Loading...
NW 10th Avenue (7th Ct. & 8th St)11111111111111 11111111111111111111111111 ���1r' 1y1n;'��i�i �. FILE .v 20170E1)03 OR BK 784 PG `°32 DATE,. 01 /04i aAFON ROBERTSON CLERK OF CIRCUIT COURT OKEECHOBEE C:OUNTYr FLORIDA RECORDING FEES $27.00 RECORC+EC BY G Mewbourn P9S 932 __ 934; ':3 c,9S LICENSE AGREEMENT THIS AGREEMENT, BY AND BETWEEN THE CITY OF OKEECHOBEE, FLORIDA, a Florida Municipal corporation (hereinafter "CITY /OWNER "), and JEREMY LARUE, Manager of JETALARUE HOLDINGS, LLC and TOTAL ROADSIDE SERVICE CENTER, LLC, (hereinafter "ADJOINING LANDOWNER "), dated this 29th day of December, 2016. WHEREAS, CITY /OWNER holds fee simple title to the following described real property in Okeechobee County, Florida, to wit: Legal Description: A TWO HUNDRED FEET (200') BY SIXTY FEET (60') PORTION OF NORTHWEST 10TH AVENUE (FORMERLY KNOWN AS PENSACOLA STREET) LYING EAST OF BLOCK 13, NORTHWEST ADDITION (PLAT BOOK 1 PAGE 25, OKEECHOBEE COUNTY PUBLIC RECORDS); MORE SPECIFICALLY THE WEST SIXTY FEET (60') OF THE SEVENTY FOOT -WIDE (70') RIGHT -OF -WAY LOCATED SOUTH OF NORTHWEST 8TH STREET (FORMERLY KNOWN AS NORTH 14TH STREET) TO NORTHWEST 7TH COURT (FORMERLY KNOWN AS SEABOARD STREET), EXCLUDING THE INTERSECTION OF 7TH COURT AND 10TH AVENUE AS RECORDED IN PLAT BOOK 1, PAGE 25, PUBLIC RECORDS OF OKEECHOBEE COUNTY, FLORIDA. (MAP ATTACHED HERETO). WHEREAS, the ADJOINING LANDOWNER desires to make use of a portion of this unimproved Northwest 10th Avenue which dead -ends into the CSX Railroad right -of -way for access to his property within said Block 13 and located to the East, and erecting a fencing with gates across 10th Avenue along the Northern line of the intersection of Northwest 7th Court and 10th Avenue, for a temporary use, being preliminary to his obtaining of approval of Abandonment of Right -of -Way Petition No. 17- 001 -SC by Ordinance from the City to close this portion of the unimproved platted right -of -way. NOW, THEREFORE, in consideration of the mutual promises and covenants set forth herein, the parties agree as follows: 1. The CITY /OWNER hereby grants this revocable license for use, of the described street, with the understanding the ADJOINING LANDOWNER will maintain the right -of -way and should it ever become necessary to remove any fencing, or any improvement thereon, in order to allow either the installation or maintenance of water, sewer, or other utility lines or any other type of installation or construction, or for any other reason chosen by the CITY /OWNER, the fencing, or any improvement thereon, will be removed by the ADJOINING LANDOWNER or their agents and /or assigns at the ADJOINING LANDOWNER'S expense within seven days of receipt of written request by the CITY /OWNER for such removal. Should the CITY /OWNER, for valid reasons, require the removal of the fencing or any improvements thereon with less than seven days' notice, the ADJOINING LANDOWNER agrees to exercise reasonable efforts to comply with such requests. 2. ADJOINING LANDOWNER agrees to contact their insurance company and require an endorsement be added to their insurance policy listing the CITY /OWNER as additional insured with a Certificate of Insurance furnished to the CITY /OWNER showing the street, as herein described, to be used by them, insures the CITY /OWNER against any liability arising out of alleged injuries or other activities which may occur within the right -of -way. In any event, ADJOINING LANDOWNER agrees and shall hold the CITY /OWNER harmless for any and all action, suit, claim, injury or cause of action of any nature arising out of ADJOINING LANDOWNER'S permissive use, and indemnify CITY /OWNER for such, including costs and attorney fees. 3. ADJOINING LANDOWNER agrees to furnish a copy of the Certificate of Insurance listing the CITY /OWNER as an additional insured to the CITY /OWNER annually upon renewal with their insurance carrier. Page 1 of 3 4. That ADJOINING LANDOWNER is permitted to place a locked gate across the Southern end of Northwest 10th Avenue provided a key is given to the CITY /OWNER for its access, and such gate shall not infringe on the intersection of Northwest 7th Court and 10th Avenue. 5. That the ADJOINING LANDOWNER agrees that this license is non - assignable without the express written consent of the CITY /OWNER; and if owner sells or transfers the subject property, their covenants and agreements shall run with the land. 6. The City Clerk shall cause this license to be recorded in the public records of Okeechobee County, Florida. 