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CONSTRUCTION CONTRACT THIS AGREEMENT, dated this 18th day of April, 1995, by and between the City of Moscow, Idaho, a municipal corporation of the State of Idaho (hereinafter, 1 City11) and David Steele, Larry Richard, and Richard Thompson DBA Advantage Tennis Courts, (hereinafter, 11COntraCtOr11): WITNESSETH: WHEREAS, pursuant to the invitation of the City, extended through an officially published "Advertisement for Bids", the Contractor did, in accordance therewith file with the City a proposal containing an offer which was invited by said notice; and WHEREAS, the City has determined that said offer was the lowest and best submitted: NOW THEREFORE, the parties to this Contract, in consideration of the mutual covenants and stipulations set out, agree as follows: ARTICLE 1. CONTRACT DOCUMENTS The Contract Documents which comprise the entire agreement between the City and the Contractor concerning the work to be performed are this Contract, pages one through and the following: 1. Advertisement for Bids; 2. Project Specifications titled : TENNIS COURTS RENOVATION - 1995; 3. Bid/Proposal of the Contractor, dated April 1, 1995, to be physically attached to this Contract; 4. The Engineering Plans; 5. Performance and Payment Bonds and Insurance Certificates, to be physically attached to this Contract; 6. Change Orders which may be delivered or issued after the effective date of this Agreement; There are no Contract Documents other than those listed in Article 1. This Contract may only be amended by change order as provided in the General Specifications. CONSTRUCTION CONTRACT PAGE 1 95-55 ---PAGE BREAK--- ARTICLE 2. WORK The Contractor shall complete the entire work as specified, indicated and required under the Contract Documents. ARTICLE 3. CONTRACT TIME/SUBSTANTIAL COMPLETION The work to be performed pursuant to this Contract shall be substantially complete on or before forty-five (45) calendar days from the issuance of the Notice to Proceed, unless adjustment of the contract time is made in accordance with the provisions of the Contract Documents. The Contractor shall begin work in conformance with the Contract Documents and shall complete the work prior to the date of completion. ARTICLE 4. CONTRACT SUM The City shall pay the Contractor for completion of the Work in accordance with the Contract Documents in current funds the amount of Seven Thousand One Hundred Forty-five DOLLARS 145. 00) . Said Contract Sum shall be paid in accordance with the Contract Documents. ARTICLE 5. INDEPENDENT CONTRACTOR The parties warrant by their signature that no employer-employee relationship is established between the Contractor and the City by the terms of this contract. It is understood by the parties hereto that the Contractor is an independent contractor and as such neither it nor its employees, agents, representatives or subcontractors, if any, are employees of the City for purposes of tax, retirement system, or social security (FICA) withholding. CONSTRUCTION CONTRACT PAGE2 ---PAGE BREAK--- ARTICLE 6. SCOPE OF SERVICES The Contractor shall perform all services required by the Contract Documents. All work shall be completed in accordance with the specifications and plans established for this project. ARTICLE 7. HOLD HARMLESS/INDEMNIFICATION In addition to other rights granted the City by the Contract Documents, the Contractor shall indemnify and save harmless the Engineer and the City, its officers and employees, from all suits, actions, or claims of any character brought because of any injuries or damages received or sustained by any person, persons, or property on account of the operations of the Contractor or his subcontractors; or on account of or in consequence of any neglect in safeguarding the work; or through use of unacceptable