendar days from the date of the Notice to Proceed. Once the work is
commenced, the Contractor shall diligently pursue the work to completion within the time
specified in this Contract.
4. Wty of Contractor. Contractor warrants that it is qualified to be awarded a public
works contract in compliance with RCW 39.04.354; and further agrees to comply with all
State and Federal laws relating to the employment and wage rates to be paid.
S. Indemnification.
5.1 The Contractor shall defend, indemnify, and hold harmless the City, its officers,
officials, agents, employees, and volunteers from any and all claims and causes of
action, including, but not limited to, actions of law or administrative proceedings
for all injuries to persons or damages to property, and all losses, damages, demands,
Desert Sunset irrigation Well Gleaning and Rehabilitation — 21-006 Page 1
MRSC Small Works Roster Agreement#: [21-006] — Fogle Pump and Supply Inc.
suits, judgments, including attorney fees, arising out oil or as a result oft or in
connection with the work performed under this Agreement, and caused or
occasioned in whole or in part by reason of errors, negligent acts or omissions of
the Consultant or its subcontractors in the performance of this Agreement, except
for injuries and damages caused by the sole negligence of the City, its officers,
employees, agents, and volunteers.
5.2 Should a Court of competent jurisdiction determine that this Agreement is subject
to RCW 4.24.115, then, in the event of liability for damages arising out of bodily
injuries or damages to property caused by or resulting from the concurrent
nt
negligence of the Contractor, and the City, its officers, employees, agents and
volunteers, the Contractor's liability and obligation to defend hereunder shall only
be the proportionate extent of the Contractor's negligence.
5.3 It is further agreed that the indemnification provided herein constitutes the
Contractor's waiver of immunity under Industrial Insurance, Title 51 RCW, solely
for the purposes of this indemnification.
5.4 No liability shall attach to the City by reason of entering into this Agreement except
as expressly provided herein.
5.5 This indemnification shall include e damages, penalties and attorney fees sustained
as a result of Contractor's delayed or failed. performance.
5.6 This waiver has been mutually negotiated by the parties, and the provisions of this
section shall survive the expiration or termination of this Agent.
6. Insurance. The Contractor shall procure and maintain for the duration of the Agreement,
insurance against claims for injuries to persons or damage to property which may arise
from or in connection with the performance of the work hereunder by the Contractor, its
agents, representatives, employees, or subcontractors.
6.1 Minimum Scone of Insurance. Contractor shall obtain insurance of the types
described below:
6.1.1 Automobile Liability insurance covering all owned, non -owned, hired and
leased vehicles. Coverage shall be written on Insurance Services Office
(ISO) form CA 00 01 or a substitute form providing equivalent liability
coverage. If necessary, the policy shall be endorsed to provide contractual
liability coverage.
6.1.2 Commercial General Liability insurance shall be written on ISO occurrence
form CO 00 01 and shall cover liability arising from premises, operations,
independent contractors and personal injury and advertising injury- The
City shall be named as an insured under the Contractor's Commercial
General Liability insurance policy with respect to the work performed for
Desert Sunset Irrigation Well Cleaning and Rehabilitation — 21-006 Page 2
MRSC Small Works Roster Agreement#: [21-W] —Fogle Pump and Supply Inc.
the City using an additional insured endorsement at least as broad as ISO
endorsement form CG 20 26.
6.13 Workers' Compensation coverage as required by the Industrial Insurance
laws of the State of Washington.
6.1.4 Professional Liability insurance appropriate to the Contractor's profession.
6.2 Minimum Amounts of Insurance, Contractor shall maintain the following
insurance limits:
6.2.1 Automobile Liability insurance with a minimum combined single limit for
bodily injury and property damage of $1,000,000 per accident.
6.2.2 Commercial General Liability insurance shall be written with limits no less
than:
❑ $1,000,000 each occurrence;
® $2,000,000 general aggregate; or
❑ $ each occurrence; and $ general aggregate
6.2.3 Professional Liability insurance shall be written with limits no less titan:
❑ $1,000,000 per claim;
® $1,000,000 policy aggregate limit; or
❑ $ per claim; and $ per policy aggregate limit
6.3 Other Insurance Provisions. The insurance policies are to contain, or be endorsed
to contain, the following provisions for Automobile Liability and Commercial
General Liability insurance:
6.3.1 The Contractor's insurance coverage shall be primary insurance as respects
the City. Any insurance, self-insurance, or insurance pool coverage
maintained by the City shall be excess of the Contractor's insurance and
shall not contribute with it.
6.3.2 The Contractor's insurance shall be endorsed to state that coverage shall not
be cancelled by either party, except after thirty (30) days prior written notice
by certified mail, return receipt requested, has been given to the City.
6.4 Acceptability ofImm. Insurance is to placed with insurers with a current A.M.
Best rating of not less than A:VII.
6.5 Verification of Coverage. Contractor shall furnish the City with original
certificates and a copy of the amendatory endorsements, including but not
Desert Sunset Irrigation Well Cleaning and Rehabilitadon — 21-006 Page 3
MRSC Small Works Roster Agreement#: [21-006] — Fogle Pump and Supply Inc.
necessarily limited to the additional insured endorsement, evidencing the insurance
requirements of the Contractor before commencement of the work.
7. Retainaze and Performance Bond.
7.1 Unless it is waived as provided below, the Contractor shall provide and post for the
benefit of the City a Performance and Payment Bond issued by a qualified surety
insuring the Contractor's performance of all the provisions of the Contract and
payment of all labors, mechanics, and subcontractors and materialmen as required
by RCW 39.08.010.
