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16335
Docusign Envelope ID: OBA632D4-OD3D-86B1-8227-8B3B52F825C3 City Clerk's Office Item # M2 ciily of "PUEBLO m;µ ...w aflorado Background Paper for Proposed Resolution COUNCIL MEETING DATE: June 8, 2026 TO: President Mark Aliff and Members of City Council CC: Mayor Heather Graham VIA: Clyde Bishop, City Clerk FROM: Andrew Hayes, Public Works Director SUBJECT: A RESOLUTION APPROVING AMENDMENT NO. 1 OF THE AGREEMENT FOR PROFESSIONAL SERVICES BETWEEN THE CITY OF PUEBLO, A COLORADO MUNICIPAL CORPORATION, AND GSG ARCHITECTURE, INC., IN THE AMOUNT OF $30,575 FOR PROJECT NO. 25-059, DESIGN FOR LIMITED REMODEL OF FIRE STATIONS #3 AND #5, AND AUTHORIZING THE PURCHASING AGENT TO EXECUTE SAME SUMMARY: This Resolution approves Amendment No. 1 to the Professional Services Agreement awarded to GSG Architecture, Inc., in the amount of $30,575.00 for Project No. 25-059, Design for Limited Remodel for Fire Stations #3 and #5. PREVIOUS COUNCIL ACTION: Resolution 16243, dated February 9, 2026, awarded a Professional Services Agreement in the amount of $145,150.00 to GSG Architecture, Inc., for Project No. 25- 059, Design for Limited Remodel of Fire Stations #3 and #5. BACKGROUND: The City of Pueblo is firmly committed to protecting the health, safety, and comfort of its firefighters through targeted investments to modernize facilities, equipment, and operating practices to reduce occupational hazards and improve operational readiness. As such, a request for proposals for an architect was submitted to renovate Fire Stations #3 and #5. Fire Station #3 renovation includes the existing showers and restrooms. Fire Station #5 renovation includes the separation of the existing living space from the truck bay and creating a workout area. The Fire Department has requested to increase the scope to Fire Station #3 to develop an alternate design for enclosing part of the truck bay to make a separate living area, enclose an area by the current washer and dryers to make a bunker gear storage room, demolition/salvage of unused equipment, such as vehicle exhaust extraction systems, Docusign Envelope ID: OBA632D4-OD3D-86B1-8227-8B3B52F825C3 and design and a new separate exhaust and make up air system to handle off gassing from the fire suits/equipment storage in the bunker gear room. The cost of the additional design exceeds the threshold for administrative approval of an amendment. FINANCIAL IMPLICATIONS: Funding for Amendment No. 1 ($30,575.00) will be paid from account C12502, Station Upgrades. BOARD/COMMISSION RECOMMENDATION: None. STAKEHOLDER PROCESS: None. ALTERNATIVES: Denial of this resolution will cancel the additional design. RECOMMENDATION: Approval of the Resolution. ATTACHMENTS: 1. 25-059 GSG Amendment No 1 Docusign Envelope ID: OBA632D4-OD3D-86B1-8227-8B3B52F825C3 RESOLUTION NO. 16335 A RESOLUTION APPROVING AMENDMENT NO. 1 OF THE AGREEMENT FOR PROFESSIONAL SERVICES BETWEEN THE CITY OF PUEBLO, A COLORADO MUNICIPAL CORPORATION, AND GSG ARCHITECTURE, INC., IN THE AMOUNT OF $30,575 FOR PROJECT NO. 25-059, DESIGN FOR LIMITED REMODEL OF FIRE STATIONS #3 AND #5, AND AUTHORIZING THE PURCHASING AGENT TO EXECUTE SAME WHEREAS, Project No. 25-059, Design for Limited Remodel of Fire Stations #3 and #5 was awarded to GSG Architecture, Inc., on February 23, 2026; and, WHEREAS, additional scope contemplated by Amendment No. 1 is needed; and, WHEREAS, it is in the best interest of the City of Pueblo to proceed with the additional scope of work in the manner herein provided; NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF PUEBLO, that SFCTION 1 Amendment No. 1, by and between the City of Pueblo, a Municipal Corporation, and GSG Architecture, Inc., a Wyoming Corporation, registered to do business in Colorado, a copy of which is attached hereto, having been approved as to form by the City of Pueblo Attorney, is hereby approved, and City Council authorizes the additional work contemplated by Amendment No. 1 to be performed in the amount of $30,575.00. SECTION 2. Funds in the amount of $30,575.00 will be paid from Project C12502, Station Upgrades. SECTION 3. The Purchasing Agent is hereby authorized to execute Amendment No. 1 on behalf of the City of Pueblo, a Colorado Municipal Corporation, and the City Clerk shall affix the seal of the City thereto and attest same. SECTION 4. The officers of the City are authorized to perform any and all acts consistent with this Resolution to implement the policies and procedures described herein. Docusign Envelope ID: OBA632D4-OD3D-86B1-8227-8B3B52F825C3 SECTION 