materials in constructing the work; or because of any act or omission, neglect, or misconduct of the Contractor or his subcontractors; or because of any claims or amounts recovered from any infringements of patent, trademark or copyright; or from any claims or amounts arising or recovered under the Workmen's Compensation Act or any other law, ordinance, order or decree. ARTICLE 8. CONFLICT OF INTEREST The Contractor covenants that it presently has no interest and will not acquire any interest, direct or indirect, in the project which would conflict in any manner or degree with the performance of its services hereunder. The Contractor further covenants that, in performing this Contract, it will employ no person who has any such interest. Should any conflict of interest arise during the performance of this Contract, Contractor shall immediately disclose such conflict to the Project Engineer/Engineer and the City . ARTICLE 9. ENTIRE AGREEMENT, MODIFICATION AND ASSIGNABILITY This Contract and the exhibits hereto contain the entire agreement between the parties, and no statements, promises, or inducements made by either party, or agents of either party are valid or binding unless contained herein. This contract may not be enlarged, modified CONS1RUCTION CONTRACT PAGE3 ---PAGE BREAK--- or altered except upon written agreement signed by the parties hereto. The Contractor may not subcontract or assign its rights (including the right to compensation) or duties arising hereunder other than as contemplated by the Contract Documents, without the prior written consent and express authorization of the City of Moscow. ARTICLE 10. ADHERENCE TO LAW REQUIRED All applicable local, state and federal statutes and regulations are hereby made a part of this contract and shall be adhered to at all times. Violation of any of these statutes or regulations by the Contractor shall be deemed material and shall subject the Contractor to termination of this contract for cause. No pleas of misunderstanding or ignorance on the part of the Contractor will in any way serve to modify the provisions of this requirement. The Contractor and his surety shall indemnify and save harmless the City and its employees, agents and representatives against any claim or liability arising from or based on the violation of any such laws, codes, ordinances, or regulations, whether by himself, his employees, or his subcontractors. ARTICLE 11. LEGAL FEES In the event either party incurs legal expenses to enforce the terms and conditions of this contract, the prevailing party is entitled to recover reasonable attorney r s fees and other costs and expenses, whether the same are incurred with or without suit. ARTICLE 12. SPECIAL WARRANTY The Contractor warrants that nothing of monetary value has been given, promised or implied as remuneration or inducement to enter into this Contract. The Contractor further declares that no improper personal, political or social activities have been used or attempted in an effort to influence the outcome of the competition, discussion, or negotiation leading to the award of this Contract. Any such activity by the Contractor shall make this Contract null and void . CONS1RUCTION CONTRACT PAGE4 ---PAGE BREAK--- ARTICLE 13. COMMUNICATIONS Such communications as are required by this contract shall be satisfied by mailing or by personal delivery to the parties at the following address: Contractor: City: Advantage Tennis Courts 212 Spencer Road Libby, MT 59923 City of Moscow 122 E. 4th Street P. O. Box 9203 Moscow, Idaho 83843 IN WITNESS WHEREOF, said Contractor and the City have caused this Contract to be executed on the day and year first above written. Contractor: David Steele, Larry Richard, and Richard Thompson DBA Advantage Tennis U-JJ 7 CONSTRUCTION CONTRACT PAGES City: Paul C. Agidius, Mayor