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Contract 2021-089A A16
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
DEPT/OFFICE: INFORMATION TECHNOLOGY MEETING DATE: 3/4/2024
DIRECTOR/MANAGER: RICHARD VAN NATTA REQUEST TYPE: Consent
AGENDA REQUEST
Approval and authorization for the Chair/Vice Chair to sign Amendment #1 with Miller Electric Company,
Jacksonville, Florida, to extend the term of the service agreement for Countywide video surveillance and
access control security system installation, maintenance, repairs and upgrades, and the continued
standardization of security systems at County facilities on an as needed basis, (RFP-21-12227-TP); estimated
expenditures shall increase from $2,32-2,000.00 to $3,096,000.00 through April 30, 2025.
STRATEGIC PLAN GOAL
Efficient and High Performing County Government
FINANCIAL INFORMATION
TOTAL REQUESTED AMOUNT: $774000.00
Funds are appropriated in various department budgets countywide for this purpose. Fund availability is
confirmed prior to the issuance of a purchase order.
Appropriations beyond Fiscal Year 2024 are subject to future Board approval.
APPROVING DEPARTMENTS
OMB: MATTHEW J FUHRER
Procurement: REBECCA JONES
Attorney: FRANK TOWNSEND
BACKGROUND INFORMATION
• This engagement provides for system installation, maintenance, repairs, and upgrades to the County's
security video surveillance and access control systems on an as -needed basis.
• Approval of this request will extend the term of the agreement for one year, and increase compensation
by $774,000 for a total of $3,096,000 through April 30, 2025.
• The estimated cumulative expenditures include tasks, projects, upgrades, maintenance, and new
installations necessary to allow the County to effectively manage video surveillance and access control at
various facilities Countywide, such as Corrections facilities, Emergency Operations Center, Courthouse,
Libraries, Government Center, Administration Building, NeoCity, Osceola Heritage Park, and other locations
as needed.
• On July 12, 2021, the Board approved the agreement with Miller Electric Company of Jacksonville, Florida
for the provision of Countywide video surveillance and access control security system installation,
maintenance, repairs, and upgrades, including continued standardization of security systems in County
facilities, on an as -needed basis not to exceed $2,322,000 through April 30, 2024.
• The Board also authorized the County Manager to sign amendments that do not exceed 10% of the
Board's total approved amount.
The Project Manager for this engagement is Dan Andrews, Information Security Manager.
• Staff recommends approval. I y ,,
DocuSign Envelope ID: F55FEEB7-ABA5-4CAD-9F4F-OFE7E1369FD1
AMENDMENT # 1
TO THE AGREEMENT BETWEEN
OSCEOLA COUNTY AND MILLER ELECTRIC COMPANY
THIS AMENDMENT is made and entered between OSCEOLA COUNTY, a political
subdivision of the State of Florida, 1 Courthouse Square, Kissimmee, Florida 34741, hereinafter
referred to as the "COUNTY," and MILLER ELECTRIC COMPANY, 6805 Southpoint Parkway,
Jacksonville, Florida 32216, hereinafter referred to as the "CONTRACTOR".
WITNESSETH:
WHEREAS, the COUNTY desires to maintain the professional services of the CONTRACTOR
to continue to provide and perform video surveillance and access control security system
installation, maintenance, repairs and upgrades on an as -needed basis, as further described in
the Agreement RFP-21-12227-TP, approved by the Board of County Commissioners on July 12,
2021, between the COUNTY and the CONTRACTOR; and
WHEREAS, pursuant to 24. Modifications, the covenants, terms and provisions of the
Agreement may be modified by way of a written instrument, mutually accepted by the parties;
and
WHEREAS, the purpose of this Amendment is to extend the term of the agreement for an
additional year,
NOW, THEREFORE, in consideration of the mutual covenants, terms, and provisions
contained herein, the parties agree as follows:
1. Section 1. Term is hereby amended to read as follows:
SECTION 1. TERM
The term of this Agreement is amended to extend through April 30, 2025 and may
be extended when in the best interest of the County.
2. Section 5. Compensation is deleted in its entirety and replaced with the following:
SECTION 5. COMPENSATION.
A. The amount to be paid underthis Agreement for services rendered will not
exceed Three Million Ninety -Six Thousand and 00/100 Dollars
(3,096,000.00) for the term of this Agreement, in accordance with the
DocuSign Envelope ID: F55FEEB7-ABA5-4CAD-9F4F-QFE7E1369FD1
pricings chedule set forth in Exhibit "B" which is attached hereto and made
a binding part hereof.
B. Compensation for services completed by the CONTRACTOR will be paid in
accordance with section 218.70, Florida Statutes, Florida's Prompt
Payment Act.
C. Services to be performed in accordance with this Agreement are subject
to the annual appropriation of funds by the COUNTY. in its sole discretion,
the COUNTY reserves the right to forego use of the CONTRACTOR for any
project which may fall within the Scope of Services listed herein. In the
event the COUNTY is not satisfied with the services provided by the
CONTRACTOR, the COUNTY will hold any amounts due until such time as
the CONTRACTOR has appropriately addressed the problem.
3. Section 12. Public Records is deleted in its entirety and replaced with the
following:
SECTION 12. PUBLIC RECORDS.
A. IF THE CONTRACTOR HAS QUESTIONS REGARDING THE
APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE
CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS
RELATING TO THIS AGREEMENT, CONTACT THE CUSTODIAN OF
PUBLIC RECORDS AT THE FOLLOWING:
Custodian of Public Records
C/O Public Records Coordinator
1 Courthouse Square, Suite 4700
Kissimmee, Florida 34741
407-742-2395
PublicRecords@osceola.orp
B. The CONTRACTOR understands that by virtue of this Agreement all of its
documents, records and materials of any kind, relating to the relationship
created hereby, shall be open to the public for inspection in accordance
with Florida law. If CONTRACTOR will act on behalf of the COUNTY, as
provided under section 119.011(2), Florida Statutes, the CONTRACTOR,
subject to the terms of section 287.058(1)(c), Florida Statutes, and any
other applicable legal and equitable remedies, shall:
Amendment #1 - RFP-21-12227-TP 2 Rev 092023
DocuStgn Envelope ID: F55FEEB7-ABA5-4CAD-9F4F-0FE7E1369FD1
1. Keep and maintain public records required by the COUNTY to
perform the service.
2. Upon request from the COUNTY'S custodian of public records,
provide the COUNTY with a copy of the requested records or allow
the records to be inspected or copied within a reasonable time at
a cost that does not exceed the cost provided by Florida law.
3. Ensure that public records that are exempt or confidential and
exempt from public records disclosure requirements are not
disclosed except as authorized by law for the duration of the
contract term and following completion of the contract if the
CONTRACTOR does not transfer the records to the COUNTY.
4. Upon completion of the contract, transfer, at no cost, to the
COUNTY all public records in possession of the CONTRACTOR or
keep and maintain public records required by the COUNTY to
perform the service.. If the CONTRACTOR transfers all public
records to the COUNTY upon completion of the contract, the
CONTRACTOR shall destroy any duplicate public records that are
exempt or confidential and exempt from public records disclosure
requirement. If the CONTRACTOR keeps and maintains public
records upon completion of the contract, the CONTRACTOR shall
meet all applicable requirements for retaining public records. All
records stored electronically must be provided to the COUNTY,
upon request from the COUNTY'S custodian of public records, in a
format that is compatible with the information technology systems
of the county..
5. If the CONTRACTOR does not comply with a public records request,
the COUNTY shall enforce the contract provisions in accordance
with the contract.
4. These changes shall be effective upon this Amendment being executed by both
parties.
S. The terms and conditions of the original Agreement and any subsequent
Amendment(s) shall remain in full force and effect. To the extent of any conflict
between this Amendment and the original Agreement or any prior Amendment(s)
thereto, the terms and conditions of this Amendment shall prevail.
SIGNATURE PAGE TO FOLLOW
Amendment #1— RFP-21-12227-TP 3 Rev 092023
DocuSign Envelope ID: F55FEE87-ABA5-4CAD-9F4F-OFE7E1369FD1
IN WITNESS WHEREOF, the parties hereto, by their duly authorized representatives, have
executed this Amendment effective the later of the dates that each party signed this
Amendment.
ATTEST:
OSCEOLA COUNTY CLERK OF THE BOARD
By: &'Mt imo V. VMd&M
Clerk/Deputy Clerk o the Board
As authorized for execution at the Board of
County Commissioners meeting of:
STATE OF FLORIDA
COUNTY OF Duval
BOARD OF COUNTY COMM SSI IRS
OF OSCEOLA CO , FLI__
By:
hair/ ice Cha
l`
-
: 2W
s
==
MILLER ELECTRIC COMPANY
"_Cvc as qua by:
By: I "V, �Luuj,.