0 The City shall hold a 10% retainage in lieu of a performance bond per RCW
39.08.010
7.2 The City shall withhold five percent (50%) of the money due to the Contractor for
the work performed under this Contact until completion and/or acceptance of the
Contract as provided by RCW 60.28.011. Contractor may elect an option for
management of the statutory retainage by notice to the City of the elected option
under RCW 60.28.011.
8. Work Site Conditions. The work performed under this Contract is done at the Contractor's
risk and that Contractor is familiar with the conditions present and other contingencies
likely to affect the work and has submitted their quote accordingly. The Contractor will
assume the responsibility and risk of all loss or damage to materials or work which may
arise prior to completion.
The Contractor shall keep the work site in a neat, orderly condition and after completion
of the work, the Contractor shall, at its expense, clean up and remove all refuse and unused
materials of any kind resulting from the work.
9. General Provisions.
9.1 For the purpose of this Contract, time is of the essence.
9.2 Notice. Notice provided for in this Contract shall be sent by:
9.2.1 Personal service upon the Project Administrators.
9.2.2 Certified mail to the physical address of the parties, or by electronic
transmission to the e-mail addresses designated for the parties below.
9.3 The Project Administrator for the purpose of this Contract shall be:
9.3.1 For the City: Albert Obermiller, or his/her designee
Public Works Project Coordinator
1025 S Gray St.
Desert Sunset Irrigation Well Cleaning and Rehabilitation — 21-006 Page 4
MRSC Small Works Roster Agreement#: [21-006] — Fogle Pump and Supply Inc.
Pasco WA 99301
obermillerar_a-' oasco-wa. Dov
9.3.2 For the Contractor: Alaina Fogle, or his/her designee
Fogle Pump and Supply Inc.
2250 N. Hwy
Colville, WA 99114
Alaina@foglepump.com
10. Plante Resolution. This Contract has been and shall be construed as having been made
and entered into and delivered within the State of Washington, and it is agreed by each
party hereto that this Agreement shall be governed by the laws of the State of Washington.
In the event of a dispute regarding the enforcement, bres * default or, interpretation of
this Contract, said dispute shall be resolved by arbitration pursuant to RCW 7.04A, as
amended, with both parties waiving the right of a jury trial upon trial de novo, with venue
placed in Pasco, Franklin County, Washington. The substantially prevailing party shall be
entitled to its reasonable attorney fees and costs as additional award and judgment against
the other.
IN WITNESS WHEREOF, the parties have executed by their duly authorized official
this Contract in triplicate, each of which being deemed an original on the date first written above.
Crff OF PASCO. WASHINGTON
By:WZtev
CONTRACTOR
By: etft,&'t I A
Alaina Fogle, Direct ef- ons
Desert Sunset Irrigation Well Cleaning and Rehabilitation — 21-006 Page 5
MRSC Small Works Roster Agement#: [21-(}06j — Fogle Pump and Supply ire.
Schedule A
Desert Sun Cleaning and Rehabilitation
March 7.n -4t'
Move service truck, pump truck and frac unit from Colville. Tear down fence and open roof
access to pump house. Use frac unit with brush to brush well removing initial layer of scaling.
Add liquid descaler chemical to well using frac unit to brush and agitate. As acid is consumed by
the well, use frac unit with venturi clean out tool to recirculate water into sediment holding
tank and back into well. Use PH strips to test the PH of the well every 3-4 hours. When PH holds
steady at around 2, camera the well and record video. Sanitize the well using Wel-Chlor plus.
Replace fence and roof access. Secure work site and equipment nightly.
EXHIBIT A
Request for Quote
Scope of Work
The quote shall include a description and associated cost for the following line items:
➢ Timeline of work
➢ Mobilization/demobilization
➢ Post -cleaning video inspection
➢ Cleaning method
➢ Treatment
➢ Rehabilitation/re-development
➢ Site cleanup - to include removal of all material removed from the well
➢ Any remediation required, i.e. pH adjustment, sediment disposal, etc.
Information about the Desert Sunset Irrigation Well
A site visit will be required to bid on this job. The site visit will be on January 19th, 2021 at 9:OOam.
This work shall start after February 15th, 2021, and must be completed and invoiced before March 31St 2021.
Information is from a City inspection in January 2021.
• 16" diameter well.
• The year of construction is unknown.
• Depth is 201.2'.
• Screen is perforated -166'-198'.
• Static water level -164.7'
• Possible presence of biofouling and incrustation which are possibly plugging screens and perforations.
• Inspection video can be found at https://Pascofileshare.com/link/cLfNfGCil849KEZv1ED3Xkh
(Instruction for fileshare site located on last page)
General Considerations
Site Safety - The CONTRACTOR shall mark, barricade or take other safety measures as necessary to
prevent tampering with the work site and to eliminate dangerous conditions for persons or animals in the
area. All tanks, pits, or other excavations shall be properly flagged and barricaded as required to eliminate
any potential health hazards. The CONTRACTOR is expected to maintain the site and any related
equipment and supply storage areas in a clean and orderly manner in order to prevent injury to people and
animals. The CONTRACTOR shall maintain a first aid kit, fire extinguisher, and other safety equipment
required for the work by regulation on site at all times. All work shall be conducted in accordance with
applicable State and Local regulations.
• Noise and Working Hours - The CONTRACTOR shall comply with all applicable laws, orders, and
regulations concerning the prevention, control, and abatement of excessive noise.
