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R2022-157 2022-08-08
RESOLUTION NO. R2022-157 A Resolution of the City Council of the City of Pearland, Texas, authorizing a professional services contract with Leaf Engineers, for design, bid and construction phase services associated with the Natatorium Air Handler Replacement Project, in the estimated amount of $324,250.00. BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF PEARLAND, TEXAS: Section 1. That certain contract for professional services associated with the Natatorium Air Handler Replacement Project, a copy of which is attached hereto as Exhibit “A” and made a part hereof for all purposes, is hereby authorized and approved. Section 2. That the City Manager or his designee is hereby authorized to execute and the City Secretary to attest a contract for professional services associated for the Natatorium Air Handler Replacement Project. PASSED, APPROVED and ADOPTED this the 8th day of August, A.D., 2022. _____________________________ J.KEVIN COLE MAYOR ATTEST: _____________________________ FRANCES AGUILAR, TRMC, MMC CITY SECRETARY APPROVED AS TO FORM: ________________________________ DARRIN M. COKER CITY ATTORNEY DocuSign Envelope ID: FEA01432-5010-4036-9BD6-F0D8CB197300 Exhibit A DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 8/10/2022 | 8:39 AM CDT DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 Controlling Name of Interested Party4 Nature of interest City, State, Country (place of business) Intermediary (check applicable) CERTIFICATE OF INTERESTED PARTIES 1295FORM 1 of 1 1 OFFICE USE ONLY 2 06/20/2022 Complete Nos. 1 - 4 and 6 if there are interested parties. Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. Name of business entity filing form, and the city, state and country of the business entity's place of business. LEAF Engineers Houston, TX United States Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. 3 City of Pearland Natatorium Air Handling Replacement - MEP Design Services FA2203 2022-901171 06/22/2022 Date Filed: Date Acknowledged: Certificate Number: CERTIFICATION OF FILING Boggio, Dan XHouston, TX United States 6 Signature of authorized agent of contracting business entity My name is _______________________________________________________________, UNSWORN DECLARATION Check only if there is NO Interested Party.5 My address is _______________________________________________, _______________________, and my date of birth is _______________________. Executed in ________________________________________County, I declare under penalty of perjury that the foregoing is true and correct. (street)(state)(zip code)(country) (year)(month) _______, ______________, _________. State of ________________, on the _____day of ___________, 20_____. (city) (Declarant) Version V1.1.191b5cdcwww.ethics.state.tx.usForms provided by Texas Ethics Commission DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 6/21/2022 Arthur J.Gallagher Risk Management Services,Inc. 2618 Broadway St Pearland TX 77581 281-485-7500 281-485-6933 Continental Casualty Company 20443 PBKARCH-01 LM Insurance Corporation 33600PBKArchitectsdbaLEAFEngineers 11 Greenway Plaza,Suite 2210 Houston,TX 77046-1104 Liberty Mutual Fire Insurance Company 23035 2107601819 B X 1,000,000 X 1,000,000 10,000 1,000,000 2,000,000 X TB5-Z91-472898-022 4/25/2022 4/25/2023 2,000,000 C 1,000,000 X AS2-Z91-472898-032 4/25/2022 4/25/2023 B X X 5,000,000TH7-Z91-472898-052 4/25/2022 4/25/2023 5,000,000 X 10,000 B X N WC5-Z91-472898-012 4/25/2022 4/25/2023 1,000,000 1,000,000 1,000,000 A Professional Liability Claims Made Form AEH591912035 8/1/2021 8/1/2022 Each Claim Aggregate $5,000,000 $10,000,000 The General Liability and Auto policy includes a Blanket additional insured endorsement that provides additional insured status only when there is a written contract,agreement or permit between the named insured and the certificate holder that requires such status. The General Liability,Auto,Professional Liability and Workers Compensation policy includes a Blanket waiver of subrogation endorsement that provides this feature only when there is a written contract,agreement or permit between the named insured and the certificate holder that requires such status. General Liability is primary &non-contributory when required by written contract,agreement or permit. See Attached... City of Pearland 2016 Old Alvin Pearland TX 77581 DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: PBKARCH-01 1 1 Arthur J.Gallagher Risk Management Services,Inc.PBK