�YClI. W aL�tl<W
Title: sr. vice President
Date:1/24/2024 1 3:15 PM EST
The foregoing instrument was executed before me by means of _ physical presence or,
x online notarization, this 26th day of 7anuary 1 2024, by
Kevin Flanigan as sr. vice President of Miller Electric Company,
who personally swore or affirmed that he/she is authorized to execute this Agreement and
thereby bind the Corporation, and who is personally known to me OR has produced
as identification.
MEGANFRYMAN
?W&Ap%y
Notary Public • State of Florida
Commission K HH 295757
Comm. ExpvesAug 1, 2026
7onded through National Notary Assn,
Amendment #1— RFP-21-12227-TP
NOTARY PUBLIC, State of Florida
4 Rev 092023
DocuSign Envelope ID: F55FEEB7-ABA5-4CAD-9F4F-OFE7E1369FD1
Exhibit "B"
Pricing Schedule
Labor Hours Price Schedule
Standard/Normal Hours
Description
Project Management
Installation Technician
Installation Technician (Helper)
Field Engineer
Service Technician
Application Engineer
Draftsman/CADD Technician
Clerical (O&M Documentation)
Labor Hours Price Schedule
Over Time/After Hours
Description
Project Management
Installation Technician
Installation Technician (Helper)
Field Engineer
Service Technician
Application Engineer
Draftsman/CADD Technician
Clerical (O&M Documentation)
Hourly Rate
$ 115.00
$ 105.00
$ 95.00
$ 115.00
$ 105.00
$ 115.00
$ 115.00
$ 75.00
Hourly Rate
$ 172.50
$ 157.50
$ 142.50
$ 172.50
$ 157.50
$ 172.50
$ 172.50
$ 112.50
Amendment #1— RFP-21-12227-TP 5 Rev 092023
DocuSign Envelope 10: F55FEEB7-ABA54CAD-9F4F-OFE7E1369FD1
IGenetecTM Specific Parts and Materials
Description
All GenetecTM, AASTM, SynergiSTM, OnmicastTM, HIDTM and other GenetecTM
System specific Parts and Materials
Miscellaneous Consumable Parts and Materials
Description
I
Miscellaneous Consumable Parts and Materials
Percentage Discount
13% minimum
Percentage Markup
Cost plus 15%
Subcontractor and Equipment Rental Costs
For both Subcontractor and Equipment Rental Costs, the County will provide a reimbursement of expenses. The awarded
contractor will provide a copy of the subcontractor and equipment rental invoice to support reimbursement with their invoice
for work performed.
Description
Subcontractor Costs
Equipment Rental Costs
Estimated Costs
Cost plus 15% - requires prior
approval by the County's Project
Manager or Designee
Cost plus 15%- requires prior
approval by the County's Project
Manager or Designee
Amendment #1— RFP-21-12227-TP 6 Rev 092023
MILLELE-01 ZALLEN
A�OR� CERTIFICATE OF LIABILITY INSURANCE DATD/YYYY)
6/11/21112023
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT Zachary Allen, CRM, CRIS, MLIS
Cecil W. Powell & Company PHONE FAX
219 N. Newnan Street (AlC, No, Extl: (A/C, No):
Jacksonville, FL 32202 1 E-MAIL s, ZAllen@cwpowellins.com
INSURER(SI AFFORDING COVERAGE NAIC N
INSURER A: Zurich American Ins Co 16535
INSURED INSURER B: Travelers Prop CaS CO Of Am 25674
Miller Electric Company INSURER C:XL Specialtv Insurance Co 37885
P O Box 1799 INSURER D :
Jacksonville, FL 32201-1799
INSURER E
INSURER F :
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH 30LICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY 'AID CLAIMS.
INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
LIR IUD WVD iMMIDOIYYYYI IMMIDDIYYYYI
A X COMMERCIAL GENERAL LIABILITY RR 2,000,000
CLAIMS -MADE FX] OCCUR
X Contractual Liab.
X XCU
G��E77N'L AGGREGATE LIMIT APPLIES PER.
POLICY FX PEST l -- I LOC
OTHER,
A AUTOMOBILE LIABILITY
X ANY A' TO
OWNED SCHEDULED
AUTOS ONLY ALTOppSyyT.�E
AUTODS ONLY AUOTOS ONLDY
B �UMBRELLA LIAB H OCCUR
EXCESS LIAB CLAIMS -MADE
DED I X I RETENTIONS 10,000
A WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
X X GL0038137508
X X BAP038137608
X X CUP-4T706941-23-NF
ANY PROPRIIETORIPARTNERiEXECUTIVE YIN X WC038137408
MCER ry in NH) EXCLUDED? LN J NIA
If yes describe under
DESCRIPTION QQ OPeERATIONS below
C Equipment F�o I er UM00040936MA23A
EACH OCCU ENCE S
7/112023 711 /2024 DAMAGE TO RENTED
PREMISES IEa occurrence] _ s
MED EXP (Any one person) S
PERSONAL B ADV INJURY S
GENERAL AGGREGATE S
Pf<orUCTS - COMP/OP AGG S
IEBL AGGREGATE S
I COMBINED SINGLE LIMIT
en11 S
7/112023 711 /2024 BODILY INJURY (Per person) $
I BODILY INJURY Per acadent) S
PROPERTY DAMAGE
(Per acadent) S
(EACH OCCURRENCE S
7/1/2023 ' 7/1/2024 I AGGREGATE S
Aggregate S
X 1 PT RT I EDRH-
7/112023 711/2024 EL. EACH ACCIDENT S
E L DISEASE - EA EMPLOYEE S
E L. DISEASE -POLICY LIMIT S
7/112023 711/2024 Any One Item:
1,000,000
10,000
2,000,000
4,000,000
4,000,000
2,000,000
2,000,000
15,000,000
15,000,000
1,000,000
1,000,000
1,000,000
1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space Is required)
Project: Video Surveillance and Access Control Security System Installation, Maintenance, Repairs and Upgrades _
r,
U� rCD
Osceola County is included as additional insured as respects general liability and auto liability on a primary and non-contributory basiTpgr thgahed
endorsements. A waiver of subrogation is granted in favor of the additional insured as respects general liability, auto liability, and work—rs corbpe'n5ation per
the attached endorsements, and where permitted. Umbrella liability applies excess to general liability, auto liability, and employers Iiabi Wwor�drtfiT " -
compensation). 30 days notice of cancellation applies. cd'
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE WaLLEDZE11FORE
Osceola County THE EXPIRATION DATE THEREOF, NOTICE WILL BF�ELIMED IN
tY ACCORDANCE WITH THE POLICY PROVISIONS.
1 Courthouse Square
Kissimmee, FL 34741
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016103) @ 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
Miller Electric Companv
Addendum to Certificate of Insurance
Additional Description of Operations:
Auto Liability Includes:
Hired and Non -Owned Liability
Hired and Non -Owned Physical Damage - Deductibles as follows
$250 Comprehensive; $500 Collision
General Liability — Additional Insured Status: Additional Insured status provided through
U-GL-2162-A CW (02/19) endorsement. This form allows for entities to be named as
additional insureds via one of the 04/13, 07/04, or 10/01 edition date versions of the
ISO CG 20 10 and CG 20 37 endorsements, as required and specified by the applicable
contract(s). If no form version is specified, then the current editions of the CG 20 10
and CG 20 37 endorsements will apply.
Contractors Pollution and Professional Liabilitv
Policy # PCADB-5018580-0723
Insurer: Berkley Assurance Company
Effective 07/01/2023; Expiration 07/01/2024
Policy Aggregate Limit of Liability: $10,000,000
Professional Liability
Per Claim Limit: $10,000,000
Aggregate Limit of Liability: $10,000,000
Self -Insured Retention: $100,000
Professional Liability Coverage is Claims Made.
Retroactive date: 12/03/2010
Contractors Pollution Liabilitv
Each Pollution Condition: $10,000,000
Aggregate Limit of Liability: $10,000,000
Retention: $100,000
Pollution Coverage is Occurrence based.