Request for Quotes: Desert Sunset Page 5 of 8
Well Cleaning and Rehabilitation
EXHIBIT A
Discharge of Water - The CONTRACTOR shall be responsible for preventing the release of water, or any
other materials used in or related to the rehabilitation operation from the immediate vicinity of the work site
onto neighboring properties or any open water bodies.
Prevention of Contamination
• The CONTRACTOR shall use a minimum of hydrocarbon products, other than fuel, motor oil, hydraulic oil
and grease that is normally used on site.
• No hydrocarbon -based lubricants or oils shall be used on equipment that will enter the borehole.
• Should any spills occur, the CONTRACTOR shall immediately repair the cause and take the necessary steps
to contain and thoroughly remove all contaminated soils and materials, and transfer such wastes off site for
legal disposal at the CONTRACTOR'S expense.
Site Access and Preparation
• Access — The well site is located south of Laredo dr., east of the Porto Lane intersection, in Casa Del Sol
Park in pasco,WA. This well is in a fenced area in a building.
• Services and Supplies — No on site water or power is available. The CONTRACTOR is responsible for
inquiring about the availability of services and supplies needed for rehabilitation activities. The
CONTRACTOR assumes full responsibility for all supporting services and supplies necessary to properly
undertake the work, not limited to water and power, and is entitled to no additional compensation for the
lack of any such services or supplies.
Request for Quotes: Desert Sunset Page 6 of 8
Well Cleaning and Rehabilitation
EXHIBIT
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PERFORMANCE BOND
BOND TO THE CITY OF PASCO
Bond No. 107368796
KNOW ALL MEN BY THESE PRESENTS:
That we, the undersigned, Fogle Pump & Supply, Inc. as principal, and Travelers Casualty and Surety
Company a corporation organized and existing under the laws of the State of CT, as a surety corporation,
and qualified under the laws of the State of Washington to become surety upon bonds of contractors,
as surety, are jointly and severally held and firmly bound to the City of Pasco in the penal sum of
***Thirty Two Thousand Three Hundred and Eight and 50/100*** ($32,308.50), for the payment of
which sum on demand we bind ourselves and our successors, heirs, administrators or personal
representatives as the case may be.
This obligation is entered into a pursuance of the statutes of the State of Washington, and ordinances of
the City of Pasco.
Dated at Spokane, Washington, this 18th day of February, 2021.
Nevertheless, the conditions of the above obligation are such that:
WHEREAS, pursuant to action taken by the City Council of the City on a" , 201�1the
Mayor and City Clerk of the City of Pasco have let or are about to let to the said Fogle Pump & Suppfy, Inc.,
the above bounden principal, a certain contract, the same contract being numbered 21-006 and providing
for Desert Sunset Well Cleaning and Rehabilitation (which contract is referred to herein and is made
a part hereof as though attached hereto.)
WHEREAS, the said principal has accepted, or is about to accept the said contract, and undertake to
perform the work wherein provided for in the manner and within the time set forth.
NOW, THEREFORE, if the said Fogle Pump & Supply. Inc. shall faithfully perform all of the provisions of
said contract in the manner and within the time therein set forth, or within such extensions of the time
as may be granted under the contract, and shall pay all laborers, mechanics, subcontractors, and material
men, and all persons who shall supply said principal or subcontractors with provisions and supplies for the
carrying on of said work, and shall indemnify and hold said City of Pasco harmless from any loss or damage
occasioned to any person or property by reason of any carelessness or negligence on the part of said
principal, or any subcontractor in the performance of said work, and shall indemnify and hold the City of
Pasco harmless from any damage or expense by reason or failure of performance as specified in said
contract or from defects appearing or developing in the material or workmanship provided or performed
under said contract after its acceptance thereof by the City of Pasco, then and in that event this obligations
shall be void; but otherwise it shall be and remain in full force and effect.
Approved as to Form:
Travelers CasuaIt nd Surety Company
Surety She& Donovan, Attorney In Fact
2W
Fogle Pump & Supply, Inc..
Contractor
PAYMENT BOND
To City of Pasco, Washington
Bond No. 107368796
The City of Pasco, Washington, City has awarded to Fogle Pump & Supply. Inc. (Principal), a contract for
the construction of the project designated as Desert Sunset Well Cleaning and Rehabilitation, Project No.
21-006, in Pasco, Washington (Contract), and said Principal is required under the terms of that Contract
to furnish a payment bond in accord with Title 39.08 Revised Code of Washington (RCW).
The principal, and Travelers Casualty and Surety Company (Surety), a corporation organized under the
laws of the State of CT and licensed to do business in the State of Washington as surety and named in the
current list of "Surety Companies Acceptable in Federal Bonds" as published in the Federal Register by the
Audit Staff Bureau of Accounts, U.S. Treasury Dept., are jointly and severally held and firmly bound to the
City, in the sum of ***Thirty Two Thousand Three Hundred and Eight and 50/100*** US Dollars
($32,308.50) Total Contract Amount, subject to the provisions herein.
This statutory payment bond shall become null and void, if and when the Principal, its heirs, executors,
administrators, successors, or assigns shall pay all persons in accordance with RCW Titles 39.08, and 39.12
including all workers, laborers, mechanics, subcontractors, and material suppliers for the carrying on of
such work, and all taxes incurred on said Contract under Title 50 and 51 RCW an all taxes imposed on the
Principal under Title 82 RCW; and if such payment obligations have not been fulfilled, this bond shall
remain in full force and effect.