Architects dba LEAF Engineers 11 Greenway Plaza,Suite 2210 Houston,TX 77046-1104 25 CERTIFICATE OF LIABILITY INSURANCE Auto liability is primary &non-contributory as respects the insured's owned &covered vehicles. The umbrella is follow form and does not include the professional liability. RE:Project:Natatorium Air Handling Replacement DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 Policy #TB5-Z91-472898-021 4/25/2021-4/25/2022 DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 POLICY NUMBER:COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM SCHEDULE Name Of Person(s) Or Organization(s): Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CA 20 48 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 COVERED AUTOS LIABILITY COVERAGE BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement identifies person(s)or organization(s)who are "insureds"for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form.This endorsement does not alter coverage provided in the Coverage Form. Each person or organization shown in the Schedule is an "insured"for Covered Autos Liability Coverage,but only to the extent that person or organization qualifies as an "insured"under the Who Is An Insured provision contained in Paragraph A.1.of Section II -Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2.of Section I -Covered Autos Coverages of the Auto Dealers Coverage Form. Any person or organization whom you have agreed in writing to add as an additional insured, but only to coverage and minimum limits of insurance required by the written agreement, and in no event to exceed either the scope of coverage or the limits of insurance provided in this policy. AS7-Z91-472898-031 DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 AC 84 07 11 17 © 2017 Liberty Mutual Insurance Page 1 of 10 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Policy Number Issued by THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM I.Newly Acquired or Formed Organizations II.Employees as Insureds III.Lessor - Additional Insured and Loss Payee IV.Supplementary Payments - Increased Limits V.Fellow Employee Coverage VI.Personal Property of Others VII.Additional Transportation Expense and Cost to Recover Stolen Auto VIII.Airbag Coverage IX.Tapes, Records and Discs Coverage X.Physical Damage Deductible - Single Deductible XI.Physical Damage Deductible - Glass XII.Physical Damage Deductible - Vehicle Tracking System XIII.Duties in Event of Accident, Claim, Suit or Loss XIV.Unintentional Failure to Disclose Hazards XV.Worldwide Liability Coverage - Hired and Nonowned Autos XVI.Hired Auto Physical Damage XVII.Auto Medical Payments Coverage Increased Limits XVIII.Drive Other Car Coverage - Broadened Coverage for Designated Individuals XIX.Rental Reimbursement Coverage XX.Notice of Cancellation or Nonrenewal XXI.Loan/Lease Payoff Coverage XXII.Limited Mexico Coverage XXIII.Waiver of Subrogation I.NEWLY ACQUIRED OR FORMED ORGANIZATIONS Throughout this policy,the words "you"and "your"also refer to any organization you newly acquire or form, other than a partnership or joint venture,and over which you maintain ownership of more than 50 percent interest, provided: A.There is no similar insurance available to that organization; B.Unless you notify us to add coverage to your policy,the coverage under this provision is afforded only until: 1.The 90th day after you acquire or form the organization; or 2.The end of the policy period, whichever is earlier; and C.The coverage does not apply to an "accident"which occurred before you acquired or formed the organization. AS7-Z91-472898-031 Liberty Insurance Corp. DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 AC 84 07 11 17 © 2017 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 10 II.EMPLOYEES AS INSUREDS Paragraph A.1.Who Is An Insured of SECTION II -COVERED AUTOS LIABILITY COVERAGE is amended to add the following: Your "employee"is an "insured"while using with your permission a covered "auto"you do not own,hire or borrow in your business or your personal affairs. III.LESSOR - ADDITIONAL INSURED AND LOSS PAYEE A.Any "leased auto"will be considered an "auto"you own and not an "auto"you hire or borrow.The coverages provided under this section apply to any "leased auto"until the expiration date of this policy or until the lessor or his or her agent takes possession of the "leased auto" whichever occurs first. B.For any "leased auto"that is a covered "auto"under SECTION II -COVERED AUTOS LIABILITY COVERAGE,Paragraph A.1.Who Is An Insured provision is changed to include as an "insured"the lessor of the "leased auto".However,the lessor is an "insured"only for "bodily injury"or "property damage" resulting from the acts or omissions by: 1.You. 2.Any of your "employees" or agents; or 3.Any person,except the lessor or any "employee"or agent of the lessor,operating a "leased auto" with the permission of any of the above. C.Loss Payee Clause 1.We will pay,as interests may appear,you and the lessor of the "leased auto"for "loss"to the covered "leased auto". 