5. This Resolution shall become effective immediately upon passage and approval. FiD;0GISigned by: ATTESTED BY: CIT INTRODUCED: June 8, 2026 BY: Brett Boston MEMBER OF C a���QnU rjqIL APPROVED: PRESIDENT OF CITY COUNCIL Docusign Envelope ID: 1 DC9EBCF-5EAD-8FOE-83E2-9AD8ABB77C74 Amendment No.1 for #25-059 Title: Design for Limited Remodel of Fire Stations 3 and 5 AMENDMENT NO. "III -II E 1:111-01"ISSIONAL, SERVICES AGDII' EE EN" B iI ij rRODUc rimi This Amendment No. 1 to the Professional Services Agreement ("Amendment") is executed to be effective as of the loth day of ,tune 202r, by and between the City of Pueblo, a Colorado Municipal Corporation ("City") and GSG Architecture, Inc., a Wyoming corporation registered to do business in Colorado ("Consultant"). City and Consultant are sometimes referred to herein as a "Party" and collectively, as the "Parties." WITNESSETH THAT: WHEREAS, City and Consultant entered into that certain Professional Services Agreement dated February 23, 2026 for Bid 25-059 Design for Limited Remodel of Fire Stations 3 and 5 (the "Agreement"); WHEREAS, City and Consultant desire to amend the Agreement pursuant to the provisions set forth herein; NOW, THEREFORE, in consideration of the foregoing premises, the mutual promises set forth herein and other good and valuable consideration, the receipt and adequacy of which is hereby acknowledged, City and Consultant hereby agree to the following conditions. m AGREERAHj A. The Agreement is amended by expanding the scope of services to include the following additional services: 1. Consultant shall provide schematic design, design development, construction documents, bidding, construction administration, and other related services for additional scope of services at Fire Station #3 remodel as identified in Attachment A. 2. Attachment A to this Amendment No. 1 shall be additional work as agreed upon by Consultant and City, and Consultant shall complete the work items as generally described in said Attachment A in accordance with the terms of the Agreement. B. With respect to services provided under the Amendment No. 1, the fee schedule attached as Attachment B to this Amendment No. 1 shall apply to compensation payable to Consultant. The aggregate compensation payable to the Consultant for performance of the additional services authorized by this Amendment No. 1 shall not exceed the maximum amount of $30,575.00 as set forth in the Attachment B and notwithstanding whether the service is billed as Time and Material. 1. The compensation payable to the Consultant by this Amendment No. 1 shall be billed at the amounts set forth in the Attachment B. 2. City must respond in writing with written approval prior to Consultant beginning work. Docusign Envelope ID: 1 DC9EBCF-5EAD-8FOE-83E2-9AD8ABB77C74 Amendment No.1 for #25-059 Title: Design for Limited Remodel of Fire Stations 3 and 5 C. City and Consultant shall establish a mutually agreeable work schedule for completion of each major work item. Consultant shall commence and complete all work according to such schedule; however, Consultant will not be responsible for delays beyond Consultant's control. D. This Amendment shall be binding upon and inure to the benefit of the Parties hereto and their respective successors and assigns. E. Except as expressly modified by this Amendment No. 1, the Agreement shall remain in full force and effect. Except as modified by this Amendment No. 1, any obligations to be performed under the Agreement by either party are not waived nor excused in any manner but shall be performed in accordance with the terms and conditions of the Agreement as it existed prior to this Amendment No. 1. F. This Amendment may be executed in one or more counterparts, each of which shall be deemed an original and all of which shall constitute one and the same document with the same effect as if all Parties had signed the same original. The Parties further agree that transmission of this Amendment by any electronic format, telecopy or via email in a PDF format, shall be deemed transmission of the original Amendment for all purposes. Electronic signatures shall be deemed valid and binding to the same extent as the original. IN WITNESS WHEREOF, the parties hereto have caused this instrument to be executed the day and year first above written. CITY OF PUEBLO, A MUNICIPAL CORPORATION GSG ARCHITECTURE, INC Signed by: DocuSigned by: By Wt St1 � ?UVL� S �y iJ By JRMes (Z ay �F VBurns, Director of Purchasing ISR69141i'lloway, CEO/President Docusigned by: Attest G'-aCG""� F 1 17'•B1 9A... C'fyAeisliop, City Clerk [SEAL] BALANCE OF APPROPRIATION EXISTS FOR THIS APPROVED AS TO FORM AGREEMENT AND FUNDS ARE AVAILABLE. DEPARTMENT OF LAW Signed by: F�DOGL!Slgned by: S �anr y*unn� Director of Finance '°2oSert dagger, Deputy City Attorney Attachments: Attachments A - B and Additional Information for Amendment Docusign Envelope ID: 1 DC9EBCF-5EAD-8FOE-83E2-9AD8ABB77C74 tta III iiimen curie of Services Excerpt fr urn Consultant Proposal l dated April 30, 2026, Page 1 This add service proposal responds to the City of Pueblo's request to provide additional scope for the Fire Station #3 remodel. This additional scope of work includes: • Develop an alternate design for enclosing part of the truck bay to make a separate living area for weight training or other miscellaneous functions and enclose an area by the current washer and dryer systems and make a Bunker Gear Storage room. • Infill one of the large bay doors with appropriate material and one 8'-0" x 8'-0" overhead door. • Demolition/Salvage of unused equipment within these areas of construction, i.e., vehicle exhaust extraction systems. • Design a new and separate exhaust and make-up air system to handle any off gassing from the fire suits/equipment stored in the Bunker Gear room. • Ensure the alternate design does not affect the overall design of the original scope of work so that if the alternate is not completed until a later date, the original scope of work can progress with little to no modifications to the design documents. General Assumptions: Unless specifically noted in this proposal, all previously noted assumptions and exclusions from GSG Architecture's proposal (dated 11/25/25), and Contract #25-059 between GSG Architecture and the City of Pueblo (fully executed 02/23/26), remain in force. General Exclusions: (The following services can be delivered at an additional negotiated fee.) • No additional exclusions noted at this time. Docusign Envelope ID: 1 DC9EBCF-5EAD-8FOE-83E2-9AD8ABB77C74 Fee Scliedule Excerpt fi orn Consultant Proposal dated April 30, 2026, Page 1 ADD SERIVCES PROSED FEES: Schematic Design (SD) Design Development (DD) $ 5,130 $ 7,730 Construction Documents (CD) $ 11,080 $ 1,975 Construction Administration (CA) $ 4,660 GRAND TOTAL $ 30,575 Docusign Envelope ID: 1 DC9EBCF-5EAD-8FOE-83E2-9AD8ABB77C74 Additional IIII far,imatian far, Amendment Certificate of Good Standing PERA Questionnaire �lnsurance Certificate(s) �Note- As of 5/27/2026 Consultant addiress Ihas Iraeen chainged to GSG Architecture Iliac. 2068 South Cedair Street Casper, WY 82601. Consultant will update Colorado Secretary of State Registration Docusign Envelope ID: 1 DC9EBCF-5EAD-8FOE-83E2-9AD8ABB77C74 For this Record... IFiilliing history and documents Get a ceirtufiicate of good standing IFrille a foirim Subscribe to emrnaiill notufiicatiion Unsubscribe firor n emrnaiill inotufiicatiion Subscribe to text notufiicatiion Unsubscribe firor n text inotufiicatiion IBusiness Horne IBusiness anfoirimaUoin IBusiness Search IFAQsa Gllxussairy and anfoirimaUoin Summary Details Name GSG Architecture, Inc. Status Good Standing Formation date 05/22/2017 ID number 20171379642 Form Foreign Corporation Periodic report month November Jurisdiction Wyoming Principal office street 1042 S David St, Casper, WY82601, US address Principal office mailing 1042 S David St, Casper, WY82601, US address Registered Agent Name CRYSTAL LOUISE KLOSTERMAN Street address 1532 Honeysuckle Ct, Brighton, CO 80601, US Mailing address 1532 Honeysuckle Ct, Brighton, CO80601, US Filing history and documents Get a certificate of good standing, Get certified copies of documents File a form Set up secure business filing, Subscribe to email notification Unsubscribe from email notification Subscribe to text notification Unsubscribe from text notification II .. Back .. ..II Docusign Envelope ID: 1 DC9EBCF-5EAD-8FOE-83E2-9AD8ABB77C74 OFFICE OF THE SECRETARY OF STATE OF THE STATE OF C OL ORAD O CERTIFICATE OF FACT OF GOOD STANDING I, Jena Griswold, as the Secretary of State of the State of Colorado, hereby certify that, according to the records of this office, GSG Architecture, Inc. is an entity formed or registered under the law of Wyoming , has complied with all applicable requirements of this office, and is in good standing with this office. This entity has been assigned entity identification number 20171379642 . This certificate reflects facts established or disclosed by documents delivered to this office on paper through 05/11/2026 that have been posted, and by documents delivered to this office electronically through 05/14/2026 @ 11:56:07 . I have affixed hereto the Great Seal of the State of Colorado and duly generated, executed, and issued this official certificate at Denver, Colorado on 05/14/2026 @ 11:56:07 in accordance with applicable law. This certificate is assigned Confirmation Number 18560070 Secretary of State of the State of Colorado End of Certificate Notice: A certificate issued electronically from the Colorado Secretary of State's website is fully and immediately valid and effective. However, as an option, the issuance and validity of a certificate obtained electronically may be established by visiting the Validate a Certificate page of the Secretary of State's website, httpsJ/www.coloradosos.gov/biz/Cer tificateSear chCr iter ia.do entering the certificate's confirmation number displayed on the certificate, and following the instructions displayed Confirming the issuance of a certificate is merely optional and is not necessary to the valid and effective issuance of a certificate. For more information, visit our website, httpsJ/N,N,N,.coloradosos.gov click "Businesses, trademarks, trade names" and select "Frequently Asked Questions." Docusign Envelope ID: 1 DC9EBCF-5EAD-8FOE-83E2-9AD8ABB77C74 COLORADO PUBLIC EMPLOYEES RETIREMENT ASSOCIATION SUPPLEMENTAL QUESTIONNAIRE TO BE ANSWERED BY ANY BUSINESS PERFORMING SERVICES FOR THE CITY OF PUEBLO Pursuant to section 24-51-1101(2), C.R.S., salary or other compensation from the employment, engagement, retention or other use of a person receiving retirement benefits (Retiree) through the Colorado Public Employees Retirement Association (PERA) in an individual capacity or of any entity owned or operated by a PERA Retiree or an affiliated party by the City of Pueblo to perform any service as an employee, contract employee, consultant, independent contractor, or through other arrangements, is subject to employer contributions to PERA by the City of Pueblo. Therefore, as a condition of contracting for services with the City of Pueblo, this document must be completed, signed and returned to the City of Pueblo: (a) Are you, or do you employ or engage in any capacity, including an independent contractor, a PERA Retiree who will perform any services for the City of Pueblo? Yes_, No X . (If you answered "no" please proceed to signature section at bottom of this page.) (b) If you answered "yes" to (a) above, please answer the following question: Are you an individual, sole proprietor or partnership, or a business or company owned or operated by a PERA Retiree or an affiliated party? For purposes of responding to this question, an "affiliated party" includes (1) any person who is the named beneficiary or cobeneficiary on the PERA account of the PERA Retiree; (2) any person who is a relative of the PERA Retiree by blood or adoption to and including parents, siblings, half -siblings, children, and grandchildren; (3) any person who is a relative of the PERA Retiree by marriage to and including spouse, spouse's parents, stepparents, stepchildren, stepsiblings, and spouse's siblings; and (4) any person or entity with whom the PERA Retiree has an agreement to share or otherwise profit from the performance of services for the City of Pueblo by the PERA Retiree other than the PERA Retiree's regular salary or compensation. Yes , No If you answered "yes" please state which of the above entities best describes your business (c) If you answered "yes" to both (a) and (b), you agree to reimburse the City of Pueblo for any employer contribution required to be paid by the City of Pueblo to PERA for salary or other compensation paid to you as a PERA Retiree or paid to any employee or independent contractor of yours who is a PERA Retiree performing services for the City of Pueblo. You further authorize the City of Pueblo to deduct and withhold all such contributions from any moneys due or payable to you by the City of Pueblo under any current or future contract or other arrangement for services between you and the City of Pueblo. Please provide the name, address, date of birth, and social security number of each such PERA Retiree. If more than two, please attach a supplemental list. Name Address DOB Social Security Number Name Address DOB Social Security Number Failure to accurately complete, sign and return this document to the City of Pueblo may result in you being denied the privilege of doing business with the City of Pueblo. Company Name: GSG Architecture, Inc. Authorized Signature: - -.._,1 ""C', /,/,, _ ..