The Surety for value received agrees that no change, extension of time, alteration or addition to the terms
of the Contract, the specifications accompanying the Contract, or to the work to be performed under the
Contract shall in any way affect its obligation on this bond, except as provided herein, and waives notice
of any change, extension of time, alteration or addition to the terms of the Contract or the work
performed. The Surety agrees that modifications and changes to the terms and conditions of the Contract
that increase the total amount to be paid the Principal shall automatically increase the obligation of the
Surety on this bond and notice to Surety is not required for such increased obligation.
This bond may be executed in two (2) original counterparts and shall be signed by the parties' duly
authorized officers. This bond will only be accepted if it is accompanied by a fully executed and original
power of attorney for the officer executing on behalf of the surety.
PRINCIPAL Fogle Pump & Supply, Inc.
zumh 02/18/2021
Principal Signature Date
Printed Name
Ufuj:ior off- o t m
Title
SURETY Travelers Casualty and Surety Company
Y' 8/2021
Surety Sig ure Date
Shelly Donovan
Printed Name
Attorney In Fact
Title
Name, address, and telephone of local office/agent of Surety Company is:
A iant Insurance Services, Inc.
818 W. Riverside Ave., Ste. 800, Spokane, WA 99201, (509) 324-3025
Approved as to form:
Signature
Title
PBA
Date
TRAVELERSJJ
Travelers Casualty and Surety Company of America
Travelers Casualty and Surety Company
St. Paul Fire and Marine Insurance Company
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St.
Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein collectively called the
"Companies"), and that the Companies do hereby make, constitute and appoint SHELLY DONOVAN of SPOKANE ,
Washington , their true and lawful Attorney -in -Fact to sign, execute, seal and acknowledge any and all bonds, recognizances,
conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the
fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any
actions or proceedings allowed by law.
IN WITNESS WHEREOF, the Companies have caused this instrument to be signed, and their corporate seals to be hereto affixed, this 17th day of January,
2019.
&� Y AArD
- 4�COOL VA
State of Connecticut
City of Hartford ss.
By:
Robert L. Rane , enior Vice President
On this the 17th day of January, 2019, before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior Vice President
of Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company, and
that he, as such, being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of said
Companies by himself as a duly authorized officer.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
My Commission expires the 30th day of June, 2021
Anna P. Nowik, Notary Public
This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Travelers Casualty and
Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company, which resolutions are now in full
force and effect, reading as follows:
RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President, any
Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attomeys-in-Fact and
Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign
with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a
bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such appointee and revoke
the power given him or her; and it is
FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice
President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such
delegation is in writing and a copy thereof is filed in the office of the Secretary; and it is
FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional
undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any
Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any
Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary; or (b) duly executed (under seal, if
required) by one or more Attorneys -in -Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one
or more Company officers pursuant to a written delegation of authority; and it is
FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice
President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any Power of
Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys -in -Fact for purposes only of
executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of Attorney or certificate bearing
such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile
signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached.
I, Kevin E. Hughes, the undersigned, Assistant Secretary of Travelers Casualty and Surety Company of America, Travelers Casualty and Surety
Company, and St. Paul Fire and Marine Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of the Power of
Attorney executed by said Companies, which remains in full force and effect.
Dated this 18th day of February , 2021
t
ftm". Q A COWL 1
�
Kevin E. Hughes, Assistant Secretary
To verify the authenticity of this Power ofAttorney, please calf us at 1-800-421-3880,
Please refer to the above-named Attorney -in -f=act and the details of the bond to which this Power ofAttorney is attached.
Quote Price
item No. es tion 5Nt '_- & tea!kd Price -- -
1 Mobilization/DeZb,,Illzal,on Lump Sum -..-}� 1
4 l: i,1..• n t '✓P32 �% ''�.�;
2 Cleaning Lump Sum 1
6C) 6D - Iq,000, 6D
2a Chemical Gal / Lbs
(circle one)
2b i Cleaning TimeHrs
3 Rehabilitation Lump Sum 1
.! L L,r r'YGI/1�Gt>!fS I 'Gf¢C�Y qj� OEM
cD
8Uu.
3a L6 `WAab rimefGti Hrs
4 Post work Video Lump Sum 1
5 Remediation (if applicable) Lump Sum 6nD 1
ti '
r6 Cleanup Lump Sum 1
The undersigned has reviewed the RFQ and is familiar
': Sub Total
with the requirements herein, and has verified the quote
to be true and correct.
Tax Rate 8.696' / 8.0%)
Circle appropriate tax rate
,46,_
t Total
Signature Datea�.50
Reason Order was placed with the successful vendor.
❑ Lowest Price ❑ Quality Best Delivery Service ❑Only Source [Best Design
Request for Quotes: Desert Sunset Page 7 of 8
Well Cleaning and Rehabilitation
�CC�RU" FOOLPUM 41 F
_.� CERTIFICATE OF LIABILITY INSURANCE
THIS CERTIFICATE 6S ISSIIEa AS A MATTER OF 9YFORIIt/►TiON ONLY AND CONFER
9 NO MGM UPON THE CERTIFICATE HOAR. THAS
CERTIFICATE DBEs NOT AFfRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED dY THE POLICINyS
BELOW. THIS CERTIFICATE OF 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, tfw P~I* INEst have ADDRiOtU1l WSIMp If SU13ROGATiON IS WAIVED, subject to the and coadl iom of dw provisfo� or be ,
fi's certificate does not confer ri0hts to the certificate holder In Niru of'rich apalM.y, Csrtata Policies rmy esquire an aslant. A statettfant on
tPRODUCEIt
AMent Insurance Services. Inc.