2.The insurance covers the interest of the lessor of the "leased auto"unless the "loss"results from fraudulent acts or omissions on your part. 3.If we make any payment to the lessor of a "leased auto",we will obtain his or her rights against any other party. D.Cancellation 1.If we cancel the policy,we will mail notice to the lessor in accordance with the Cancellation Common Policy Condition. 2.If you cancel the policy, we will mail notice to the lessor. 3.Cancellation ends this agreement. E.The lessor is not liable for payment of your premiums. F.For purposes of this endorsement, the following definitions apply: "Leased auto"means an "auto"which you lease for a period of six months or longer for use in your business, including any "temporary substitute" of such "leased auto". "Temporary substitute"means an "auto"that is furnished as a substitute for a covered "auto"when the covered "auto" is out of service because of its breakdown, repair, servicing, "loss" or destruction. DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 AC 84 07 11 17 © 2017 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 10 IV.SUPPLEMENTARY PAYMENTS - INCREASED LIMITS Subparagraphs A.2.a.(2)and A.2.a.(4)of SECTION II -COVERED AUTOS LIABILITY COVERAGE are deleted and replaced by the following: (2)Up to $3,000 for cost of bail bonds (including bonds for related traffic law violations)required because of an "accident" we cover. We do not have to furnish these bonds. (4)All reasonable expenses incurred by the "insured"at our request,including actual loss of earnings up to $500 a day because of time off from work. V.FELLOW EMPLOYEE COVERAGE A.Exclusion B.5. of SECTION II - COVERED AUTOS LIABILITY COVERAGE does not apply. B.For the purpose of Fellow Employee Coverage only,Paragraph B.5.of SECTION IV -BUSINESS AUTO CONDITIONS is changed as follows: This Fellow Employee Coverage is excess over any other collectible insurance. VI.PERSONAL PROPERTY OF OTHERS Exclusion 6.in SECTION II -COVERED AUTOS LIABILITY COVERAGE for a covered "auto"is amended to add the following: This exclusion does not apply to "property damage"or "covered pollution cost or expense"involving "personal property"of your "employees"or others while such property is carried by the covered "auto".The Limit of Insurance for this coverage is $5,000 per "accident".Payment under this coverage does not increase the Limit of Insurance. For the purpose of this section of this endorsement,"personal property"is defined as any property that is not used in the individual's trade or business or held for the production or collection of income. VII.ADDITIONAL TRANSPORTATION EXPENSE AND COST TO RECOVER STOLEN AUTO A.Paragraph A.4.a. of SECTION III - PHYSICAL DAMAGE COVERAGE is amended as follows: The amount we will pay is increased to $50 per day and to a maximum limit of $1,000. B.Paragraph A.4.a. of SECTION III - PHYSICAL DAMAGE COVERAGE is amended to add the following: If your business is shown in the Declarations as something other than an auto dealership,we will also pay up to $1,000 for reasonable and necessary costs incurred by you to return a stolen covered "auto" from the place where it is recovered to its usual garaging location. VIII.AIRBAG COVERAGE Exclusion B.3.a. in SECTION III - PHYSICAL DAMAGE COVERAGE is amended to add the following: This exclusion does not apply to the accidental discharge of an airbag. IX.TAPES, RECORDS AND DISCS COVERAGE Exclusion B.4.a.of SECTION III -PHYSICAL DAMAGE COVERAGE is deleted and replaced by the following: a.Tapes,records,discs or other similar audio,visual or data electronic devices designed for use with audio, visual or data electronic equipment except when the tapes,records,discs or other similar audio,visual or data electronic devices: DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 AC 84 07 11 17 © 2017 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 10 (1)Are your property or that of a family member; and (2)Are in a covered "auto" at the time of "loss". The most we will