-- Title: Principal, C.E.O. Printed Name: James G. Holloway Date: 01/22/2026 Docusign Envelope ID: 1 DC9EBCF-5EAD-8FOE-83E2-9AD8ABB77C74 GSGARCH-02 RGARVI N �►co�ro,,, CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 5/7/2026 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 License # 6024 CONTACT Robbie Garvin NAME: PHONE FAX (A/C, No, Ext): (307) 429-6004 (A/C, No): HUB International Mountain States Limited 1620 E Pershing Blvd, Suite 100 Cheyenne, WY 82001 E-MAIL robbie.garvin@hubinternational.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:Cincinnati Insurance Company 10677 INSURED INSURER B: Cincinnati Casualty 28665 INSURER C : Endurance American Specialty Insurance Company 41718 GSG Architecture, Inc. INSURER D : 1042 South David Street Casper, WY 82601 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 1 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. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X X SBB0043595 3/11/2026 3/11/2027 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence 1,000,000 $ MED EXP (Any oneperson) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY PELT LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 WY STOP GAP $ 1,000,000 A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY X X SBA0043596 3/11/2026 3/11/2027 COMBINED SINGLE LIMIT Ea accident 1,000,000 $ X BODILY INJURY Perperson) $ BODILY INJURY Per accident $ PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE X X SB00043598 3/11/2026 3/11/2027 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 DED X RETENTION $ 10,000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A X SBW0043597-00 3/11/2026 3/11/2027 PER OTH- STATUTE ER E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE- EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 $ C Professional Liab. DPL30051425102 1/1/2026 1/1/2027 Per Claim/Aggregate 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Pueblo a Municipal Corporation tY P P THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 230 S. Mechanic Street Pueblo, CO 81003 AUTHORIZED REPRESENTATIVE x ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Docusign Envelope ID: 1 DC9EBCF-5EAD-8FOE-83E2-9AD8ABB77C74 SA 1111THIN A I mim, A", IF 14", la 11:111211 MIA Am" I "JIMMA'SOA, 111, In' an Mi 1110111 � �. 111 MIX M1111' , =11, INUMAJIFAM This endorsement modifies insurance provided under the following: M' F/2111111101"; MY' 11111,41 1;P1 W"121 Im" Ir'!i1ml A, RD Name and mailing address of per or organ izati on(s). CITY OF PUEBLO A MUNICIPAL CORPORATION, ITS AGENTS, OFFICERS AND EMPLOYEES ARE L 230 S MECHANIC ST PUEBLO, CO 81003-3422 Number of days, notice (other than nonpayment of premium): 45 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A- If we cancel or nonrenew this policy for any statutorily permitted reason other than nonpayment of premium we will mail notice to the person or organization shown in the Schedule. We will mail such notice at least the number of days, shown in the Schedule before, the effective date of cancellation or nonrenewal. B. If we cancel this policy for nonpayment of premium, we will mail notice to the person or organization shown in the Schedule. We will mail such notire at least 10 days before the effective date of cancellation. C. If notice is mailed, proof of mailing to the mailing address shown in the Schedule will be sufficient proof of notice. D. In no event will coverage extend beyond the actual expiration, termination or cancellation of the policy. IA 451106 19 Page 1 of 1 Docusign Envelope ID: 1 DC9EBCF-5EAD-8FOE-83E2-9AD8ABB77C74 POLICY NUMBER: SBA 004 35 96 W,91 11 MCI 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 Cover- age 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 indi- cated below. Named Insured: GSG ARCHITECTURE, INC. Endorsement Effective Date: 03/15/2026 RM/111111AM M Name Of Person(s) Or Organization(s)- "CITY OF PUEBLO A MUNICIPAL CORPORATION, ITS AGENTS, OFFICERS AND EMPLOYEES AR LISTED AS ADDITIONAL INSUREDS 230 S MECHANIC ST PUEBLO, CO 81003-3422 Information reauired to complete this Schedule, if not shown a 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 In- sured provision contained in Paragraph Al. of Sec- tion 11 - Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2® of Section I - Covered Autos Coverages of the Auto Dealers Coverage Form, will be shown in the Declarations. CA 20 48 10 13 (D Insurance Services Office, Inc., 2011 Page 1 of 1 000usignEnvelope ID: 1ocnEoc�5EAD-8FnE-aoEoeAoaAoo77c74 SIGNATURE LIABILITY PLUS ENDORSEMENT TABLE OF CONTENTS Begins mnPage: A. Coverages ..................................................................................................................................................... 