818 IAC RlVeraWe Ave Ste+(
Spokane, WA 49201
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arsueean _ - —MW Ate_&Wk"M NOW C"Uft n]L -- 21-I
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2280 N HWmoy 3 i lfiG
Colville, WA 96114
COVERAGES
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EDtGITED. NOTVMTHSTAtiDRNG ANY REOt NT, Tt7Mr1 OR CONIXTION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIIICATE AMY BE ISSUED OR MAY PERTAIN, THE INSURANCE AMMED BY THE POS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIOM AND CONDITIONS TIONS OF SUCH POLICIES. LIMITS SHOWN. _AWAY HAVE BEEN REDUCED BY PAID CLA*&
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C011er>Qe pfbteary and R
City of Pasco, WashkXr on
Public Warks Project Coordinator
1028 S Gray St
Pasco, WA 99MI SMNrATIVE
019W2015 ACORD CORPORATION. AN eigIft rsswve&
The ACORD Oulu and Iopo are registered aurins of ACORD
SHOUIX AMIE OF THE ABOVE DaCRe POLICM W cJNtCELL D 11
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ACORD 25 (2018/03)
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ iT CAREFULLY.
GENERAL LIABILITY ELITE EXTENSION
This endorsement modifies insurance provided under the f0owing:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
The COMMERCIAL GENERAL LIABILITY COVERAGE FORM
is amended to include the following clarifications and
extensions of coveiraW. The provisions of the Coverage Form apply
unless modified by endorsement
A. EXPECTED OR INTENDED INJURY
The aggregate limit listed above Is the most we will
Section I — Cie A, Exclusion a. is amend
pay for all damages because of 'Property damage'
as follows:
to property in the care custody and contrd of or
s- 'Bodily injury or "property damage' expected
prey loaned to an insured during the policy
or Intended from the standpoint of an insured.
This exclusion does not apply to *bodily injury'
Any payment we make for damages because of
or 'property damaq ' resulting from the use of
'property image" to property in the cane, custody
reasonable face to orate& persons or property.
and control of or property loaned to an insured will
B. NON4341YNED WATERCRAFT
apply against the General Aggregate Limit shorn in
Section I Coverage A. Exclusion 9.(2) is
the
the decimations,
amerxled as toilows:
obligation
Sat to pay damages on your behalf
(2) A watercran you do not own that is:
applies only to the amount of damages in
excess of the deductible amount listed above.
(a) Less than 60 feet tong; and
We may pay any part or all of the deductible
(b) Not being used to cony person(s) or
amount fisted above. We may pay any part or
all of the deductible amount to effect settlement
property fog a charge;
of any claim or 'suit" and upon notification by
C. EXTENDED PROPERTY DAMAGE COVERAGE
us, you will promptly reimburse us for that part
Section I — Coverage A Exclusions j.(3) and (4) is
of the deductible we paid.
amended to add the following:
c. if two or more coverages apply under one
Paragraphs (3) and (4) of this exclusion do not
"occurrence", only the figs per claim
apply to tools or equipment loaned to you, provided
deductible applicable to these coverages will
they are riot being used to perform operates at
apply
the time of toss.
d. insurance provided by this provision is excess
SCHEDULE
over any other insurance, whether primary,
excess, contingent or any other basis. Since
Limlta Of Insurance Deductible
insurance provided by this andorsernent is
-
X5.000 Each Occurrence $250 Rmi Claim
excess, we will have no duty to defend any
claim or 'suit" to which Insurance provided by
$10„000 Annual Aggregate
this endorsement applies if any other insurer
-
a. The each occurrence limit listed above is the
has a duty to defend such a claim or `suit. if
no other insurer defends, we wr11 undertake to
most we will pay for all damages because of
.
do so but we will be e0illed to the insureds
property damage to property in the care,
rights against all those other insurers.
custody and control of or property loaned to an D.
Insured as the result of any one "occurrence',
PROPERTY DAMAGE —ELEVATORS
regardless of the number of:
Section 1— Coverage A.2. Exclusions paragraphs
(1) insureds;
J (3). 1-(4), i46) and k. do not apply to use of
(2) claims made or `suits' brought;
elevators. This insurance afforded by this provision
is excess over any valid and Collectible property
(3) persons or organizations making claims or
insurance (including any deductible) available to
bringing "suits”.
the insured and Section IV — Commercial General
L.iabiliiy Conditions Paragraph 4. Other
Insurance is changed accordingly.
CG7578(2-19) Wudes copye*W niaodr of 1So PrW-t :- trrc, % tti its pfrfisriotr. Pap i of 6
E. RRE, LIGHTNING OR EXPLOSION
DAMAGE
Except Wtie e I Is used In the term
-hostile fw, , the
word fire nckxies fire, lighbirig or explosion wherever
R appears In the Coverage Form.
Under Section i — Coverage A. the last paragraph
(after the exclusions) is repWced with the k4lcvAng:
Exclusbm c. through n. do not apply to damage by
fie, smoke or Mage from automatic fire protection
systms to prerr es while rented to you or
temporarily occup0d by you with permission of the
owner• A separate limit of ln3urzince applies to this
coverage as described in Section M — Limits; of
Insurance.
F. MEDICAL PAYMENTS
If Section I — Coverage C. Medical Pa is
is not othennse etaci led from this
Coverage Form:
The mquirement, in the insuring Agreement of
Coverage C., that 090raft must be incurred and
reported to us wrkhln one year of the accident date is
c hanged to throe years
G. SUPPLEMENTARY PAYMENTS
Su Mary PRIFF1011ft — e* A and 8
Paragraphs 11. and 1.d. are replaced by the
foilOwing:
1.b. Up to $5,000 for cost of ball bonds required
because of aOcidents or traffic bw violations
arising out of the use of any vehicle to which the
Bodily injury Liability Coverage applies. We do
not have to furnish these bonds.