ATTEST: Elaine Rus City Clerk Attorney ---PAGE BREAK--- ACKNOWLEDGMENT On this d 1 day of Apr('\ , 1995, before me, a Notary Public of the State of IƂaho , personally appeared Larry Richard and Richard Thompson, in £hÎffüÍtficial capacity as Partners in Advantage Tennis Courts, known to me to be the person described in the above document and acknowledged to me he executed the same. ýNotary PubliÌsiding at 'hby.r Ia? r . . My Comm1ss1on exp1res 3-crJ:-?'fr ACKNOWLEDGMENT On this cf< f-.1- day of fg 1995, before me, a Notary Public of the State Jj I ho, personally appeared Paul C. Agidius in his official capacity as Mayor of the City of Moscow, known to me to be the person described in the above document and acknowledged to me he executed the same. On this 51¢(! day Notary Public of the Russell in her official be the person described she executed the same. CONSTRUCTION CON1RACT PAGE6 ACKNOWLEDGMENT 7 ' ' of 1995, before me, a Stat of Idaho, personally appeared Elaine capacity as Moscow City Clerk, known to me to in the above document and acknowledged to me at expires ---PAGE BREAK--- BID PROPOSAL TO: Mayor and City Council City of Moscow, Idaho This proposal is submitted as an offer by the undersigned to enter into contract with the City of Moscow, Idaho as represented by the City Council, hereinafter referred to as the 'CITY' for TENNIS COURTS RENOVATION - 1995, specified herein and which construction documents are on file with the City Engineer, City Hall Annex, Moscow, Idaho, and which are a condition hereof with the same force and effect as though they were attached hereto. The offer is conditioned on the following declarations as to the facts, intention and understanding of the undersigned and the agreement of the CITY to the terms and prices herein submitted. 1. All project specifications and drawings examined by the undersigned and their terms and conditions are hereby agreed to. 2. The undersigned certifies that he has received or made himself aware of any and all existing site conditions that may affect the proposed work . 3. It is understood that the contract drawings may be supølùmented by additional drawings and specifications in.explanation and elaboration of the contract drawings and it is agreed that such supplemental drawings, when not in conflict with those referred to in paragraph 1 above, will have the same force and effect as if attached hereto and that when received they will be considered a part of the contract. 4. Tne undersigned will furnish separate performance and payment bonds in the full amount of the contract price. 5. The cash, certified check, bid bond, or cashier's check accompanying this proposal shall be forfeited to the City of - Moscow;- Idaho to the extent of 5% of the amouút bid if the undersigned shall fa1l or refuse to execute the contract, furnish performance and payment bonds, Page 2 ---PAGE BREAK--- insurance certificate as required by the specifications within the time limit therein after notlf1cation that the said proposaûis accepted, all in accordance with the provisions of this proposal and the specifications. 6. The undersigned further agrees that the CITY shall have the right to accept or reject any bid item deemed to be in the best interest of the City. 7. The undersigned agrees to order all necessary equipment and materials within a period of three days after Notice to Proceed has been issued by the City Engineer. 8. The undersigned, as a bidder, acknowledges that Addenda Number through have been delivered to him and have been examined as part of the contract documents. 9. The undersigned agrees to complete all work embraced in the contract by the date set forth in paragraph IB-13 of the Instruction to Bidders. 10. The undersigned certifies that the attached Bidder Qualification information is true and correct. 