pay for "loss" is $200. No Physical Damage Coverage deductible applies to this coverage. X.PHYSICAL DAMAGE DEDUCTIBLE - SINGLE DEDUCTIBLE Paragraph D. in SECTION III - PHYSICAL DAMAGE COVERAGE is deleted and replaced by the following: D.Deductible For each covered "auto",our obligation to pay for,repair,return or replace damaged or stolen property will be reduced by the applicable deductible shown in the Declarations.Any Comprehensive Coverage deductible shown in the Declarations does not apply to "loss" caused by fire or lightning. When two or more covered "autos"sustain "loss"in the same collision,the total of all the "loss"for all the involved covered "autos"will be reduced by a single deductible,which will be the largest of all the deductibles applying to all such covered "autos". XI.PHYSICAL DAMAGE DEDUCTIBLE – GLASS Paragraph D. in SECTION III - PHYSICAL DAMAGE COVERAGE is amended to add the following: No deductible applies to "loss" to glass if you elect to patch or repair it rather than replace it. XII.PHYSICAL DAMAGE DEDUCTIBLE - VEHICLE TRACKING SYSTEM Paragraph D. in SECTION III - PHYSICAL DAMAGE COVERAGE is amended to add: Any Comprehensive Coverage Deductible shown in the Declarations will be reduced by 50%for any "loss" caused by theft if the vehicle is equipped with a vehicle tracking device such as a radio tracking device or a global positioning device and that device was the method of recovery of the vehicle. XIII.DUTIES IN EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS Subparagraphs A.2.a. and A.2.b. of SECTION IV- BUSINESS AUTO CONDITIONS are changed to: a.In the event of "accident",claim,"suit"or "loss",your insurance manager or any other person you designate must notify us as soon as reasonably possible of such "accident",claim,"suit"or "loss".Such notice must include: (1)How, when and where the "accident" or "loss" occurred; (2)The "insured's" name and address; and (3)To the extent possible, the names and addresses of any injured persons and witnesses. Knowledge of an "accident",claim,"suit"or "loss"by your agent,servant or "employee"shall not be considered knowledge by you unless you,your insurance manager or any other person you designate has received notice of the "accident", claim, "suit" or "loss" from your agent, servant or "employee". b.Additionally, you and any other involved "insured" must: (1)Assume no obligation,make no payment or incur no expense without our consent,except at the "insured's" own cost. DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 AC 84 07 11 17 © 2017 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 10 (2)Immediately send us copies of any request,demand,order,notice,summons or legal paper received concerning the claim or "suit". (3)Cooperate with us in the investigation or settlement of the claim or defense against the "suit". (4)Authorize us to obtain medical records or other pertinent information. (5)Submit to examination,at our expense,by physicians of our choice,as often as we reasonably require. XIV.UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS Paragraph B.2. in SECTION IV - BUSINESS AUTO CONDITIONS is amended to add the following: Any unintentional failure to disclose all exposures or hazards existing as of the effective date of the Business Auto Coverage Form or at any time during the policy period will not invalidate or adversely affect the coverage for such exposure or hazard.However,you must report the undisclosed exposure or hazard to us as soon as reasonably possible after its discovery. XV.WORLDWIDE LIABILITY COVERAGE - HIRED AND NONOWNED AUTOS Condition B.7. in SECTION IV - BUSINESS AUTO CONDITIONS is amended to add the following: For "accidents"resulting from the use or operation of covered "autos"you do not own,the coverage territory means all parts of the world subject to the following provisions: a.If claim is made or "suit"is brought against an "insured"outside of the United States of America,its territories and possessions,Puerto Rico and Canada,we shall have the right,but not the duty to investigate, negotiate, and settle or defend such claim or "suit". If we do not exercise that right,the "insured"shall have the duty to investigate,negotiate,and settle or defend the claim or "suit"and we will reimburse the "insured"for the expenses reasonably incurred in connection with the investigation,settlement or defense.Reimbursement will be paid in the currency of the United States of America at the rate of exchange prevailing on the date of reimbursement. The "insured"shall