Installation Floater & Riggers Liabilitv
Policy # UM00040936MA23A
Insurer: XL Specialty Insurance Company
Effective 07/01 /2023 - 07/01 /2024
Installation: Limit -Any One Jobsite: $5,000,000
Installation: Maximum Amount of Payment: $10,000,000
Temporary Location: $1,000,000
Transit: $1,000,000
Excludes Flood and Earth Movement
Riggers Liabilitv
Coverage Limit: $50,000
Crime Coveraqe
Policy # 47-EMC-322303
Insurer: Berkshire Hathaway Specialty Insurance Company
Effective: 07/01 /2023 — 07/01 /2024
Employee Dishonesty - $5,000,000 - Loss Limit
Client Property - $5,000,000 - Loss Limit
Self -Insured Retention - $50,000 - Per Occurrence
Cvber Liabilitv Coveraqe
Policy # PRO30025668600
Insurer: Endurance American Specialty Insurance Company
Effective: 10/01 /2022 — 10/01 /2023
Aggregate: $5,000,000
0
Additional Insured — Automatic — Owners, Lessees Or ZURICH
Contractors
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Policy No. GL0038137508 I Effective Date: 07/01/2023
This endorsement modifies insurance provided under the:
Commercial General Liability Coverage Part
A. Section II — Who Is An Insured is amended to include as an additional insured any person or organization whom you
are required to add as an additional insured under a written contract or written agreement executed by you, but only
with respect to liability for "bodily injury", "property damage' or "personal and advertising injury" and subject to the
following:
1. If such written contract or written agreement specifically requires that you provide that the person or organization
be named as an additional insured under one or both of the following endorsements:
a. The Insurance Services Office (ISO) ISO CG 20 10 (10/01 edition); or
b. The ISO CG 20 37 (10/01 edition),
such person or organization is then an additional insured with respect to such endorsement(s), but only to the extent
that 'bodily injury', "property damage' or "personal and advertising injury" arises out of:
(1) Your ongoing operations, with respect to Paragraph 1.a. above; or
(2) "Your work", with respect to Paragraph 1.b. above,
which is the subject of the written contract or written agreement.
However, solely with respect to this Paragraph 1., insurance afforded to such additional insured:
(a) Only applies if the "bodily injury", "property damage' or "personal and advertising injury' offense occurs
during the policy period and subsequent to your execution of the written contract or written agreement,
and
(b) Does not apply to 'bodily injury" or "property damage" caused by "your work" and included within the
"products -completed operations hazard" unless the written contract or written agreement specifically
requires that you provide such coverage to such additional insured.
2. If such written contract or written agreement specifically requires that you provide that the person or organization
be named as an additional insured under one or both of the following endorsements:
a. The Insurance Services Office (ISO) ISO CG 20 10 (07/04 edition), or
b. The ISO CG 20 37 (07/04 edition),
such person or organization is then an additional insured with respect to such endorsement(s), but only to the extent
that 'bodily injury", "property damage" or "personal and advertising injury' is caused, in whole or in part, by:
(1) Your acts or omissions; or
(2) The acts or omissions of those acting on your behalf,
U-GL-2162-A CW (02/19)
Page 1 of 4
Includes copyrighted material of Insurance Services Office, Inc , with its permission.
in the performance of:
(a) Your ongoing operations, with respect to Paragraph 2.a. above; or
(b) "Your work" and included in the "products -completed operations hazard", with respect to Paragraph
2.b. above,
which is the subject of the written contract or written agreement.
However, solely with respect to this Paragraph 2., insurance afforded to such additional insured:
(i) Only applies if the 'bodily injury', "property damage" or "personal and advertising injury" offense
occurs during the policy period and subsequent to your execution of the written contract or written
agreement; and
(ii) Does not apply to "bodily injury" or "property damage" caused by "your work" and included within
the "products -completed operations hazard" unless the written contract or written agreement
specifically requires that you provide such coverage to such additional insured.
3. If neither Paragraph 1. nor Paragraph 2. above apply and such written contract or written agreement requires that
you provide that the person or organization be named as an additional insured:
a. Under the ISO CG 20 10 (04/13 edition, any subsequent edition or if no edition date is specified), or
b. With respect to ongoing operations (if no form is specified),
such person or organization is then an additional insured only to the extent that 'bodily injury", "property damage"
or "personal and advertising injury" is caused, in whole or in part by:
(1) Your acts or omissions; or
(2) The acts or omissions of those acting on your behalf,
in the performance of your ongoing operations, which is the subject of the written contract or written agreement.
However, solely with respect to this Paragraph 3., insurance afforded to such additional insured:
(a) Only applies to the extent permitted by law;
(b) Will not be broader than that which you are required by the written contract or written agreement to
provide for such additional insured; and
(c) Only applies if the "bodily injury', 'property damage" or "personal and advertising injury" offense occurs
during the policy period and subsequent to your execution of the written contract or written agreement.
4. If neither Paragraph 1. nor Paragraph 2. above apply and such written contract or written agreement requires that
you provide that the person or organization be named as an additional insured:
a. Under the ISO CG 20 37 (04/13 edition, any subsequent edition or if no edition date is specified); or
b. With respect to the 'products -completed operations hazard" (if no form is specified),
such person or organization is then an additional insured only to the extent that "bodily injury' or "property damage"
is caused, in whole or in part by "your work" and included in the "products -completed operations hazard", which is
the subject of the written contract or written agreement.
However, solely with respect to this Paragraph 4., insurance afforded to such additional insured:
(1) Only applies to the extent permitted by law,
(2) Will not be broader than that which you are required by the written contract or written agreement to provide
for such additional insured;
(3) Only applies if the 'bodily injury' or "property damage" occurs during the policy period and subsequent to
your execution of the written contract or written agreement, and
(4) Does not apply to 'bodily injury" or "property damage" caused by "your work" and included within the
"products -completed operations hazard" unless the written contract or written agreement specifically
requires that you provide such coverage to such additional insured.
U-GL-2162-A CW (02/19)
Page 2 of 4
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
B. Solely with respect to the insurance afforded to any additional insured referenced in Section A. of this endorsement,
the following additional exclusion applies:
This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of
the rendering of, or failure to render, any professional architectural, engineering or surveying services including:
1. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field
orders, change orders or drawings and specifications; or
2. Supervisory, inspection, architectural or engineering activities.
This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision,
hiring, employment, training or monitoring of others by that insured, if the 'occurrence' which caused the "bodily injury'
or "property damage', or the offense which caused the "personal and advertising injury", involved the rendering of or
the failure to render any professional architectural, engineering or surveying services.
C. Solely with respect to the coverage provided by this endorsement, the following is added to Paragraph 2. Duties In The
Event Of Occurrence, Offense, Claim Or Suit of Section IV — Commercial General Liability Conditions:
The additional insured must see to it that:
(1) We are notified as soon as practicable of an 'occurrence' or offense that may result in a claim;
(2) We receive written notice of a claim or "suit" as soon as practicable; and
(3) A request for defense and indemnity of the claim or "suit' will promptly be brought against any policy issued by
another insurer under which the additional insured may be an insured in any capacity. This provision does not
apply to insurance on which the additional insured is a Named Insured if the written contract or written
agreement requires that this coverage be primary and non-contributory.
D. Solely with respect to the coverage provided by this endorsement:
1. The following is added to the Other Insurance Condition of Section IV — Commercial General Liability
Conditions:
Primary and Noncontributory insurance
This insurance is primary to and will not seek contribution from any other insurance available to an additional
insured provided that:
a. The additional insured is a Named Insured under such other insurance; and
b. You are required by written contract or written agreement that this insurance be primary and not seek
contribution from any other insurance available to the additional insured.
2. The following paragraph is added to Paragraph 4.b. of the Other Insurance Condition under Section IV —
Commercial General Liability Conditions:
This insurance is excess over:
Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional
insured, in which the additional insured on our policy is also covered as an additional insured on another policy
providing coverage for the same 'occurrence", offense, claim or "suit'. This provision does not apply to any
policy in which the additional insured is a Named Insured on such other policy and where our policy is required
by a written contract or written agreement to provide coverage to the additional insured on a primary and non-
contributory basis.
E. This endorsement does not apply to an additional insured which has been added to this Coverage Part by an
endorsement showing the additional insured in a Schedule of additional insureds, and which endorsement applies
specifically to that identified additional insured.
F. Solely with respect to the insurance afforded to an additional insured under Paragraph A.3. or Paragraph A.4. of this
endorsement, the following is added to Section III — Limits Of Insurance:
Additional Insured — Automatic — Owners, Lessees Or Contractors Limit
The most we will pay on behalf of the additional insured is the amount of insurance:
U-GL-2162-A CW (02/19)
Page 3 of 4
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
1. Required by the written contractor written agreement referenced in Section A. of this endorsement; or
2. Available under the applicable Limits of Insurance shown in the Declarations,
whichever is less.
This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.
All other terms, conditions, provisions and exclusions of this policy remain the same.
U-GL-2162-A CW (92119)
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Blanket Notification to Others of Cancellation
or Non -Renewal
PolicyNo. Eff. Date of Pol. Es Date of Pol Eff Date of End Producer No Add] Prem
P
I GLO 0381375-OS 07/01/2023 07/01/2024 84099000 INCL
0
ZURICH
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the:
Commercial General Liability Coverage Part
Return Prom.