11. The undersigned holds Idaho State Contractor's License Number I 0 7 1 CJ - - Lf ( 1 12. The undersigned proposes to use the following sub contractors in the performance of meeting the contract requirements: Subcontractors Trade Speciality Amount a. b. c. 13. The undersigned proposes to furnish labor, materials, equipment and services of all kinds required for TENNIS COURTS RENOVATION - 1995, as described in the specifications, including all appurtenant work, all as required by the specifications and this proposal for the prices in accordance with the completed schedule contract prices as follows: Page 3 ---PAGE BREAK--- BASE BID SCHEDULE To construct the TENNIS COURTS RENOVATION - 1995, completed as herein specifieó , the bidd7f submits a lump sum price of : Ç Êr-t/lËJ t>-,vz_bwV do--'Jôõ-t'öwords) $ !z J '-Is=È (Dollars & Cents) . No. SEAL (If Incorporated) fJJvA,/-I)!L 44- Firm Name of Bidder Signature of Bidder Mailin÷ Ad ress L-166(}-, j/Vff É79;t.3 I o 7 71- J) - { L/1 ) J Public Works License State of Incorporation if Incorporated Dated at _ This day of 1995. FILED APR 111995 Page 4 ---PAGE BREAK--- THE AMERICAN INSTITUTE OF ARCHITECTS AlA DOCUMENT A310 BID BOND Bond No. TPI-3226172 KNOW ALL MEN BY THESE PRESENTS, that we STEVE THORSTENSON, RICHARD THOMPSON AND JACK GRAHAM DBA ADVANTAGE TENNIS COURTS 212 SPENCER ROAD LIBBY,MT 59923 as Principal, hereinafter called the Principat and TIG PREMIER INSURANCE COMPANY 70 W. MICHIGAN AVE ADMINISTRATIVE OFFICE BATTLE CREEK,MI 49017 a corporation duly organized under the laws of the state of CA as Surety, hereinafter called the Surety, are held and firmly bound unto CITY OF MOSCOW 122 E. 4TH STREET MOSCOW,ID 83843 as Obligee, hereinafter called the Obligee, in the sum of 5 % OF THE AMOUNT BID NOT TO EXCEED FIVE HUNDRED AND 00/100 Dollars 500.00 for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for TENNIS COURTS RENOVATION - 1995 Project Number: NOW THEREFORE. if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee in accordance with the terms of such bid, and give such bond or bonds as may be specified in the bidding or Contract Documents with good and sufficient surety for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof, or in the event of the failure of the Princtpal to enter such Contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larGer amount for which the Obligee may in good faith contract with another party to perform the Work covered by satd bid, then this obligation shall be null and void, otherwise to remain in full force and effect. Signed and sealed this 11 day of April A.D.1995 STEVE THORSTENSON, RICHARD THOMPSON AND JACK GRAKƁ (Witness) (Principal) (Seal) DBA ANTAGE, NN{S COURTS vJ (ztty0-?nr AIA DOCUMENT A3 10 BID BOND AIA FEBRUARY 1970 ED. THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 N.Y. AVE., N.W., WASHINGTON, D.C. 20006 Printed on Recylced Paper 9/93 1 ---PAGE BREAK--- TIG Premier Insurance Company ifflca: Battle Creek, Michigan 000367 GENERAL POWER OF ATTORNEY GPA Power Of Attorney valid only If numbered tn red: Know All Men by These Presents, That TIG Premier Insurance Company, a corporation duly organized and existing Ul')der the laws of the State of California, and having its administrative office in Battle Creek, Calhoun County, Michigan, does by these presents make, constitute and appoint KIMBERLY D. JOHNSON of ARVADA and State of COLORADO its true and lawful Attorney(s)-in-Fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and CONTRACT BONDS (S.B.A. GUARANTEE AGREEMENT) - MAXIMUM PENALTY $1,000,000.00 OTHER CONTRACT BONDS - MAXIMUM PENALTY $250,000.00 ALL OTHER BONDS - MAXIMUM PENALTY $25,000.00 0THIS POWER OF ATTORNEY SHALL TERMINA1'E AND BE OF NO FURTHER EFFECT AFTER DECEMBER 31. 