provide us with such information we shall reasonably request regarding such claim or "suit" and its investigation, negotiation, and settlement or defense. The "insured"shall not agree to any settlement of the claim or "suit"without our consent.We shall not unreasonably withhold consent. b.We are not licensed to write insurance outside of the United States of America,its territories or possessions, Puerto Rico and Canada. We will not furnish certificates of insurance or other evidence of insurance you may need for the purpose of complying with the laws of other countries relating to auto insurance. Failure to comply with the auto insurance laws of other countries may result in fines or penalties.This insurance does not apply to such fines or penalties. XVI.HIRED AUTO PHYSICAL DAMAGE If no deductibles are shown in the Declarations for Physical Damage Coverage for Hired or Borrowed Autos, the following will apply: A.We will pay for "loss"under Comprehensive and Collision coverages to a covered "auto"of the private passenger type hired without an operator for use in your business: DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 AC 84 07 11 17 © 2017 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 10 1.The most we will pay for coverage afforded by this endorsement is the lesser of: a.The actual cost to repair or replace such covered "auto"with other property of like kind and quality; or b.The actual cash value of such covered "auto" at the time of the "loss". 2.An adjustment for depreciation and physical condition will be made in determining actual cash value in the event of a total "loss". 3.If a repair or replacement results in better than like kind or quality,we will not pay for the amount of the betterment. B.For each covered "auto",our obligation to pay for,repair,return or replace the covered "auto"will be reduced by any deductible shown in the Declarations that applies to private passenger "autos"that you own. If no applicable deductible is shown in the Declarations, the deductible will be $250. If the Declarations show other deductibles for Physical Damage Coverages for Hired or Borrowed Autos, this Section XVI of this endorsement does not apply. C.Paragraph A.4.b. of SECTION III - PHYSICAL DAMAGE COVERAGE is replaced by the following: b.Loss of Use Expenses For Hired Auto Physical Damage provided by this endorsement,we will pay expenses for which an "insured"becomes legally responsible to pay for loss of use of a private passenger vehicle rented or hired without a driver,under a written rental contract or agreement.We will pay for loss of use expenses caused by: (1)Other than collision only if the Declarations indicate that Comprehensive Coverage is provided for any covered "auto"; (2)Specified Causes of Loss only if the Declarations indicate that Specified Causes of Loss Coverage is provided for any covered "auto"; or (3)Collision only if the Declarations indicate that Collision Coverage is provided for any covered "auto". However, the most we will pay under this coverage is $30 per day, subject to a maximum of $900. XVII.AUTO MEDICAL PAYMENTS COVERAGE - INCREASED LIMITS For any covered "loss",the Limit of Insurance for Auto Medical Payments will be double the limit shown in the Declarations if the "insured"was wearing a seat belt at the time of the "accident".This is the maximum amount we will pay for all covered medical expenses,regardless of the number of covered "autos", "insureds", premiums paid, claims made, or vehicles involved in the "accident". If no limit of insurance for Auto Medical Payments is shown on the Declarations,this paragraph Section XVII of this endorsement does not apply. XVIII.DRIVE OTHER CAR COVERAGE - BROADENED COVERAGE FOR DESIGNATED INDIVIDUALS A.This endorsement amends only those coverages indicated with an "X"in the Drive Other Car section of the Schedule to this endorsement. B.SECTION II - COVERED AUTOS LIABILITY COVERAGE is amended as follows: 1.Any "auto"you don't own,hire or borrow is a covered "auto"for Liability Coverage while being used by any individual named in the Drive Other Car section of the Schedule to this endorsement or by his or her spouse while a resident of the same household except: DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 AC 84 07 11 17 © 2017 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 10 a.Any "auto" owned by that individual or by any member of his or her household; or b.Any "auto"used by that individual or his or her spouse while working in a business of selling, servicing, repairing or parking "autos". 