1.d.AIIreasonable incurred by the insured
at our request to . us in the inves#igatron or
defense of the claim or "stair, including actual
loss of eamings up to $500 a day because of
time off from work.
SUBSIDIARIES AS WWREDS
Section 0 — Who Is An Insured is amended to add
the following:
1J. Any legally incorporated subsidiary in which you
own more than 50% of the voting stock on the
effective date of this policy. However, Insured
does not include any subsidiary that is an insured
under any other general iiabilitgr poky, or would
have been an insured under such a policy but for
terminatim of that policy or the exhaustion of that
policy's limits of liability.
BLANKET ADDITIONAL INSUREDS — AS
REQUIRED BY CONTRACT
1. Section Il — Who Is An Insured is amended to
indttde as an additional Insured any person(s) or
oig (s) subject to provsi" in Paragraph
2. below, (hereinafter referred to as additional
insured) when you and such person(s) or
ar ni¢ation(s) have agreed in a wry contract
or written agreement that such person(s) or
organization(s) be added as an additional insured
on your policy pied that the written contract or
agreement Is:
a. Currently in effect or becomes effective
during the policy period; and
b. Executed prior to an "occumerxe' or
offense to which this insurance Mould
However, the nsurance afforded to such
additional Insured:
a. end applies to the wdent permitted by law;
b. WM not be broader than that which you are
required by the contact or agreement to
provide for such additional insured; and
c. Applies only if the person or organization is
not specifically named as an additional
insured under any other provision of, or
endorsement added to, Section U — Who
Is An insured of this policy.
2 As provided herein, the insurance coverage
provided to such additional insureds is limited
to:
a. Any Controlling Interest, blit only with
respect to their liability arising out of their
financial control of you; or premises they
awn, maintain, or control while you lease or
occupy these Premises.
This insurance does not apply to atructrral
alterations, new construction and
demolition operations performed by or for
that person or organic.
b. Any architect, engitnaerr°, or surveyor
engaged by you but only with respect to
fiabdtY for "bodily k1u7', "Prey
damage" or "personal and advertising
miurY" caused, in whole or in pe, by your
acts or omissions or the ads or omissions
of those aging on your behalf:
(1) In connection with your premises; or
(2) in the performance of your ongoing
operations.
With respect to the insurance afford to
these additional insureds. the foil ng
additional exclusbn applies:
This insurance does not apply to "bodily
inj"9. "property dee" or "personal and
advertising injury" wising out of the
rendering of or the failure to render any
professional services by or for YOU.
Including:
(i) The preparing, r proving, or failing to
prepare or approve, maps, shop
drawings, opinions, reports, surveys,
flee orders, change orders or drawings
and specifications; or
(2) Supervisory, inspection, architectural or
engineering activities.
CG757ti(219) (nolo tturww ON ISO Properties, W- With ag pWrrl$SWL Pape 2 of 6
C.
d.
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 damagen, or the offense which
caused the "personal and advertising
Injury`,. involved the rendering of or the
failure to render any professional services
by or for you.
Any manager or lessor of a premises
leased to you, but only with respect to
liability arising out of the ownership,
maintenance or use of that part of a
premises leased to you, subject to the
following additional exclusions:
This insurance does not apply to:
(1) Any 'occurrence which takes place
atter you cease to be a tenant in that
premises.
(2) Structural alterations, new construction
or demolition operations performed by
or on behalf of such additional insured.
Any state or governmental agency or
subdivision or pokcW sem, subjed to
the following:
(1) This insurance applies only with respect
to ft Mowing hazards for which any
state Or governrnexntal agency or
subdNzion or political suitidnism has
issued a permit or authorization in
connection with premises you own, rent
or control and to which this insurance
applies:
(a) The exp, maintenance, repair,
construction, miction or removal of
advertising signs, ate,
canopies, cellar entrames, coal
how, driveways, manholes,
marquees, twist away openings,
sidewalk vaults, street banners or
decorations and similar exposures;
or
(b) The Win, miction or
removal of atm; or
(c) The ownership, maintenance or use
of any elevators covered by this
Insurance.
(2) This insurance apples only with respect
to operations performed by you or on
your behalf for which any state or
gDvernmental agency or subdivision or
political subdivision has issued a permit
or authorization.
This insurance does not apply to:
(a) "Bodily injury", "Property daMaW or
"Personal and advertisNV "W
arising out of operations perforrned
for the federal government, state or
municipality; or
(b) "Bodily inajurr or „property damage"
inducted within the "products..
Completed operations hazard'.
e. Any vendor, but only with respect to 'bodily
inW or 'Property dam" arising out of
"Your products' which are distributed or sn
in the regular course of the vendors
business.