A. If we cancel or non -renew this Coverage Part by written notice to the first Named Insured, we will mail or deliver
notification that such Coverage Part has been cancelled or non -renewed to each person or organization shown in a
list provided to us by the first Named Insured if you are required by written contact or written agreement to provide
such notification. However, such notification will not be mailed or delivered if a conditional notice of renewal has been
sent to the first Named Insured. Such list:
1. Must be provided to us prior to cancellation or non -renewal;
2. Must contain the names and addresses of only the persons or organizations requiring notification that such
Coverage Part has been cancelled or non -renewed; and
3. Must be in an electronic format that is acceptable to us.
B. Our notification as described in Paragraph A. of this endorsement will be based on the most recent list in our records
as of the date the notice of cancellation or non -renewal is mailed or delivered to the first Named Insured. We will mail
or deliver such notification to each person or organization shown in the list.-
1. Within seven days of the effective date of the notice of cancellation, if we cancel for non-payment of premium; or
2. At least 30 days prior to the effective date of:
a. Cancellation, if cancelled for any reason other than nonpayment of premium: or
b. Non -renewal, but not including conditional notice of renewal.
C. Our mailing or delivery of notification described in Paragraphs A. and B. of this endorsement is intended as a courtesy
only. Our failure to provide such mailing or delivery will not:
1. Extend the Coverage Part cancellation or non -renewal date;
2. Negate the cancellation or non -renewal, or
3. Provide any additional insurance that would not have been provided in the absence of this endorsement.
D. We are not responsible for the accuracy, integrity, timeliness and validity of information contained in the list provided
to us as described in Paragraphs A. and B. of this endorsement.
All other terms and conditions of this policy remain unchanged.
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0
General Liability Supplemental Coverage Endorsement Z U RIC H
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Policy No. GLO 0381375-08 1 Effective Date: 07/01/2023
This endorsement modifies insurance provided under the:
Commercial General Liability Coverage Part
The following changes apply to this Coverage Part. However, endorsements attached to this Coverage Part will
supersede any provisions to the contrary in this General Liability Supplemental Coverage Endorsement.
A. Broadened Named Insured
1. The following is added to Section II —Who Is An Insured:
Any organization of yours, other than a partnership or joint venture, which is not shown in the Declarations, and
over which you maintain an ownership interest of more than 50% of such organization as of the effective date of
this Coverage Part, will qualify as a Named Insured. However, such organization will not qualify as a Named
Insured under this provision if it:
a. Is newly acquired or formed during the policy period,
b. Is also an insured under another policy, other than a policy written to apply specifically in excess of this
Coverage Part; or
c. Would be an insured under another policy but for its termination or the exhaustion of its limits of insurance.
Each such organization remains qualified as a Named Insured only while you maintain an ownership interest of
more than 50% in the organization during the policy period.
2. The last paragraph of Section II — Who Is An Insured does not apply to this provision to the extent that such
paragraph would conflict with this provision.
B. Newly Acquired or Formed Organizations as Named Insureds
1. Paragraph 3. of Section II — Who Is An Insured is replaced by the following:
3. Any organization you newly acquire or form during the policy period, other than a partnership or joint venture,
and over which you maintain an ownership interest of more than 50% of such organization, will qualify as a
Named Insured if there is no other similar insurance available to that organization. However:
a. Coverage under this provision is afforded only until the 1801' day after you acquire or form the
organization or the end of the policy period, whichever is earlier,
b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or
formed the organization; and
c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before
you acquired or formed the organization.
An additional premium will apply in accordance with our rules and rates in effect on the date you acquired or
formed the organization.
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2. The last paragraph of Section II — Who Is An Insured does not apply to this provision to the extent that such
paragraph would conflict with this provision.
C. Insured Status — Employees
Paragraph 2.a.(1) of Section II — Who Is An Insured is replaced by the following:
2. Each of the following is also an insured:
a. Your "volunteer workers" only while performing duties related to the conduct of your business, or your
"employees", other than either your "executive officers" (if you are an organization other than a partnership,
joint venture or limited liability company) or your managers (if you are a limited liability company), but only for
acts within the scope of their employment by you or while performing duties related to the conduct of your
business. However, none of these "employees" or "volunteer workers" are insureds for:
(1) "Bodily injury" or "personal and advertising injury":
(a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if
you are a limited liability company), to a co -"employee" while in the course of his or her employment
or performing duties related to the conduct of your business, or to your other "volunteer workers"
while performing duties related to the conduct of your business,
(b) To the spouse, child, parent, brother or sister of that co -"employee" or "volunteer worker as a
consequence of Paragraph (1)(a) above;
(c) For which there is any obligation to share damages with or repay someone else who must pay
damages because of the injury described in Paragraphs (1)(a) or (b) above; or
(d) Arising out of his or her providing or failing to provide professional health care services.
However:
Paragraphs (1)(a) and (1)(d) do not apply to your "employees" or "volunteer workers", who are not
employed by you or volunteering for you as health care professionals, for "bodily injury" arising out of
"Good Samaritan Acts" while the "employee" or "volunteer worker" is performing duties related to the
conduct of your business.
"Good Samaritan Acts" mean any assistance of a medical nature rendered or provided in an emergency
situation for which no remuneration is demanded or received.
Paragraphs (1)(a), (b) and (c) do not apply to any "employee" designated as a supervisor or higher in
rank, with respect to "bodily injury" to co -"employees". As used in this provision. "employees" designated
as a supervisor or higher in rank means only "employees" who are authorized by you to exercise direct or
indirect supervision or control over "employees" or "volunteer workers" and the manner in which work is
performed.
D. Additional Insureds — Lessees of Premises
1. Section II — Who Is An Insured is amended to include as an additional insured any person(s) or organization(s)
who leases or rents a part of the premises you own or manage who you are required to add as an additional
insured on this policy under a written contract or written agreement, but only with respect to liability arising out of
your ownership, maintenance or repair of that part of the premises which is not reserved for the exclusive use or
occupancy of such person or organization or any other tenant or lessee.
This provision does not apply after the person or organization ceases to lease or rent premises from you.
However, the insurance afforded to such additional insured:
a. Only applies to the extent permitted by law, and
b. Will not be broader than that which you are required by the written contract or written agreement to provide for
such additional insured.
2. With respect to the insurance afforded to the additional insureds under this endorsement, the following is added to
Section III — Limits Of Insurance:
The most we will pay on behalf of the additional insured is the amount of insurance:
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a. Required by the written contract or written agreement referenced in Subparagraph D.1, above (of this
endorsement), or
b. Available under the applicable Limits of Insurance shown in the Declarations,
whichever is less.
This Paragraph D. shall not increase the applicable Limits of Insurance shown in the Declarations.
E. Additional Insured —Vendors
1. The following change applies if this Coverage Part provides insurance to you for "bodily injury' and "property
damage" included in the "products -completed operations hazard". -
Section II — Who Is An Insured is amended to include as an additional insured any person or organization
(referred to throughout this Paragraph E. as vendor) who you have agreed in a written contract or written
agreement, prior to loss, to name as an additional insured, but only with respect to "bodily injury' or "property
damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's
business:
However, the insurance afforded to such vendor:
a. Only applies to the extent permitted by law; and
b. Will not be broader than that which you are required by the written contract or written agreement to provide for
such vendor.
2. With respect to the insurance afforded to these vendors, the following additional exclusions apply:
a. The insurance afforded the vendor does not apply to:
(1) 'Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the
assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages
that the vendor would have in the absence of the contract or agreement,
(2) Any express warranty unauthorized by you,
(3) Any physical or chemical change in the product made intentionally by the vendor;
(4) 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
container;
(5) Any failure to make such inspections, adjustments, tests or servicing as the 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;
(6) Demonstration, installation, servicing or repair operations, except such operations performed at the
vendor's premises in connection with the sale of the product;
(7) 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 the vendor, or
(8) 'Bodily injury' or "property damage" arising out of the sole negligence of the vendor for its own acts or
omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not
apply to
(a) The exceptions contained in Subparagraphs (4) or (6), or
(b) Such inspections, adjustments, tests or servicing as the 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.
b. 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.
c. This insurance does not apply to any of "your products" for which coverage is excluded under this Coverage
Part.
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3. With respect to the insurance afforded to the vendor under this endorsement, the following is added to Section III
— Limits Of Insurance:
The most we will pay on behalf of the vendor is the amount of insurance:
a. Required by the written contract or written agreement referenced in Subparagraph E.1. above (of this
endorsement), or
b. Available under the applicable Limits of Insurance shown in the Declarations,
whichever is less.
This Paragraph E. shall not increase the applicable Limits of Insurance shown in the Declarations.