7 ADJOINING LANDOWNER agrees to reimburse the CITY /OWNER for all recordings costs. 8. This agreement shall expire within 12 months or upon adoption of closing the right -of -way whichever occurs first. IN WITNESS WHEREOF, the parties hereto set their hands and seals on the aforesaid date. Signed, sealed and delivered in presence of: (Wit ss �. -,14, nature) MetAy A. pmas (Witness Printed Name) SS 5 At,z QWeecJ ,bu,FL (Witness Address) , Adjoining Owner Cyii tness Signature) (Witness Printed Name) �r Q ✓�:L CtJd3 cc, (Witness Address) STATE OF FLORIDA COUNTY OF OKEECHOBEE The foregoing instrument was acknowledged before me on d Cel111Y3D,20 /to, by Jeremy LaRue, who signed in the presence of these witness(es); and who produced as identification or is personally known ACCEPTED FOR THE CITY: f David Allen, Public Works Director BOBBIE JO JENKINS Commission 4 FF 975408 My Commission Expires March 24, 2020 REVIEWED FOR LEGAL SUFFICIENCY: John R. Cook, City Attorney Page 2 of 3 ry Public Signature bobble Jjefik)ng Name of Notary (typed, pr�Oa stamped) Commission No. FF J (city seal) Lane Ga iotea, CMC, City Clerk CSX RAILROAD R-O-W BLOCK 13 NW ADDITION FENCE/GATE NW 7th CT (F/KJA Seaboard St) 0 01 0.02 0.03 0.04 0.05 0.06 0 0- 0.06 0.0g 0.1 rni Okeechobee C * unty PropiN'ty Appraiser W.C. Bill Sherman, CFA 1 Okeechobee, Florida 1 863-763-4422 PARCEL: Owner: Site: Sales Info 2016 Certified Values Mkt Lnd Appraised Ag Lnd Exempt N 0 N E Bldg Assessed XFOB Total Just Taxable Class This information,updated. 10/27/2016, was derived from data which was compiled by the Okeechobee County Property Appraiser Office solely for the governmental purpose of property assessment. This information should not be relied upon by anyone as a determination of the ownership of property or market value. No warranties, expressed or implied, are provided for the accuracy of the data herein, it's use or it's interpretation. Although it is periodically updated, this information may not reflect the data currently by fir. in thp Prnnarty Aboraiser's office. to ic.cor Page 3 of 3 12/30/2016 Okeechobee Courity Property Appraiser Okeechobee County Property Appraiser WC. Bill Shernian, CFA Parcel: L` 346~37-35-0168-00130-0010 `>` Owner & Property Info TOTAL ROADSIDE SERVICE CENTER Owner |PO BOX 147 | / OKEECHOBEE, FL 349730147 Site ��7��'855NVV1OTH/�/E.OKEECHO8EE NORTHWEST ADDITION TOOxEsCHOgss Description * BOOK 1 PAGE 25) LOTS 1 THROUGH 6 AND LOTS 15 THROUGH 20 BLOCK 13 Area 1.474AC Use Code * VACANT (000000) S/TlFt Tax District 2016 Tax Roll Year updated: 12/22/2016 Aerial Viewer Pictometery Google Maps 2015 2014 2011 2009 2005 Sales Pok + 50 * The Descrirtion above is not to be used as the Legal Descnption for this parcel in any legal transaction. The Use Cod is a Dept. of Reve code. Please contact the Okeechobee County Planning & Development office at 863-763-5548 for specific zoning information. Property & Assessment Values 2Q15 Certified Values 2O1G Certified Values Ag Land (0) $0 AA Land (o) Building (0) XFOB (0) Just $0 Building (0) $0 XFOBK0 $27,451 Just Class $0 Class Appraised Exempt Assessed $27,451 Appraised $0 Exempt $27,451 Assessed Total ; Taxable Sales History Sale Date vvunty:$27,451 city:$27,451 Total other:$27,451 Taxable =a""/:$27,451 Sale Price cvunty:$15,292i omvc$15,292� ,chvoi:$15,292| Book/Pa e Deed V8 Quail Codes - RCode 11/10/2016 $100 _' 782n106 QC _'___^. V .. � � U / 11 1^ 11 1 6/6/2010 $24,000 776/0505 QC V U / 11/19/2015 $20,000 767/1116 QC V � U 12M0/2013 $8,500 7*0m675 TD V U 11 10M0/2012 $100 723m224 QC V U 11 2/24/2006 $0 593/1605 PR V U 01 10/17/2005 $0 580m778 PB V U 03 7/26/2005 $0 571/1786 WD V U 03 12;4/2001 $0 466/1968 WD V U 03 [ 128/2001 $1.000 466m118 WD V U 03 4/1/1982 $12.000 249me82 WD V U 03 9C2/1972 $0 141m619 WD V Q 9/1/1972 $0 1*1m617 WD V Q 7/1/1972 $0 1400265 QC V U 03 4/1/1972 $12.000 1360238 WD V Q Building C oo ' 1/2 12/30/2016 Bldg Sketch Bldg Item Extra Features & Out Buildings Okeechobee County Property Appraiser Bldg Desc Year Blt NONE Base SF Code I Desc ] Year Blt Value Units Dims Land Breakdown Land Code L161016 161C16 Desc CITY LT (MKT) CITY LT (MKT) NONE Units 306.800 FF - (0.737 AC) 225.000 FF - (0.542 AC) Actual SF I Bldg Value Condition (% Good) Adjustments 0.25/1.00 1.00/1.00 0.60/1.00 1.00/1.00 © Okeechobee County Property Appraiser 1 W.C. Bill Sherman, CFA! Okeechobee, Florida 1863- 763 -4422 Eff Rate $18 $43 Land Value $5,540 $9,752 by: GrizzlyLogic.com http : / /ap2.okeechobeepa.com /gis/ 2/2 12/30/2016 Detail by Entity Name