With respect to the insurance afforded to
these vendors, the following additional
exclusions apply -
(1) The insurance afforded any vendor does
not apply to:
(a) "Bodily injury' or "Property damage
for which any vendor is obkjated to
Pay danvQft by reason of the
assumpbon of liability in a contract or
agreerrmt This exclusion oboes not
apply to RaWlity for darnages that any
vendor would have in the absence of
the contra or agreement
(b) Any express warranty unauthorized
by you;
(c) Any physical or chemical change in
the product made intentionally by
any vendor,
(d) Repackaging, except when
unpacked solely for the purpose of
inspection, demonstration, testing,
or the substitution of parts under
instructions from the manufacturer,
and then repackaged in the original
containK;
(e) Any failure to make such
ir>sictions, adjustments, tests or
servicing as any vendor has
agreed to make or normally
undertakes to make in the usual
course of business, in connection
with the distribution or sale of the
products;
(f) Demonstration, installation,
servicing or repair operations,
except such operations perfon-ned
at any vendors premises in
connection with the sale of the
product;
(9) Products which, after distribution or
sale by you, have been labeled or
relabeled or used as a container,
part or ingredient of any other thing
or substance by or for any vendor,
or
CG75M-19) Inckdst oorryrip dzd milia! of Iso Prop riles, hoc. with pen nlssiom Pape 3 of 6
(h) "Bodily injury" or "property
darnage" arising out of the sole
negligence of any vendor for its
own ads or omissions or those of
its employees or anyone else
acting on its behalf. However, this
exclusion does not apply to:
(i) The exceptions contained in
Subparagraphs (d) or (f); or
(s) Such inspections, adjustrments,
tests or servicing as any
vendor has agreed to make or
normally undertakes to make in
the usual course of business,
in connection with the
distribution or sate of the
products -
(2) This insurance does not apply to any
insured person or organization, from
whom you have acquired such
products, or any ingredient, part or
container, entering into, accompanying
or containing such products_
f. Any Mortgagee, Assignee Or Receiver, but
only with respect to their liability as
mortgagee, assignee, or receiver and
arising out of the ownership, maintenance,
or use of the premises by you.
This insurance does not apply to structural
alterations, new construction and
demolition operations performed by or for
that person or organization.
9• Any Owners Or Other Interests From
Whom Land Has Been Leased, but only
with respect to liability arising out of the
ownership, maintenance or use of that part
of the land teased to you.
With respect to the insurance afforded to
these additional insureds, the following
additional exclusions apply:
(1) This insurance does not apply to:
(a) Any "occurrence" which takes
place aft you cease to lease that
land; or
(b) Structural alterations, new
construction or demolition
operations performed by or on
behalf of such additional insured.
h. Any person or organization from whom you
lease equipment, but 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).
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.
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.
Any Owners, Lessees, or Contractors for
whom you are performing operations, but
only with respect to liability for "bodily
injury" "property damage" or "personal and
advertising injury" caused, in whoie or in
per, by
(1) Your acts or missions; or
(2) The acts or oma of those aging
on your behalf;
in the performance of your ongoing
operations for the additional insured.
A person's or organization's status as an
additional insured under this endorsement
ends when your operations for that
additional insured are completed_
With respect to the insurance afforded to
these additional insureds, the following
additional exclusions apply:
This insurance does not apply to:
(1) "Bodily Injury", "property damage" or
"personal and advertising injury" arising
out of the rendering of, or the failure to
render, any professional architectural,
engineering or surveying services,
including:
(a) The preparing, appmving, or failing
to prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders, change orders or
drawings and spetions; or
(b) 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.
(2) "Bodily injury" or "property damage"
occurring after.
CG7578(2-18) tncltdss copyrtghisd MWA6,1 of ISO P1op8dkM kV— Vitro it-, pen"MIOn. Pace 4 of 6
(a) All work, including materials, parts
This endorsement shaj not increase the
or equipment fumished in
connection with such work, on the
aPPkable Limits of Insures shown in the
Declarations.
project (ofd+' than service,
maintenance or repairs) to be
J.
COVERAGE FOR INJURY TO C049WLOYEES
performed by or on behalf of the
ANDIOR YOUR OTHER VOLUNTEER WORKERS
additional insured(s) at the location
Section i1— Who is an insured, Paragraph 2.a. (1) is
Of the covered operations has been
amended to add the_following:
completed; or
e. Pana�aphs (a), (b). and (c) do not apply to your
(b) That portion of "your work" out of
which the injury or damage arises
'employees' or "vdunteer workers" with respect
to 'bodily irrjtrty' to a Wem ployW or other
has been put to its intended use by
"volunteer worker'.
any Pemw or organization otherDamages
than another contractor
fB
owed to an � �' „ emplta or
"volunteer
or
subcontractor engaged In
performing operations for
worker" will be seduced by any
amountpaidor available co -
a
principal as a part of the same
projecL
��too�th,�epurred
„ �jwidwww Or 'volunteerworker" orkert uncle
ottherrvalid and collectible insurance. y
j. Any Grantor of Licenses to you, but only
K
HEALTH CARE SERVICE PROFESSIONALS AS
INSUREDS - INCIDENTAL_ MALPRACTICE
with respect to their liability as grantor oflicenses
to YOU.
Section 11— Who is an Para~ La. (1)
Their status as additkwW insured under
(d) is amended as
this endorsement ends when:
This provision does not apply to Nurses, Ernergency
1. The {bias granted you by such
Medical Technicians, or P who provide
Pry heathrare servers on yourbehalf.
o
pe(s) Organization(s) expires; or
2. Your license is terminated or revoked
hthwevsr this exception does notin
the business or aPPfy if a�
occupation P�r+dl►g Y such
by such person(s) or organization
professional services.
Prior to expiration of the license as
stipulated by the contract or
L
NEWLY FORMED OR ACQUIRED
agreement
ORGANIZATIONS
k. Any Grantor of Franchise, but only with
Section ti — Who Is An Insured, Paragraph 3.a. is
respect to their liab ty as grantor of a
replacedby the following:
franchise to you.
3.a. Coverage under this provision is afforded until
I. Any Co-owner of Insured Premises, but
the end of the policy period.
only with respect to their liability as co-
This provision does not aPPIY if newly formed or
owner of any Insured premises.
acquired
uir� organizations coverage is ear either by
m. Any Con
Concessionaires Trading Under Your
th provisions of the Coverage Form or by
Name. but only with respect to their liability
eradorsernernts.
as a concessionaire trading under your
M.