1995" and to bind the Company thereby as fully and to the same extent as if such bonds were signed by the President, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney(s)-in-Fact may do in the premises. Said appointment is made under and by authority of Section 35 of the bylaws, as amended, and duly adopted by the Board of Directors of the TIG Premier Insurance Company. "Be It Resolved, that the President, any Vice-President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any or more suitable persons as Attorney(s) in-Fact to represent and act for and on behalf of the Company subject to the following provisions: "Section 1. Attorney-in-Fact Attorney-in-Fact may be given full power and authority for and in the name of and on behalf of the Company, to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements of indemnity, consents of surety and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney-in-Fact shall be binding upon the Company as if signed by the President and sealed and attested by the Corporate Secretary." In Witness Whereof, TIG Premier Insurance Company VICE PRESIDENT has caused these presents to be signed by its and its corporate seal to be hereto , A.D., 19 TIG PREMIER INSURANCE COMPANY By tt-11 ;_{11.14 A -CJ f Attorney issued by said Company, and do hereby further certify that the said Power of Attorney IS st1ll 1n force and effect. And 1 do hereby further certify that the Certification of this Power of Attorney is signed and sealed by facsimile under and by the authority of Section 30 of the bylaws, as mende.d, and duly a.dopted by the Board of Directors of the TIG Premier Insurance Company and that sa1d Sect1on 30 of sa1d bylaws has not been amended or repealed as of the date hereof; "Resolved, that the signature of the Secetary or ny Assistant .scretary of thi ,Corporation, and the seal of the Corporation, may be aff1xed or pnnted by fa¡slml.le to any cert1f1cate to a Poyver of Attorney of this Corporation, and that such printed facs1m1le s1gnature and seal shall be valid and binding upon this Corporation." 1 ?IJ'JJ ---PAGE BREAK--- 07/14/1995 16:11 [PHONE REDACTED] lltiODUCUl CENTRAL INSURANCE AGENCY 161 WEST HADISON PO BOX 1170 BELGRADE, MT 597li-1110 ADVANTAGE TENNIS COURTS RICHARD THOMPSoN DBA : 212 SPENCER RD. LIBBY, MT 59923 CENTRAL INSURANCE PAGE 02 COMPANIES AFFORDING COVERAGE » A HAWKEYE SECURITY a:JWANY 8 SECURITY 'ITER =IS IS TO CJ;ATIFY THAT THE POLICIES OF INSURANCE UST£0 BELOW HAVE BEEN 165UEO TO THE INSURED NAMED ABOVE FOR TJ-tE POUCY PERIOD INotcATEO, N01Wirt4STANDING ANY REQUIREMENT, TERM OR CONDITION Of ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY H JSSUEO OR MAY PeRTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THt: TEAMS. PP018S72 UMITS MAY HAVE CLAIMS. 04/01/95 04/01/96 Of/01/95 04/0l/96 ITDD CITY OF MOScOW IDAHO AS ADDITIONAL INSURED CITY OF MOSCOW 122 E 4TH STREET MOSCOW, ID 83843 JUL-14-1995 15:15 [PHONE REDACTED] 95% P.02 ---PAGE BREAK--- S!fA-T-E .FUND STATE COMPENSATION h -3URANCE FUND 5 SOUTH LAST CHANCE GULCH P.O. BOX 4759 HELENA, MONTANA 59604-4759 lNSUilED: General Information (406) 444-6500 JULY 3-1287-94-9 RICHARD làDMPSON & LOU PICKELL ADVANTAGE TENNIS COURTS 212 SPENCER RD LIBBY ftT ɏ9923-9023 TO: CITY OF "áSCOW ATTN: DEAâ WION PO BOX 92&3 MOSCOW ID 83843-9203 10' 1995 Carl W. Swanson, President Executive (406) 444-6518 CER TIFICATE OF INSURANCE THIS DOCUMENT CERTIFIES ThE STATE FOND FRUdlDES eORKERSI COɍP E hSATION AND OCCUPATIONAL DISEASE INSURANCE COVERAGE FOR THE ABOVE AAMEll INSURED. THE POLICY INCLUDES COVERAGE FOR ALL ltOtHANA Ef!IPLOYEES AS REQUIRED BY LAW. COVERAGE FOR SOftE EftPLOYMENTS UNDER LAW HAY BE ELECTED OR RESCINDED, AT THE REQUEST O F THE INSUREV, AT ANY liME DURING THE POLICY PERIOD. WE CANNOT VERIFY THE COVERAGE STATUS OF THE FOLLOWING EMPLOYMENTS WHICH YOU SHOULD VERIFY WITH THE INSURED: SOLE PROPRIETORS AND •ORKING PARTNERS, INCLUDlHG IHOSE WHil CONSIDER lHãHSELVES