DIVISION of CORPORATIONS an official Stare of Florida wehsite DETo.rtment of State / Division of Corporations / S _ar f_NecorJ.., / Detail By Document Nu tber / Detail by Entity Name Florida Limited Liability Company TOTAL ROADSIDE SERVICE CENTER, LLC Filing Information Document Number L11000145107 FEI /EIN Number 80- 0785591 Date Filed 12/29/2011 Effective Date 12/15/2005 State FL Status ACTIVE Last Event CONVERSION Event Date Filed 12/29/2011 Event Effective Date NONE Principal Address 3176 HIGHWAY 710 OKEECHOBEE, FL 34974 Mailing Address PO BOX 147 OKEECHOBEE, FL 34973 Changed: 03/09/2012 Registered Agent Name & Address Laura K. Sims, CPA 319 N PARROTT AVE STE A Okeechobee, FL 34974 Name Changed: 04/22/2014 Address Changed: 01/22/2016 Authorized Person(s) Detail Name & Address Title MGR JETALARUE HOLDINGS, LLC 3176 HIGHWAY 710 OKEECHOBEE, FL 34974 http:// search. sunbiz. org /Inquiry /C or porati onSearch/SearchRes ul tD etai I ?i nqui rytype= Enti tyN am e &di rectionType= Initial &searchN am eOrder= TOTALR OAD SI D... 1/2 12/30/2016 Annual Reports Report Year Filed Date 2014 04/22/2014 2015 02/24/2015 2016 01/22/2016 Document Images 01/22/201x: -- ANNUAL REPORT 02/24/2015 — ANNUAL REPORT 04/22/2011 — ANNUAL RFPORI 03/26/2013 -- ANNUAL REPORT 03/09/2012 -- ANNUAL REPORT 12/29/2011: -- Florida Limited Liability View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format Detail by Entity Name Florida Department of State, Division of Corporations http:// search. sunbiz. org / Inquiry/ CorporationSearch /SearchResultDetai I ?i nqui rytype= EntityName &directionType= Initial &searchN am eOrder= TOTALROAD SID... 2/2 12/30/2016 Detail by Entity Name FLORIDA DEPARTMENT 0l STATE DIVISION OF CORPORATIONS DIVISION of CORPORATIONS an official State of Florida website Department of State / Division of Cot tc rat. / Detail ti, uo Detail by Entity Name Florida Limited Liability Company JETALARUE HOLDINGS, LLC Filing Information Document Number L11000126978 FEI /EIN Number 45- 3762774 Date Filed 11/08/2011 State FL Status ACTIVE Last Event LC AMENDMENT Event Date Filed 02/03/2012 Event Effective Date NONE Principal Address 3176 HIGHWAY 710 OKEECHOBEE, FL 34974 Mailing Address P.O. BOX 147 OKEECHOBEE, FL 34973 Changed: 02/03/2012 Registered Agent Name & Address Laura K. Sims, CPA 319 N PARROTT AVE STE A Okeechobee, FL 34974 Name Changed: 04/22/2014 Address Changed: 01/22/2016 Authorized Person(s) Detail Name & Address Title MGR LARUE, JEREMY OR TABITHA R 912 NE 42ND TERRACE OKEECHOBEE, FL 34972 Annual Reports http: / /search.sunbiz.org/Inqui ry /C orporationSearch /SearchResul tDetai I?i nqui rytype= EntityN am e &di rectionType= Initial &searchN am eOrder =J ETALAR U EH OL .. 1/2 12/30/2016 Report Year Filed Date 2014 04/22/2014 2015 02/24/2015 2016 01/22/2016 Document Images 01/22/2016 -- ANNUAL REPORT View image in PDF format 0224 %2015__ ANNUAL REPORT View image in PDF format 1)4!222014 _/\NNU1L REPORT View image in PDF format 0312672013 ANNUAL REPORT View image in PDF format 03/09/2012 -- ANNUAL REPORT View image in PDF formal 02/03/2012 -- LC Amendment View image in PDF format 11108/2011 — Florida Limited Liability View image in PDF format Detail by Entity Name Florida Department of State, Division of Corporations http:// search. sunbiz. org / Inquiry/ CorporationSearch /SearchResultDetai I ?i nqui rytype =Enti tyN am e &directionType= Initial &searchN am eOrder =J ETALAR U EH OL .. 2/2 SHARON ROBERTSON CLERK OF CIRCUIT COURT OKEECHOBEE COUNTY, FLORIDA 312 N.W. 3 STREET, SUITE 155 OKEECHOBEE, FL 34972 863.763.2131 REF: DATE:1 /4/2017 TIME:12:52:22 PM RECEIPT: 2017000074 CITY OF OKEECHOBEE ACCOUNT #: 0 ITEM - 01 AGR RECD: 1/4/2017 12:52:22 PM FILE: 2017000073 BK /P0 0 784/932 CITY OF OKEECHOBEE JETALARUE HOLDINGS LLC Recording Fees Subtotal 27.00 TOTAL DUE PAID TOTAL PAID CASH CASH RETURNED $27.00 $30.00 $30.00 ($3.00) REC BY: G MEWBOURN DEPUTY CLERK www.clerk.co.okeechobee.fl.us 27.00 Receipt # moq 'lia iecei ved eke o t qf ife7 dv Bobbie Jenkins From: Whitney Godwin <wgodwin @pritchardsinc.com> Sent: Friday, December 30, 2016 2:43 PM To: Bobbie Jenkins Cc: 'TOTAL ROADSIDE SERVICES LLC' Subject: City of Okeechobee Attachments: TotaiRCity of Okeechobee -l.pdf Good afternoon! Please find the revisions requested on the attached! Tab, I've cc'd you for your records! Make Today Ridiculously Amazing, Whitney Goc win �( (pritchards VNlf - isSt3t 1111's Direct 772 - 345 -7700 www.pritchardsinc.com Independent Insurance Agency find us on Lei Facebook ?v(anaJcer, 6yenerai2lrenf