F. Additional Insured — Managers, Lessors or Governmental Entity
1. Section II — Who Is An Insured is amended to include as an insured any person or organization who is a
manager, lessor or governmental entity who you are required to add as an additional insured on this policy under
a written contract, written agreement or permit, but only with respect to liability for "bodily injury", "property
damage" or "personal and advertising injury" caused, in whole or in part, by:
a. Your acts or omissions; or
b. The acts or omission of those acting on your behalf, and
resulting directly from:
a. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit,
b. Ownership, maintenance, occupancy or use of premises by you, or
c. Maintenance, operation or use by you of equipment leased to you by such person or organization.
However, the insurance afforded to such additional insured:
a. Only applies to the extent permitted by law, and
b. Will not be broader than that which you are required by the written contract or written agreement to provide for
such additional insured.
2. This provision does not apply:
a. Unless the written contract or written agreement has been executed, or the permit has been issued, prior to
the "bodily injury", "property damage' or offense that caused "personal and advertising injury";
b. To any person or organization included as an insured under Paragraph 3. of Section II — Who Is An Insured,
c. To any lessor of equipment if the 'occurrence" or offense takes place after the equipment lease expires;
d. To any:
(1) Owners or other interests from whom land has been leased by you; or
(2) Managers or lessors of premises, if:
(a) The 'occurrence' or offense takes place after the expiration of the lease or you cease to be a tenant
in that premises;
(b) The "bodily injury", "property damage' or "personal and advertising injury" arises out of the structural
alterations, new construction or demolition operations performed by or on behalf of the manager or
lessor; or
(c) The premises are excluded under this Coverage Part.
3. With respect to the insurance afforded to the additional insureds under this endorsement, the following is added to
Section III — Limits Of Insurance:
The most we will pay on behalf of the additional insured is the amount of insurance:
a. Required by the written contract or written agreement referenced in Subparagraph F.1. above (of this
endorsement); or
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b. Available under the applicable Limits of Insurance shown in the Declarations,
whichever is less.
This Paragraph F. shall not increase the applicable Limits of Insurance shown in the Declarations.
G. Damage to Premises Rented or Occupied by You
1. The last paragraph under Paragraph 2. Exclusions of Section I — Coverage A — Bodily Injury And Property
Damage Liability is replaced by the following:
Exclusions c. through n. do not apply to damage by "specific perils" to premises while rented to you or temporarily
occupied by you with permission of the owner. A separate Damage To Premises Rented To You Limit of
Insurance applies to this coverage as described in Section III — Limits Of Insurance.
2. Paragraph 6. of Section III — Limits Of Insurance is replaced by the following:
6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under
Coverage A for damages because of "property damage" to any one premises while rented to you, or in the
case of damage by one or more "specific perils" to any one premises, while rented to you or temporarily
occupied by you with permission of the owner.
H. Broadened Contractual Liability
The "insured contract" definition under the Definitions Section is replaced by the following:
"Insured contract" means:
a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies
any person or organization for damage by "specific perils" to premises while rented to you or temporarily occupied
by you with permission of the owner is not an "insured contract';
b. A sidetrack agreement;
c. Any easement or license agreement;
d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a
municipality;
e. An elevator maintenance agreement;
f. That part of any other contract or agreement pertaining to your business (including an indemnification of a
municipality in connection with work performed for a municipality) under which you assume the tort liability of
another party to pay for "bodily injury", "property damage", or "personal and advertising injury" arising out of the
offenses of false arrest, detention or imprisonment, to a third person or organization. Tort liability means a liability
that would be imposed by law in the absence of any contract or agreement.
Paragraph f. does not include that part of any contract or agreement:
(1) That indemnifies an architect, engineer or surveyor for injury or damage arising out of:
(a) Preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys,
field orders, change orders or drawings and specifications; or
(b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or
damage; or
(2) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage
arising out of the insured's rendering or failure to render professional services, including those listed in
Paragraph (1) above and supervisory, inspection, architectural or engineering activities.
1. Definition — Specific Perils
The following definition is added to the Definitions Section:
"Specific perils" means:
a. Fire;
b. Lightning,
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c. Explosion,
d. Windstorm or hail;
e. Smoke,
f. Aircraft or vehicles;
g. Vandalism;
h. Weight of snow, ice or sleet;
i. Leakage from fire extinguishing equipment, including sprinklers; or
j. Accidental discharge or leakage of water or steam from any part of a system or appliance containing water or
steam.
J. Limited Contractual Liability Coverage — Personal and Advertising Injury
1. Exclusion e. of Section I — Coverage B — Personal And Advertising Injury Liability is replaced by the following:
2. Exclusions
This insurance does not apply to:
e. Contractual Liability
"Personal and advertising injury" for which the insured has assumed liability in a contract or agreement.
This exclusion does not apply to:
(1) Liability for damages that the insured would have in the absence of the contract or agreement, or
(2) Liability for "personal and advertising injury" if:
(a) The "personal and advertising injury" arises out of the offenses of false arrest, detention or
imprisonment,
(b) The liability pertains to your business and is assumed in a written contract or written agreement in
which you assume the tort liability of another. Tort liability means a liability that would be
imposed by law in the absence of any contract or agreement; and
(c) The "personal and advertising injury" occurs subsequent to the execution of the written contract
I or written agreement.
Solely for purposes of liability so assumed in such written contract or written agreement, reasonable
attorney fees and necessary litigation expenses incurred by or for a party other than an insured are
deemed to be damages because of "personal and advertising injury" described in Paragraph (a)
above, provided:
(i) Liability to such party for, or for the cost of, that party's defense has also been assumed in the
same written contract or written agreement, and
(ii) Such attorney fees and litigation expenses are for defense of that party against a civil or
alternative dispute resolution proceeding in which damages to which this insurance applies are
alleged.
2. Paragraph 2.d. of Section I — Supplementary Payments — Coverages A and B is replaced by the following:
d. The allegations in the "suit" and the information we know about the "occurrence" or offense are such that no
conflict appears to exist between the interests of the insured and the interests of the indemnitee,
3. The following is added to the paragraph directly following Paragraph 2.f. of Section I — Supplementary
Payments — Coverages A and B:
Notwithstanding the provisions of Paragraph 2.e.(2) of Section I — Coverage B — Personal And Advertising
Injury Liability, such payments will not be deemed to be damages for "personal and advertising injury" and will
not reduce the limits of insurance.
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K. Supplementary Payments
The following changes apply to Supplementary Payments — Coverages A and B:
Paragraphs 1.b. and 1.d. are replaced by the following:
b. Up to $2,500 for the cost of bail bonds required because of accidents or traffic law violations arising out of the use
of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds.
d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the
claim or "suit", including actual loss of earnings up to $500 a day because of time off from work.
L. Broadened Property Damage
1. Property Damage to Contents of Premises Rented Short -Term
The paragraph directly following Paragraph (6) in Exclusion j. of Section I — Coverage A — Bodily Injury And
Property Damage Liability is replaced by the following:
Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to premises (other than damage
by "specific perils"), including "property damage" to the contents of such premises, rented to you under a rental
agreement for a period of 14 or fewer consecutive days. A separate Limit of Insurance applies to Damage to
Premises Rented to You as described in Section III — Limits Of Insurance.
2. Elevator Property Damage
a. The following is added to Exclusion j. of Section I — Coverage A — Bodily Injury And Property Damage
Liability:
Paragraphs (3) and (4) of this exclusion do not apply to "property damage" arising out of the use of an
elevator at premises you own, rent or occupy.
b. The following is added to Section III — Limits Of Insurance:
Subject to Paragraph 5. above, the most we will pay under Coverage A for damages because of "property
damage" to property loaned to you or personal property in the care, custody or control of the insured arising
out of the use of an elevator at premises you own, rent or occupy is $25,000 per "occurrence".
3. Property Damage to Borrowed Equipment
a. The following is added to Exclusion j. of Section I — Coverage A — Bodily Injury And Property Damage
Liability:
Paragraph (4) of this exclusion does not apply to "property damage" to equipment you borrow from others at a
jobsite.
b. The following is added to Section III — Limits Of Insurance:
Subject to Paragraph 5. above, the most we will pay under Coverage A for damages because of "property
damage" to equipment you borrow from others is $25,000 per "occurrence".
M. Expected or Intended Injury or Damage
Exclusion a. of Section I — Coverage A — Bodily Injury And Property Damage Liability is replaced by the following:
a. Expected Or Intended Injury Or Damage
"Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does
not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or
property.
N. Definitions — Bodily Injury
The "bodily injury" definition under the Definitions Section is replaced by the following:
"Bodily injury" means bodily injury, sickness or disease sustained by a person, including mental anguish, mental
injury, shock., fright or death sustained by that person which results from that bodily injury, sickness or disease.