TG BE INDEPEhDENT CONTRACTORS; DEPENDENT F AJtlL.Y MEfiBERS llF SOLE PɎUPRIE.IOuS DR PA.tlNERS; HOUSEHOLD AND CASUAL EMPLOYEES; VGLUNT£ERS OR PERSONS å IN RETURN FOR BOARD AND ROOM ONLYi SCHOOL AMATEUR ATHLETIC OFFICIALS; LlCEhSED RtAL ESTATE BROKERS OH DIRECT hOME SELLERS SF CQNSäMER PRODUCTS; NEWSPAPER C ARRIERS OR FREELANCE åHD HAVE ACK NOWLEDGED NOf COUERAGE I N WRITING; AND QUALIFIED OFFICERS OF CORPORATIOæS. THIS CERTIFICATE IS VALID FOR ONE çEAR FRO" THE D A TE Of ISSUE UNLESS CANCELLATION PROCEDURES AgE INITIATED, IN èHICH CASE YCU kiLL Bt NOTIFIED. IF THE INSURED IS STILL CONTRACTING FOR YOUR COMPANY WHEN THIS CERTIFICATE EXPIRES, YOU MAY REQEUST RE-CERTIFICATICN. PLEASE ADVISE US IF THE CONTRACI EXPIRES PRIUé TO THAT TIMEa POLICY SERVICES CC: RICHARD & LOU PICKELL SF-MIS CN 130A (REVa 5/90) SF 001 Claims Department 1-[PHONE REDACTED] Fraud Hotline 1-[PHONE REDACTED] First Report of Accident 1-[PHONE REDACTED] Underwriting Department 1-[PHONE REDACTED] Loss Control/ Premium Audit (406) 444-6584 TDD (406) 444-5971 ---PAGE BREAK--- l5 4J-1Ż(6żUU HAWKEYŽ-SECUAlfY !NSURANCź COžPANY PO BOX 1848 DES MOINES IA 50306-184e ·.CONTRACTORS PLUS COMMERt IAL sENERAL LIABILITY POLIC'ir;·\} ·rq COMMERCIAl GENERAL LIABILITY COVERAGE PART CONTRACTORS PLUS CHANGE DECLARATIONS PAGE POLICY NUMBER: HDKZ-018572/15 . . . . . . ( Ɍ . . ' DIRECT SILL. CHANGE EFFECTIVE: 05-24-95 MISCELLANEOUS REVISIONS Z-R-- i ' . AGENT1 S TELEPHONE NO.: · 406i3B8-4221.' ô nRD ADVANTAGE TENNIS COURTS AGENT CENTRAL INSURANCE.AGENCY M021 AND 212'SPENCER RD AND 161 W MADISON ADDRESS PO BOX ·1170 BELGRADe,·.PIT l MAILING LIBBYõ .MT. 59923 ADDRESS 59714, I i INSURED·IS: .lNDIVlDUAL COMPANrUSE BUSINESS IS: RESURFACING TENNIS COURTS 94 285:101 000·68=1 -uDT:FRioD; pqrst1-·- ·POLICY P.i:Jiioo: · · FROM: o4so1t95 · · · To: · 04u01v96; · · · · I . .12:01 A.M. STANDARD TIME AT.YOUR MAILING ADDRESS SHOWN:ABOVE. IN RETURN · FOR·· THE ' PAYMENT OF THE PREMIUM, AND SUBJECT : TO ALLö.lHE TERMS ' Of : THIS POL!C÷, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED N THIS : øOLICY. . ' . . LIMIT $ . OF . INSURANCE . . . . ' . ' ' ' GENERAL AGGREGATE LIMIT (OTHER THAN PRODUCTS-COMPLETED.OPERATIONS). $ • 2',888,' 80 PRODUCTS-COMPLETED OPERATIONS AGGREGATE LIMIT . $ 2 0 PERSONAL AND ADVERTISING INJURY LIMIT $.1,000,00 EACH OCCURRENCE LIMIT $>1,000,00 FIRE DAMAGE LIMIT (ANY ONE FIRE) $ 5o,gc MEDICAL EXPENSE LtMIT (ANY ONE PERSON) $ 5, 0 • ' t • • ' • • • ' • • • • • , LOC NO. 001 SCHEDULE OF HAZARDS CLASSIFICATION DRIVEWAY, PARKING AREA OR SIDEWALK - PAVING OR REPAIRING - NC STREET OR ROAD WORk ll.t._J.]NTRAL INSURANCEAGENCY 161 W. Madison, PO Box 1170 Belgrade, MT 59714 (406) 388-4227 CLASS EXPOSURE CODE EMPLOYEES) 00181 FULL TIME: 1 PART TIME: 1 ADVANCE RATE PREMIU[I! 491.40 $ 491 163.80 $ . 164 PREMIUM FOR ENDORSEMENTS $ 89 ESTIMATED TOTAL PREMIUM $ .744 . . . _ . . . , ADDITIONAL PREMIUM DUE . . _25 LOCATION ri01 ·ti D IFFERENT FRriù·iNitiREDúS MAILING ADDRESS): . . . . . . • ' j I ; • ' • • . • ' fORMS APPûICABLE: "REFER TO THE COMMüRCIAL INSURANCE .COVERAGE SCHEDULE OF FORMS AND ENDORSEMENTS •IL9 ·00 93 Ź10 94 DATE iss UEO: '06-26- 9 5 ' couNTERSIGN EA BY: . . . . . - . . :pcp . ---PAGE BREAK--- nDK2-018572/AIJ ul L It. , , t po %··O:RCIAL GENERAL LIABILITY V r J CG 20 10 11 85 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED- OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: CITY OF MOSCOW 122 E 4TH ST MOSCOW ID 83843 (If no entry appears above, Information required to complete this endorsement will be shown In the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) Is amended to Include as an Insured the person or organization shown In the Schedule, but only with respect to liability arising out of "your work" for that Insured by or for you. CG 201011 85 Copyright, Insurance Services Office, Inc., 1984