2.The following is added to Who Is An Insured: Any individual named in the Drive Other Car section of the Schedule to this endorsement and his or her spouse,while a resident of the same household,are "insureds"while using any covered "auto" described in Paragraph B.1. of this endorsement. C.Auto Medical Payments,Uninsured Motorist,and Underinsured Motorist Coverages are amended as follows: The following is added to Who Is An Insured: Any individual named in the Drive Other Car section of the Schedule to this endorsement and his or her "family members"are "insured"while "occupying"or while a pedestrian when struck by any "auto"you don't own except: Any "auto" owned by that individual or by any "family member". D.SECTION III - PHYSICAL DAMAGE COVERAGE is changed as follows: Any private passenger type "auto"you don't own,hire or borrow is a covered "auto"while in the care, custody or control of any individual named in the Drive Other Car section of the Schedule to this endorsement or his or her spouse while a resident of the same household except: 1.Any "auto" owned by that individual or by any member of his or her household; or 2.Any "auto"used by that individual or his or her spouse while working in a business of selling, servicing, repairing or parking "autos". E.For purposes of this endorsement, SECTION V - DEFINITIONS is amended to add the following: "Family member"means a person related to the individual named in the Drive Other Car section of the Schedule to this endorsement by blood,marriage or adoption who is a resident of the individual's household, including a ward or foster child. XIX.RENTAL REIMBURSEMENT COVERAGE A.For any owned covered "auto"for which Collision and Comprehensive Coverages are provided,we will pay for rental reimbursement expenses incurred by you for the rental of an "auto"because of a covered physical damage "loss"to an owned covered "auto".Such payment applies in addition to the otherwise applicable amount of physical damage coverage you have on a covered "auto".No deductibles apply to this coverage. B.We will pay only for those expenses incurred during the policy period beginning 24 hours after the "loss" and ending with the earlier of the return or repair of the covered "auto",or the exhaustion of the coverage limit. C.Our payment is limited to the lesser of the following amounts: 1.Necessary and actual expenses incurred; or 2.$30 per day with a maximum of $900 in any one period. DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 AC 84 07 11 17 © 2017 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 8 of 10 D.This coverage does not apply: 1.While there are spare or reserve "autos" available to you for your operations; or 2.If coverage is provided by another endorsement attached to this policy. E.If a covered "loss"results from the total theft of a covered "auto"of the private passenger type,we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided for under Paragraph A.4.Coverage Extensions of SECTION III –PHYSICAL DAMAGE COVERAGE of the Business Auto Coverage Form or Section VII of this endorsement. XX.NOTICE OF CANCELLATION OR NONRENEWAL A.Paragraph A.2. of the COMMON POLICY CONDITIONS is changed to: 2.We may cancel or non-renew this policy by mailing written notice of cancellation or non-renewal to the Named Insured,and to any name(s)and address(es)shown in the Cancellation and Non-renewal Schedule: a.For reasons of non-payment, the greater of: (1)10 days; or (2)The number of days specified in any other Cancellation Condition attached to this policy; or b.For reasons other than non-payment, the greater of: (1)60 days; (2)The number of days shown in the Cancellation and Non-renewal Schedule; or (3)The number of days specified in any other Cancellation Condition attached to this policy, prior to the effective date of the cancellation or non-renewal. B.All other terms of Paragraph A.of the COMMON POLICY CONDITIONS,and any amendments thereto, remain in full force and effect. XXI.LOAN/LEASE PAYOFF COVERAGE The following is added to Paragraph C.Limits Of Insurance of SECTION III -PHYSICAL DAMAGE COVERAGE: In the event of a total "loss"to a covered "auto"of the private passenger type shown in the schedule or declarations for which Collision and Comprehensive Coverage apply,we will pay any unpaid amount due on the lease or loan for that covered "auto", less: 1.The amount paid under the PHYSICAL DAMAGE COVERAGE SECTION of the policy; and 2.Any: a.Overdue lease/loan payments at the time of the "loss"; b.Financial penalties imposed under a lease for excessive use,abnormal wear and tear or high mileage; c.Security deposits not returned by the lessor; d.Costs for extended warranties,Credit Life Insurance,Health,Accident or Disability Insurance purchased with the loan or lease; and DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 AC 84 07 11 17 © 2017 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 9 of 10 e.Carry-over balances from previous loans or leases. This coverage is limited to a maximum of $1,500 for each covered "auto". XXII.LIMITED MEXICO COVERAGE WARNING AUTO ACCIDENTS IN MEXICO ARE SUBJECT TO THE LAWS OF MEXICO ONLY -NOT THE LAWS OF THE UNITED STATES OF AMERICA.THE REPUBLIC OF MEXICO CONSIDERS ANY AUTO ACCIDENT A CRIMINAL OFFENSE AS WELL AS A CIVIL MATTER. IN SOME CASES THE COVERAGE PROVIDED UNDER THIS ENDORSEMENT MAY NOT BE RECOGNIZED BY THE MEXICAN AUTHORITIES AND WE MAY NOT BE ALLOWED TO IMPLEMENT THIS COVERAGE AT ALL IN MEXICO.YOU SHOULD CONSIDER PURCHASING AUTO COVERAGE FROM A LICENSED MEXICAN INSURANCE COMPANY BEFORE DRIVING INTO MEXICO. THIS ENDORSEMENT DOES NOT APPLY TO ACCIDENTS OR LOSSES WHICH OCCUR BEYOND 25 MILES FROM THE BOUNDARY OF THE UNITED STATES OF AMERICA. A.Coverage 1.Paragraph B.7.of SECTION IV -BUSINESS AUTO CONDITIONS is amended by the addition of the following: The coverage territory is extended to include Mexico but only if all of the following criteria are met: a.The "accidents" or "loss" occurs within 25 miles of the United States border; and b.While on a trip into Mexico for 10 days or less. 2.For coverage provided by this section of the endorsement,Paragraph B.5.Other Insurance in SECTION IV - BUSINESS AUTO CONDITIONS is replaced by the following: The insurance provided by this endorsement will be excess over any other collectible insurance. B.Physical Damage Coverage is amended by the addition of the following: If a "loss"to a covered "auto"occurs in Mexico,we will pay for such "loss"in the United States.If the covered "auto"must be repaired in Mexico in order to be driven,we will not pay more than the actual cash value of such "loss" at the nearest United States point where the repairs can be made. C.Additional Exclusions The following additional exclusions are added: This insurance does not apply: 1.If the covered "auto" is not principally garaged and principally used in the United States. 2.To any "insured" who is not a resident of the United States. XXIII.WAIVER OF SUBROGATION Paragraph A.5. in SECTION IV - BUSINESS AUTO CONDITIONS does not apply to any person or organization where the Named Insured has agreed, by written contract executed prior to the date of "accident", to waive rights of recovery against such person or organization. DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of the Information Page. 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, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule where you are required by a written contract to obtain this waiver from us. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. The premium for this endorsement is shown in the Schedule. Schedule 1.( ) Specific Waiver Name of person or organization (X)Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2.Operations: All Texas Operations 3.Premium: The premium charge for this endorsement shall be 2.0 percent of the premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operationsdescribed. 4.Advance Premium: Issued by LM Insurance Corporation 27243 For attachment to Policy No. WCS-Z91-472898-012 Issued to PBK Architects, Inc. Effective Date Premium$ Endorsement No. WC4203 04 B Ed. 06/01/2014 © Copyright 2014 National Council on Compensation Insurance, Inc. All Rights Reserved. Page 1 of 1 DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074 TEXAS NOTICE OF MATERIAL CHANGE ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Texas is shown in item 3.A. of the Information Page. In the event of cancelation or other material change of the policy, we will mail advance notice to the person or organization named in the Schedule. The number of days advance notice is shown in the Schedule. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule 1. Number of days advance notice: 60 2. Notice will be mailed to:Per schedule on file with company Issued by LM Insurance Corporation 27243 For attachment to Policy No.WC5-Z91-472898-011 Effective Date Issued to PBK Architects, Inc. Premium $ Endorsement No. WC 42 06 01 Ed. 07/01/1984 Page 1 of 1 DocuSign Envelope ID: 77D35C00-141E-4A2A-BD7B-A64E61B3E074