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O. Insured Status — Amateur Athletic Participants
Section II — Who Is An Insured is amended to include as an insured any person you sponsor while participating in
amateur athletic activities. However, no such person is an insured for:
a. 'Bodily injury" to:
(1) Your "employee", "volunteer worker" or any person you sponsor while participating in such amateur athletic
activities; or
(2) You, any partner or member (if you are a partnership or joint venture), or any member (if you are a limited
liability company) while participating in such amateur athletic activities; or
b. "Property damage' to property owned by, occupied or used by, rented to, in the care, custody or control of, or
over which the physical control is being exercised for any purpose by:
(1) Your "employee', "volunteer worker' or any person you sponsor; or
(2) You, any partner or member (if you are a partnership or joint venture), or any member (if you are a limited
liability company).
P. Non -Owned Aircraft, Auto and Watercraft
Exclusion g. of Section I — Coverage A — Bodily Injury And Property Damage Liability is replaced by the following:
g. Aircraft, Auto Or Watercraft
"Bodily injury" or "property damage' arising out of the ownership, maintenance, use or entrustment to others of
any aircraft, "auto" or watercraft owned or operated by or rented or loaned to any insured. Use includes operation
and "loading or unloading".
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' involved the ownership, maintenance, use or entrustment to others of any
aircraft, "auto' or watercraft that is owned or operated by or rented or loaned to any insured.
This exclusion does not apply to:
(1) A watercraft while ashore on premises you own or rent,
(2) A watercraft you do not own that is:
(a) Less than 51 feet long, and
(b) Not being used to carry persons for a charge:
(3) Parking an "auto' on, or on the ways next to, premises you own or rent, provided the "auto' is not owned by
or rented or loaned to you or the insured;
(4) Liability assumed under any "insured contract' for the ownership, maintenance or use of aircraft or watercraft;
(5) An aircraft that is hired or chartered by you or loaned to you, with a paid and licensed crew, and is not owned
in whole or in part by an insured; or
(6) "Bodily injury" or "property damage' arising out of.
(a) The operation of machinery or equipment that is attached to, or part of, a land vehicle that would qualify
under the definition of "mobile equipment' if it were not subject to a compulsory or financial responsibility
law or other motor vehicle insurance law where it is licensed or principally garaged; or
(b) The operation of any of the machinery or equipment listed in Paragraph f.(2) or f.(3) of the definition of
"mobile equipment".
Q. Definitions — Leased Worker, Temporary Worker and Labor Leasing Firm
1. The 'leased worker' and "temporary worker" definitions under the Definitions Section are replaced by the
following:
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"Leased worker" means a person leased to you by a "labor leasing firm" under a written agreement between you
and the "labor leasing firm", to perform duties related to the conduct of your business. "Leased worker' does not
include a "temporary worker".
"Temporary worker" means a person who is furnished to you to support or supplement your work force during
"employee" absences, temporary skill shortages, upturns or downturns in business or to meet seasonal or short-
term workload conditions. "Temporary worker" does not include a "leased worker".
2. The following definition is added to the Definitions Section:
"Labor leasing firm" means any person or organization who hires out workers to others, including any:
a. Employment agency, contractor or services;
b. Professional employer organization; or
c. Temporary help service.
R. Definition — Mobile Equipment
Paragraph f. of the "mobile equipment" definition under the Definitions Section is replaced by the following:
f. Vehicles not described in Paragraph a., b., c. or d. above maintained primarily for purposes other than the
transportation of persons or cargo.
However, self-propelled vehicles with the following types of permanently attached equipment, exceeding a
combined gross vehicle weight of 1000 pounds, are not "mobile equipment" but will be considered "autos":
(1) Equipment designed primarily for:
(a) Snow removal;
(b) Road maintenance, but not construction or resurfacing; or
(c) Street cleaning;
(2) Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower
workers; and
(3) Air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical
exploration, lighting and well servicing equipment.
S. Definitions — Your Product and Your Work
The "your product" and "your work" definitions under the Definitions Section are replaced by the following:
"Your product":
a. Means:
(1) Any goods or products, other than real property, manufactured, sold, handled, distributed or disposed of by:
(a) You;
(b) Others trading under your name, or
(c) A person or organization whose business or assets you have acquired, and
(2) Containers (other than vehicles), materials, parts or equipment furnished in connection with such goods or
products.
b. Includes:
(1) Warranties or representations made at any time with respect to the fitness, quality, durability, performance,
use, handling, maintenance, operation or safety of "your product"; and
(2) The providing of or failure to provide warnings or instructions.
c. Does not include vending machines or other property rented to or located for the use of others but not sold.
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"Your work":
a. Means:
(1) Work, services or operations performed by you or on your behalf; and
(2) Materials, parts or equipment furnished in connection with such work, services or operations.
b. Includes:
(1) Warranties or representations made at any time with respect to the fitness, quality, durability, performance,
use, handling, maintenance, operation or safety of "your work"; and
(2) The providing of or failure to provide warnings or instructions.
T. Duties in the Event of Occurrence, Offense, Claim or Suit Condition
The following paragraphs are added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit
of Section IV — Commercial General Liability Conditions:
Notice of an "occurrence" or of an offense which may result in a claim under this insurance or notice of a claim or
"suit" shall be given to us as soon as practicable after knowledge of the "occurrence", offense, claim or "suit" has
been reported to any insured listed under Paragraph 1. of Section II — Who Is An Insured or an "employee"
authorized by you to give or receive such notice Knowledge by other "employees" of an "occurrence", offense, claim
or "suit" does not imply that you also have such knowledge.
In the event that an insured reports an "occurrence" to the workers compensation carrier of the Named Insured and
this "occurrence" later develops into a General Liability claim, covered by this Coverage Part, the insured's failure to
report such "occurrence" to us at the time of the "occurrence" shall not be deemed to be a violation of this Condition.
You must, however, give us notice as soon as practicable after being made aware that the particular claim is a
General Liability rather than a Workers Compensation claim.
U. Other Insurance Condition
Paragraphs 4.a. and 4.b.(1) of the Other Insurance Condition of Section IV — Commercial General Liability
Conditions are replaced by the following:
4. Otherinsurance
If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or B of
this Coverage Part, our obligations are limited as follows:
a. Primary Insurance
This insurance is primary except when Paragraph b. below applies. If this insurance is primary, our
obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that
other insurance by the method described in Paragraph c. below. However, this insurance is primary to and
will not seek contribution from any other insurance available to an additional insured provided that:
(1) The additional insured is a Named Insured under such other insurance, and
(2) You are required by written contract or written agreement that this insurance be primary and not seek
contribution from any other insurance available to the additional insured.
Other insurance includes any type of self insurance or other mechanism by which an insured arranges for
funding of its legal liabilities.
b. Excess Insurance
(1) This insurance is excess over:
(a) Any of the other insurance, whether primary, excess, contingent or on any other basis:
(i) That is property insurance, Builder's Risk, Installation Risk or similar coverage for "your work";
(ii) That is property insurance purchased by you (including any deductible or self insurance portion
thereof) to cover premises rented to you or temporarily occupied by you with permission of the
owner;
U-GL-1345-C CW (03/20)
Page 10 of 12
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
(iii) That is insurance purchased by you (including any deductible or self insurance portion thereof) to
cover your liability as a tenant for "property damage" to premises rented to you or temporarily
occupied by you with permission of the owner;
(iv) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not
subject to Exclusion g. of Section 1 — Coverage A — Bodily Injury And Property Damage
Liability, or
(v) That is property insurance (including any deductible or self insurance portion thereof) purchased
by you to cover damage to:
Equipment you borrow from others; or
Property loaned to you or personal property in the care, custody or control of the insured arising
out of the use of an elevator at premises you own, rent or occupy.
(b) Any other primary insurance (including any deductible or self insurance portion thereof) available to
the insured covering liability for damages arising out of the premises, operations, products, work or
services for which the insured has been granted additional insured status either by policy provision or
attachment of any endorsement. Other primary insurance includes any type of self insurance or other
mechanism by which an insured arranges for funding of its legal liabilities.
(c) Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an
additional insured, in which the additional insured on our policy is also covered as an additional
insured on another policy providing coverage for the same 'occurrence', claim or "suit'. This
provision does not apply to any policy in which the additional insured is a Named Insured on such
other policy and where our policy is required by written contract or written agreement to provide
coverage to the additional insured on a primary and non-contributory basis.
V. Unintentional Failure to Disclose All Hazards
Paragraph 6. Representations of Section IV — Commercial General Liability Conditions is replaced by the
following:
6. Representations
By accepting this policy, you agree:
a. The statements in the Declarations are accurate and complete;
b. Those statements are based upon representations you made to us; and
c. We have issued this policy in reliance upon your representations.
Coverage will continue to apply if you unintentionally:
a. Fail to disclose all hazards existing at the inception of this policy; or
b. Make an error, omission or improper description of premises or other statement of information stated in this
policy.