2 1' Employee Benefit Liability C-------------------------. 2. Unintentional Failure tmDisclose Hazards ............................................................................. 3. 18ODay Coverage for Newly Formed or Acquired Organizations ....................................... 4. Waiver ofSubrogation ------------------------------------' [. Automatic Additional Unsumed -Specified Relationships • Managers or Lessors of Premises; • Lessor of Leased Equipment; • Vendors; • State or Governmental Agency or Subdivision or Political Subdivision - Permits or Authorizations Relating to Premises; and • Mortgagee, Assignee or Receiver 6. Property DtmBorrowed Equipment ............................................................................ 7. Employees asUnsmpmds-SpmcfiedHmalthCareSmnvioesandGomdSamaritsnSmrvioas 0. Broadened Notice of Ooourrence----------------'---.----------' 0. NonmwnedAipcmuft..................................................................................................................... 1O. Bodily -----'--'----'--'--'----' 11. Expected or Intended Injury Redefined -------'----'----'-------' 12. Former E.............................................................................................. 13. Supplementary Payments --'--'--'----------------------- -12 Includes copyrighted material ofInsurance Docusign Envelope ID: 1 DC9EBCF-5EAD-8FOE-83E2-9AD8ABB77C74 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SIGNATURE LIABILITY PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM Schedule - Limits of Insurance The Business Liability Limits of Insurance apply to the insurance provided by this endorsement, except as provided below: 1. Employee Benefit Liability Each Employee Limit: $ Aggregate Limit: $ Deductible Amount: $ 6. Property Damage to Borrowed Equipment Each Occurrence Limit: $ Deductible Amount: $ 13. Supplementary Payments Bail Bonds: The information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Coverages 1. Employee Benefit Liability Coverage a. The following is added to SECTION II - LIABILITY: Employee Benefit Liability a. We will pay those sums that the insured becomes legally obligated to pay as damages caused by any act, error or omission of the insured, or of any other person for whose acts the insured is legally liable, to which this insurance applies. We will have the right and duty to defend the insured against any "suit" seeking those damages. However, we will have no duty to defend against any "suit" seeking damages to which this insurance does not apply. We may, at our discretion, investigate any report of an act, error or omission and settle any claim or "suit" that may result. But: (1) The amount we will pay for damages is limited as described in SECTION II - LIABILITY, D. Liability and Medical Expenses Limits of Insurance; and (2) Our right and duty to defend ends when we have used up the applicable limit of insurance in the payment of judgments or settlements. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under SECTION II - LIABILITY, A. Coverages, 1. Business Liability, h. Coverage Extension - Supplementary Payments. b. This insurance applies to damages only if the act, error or omission, is negligently committed in the "administration" of your "employee benefit program"; and (1) Occurs during the policy period; or (2) Occurred prior to the "first effective date" of this endorsement provided: (a) You did not have knowledge of a claim or "suit' on or before the "first effective date" of this endorsement. Indudes copyrighted material of Insurance GB 227 06 23 Services Office, Inc., with its permission. Page 2 of 13 Docusign Envelope ID: 1 DC9EBCF-5EAD-8FOE-83E2-9AD8ABB77C74 You will be deemed to have knowledge of a claim or "suit" when any "authorized representative'; 1) Reports all, or any part, of the act, error or omission to us or any other insurer; 2) Receives a written or verbal demand or claim for damages because of the act, error or omission; and (b) There is no other applicable insurance. c. Exclusions This insurance does not apply to: (1) Bodily Injury, Property Damage or Personal and Advertising Injury "Bodily injury", "property damage" or "personal and advertising injury". (2) Dishonest, Fraudulent, Criminal or Malicious Act Damages arising out of any intentional, dishonest, fraudulent, criminal or malicious act, error or omission, committed by any insured, including the willful or reckless violation of any statute. (3) Failure to Perform a Contract Damages arising out of failure of performance of contract by