This message may contain confidential and/or legally privileged information and is intended for use by the indicated addressee. Access to this e -mail by anyone other than the intended recipient is unauthorized. If you are not the intended recipient (or responsible for delivery of the message to such person), you may not use, copy, distribute or deliver to anyone this message (or any part of its contents) or take any action in reliance on it. In such case. you should destroy this message, and notify us immediately. If you have received this e -mail in error. please notify us immediately by e -mail or telephone and delete the e -mail from any computer 1 ACORO CERTIFICATE OF LIABILITY INSURANCE TOTAL -1 OP ID: WH DATE (MM /DD /YYYY) 12/30/2016 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 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 Pritchards and Associates -SLC 10791 SW Tradition Square Port St. Lucie, FL 34987 Kristina M. Morgan- Agency INSURED Total Roadside Services, LLC PO Box 147 Okeechobee, FL 34973 CONTACT NAME Kristina M. Morgan- Agency PHONE 772- 345 -7700 (A/C INExA E -MAIL ADDRESS: FAX No): 772- 345 -7703 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Ohio Security 24082 INSURER B : Progressive Express Ins Co 10193 INSURER C : INSURER D : INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ANNA SUBR POLICY NUMBER POLICY EFF (MM /DDIYYYY) POLICY EXP (MMIDD /YYYY) LIMITS A X GE COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X 1 OCCUR -_- _ -_- X BKS55932196 01/16/2016 01/16/2017 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 300,000 MED EXP (Any one person) $ 15,000 PERSONAL & ADV INJURY GENERAL AGGREGATE $ 1,000,000 $ 1,000,000 'L AGGREGATE LIMIT APPLIES PER POLICY 1 PRO- JECT —1 LOC OTHER: PRODUCTS - COMP /OP AGG $ 1,000,000 $ A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS BUSINESS AUTO _ SCHEDULED AUTOS NON -OWNED AUTOS 02835494 -0 01/13/2016 01/13/2017 COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) BODILY INJURY (Per accident) $ 1 00,000 $ $ PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY PER OTH- STATUTE ER Y ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below / N N / A E . EACH ACCIDENT $ E . DISEASE - EA EMPLOYEE E . DISEASE - POLICY LIMIT $ $ A Property Section BKS55932196 01/16/2016 01/16/2017 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Okeechobee is included as Additional Insured as required by written contract per MasterPak blanket form CG8810 in accordance with the terms and conditions of the policy (Form attached) RE: Street use Agreement NW 10th Street CERTIFICATE HOLDER CANCELLATION OKEEC -6 City of Okeechobee Y 55 SE 3RD Avenue Okeechobee, FL 34974 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 1" 6 ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG 88 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX SUBJECT PAGE NON -OWNED AIRCRAFT 2 NON -OWNED WATERCRAFT 2 PROPERTY DAMAGE LIABILITY - ELEVATORS 2 EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) 2 MEDICAL PAYMENTS EXTENSION 3 EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B 3 ADDITIONAL INSUREDS - BY CONTRACT, AGREEMENT OR PERMIT 3 PRIMARY AND NON - CONTRIBUTORY- ADDITIONAL INSURED EXTENSION 5 ADDITIONAL INSUREDS - EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" 6 WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORS /MALPRACTICE AND WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES 6 NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES 7 FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES 7 KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT 7 LIBERALIZATION CLAUSE 7 BODILY INJURY REDEFINED 7 EXTENDED PROPERTY DAMAGE 8 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - 8 WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU CG 88 10 04 13 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 8 IIMOMMINIMMO With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. A. NON -OWNED AIRCRAFT Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability, exclusion g. Aircraft, Auto Or Watercraft does not apply to an aircraft provided: 1. It is not owned by any insured; 2. It is hired, chartered or loaned with a trained paid crew; 3. The pilot in command holds a currently effective certificate, issued by the duly constituted authority of the United States of America or Canada, designating her or him a commercial or airline pilot; and 4. It is not being used to carry persons or property for a charge. However, the insurance afforded by this provision does not apply if there is available to the insured other valid and collectible insurance, whether primary, excess (other than insurance written to apply specifically in excess of this policy), contingent or on any other basis, that would also apply to the loss covered under this provision. B. NON -OWNED WATERCRAFT Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability, Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by the following: This exclusion does not apply to: (2) A watercraft you do not own that is: (a) Less than 52 feet long; and (b) Not being used to carry persons or property for a charge. C. PROPERTY DAMAGE LIABILITY - ELEVATORS 1. Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liabil- ity, Subparagraphs (3), (4) and (6) of exclusion j. Damage To Property do not apply if such "property damage" results from the use of elevators. For the purpose of this provision, elevators do not include vehicle lifts. Vehicle lifts are lifts or hoists used in automobile service or repair operations. 2. The following is added to Section IV - Commercial General Liability Conditions, Condition 4. Other Insurance, Paragraph b. Excess Insurance: The insurance afforded by this provision of this endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis. D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) If Damage To Premises Rented To You is not otherwise excluded from this Coverage Part: 1. Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury and Property Damage Liability: a. The fourth from the last paragraph of exclusion j. Damage To Property is replaced by the follow- ing: Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire, lightning, explosion, smoke, or leakage from an automatic fire protection system) to: (i) Premises rented to you for a period of 7 or fewer consecutive days; or (ii) Contents that you rent or lease as part of a premises rental or lease agreement for a period of more than 7 days. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described in Section III - Limits of Insurance. CG 88 10 04 13 U 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 8 b. The last paragraph of subsection 2. Exclusions is replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III - Limits Of Insurance. 2. Paragraph 6. under 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: a. Any one premise: (1) While rented to you; or (2) While rented to you or temporarily occupied by you with permission of the owner for damage by fire, lightning, explosion, smoke or leakage from automatic protection sys- tems; or b. Contents that you rent or lease as part of a premises rental or lease agreement. 3. As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) - Paragraph 9.a. of Definitions is replaced with the following: 9.a. A contract fora lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such premises that are included in your premises rental or lease agreement, is not an "insured contract ". E. MEDICAL PAYMENTS EXTENSION If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this policy are amended as follows: Under Paragraph 1. Insuring Agreement of Section I - Coverage C - Medical Payments, Subparagraph (b) of Paragraph a. is replaced by the following: (b) The expenses are incurred and reported within three years of the date of the accident; and F. EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B 1. Under Supplementary Payments - Coverages A and B, Paragraph 1.b. is replaced by the following: b. Up to $3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2. Paragraph 1.d. is replaced by the following: 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. G. ADDITIONAL INSUREDS - BY CONTRACT, AGREEMENT OR PERMIT 1. Paragraph 2. under Section II - Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract, written agreement or permit. Such person or organization is an additional insured 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 the acts or omissions of those acting on your behalf, in the performance of your on going operations for the additional insured that are the subject of the written contract or written agreement provided that the "bodily injury" or "property damage" occurs, or the "per- sonal and advertising injury" is committed, subsequent to the signing of such written contract or written agreement; or CG 88 10 04 13 v 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 8 b. Premises or facilities rented by you or used by you; or c. The maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or d. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit subject to the following additional provisions: (1) This insurance does not apply to "bodily injury", "property damage ", or "personal and ad- vertising injury" arising out of the operations performed for the state or political subdivision; (2) This insurance does not apply to "bodily injury" or "property damage" included within the "completed operations hazard ". Insurance applies to premises you own, rent, or control but only with respect to the following hazards: (3) However: (a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar expo- sures; or (b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elevators covered by this insurance. 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insur- ance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. With respect to Paragraph 1.a. above, a person's or organization's status as an additional insured under this endorsement ends when: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. With respect to Paragraph 1.b. above, a person's or organization's status as an additional insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends. With respects to Paragraph 1.c. above, this insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage ". We have no duty to defend an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured as required in Paragraph b. of Condition 2. Duties In the Event Of Occurrence, Offense, Claim Or Suit under Section IV - Commercial General Liability Condi- tions. CG 88 10 04 13 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 8 2. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section I - Coverage A - Bodily Injury And Property Damage Liability: This insurance does not apply to: a. "Bodily injury" or "property damage" arising from the sole negligence of the additional insured. b. "Bodily injury" or "property damage" that occurs prior to you commencing operations at the location where such "bodily injury" or "property damage" occurs. c. "Bodily injury ", "property damage" or "personal and advertising injury" arising out of the render- ing of, or the 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 "occur- rence" 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. d. "Bodily injury" or "property damage" occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. e. Any person or organization specifically designated as an additional insured for ongoing operations by a separate ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS endorsement is- sued by us and made a part of this policy. 3. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: a. Required by the contract or agreement; or b. 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 Declaratio ns. H. PRIMARY AND NON - CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. Condition 4. Other Insurance of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is amend- ed as follows: a. The following is added to Paragraph a. Primary Insurance: If an additional insured's policy has an Other Insurance provision making its policy excess, and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional insured's policy for damages we cover. CG 88 10 04 13 U 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc_, with its permission. Page 5 of 8 b. The following is added to Paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non - contributory, this insurance is excess over any other insurance for which the addi- tional insured is designated as a Named Insured. Regardless of the written agreement between you and an additional insured, this insurance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies. I ADDITIONAL INSUREDS - EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. 1. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim or Suit: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence" or an offense that may result in a claim or "suit" under this insurance to us; b. Tender the defense and indemnity of any claim or "suit" to all insurers whom also have insurance available to the additional insured: and c. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. d. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured. 2. The limits of insurance applicable to the additional insured are those specified in a written contract or written agreement or the limits of insurance as stated in the Declarations of this policy and defined in Section III - Limits of Insurance of this policy, whichever are less. These limits are inclusive of and not in addition to the limits of insurance available under this policy. J. WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORS / MALPRACTICE WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES Paragraph 2.a.