You must notify us as soon as possible after the discovery of any hazards or any other information that was not
provided to us prior to inception of this Coverage Part.
W. Waiver of Right of Subrogation
Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Commercial General
Liability Conditions is replaced by the following:
8. Transfer Of Rights Of Recovery Against Others To Us
a. If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those
rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the
insured will bring "suit' or transfer those rights to us and help us enforce them.
b. If the insured waives its right to recover payments for injury or damage from another person or organization in
a written contract executed prior to a loss, we waive any right of recovery we may have against such person
or organization because of any payment we have made under this Coverage Part. The written contract will
U-GL-1345-C CW (03/20)
Page 11 of 12
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
be considered executed when the insured's performance begins, or when it is signed, whichever happen
first. This waiver of rights shall not be construed to be a waiver with respect to any other operations in whIich
the insured has no contractual interest.
X. Liberalization Condition
The following condition is added to Section IV — Commercial General Liability Conditions: i
Liberalization Clause
If we revise this Coverage Part to broaden coverage without an additional premium charge, your policy will
automatically provide the additional coverage as of the day the revision is effective in the state shown in the mailing
address of your policy.
All other terms, conditions, provisions and exclusions of this policy remain the same.
U-GL-1345-C CW (C3120)
Page 12 of 12
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
POLICY NUMBER: BAP 0381376-08
COMMERCIAL AUTO
CA 20 48 10 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED INSURED FOR
COVERED AUTOS LIABILITY COVERAGE
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
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 this 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.
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated
below.
Named Insured: MILLER ELECTRIC COMPANY
Endorsement Effective Date:
SCHEDULE
Name Of Person(s) Or Organization(s):
ANY PERSON OR ORGANIZATION TO WHOM OR WHICH YOU ARE REQUIRED TO
PROVIDE INSURED STATUS OR INSURED STATUS ON A PRIMARY,
NON-CONTRIBUTORY BASIS, IN A WRITTEN CONTRACT OR WRITTEN AGREEMENT
EXECUTED PRIOR TO LOSS, EXCEPT WHERE SUCH CONTRACT OR AGREEMENT IS
PROHIBITED BY LAW
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 2
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.I. of Section 11 — Covered
Autos Liability Coverage in the Business Auto and
Motor Carrier Coverage Forms and Paragraph D.2. of
Section 1 — Covered Autos Coverages of the Auto
Dealers Coverage Form.
CA 20 48 10 13 © Insurance Services Office, Inc., 2011
t
Page 2 of 2
POLICY NUMBER: BAP 0381376-08
COMMERCIAL AUTO
CA04441013
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US (WAIVER OF SUBROGATION)
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
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 changes the policy effective on the inception date of the policy unless another date is indicated
below.
Named Insured: MILLER ELECTRIC COMPANY
Endorsement Effective Date:
SCHEDULE
Name(s) Of Person(s) Or Organization(s):
ANY PERSON OR ORGANIZATION TO WHOM OR WHICH YOU ARE REQUIRED TO
PROVIDE INSURED STATUS OR INSURED STATUS ON A PRIMARY,
NON-CONTRIBUTORY BASIS, IN A WRITTEN CONTRACT OR WRITTEN
AGREEMENT EXECUTED PRIOR TO LOSS, EXCEPT WHERE SUCH CONTRACT OR
AGREEMENT IS PROHIBITED BY LAW
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The Transfer Of Rights Of Recovery Against
Others To Us condition does not apply to the
person(s) or organization(s) shown in the Schedule,
but only to the extent that subrogation is waived prior
to the "accident" or the "loss" under a contract with
that person or organization.
CA 04 44 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1
0
Blanket Notification to Others of Cancellation ZURICH
or Non -Renewal
Policy No Etf. Date of Pol Exp. Date of Pol. Fti Date of End Producer No Add'] Prom Return Prem
BAP 0381376-08 07/01/2023 07/01/2024 84099000 INCL
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the:
Commercial Automobile Coverage Part
A. If we cancel or non -renew this Coverage Part by written notice to the first Named Insured, we will mail or deliver
notification that such Coverage Part has been cancelled or non -renewed to each person or organization shown in a list
provided to us by the first Named Insured if you are required by written contact or written agreement to provide such
notification. However, such notification will not be mailed or delivered if a conditional notice of renewal has been sent
to the first Named Insured. Such list:
1. Must be provided to us prior to cancellation or non -renewal,
2. Must contain the names and addresses of only the persons or organizations requiring notification that such
Coverage Part has been cancelled or non -renewed, and
3. Must be in an electronic format that is acceptable to us.
B. Our notification as described in Paragraph A. of this endorsement will be based on the most recent list in our records
as of the date the notice of cancellation or non -renewal is mailed or delivered to the first Named Insured. We will mail
or deliver such notification to each person or organization shown in the list:
1. Within seven days of the effective date of the notice of cancellation, if we cancel for non-payment of premium; or
2. At least 30 days prior to the effective date of:
a. Cancellation, if cancelled for any reason other than nonpayment of premium; or
b. Non -renewal, but not including conditional notice of renewal.
C. Our mailing or delivery of notification described in Paragraphs A. and B. of this endorsement is intended as a courtesy
only. Our failure to provide such mailing or delivery will not:
1. Extend the Coverage Part cancellation or non -renewal date;
2. Negate the cancellation or non -renewal, or
3. Provide any additional insurance that would not have been provided in the absence of this endorsement.
D. We are not responsible for the accuracy, integrity, timeliness and validity of information contained in the list provided
to us as described in Paragraphs A. and B. of this endorsement.
All other terms and conditions of this policy remain unchanged.
U-CA-832-A CW (01113)
Page 1 of 1
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
POLICY NUMBER: GLO 0381375-08 COMMERCIAL GENERAL LIABILITY
CG 20 32 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - ENGINEERS, ARCHITECTS OR
SURVEYORS NOT ENGAGED BY THE NAMED INSURED
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Engineers, Architects Or Surveyors Not Engaged By The Named Insured:
ANY ENGINEERS, ARCHITECTS OR SURVEYORS WHILE NOT ENGAGED BY YOU, TO
WHOM OR TO WHICH YOU ARE REQUIRED TO PROVIDE ADDITIONAL INSURED
STATUS IN A WRITTEN CONTRACT OR WRITTEN AGREEMENT EXECUTED PRIOR TO
THE LOSS EXCEPT WHERE SUCH CONTRACT OR AGREEMENT IS PROHIBITED BY LAW
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II — Who Is An Insured is amended to
include as an additional insured the architects,
engineers or surveyors shown in the Schedule, but
only with respect to liability for "bodily injury",
"property damage" or "personal and advertising
injury" caused, in whole or in part, by.
1. Your acts or omissions; or
2. The acts or omissions of those acting on your
behalf;
in the performance of your ongoing operations
performed by you or on your behalf.
Such architects, engineers or surveyors, while not
engaged by you, are contractually required to be
added as an additional insured to your policy.
However, the insurance afforded to such additional
insured:
1. Only applies to the extent permitted by law; and
2. Will not be broader than that which you are
required by the contract or agreement to provide
for such additional insured.
B. With respect to the insurance afforded to these
additional insureds, the following additional
exclusion applies:
This insurance does not apply to "bodily injury",
"property damage" or "personal and advertising
injury" arising out of the rendering of or the
failure to render any professional services,
including:
1. The preparing, approving, or failing to
prepare or approve, maps, drawings,
opinions, reports, surveys, change orders,
designs or specifications, or
2. Supervisory, inspection or engineering
services.
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 services.
CG 20 32 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2
C. With respect to the insurance afforded to these 2. Available under the applicable Limits of
additional insureds, the following is added to Insurance shown in the Declarations;
Section III — Limits Of Insurance: whichever is less.
The most we will pay on behalf of the additional This endorsement shall not increase the
insured is the amount of insurance: applicable Limits of Insurance shown in the
1. Required by the contract or agreement; or Declarations.
i
i
i
i
i
Page 2 of 2 O Insurance Services Office, Inc., 2012 CG 20 32 0413
Policy No. WC038137408 3
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 i13
(Ed. 4-84)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce
our right against the person or organization named in the Schedule. (This agreement applies only to the extent that
you perform work under a written contract that requires you to obtain this agreement from us.) I
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Schedule
ALL PERSONS AND/OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN
CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE
ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS
POLICY FOR WORK PERFORMED BY YOU FOR THAT PERSON AND/OR ORGANIZATION
WC 00 03 13
(Ed. 4-84)
01983 National Council on Compensation Insurance.
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 43
BLANKET NOTIFICATION TO OTHERS OF CANCELLATION OR NONRENEWAL ENDORSEMENT
This endorsement adds the following to Part Six of the policy.