DAMAGE TO PREMISES RENTED TO YOU
name.
Section Ill — Limits of Insurance, Paragn4,h 6. is
3. Any insurance provided to any additional
replaced by the following:
insured doss not apply to "bodily injury,
"property damage" or 'personal and advertising
Sutalflct to &a,above, the Damage To Premises
injury* arising out of the sole negligence or
Rented To You Lind, or $500,000, wtwhew is
higher, is the most we will pay under Coverage A for
wdMful misconduct of the additional insured or its
'employees*
damages because of "property damage" to any one
agents, or any other
representative of the additional insured.
prom, while rented to you, or in the case of
damage by fire, sinuate or leakage from automatic
4. With respect to the insurance afforded to these
Protection systems, white rented to you or temporariiy
additicmal insureds, the following is added to
occupied by you with permission of the owner.
Section til — Limits of Insurance: -
N.
MEDICAL PAYMENT: — INCREASED LIMITS
If coverage provided to any additional insured
Section III — UmIts of Insurance, Paragraph 7. is
is required by a contract or agreement, the
replaced by the following:
most we will pay on behalf of the additional
insured is the amount of insurance:
7. Subject to Paragraph '.I. above, $10,000 is the
a. Required by the contract or agreement; or
Medical Expense Limit we wilt pay under
Coverage C for all medical expenses because of
b. Available under the applicable Limits of
"bodily injury" sustained by any one person,
Insurance shown in the Declarations;
unless the amount shown on the Declarations of
whichever is less.
this Coverage Part for Medical Expense Umff
states:
CG7578(2-19) Inchrdec coprtmtd m r3, :l of ISO , l+- wift its perms OrL Pike 5 of 6
(a) No Coverage; or
(b) $1,000; or
(c) $5,000; or
(d) A fimit higher than $10,000.
O. DIMES IN THE EVENT OF OCCURRENCE,
OFFENSE. CLAM OR SUIT
Section IV — COMM01rdal General Llabfttly
Condittorm Paragraph 2 is amended to add the
e. The r+equirerrm t in Condition 2.a, that you must
see to It that we are notified as soon as
practical of an "occurrence or an of ienm
which may result in a claim, applies only when the
'occurrence or offense is known to.
(1) You, if you ars an individual or a limited
liability company.
(2) A partrw, if you are a partnership;
(3) A member or rnmiagw, d you are a limited
liabR4 company:
(4) An 'examOm officer' or insurance rnarvW,
if you are a co+porWion; or
(5) A wee, if you are a trust.
f. The requirement in Condition 2bx that you must
see to it that we receive notice of a claim or'sW
as soon as practimbie will not be considered
breached unless the breach occurs atter such
claim or `suit' is known to:
(1) You, if you are an individual or a limited
IlabPlrky company;
(2) A per; If you are a partnership;
(3) A member or managw. if you are a united
liability corm;
(4) An °ftecutiV a affiCar' or insurance manager,
if you are a corporation; or
(5) A t if you are a trust.
P. PRIMARY AND NONC0.NTr4mHORY —
ADDMONAL INSURED EXTENSION
Section IV — Comrrar cbd General Liability
Conditions raph 4, Other Insurance is
amended to add to ibkwkV:
This insurance is Primary to and will not seek
contribution frau any other insurance availabie to an
additional insured under your policy provided that:
(1) The adder insured is a Named Insured under
such other wwawce, and
(2) You have agreed in writing in a contract or
agreement that this insurance would be primary
and would not seek contribution from any other
insurance available to the additional insured.
However, y the additional insured has been
added as an additional insured on other policies,
whether primary, excess, contingent or on any
other basis, this insurance is excess over any
other insurance rewrdless of the written
?gram between you and an " °
Ins
Q. UNINTENTIONAL FAILURE TO DISCLOSE
EXPOSURES
Section IV — Commercial Gen al LFdtiray
Conditions Paragraph 6. Representations is
amended to add the foilaMring:
If you uninterrtion* fait to dwiose any exposures
existing at the inception date of your poPay, we will not
deny omwage under the Coverage Form solely
because of such faifure to asdose. Hower, this
Provision does not affect our right tD comet additional
Premium or exercise our right of motion or non-
renewal.
This provision does not apply to any krx)wn injury
or dame which is excluded under any other
provision of this policy.
R. WAIVER OF TRANSFER OF RIGHTS OF
RECOVERY AGAINST OTHERS TO US
Section IV — CommwcW General Liability
CondPJ*n Paragraph & Transftr Of Rights Of
Recovery Against Others To Us is amended to
add the following:
We vrd wa any right of recovery we may have
against any Person or organization because of
Payments we make for injury or damage arising out
Of.
1. Your ongoing operations; or
2 `Your work' included in the 'products-
cornPleted operations hazard".
However, this waiver applies only when you have
agreed in writing to waive such rights of recovery in
a contract or agreement, and only if the contract or
agreement:
1. is In effect or becomes effective during the term
of this poficy; and
2. Was executed prior to loss.
S. MENTAL ANGUISH
Section V — D ninon 3. is replaced by the folloMng:
amity iryury means bodily injury, sickness or
disease sustained by a person, including menial
anguish or death resulting tom bodily injury,
sickness or disease_
T. LIBERALIZATION
If we revise this endorsement to Provide greater
coverage without additional Premium charge, we
will automatically provide the additional coverage to
all endorsement holders as of the day the revision
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