(1) of Section II - Who Is An Insured is replaced with the following: (1) "Bodily injury" or "personal and advertising injury": (a) To you, to your partners or members Of you are a partnership or joint venture), to your members Of you are a limited liability company), to a co- "employee" while in the course of his or her employ- ment 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; 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, if you are not in the business of providing professional health care services or providing profes- sional health care personnel to others, or if coverage for providing professional health care ser- vices is not otherwise excluded by separate endorsement, this provision (Paragraph (d)) does not apply. Paragraphs (a) and (b) above do not apply to "bodily injury" or "personal and advertising injury" caused by an "employee" who is acting in a supervisory capacity for you. Supervisory capacity as used herein means the "employee's" job responsibilities assigned by you, includes the direct supervision of other "employ- ees" of yours. However, none of these "employees" are insureds for "bodily injury" or "personal and (c) CG 88 10 04 13 U 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 8 advertising injury" arising out of their willful conduct, which is defined as the purposeful or willful intent to cause "bodily injury" or "personal and advertising injury', or caused in whole or in part by their intoxica- tion by liquor or controlled substances. The coverage provided by provision J. is excess over any other valid and collectable insurance available to your "employee ". K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES Paragraph 3. of Section II - Who Is An Insured is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority interest, 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 expiration of the policy period in which the entity was acquired or formed by you; 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. d. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations or qualifies as an insured under this provision. L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES Linder Section IV - Commercial General Liability Conditions, the following is added to Condition 6. Repre- sentations: Your failure to disclose all hazards or prior "occurrences" existing as of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior "occurrences" is not intentional. M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT Under Section IV - Commercial General Liability Conditions, the following is added to Condition 2. Duties In The Event of Occurrence, Offense, Claim Or Suit: Knowledge of an "occurrence ", offense, claim or "suit" by an agent, servant or "employee" of any insured shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph 1. of Section II - Who Is An Insured or a person who has been designated by them to receive reports of "occurrences ", offenses, claims or "suits" shall have received such notice from the agent, servant or "employee ". N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the day the revision is effective in your state. O. BODILY INJURY REDEFINED Under Section V - Definitions, Definition 3. is replaced by the following: 3. "Bodily Injury" means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physical injury, sick- ness or disease. CG 88 10 04 13 ® 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 8 P. EXTENDED PROPERTY DAMAGE Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following: a. Expected Or Intended Injury "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. Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU PM WWI 11111 111111•■■ 11111.11111M MI NM • 111110. II MN 1111 OM 1 IT 111 1 P. PM Under Section IV - Commercial General Liability Conditions, the following is added to Condition 8. Trans- fer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against a person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard" provided: 1. You and that person or organization have agreed in writing in a contract or agreement that you waive such rights against that person or organization; and 2. The injury or damage occurs subsequent to the execution of the written contract or written agree- ment. CG 88 10 04 13 ® 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 8 of 8