PART SIX
CONDITIONS
Blanket Notification to Others of Cancellation or Nonrenewal
1. If we cancel or non -renew this policy by written notice to you, we will mail or deliver notification that such
policy has been cancelled or non -renewed to each person or organization shown in a list provided to us by
you if you are required by written contract or written agreement to provide such notification. However, such
notification will not be mailed or delivered if a conditional notice of renewal has been sent to you. Such list:
a. Must be provided to us prior to cancellation or non -renewal;
b. Must contain the names and addresses of only the persons or organizations requiring notification that
such policy has been cancelled or non -renewed; and
c. Must be in an electronic format that is acceptable to us.
2. Our notification as described in Paragraph 1. above will be based on the most recent list in our records as of
the date the notice of cancellation or non -renewal is mailed or delivered to you. We will mail or deliver such
notification to each person or organization shown in the list:
a. Within seven days of the effective date of the notice of cancellation, if we cancel for non-payment of
premium; or
b. At least 30 days prior to the effective date of:
(1) Cancellation, if cancelled for any reason other than nonpayment of premium; or
(2) Non -renewal, but not including conditional notice of renewal.
3. Our mailing or delivery of notification described in Paragraphs 1. and 2. above is intended as a courtesy only.
Our failure to provide such mailing or delivery will not:
a. Extend the policy cancellation or non -renewal date;
b. Negate the cancellation or non -renewal; or
c. Provide any additional insurance that would not have been provided in the absence of this endorsement.
4. We are not responsible for the accuracy, integrity, timeliness and validity of information contained in the list
provided to us as described in Paragraphs 1. and 2. above.
All other terms and conditions of this policy remain unchanged.
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)
Endorsement Effective: 07-01-2023 Policy No. WC038137408 Endorsement No.
Premium $
Insured: Miller Electric Company
Insurance Company: Zurich American
Insurance Company
WC 99 06 43 Page 1 of 1
(Ed. 01-13) Includes copyright material of the National Council on Compensation Insurance, Inc. used with its permission.
© 2012 Copyright National Council on Compensation Insurance, Inc. All Rights Reserved.
COMMERCIAL INSURANCE
Insurance for this coverage part provided by:
ZURICH AMERICAN INSURANCE COMPANY
This endorsement changes the insurance as is afforded by the policy relating to the following:
Named Insured
MILLER ELECTRIC COMPANY
WORKERS COMPENSATION
AND EMPLOYERS LIABILITY
INSURANCE POLICY
ENDORSEMENT
Policy Number
WC 0381374-08
MODIFICATION OF TIME FOR NOTICE OF CANCELLATION OR NONRENEWAL
MODIFICATION OF TIME FOR NOTICE OF CANCELLATION OR NONRENEWAL
THIS ENDORSEMENT MODIFIES THE CANCELLATION OR NONRENEWAL PROVISIONS
OF THE POLICY AND ANY OTHER ENDORSEMENT TO THE POLICY STATING THE
NUMBER OF DAYS NOTICE TO BE PROVIDED BY US IN THE EVENT OF
CANCELLATION OR NONRENEWAL.
TO THE EXTENT THAT THE POLICY OR OTHER ENDORSEMENT REQUIRES THAT WE
PROVIDE NOTICE IN THE EVENT OF CANCELLATION OR NONRENEWAL,
WRITTEN NOTICE WILL BE GIVEN THE INSURED NO LESS THAN 60 DAYS PRIOR
TO THE EFFECTIVE DATE OF THE CANCELLATION OR NONRENEWAL.
NOTHING IN THIS ENDORSEMENT MODIFIES THE NUMBER OF DAYS NOTICE TO BE
PROVIDED IN THE EVENT OF NONPAYMENT OF PREMIUM.
IN NO EVENT WILL THE NUMBER OF DAYS NOTICE OF CANCELLATION OR NON -
RENEWAL CONTAINED IN THE PROVISIONS OF THIS ENDORSEMENT BE LESS THAN
WHAT IS REQUIRED BY LAW.
U-WC-332-A (07-94)
Page 1
Last page
1/23/24, 11:51 AM Detail by Entity Name
DIVISION OF CORPORATIONS
Dfvmol'I JJ I 1 jj
fill f-hirida t!.ir.m'
Deoartment of State / Division of Conoorations / Search Records / Search by Entity Name /
Detail by Entity Name
Florida Profit Corporation
MILLER ELECTRIC COMPANY
Filina Information
Document Number
176698
FEI/EIN Number
59-0361850
Date Filed
12/29/1953
State
FL
Status
ACTIVE
Last Event
AMENDMENT
Event Date Filed
08/02/2019
Event Effective Date
NONE
Principal Address
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL 32216
Changed: 03/27/2019
Mailina Address
SUSAN A. WALDEN
P. O. BOX 1799
JACKSONVILLE, FL 32201
Changed: 02/22/1999
Registered Aaent Name & Address
WALDEN, SUSAN A
6805 Southpoint Parkway
Jacksonville, FL 32216
Name Changed: 02/22/1999
Address Changed: 01/14/2020
Officer/Director Detail
Name & Address
Title CEO
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1/23/24, 11:51 AM Detail by Entity Name
BROWN, HENRY K
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL 32216
Title ST
WALDEN, SUSAN A
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL 32216
Title VP
BROWN, DANIELA
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL 32216
Title CHAIRMAN EMERITUS
AUTREY, HENRY E
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL 32216
Title President
WITT, EDWARD E, JR
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL 32216
Title VP
SMITH, DONALD
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL 32216
Title VP
MACDONALD, JAMES
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL 32216
Title VP
O'HALLORAN, EDWARD
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL 32216
Title VP
HEBERT, KEVIN
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL 32216
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1/23/24, 11:51 AM
Title VP
SEAY, BRIAN
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL 32216
Title VP
CREEL, JAMES A
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL 32216
Title ASST S
ZIMMERMAN, BRENT T.
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL 32216
Title CFO
HENSLEY, KYLE
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL 32216
Title VP
BRANNEN, MICHAEL
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL 32216
Title VP
FLANIGAN, KEVIN C
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL 32216
tllli'4Vg
BOWMAN, ROBERTANDREW
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL 32216
Title CLO
KEENAN, PATRICIA 0
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL 32216
Title VP
Detail by Entity Name
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1/23124, 11:51 AM
Detail by Entity Name
Oliver, Michael B
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL 32216
Title VP
Stewart, Kerri
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL 32216
Title VP
Christoforatos, Helga
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL 3221"6
Title VP
Elmo, Derek
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL 32216
Title VP
Yarber, Brian
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL 32216
Title VP
Sandefer, Steve
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL 32216
Title VP
Stowers, Marshall
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL32216
Title VP
Eliason, Patrick R
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL 32216
Title VP
Ferguson, Richard L, Jr
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL 32216
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1/23/24, 11:51 AM
Title VP
Swick, Scott
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL 32216
Title Controller
Sams, Renee
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL 32216
Title VP
Mortensen, Lori Ann
SUSAN A. WALDEN
P. O. BOX 1799
JACKSONVILLE, FL 32201
Title vp Safety
Watson, William
SUSAN A. WALDEN
P. O. BOX 1799
JACKSONVILLE, FL 32201
Title vp
Cannon, Terry
SUSAN A. WALDEN
P. O. BOX 1799
JACKSONVILLE, FL 32201
Title VP
Moorer, William
6805 SOUTHPOINT PARKWAY
JACKSONVILLE, FL 32216
Annual Reports
Report Year
Filed Date
2023
01 /05/2023
2023
11 /13/2023
2024
01 /05/2024
Document Imaaes
01/05/2024 --ANNUAL REPORT
11/13/2023 --AMENDEDANNUAL REPORT
01/05/2023 --ANNUAL REPORT
01/13/2022 --ANNUAL REPORT
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01/11/2021 --ANNUAL REPORT
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01/14/2020 —ANNUAL REPORT
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08/02/2019 --Amendment
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01/18/2019 --ANNUAL REPORT
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02/23/2018 —Amendment
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01/09/2018 --ANNUAL REPORT
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02/06/2017 --Amendment
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01/09/2017 —ANNUAL REPORT
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01/14/2016 —ANNUAL REPORT
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01/07/2015 —ANNUAL REPORT
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01/07/2014 —ANNUAL REPORT
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01/07/2013 --ANNUAL REPORT
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12/13/2012 --ANNUAL REPORT
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01/03/2012 --ANNUAL REPORT
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01/10/2011 --ANNUAL REPORT
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01/11/2010 — ANNUAL REPORT
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01/14/2009 --ANNUAL REPORT
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01/07/2008 --ANNUAL REPORT
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01/04/2007 --ANNUAL REPORT
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01/09/2006 —ANNUAL REPORT
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01/04/2005 --ANNUAL REPORT
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01/20/1998 —ANNUAL REPORT
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