any insurer. (4) Insufficiency of Funds Damages arising out of an insufficiency of funds to meet any obligations under any plan included in the "employee benefit program". (5) Inadequacy of Performance of Investment/Advice Given with Respect to Participation Any claim based upon: (a) Failure of any investment to perform; (b) Errors in providing information on past performance of investment vehicles; or (c) Advice given to any person with respect to that person's decision to participate or not to participate in any plan included in the "employee benefit program". (6) Workers' Compensation and Similar Laws Any claim arising out of your failure to comply with the mandatory provisions of any workers' compensation, unemployment compensation insurance, social security or disability benefits law or any similar law. (7) ERISA Damages for which any insured is liable because of liability imposed on a fiduciary by the Employee Retirement Income Security Act of 1974, as now or hereafter amended, or by any similar federal, state or local laws. (8) Available Benefits Any claim for benefits to the extent that such benefits are available, with reasonable effort and cooperation of the insured, from the applicable funds accrued or other collectible insurance. (9) Taxes, Fines or Penalties Taxes, fines or penalties, including those imposed under the Internal Revenue Code or any similar state or local law. (10) Employment -Related Practices Any liability arising out of any. (a) Refusal to employ; Indudes copyrighted material of Insurance GB 227 06 23 Services Office, Inc., with its permission. Page 3 of 13 Docusign Envelope ID: 1 DC9EBCF-5EAD-8FOE-83E2-9AD8ABB77C74 (b) Termination of employment; (c) Coercion, demotion, evaluation, reassignment, discipline, defamation, harassment, humiliation, discrimination or other employment - related practices, acts or omissions; or (d) Consequential liability as a result of (a), (b) or (c) above. This exclusion applies whether the insured may be held liable as an employer or in any other capacity and to any obligation to share damages with or repay someone else who must pay damages because of the injury. (11) Cyber Any liability, costs, expenses or damages arising, directly or indirectly, out of or as a consequence of any: (a) "Computer attack'; (b) "Network security incident"; (c) "Privacy violation'; or (d) Fraudulent communication that impersonates any person or organization that results in the transfer of funds or other property, regardless of the medium or technique used. d. Supplementary Payments SECTION II - LIABILITY, A. Coverages, 1. Business Liability, h. Coverage Extension - Supplementary Payments also apply to this Coverage. b. Who is an Insured As respects Employee Benefit Liability Coverage, SECTION II - LIABILITY, C. Who is an Insured is deleted and replaced by the following: C. Who is an Insured 1. If you are designated in the Declarations as: a. An individual, you and your spouse are insureds, but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture, you are an insured. Your members, your partners, and their spouses are also insureds but only with respect to the conduct of your business. c. A limited liability company, you are an insured. Your members are also insureds, but only with respect to the conduct of your business. Your managers are insureds, but only with respect to their duties as your managers. d. An organization other than a partnership, joint venture or limited liability company, you are an insured. Your "executive officers" and directors are insureds, but only with respect to their duties as your officers or directors. Your stockholders are also insureds, but only with respect to their liability as stockholders. e. A trust, you are an insured. Your trustees are also insureds, but only with respect to their duties as trustees. 2. Each of the following is also an insured: a. Each of your "employees" who is or was authorized to administer your "employee benefit program"; b. Any persons, organizations or "employees" having proper temporary authorization to administer your "employee benefit program" if you die, but only until your legal representative is appointed; or c. Your legal representative if you die, but only with respect to duties as such. That representative will have all your rights and duties under this Coverage Form. Includes copyrighted material of Insurance GB 227 06 23 Services Office, Inc., with its permission. Page 4 of 13 Docusign Envelope ID: 1 DC9EBCF-5EAD-8FOE-83E2-9AD8ABB77C74 3. Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain ownership or majority interest, will qualify as a Named Insured if no other similar insurance applies to that organization. However, coverage under this provision: a. Is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; and b. Does not apply to any act, error or omission that was committed before you acquired or formed the organization. c. Limits of Insurance As respects Employee Benefit Liability Coverage, SECTION II - LIABILITY, D. Liability and Medical Expenses Limits of Insurance is deleted and replaced by the following: D. Limits of Insurance 1. The Limits of Insurance shown in the Schedule of this endorsement and the rules below fix the most we will pay regardless of the number of: a. Insureds; b. Claims made or "suits" brought; c. Persons or organizations making claims or bringing "suits"; d. Acts, errors or omissions; or e. Benefits included in your "employee benefit program". 2. The Aggregate Limit shown in the Schedule of this endorsement is the most we will pay for all damages because of acts, errors or omissions negligently committed in the "administration" of your "employee benefit program". 3. Subject to the limit described in 2. above, the Each Employee Limit shown in the Schedule of this endorsement is the most we will pay for all damages sustained by any one "employee", including damages sustained by such "employee's" dependents and beneficiaries, as a result of: a. An act, error or omission; or b. A series of related acts, errors or omissions, regardless of the amount of time that lapses between such acts, errors or omissions; negligently committed in the "administration" of your "employee benefit program". However, the amount paid under this endorsement shall not exceed, and will be subject to the limits and restrictions that apply to the payment of benefits in any plan included in the "employee benefit program." The Limits of Insurance of this endorsement apply separately to each "coverage term". 4. Deductible Amount a. Our obligation to pay damages on behalf of the insured applies only to the amount of damages in excess of the Deductible Amount stated in the Schedule as applicable to Each Employee. The limits of insurance shall not be reduced by the amount of this deductible. b. The Deductible Amount stated in the Schedule applies to all damages sustained by any one "employee", including such "employee's" dependents and beneficiaries, because of all acts, errors or omissions to which this insurance applies. c. The terms of this insurance, including those with respect to: (1) Our right and duty to defend the insured against any "suits" seeking those damages; and (2) Your duties, and the duties of any other involved insured, in the event of an act, error or omission, or claim; Includes copyrighted material of Insurance GB 227 06 23 Services Office, Inc., with its permission. Page 5 of 13 Docusign Envelope ID: 1 DC9EBCF-5EAD-8FOE-83E2-9AD8ABB77C74 apply irrespective of the application of the Deductible Amount. d. We may pay any part or all of the Deductible Amount to effect settlement of any claim or "suit' and, upon notification of the action taken, you shall promptly reimburse us for such part of the Deductible Amount as we have paid. d. Additional Conditions (1) As respects Employee Benefit Liability Coverage, SECTION II - LIABILITY, E. Liability and Medical Expenses General Conditions is amended as follows: Item 2. Duties in the Event of Occurrence, Offense, Claim or Suit is replaced by the following: 2. Duties in the Event of an Act, Error or Omission, or Claim or Suit a. You must see to it that we are notified as soon as practicable of an act, error or omission which may result in a claim. To the extent possible, notice should include: (1) What the act, error or omission was and when it occurred; and (2) The names and addresses of anyone who may suffer damages as a result of the act, error or omission. b. If a claim is made or "suit" is brought against any insured, you must: (1) Immediately record the specifics of the claim or "suit" and the date received; and (2) Notify us as soon as practicable. You must see to it that we receive written notice of the claim or "suit" as soon as practicable. c. You and any other involved insured must: (1) Immediately send us copies of any demands, notices, summonses or legal papers received in connection with the claim or "suit!',- (2) Authorize us to obtain records and other information; (3) Cooperate with us in the investigation or settlement of the claim or defense against the "suit"; and (4) Assist us, upon our request, in the enforcement of any right against any person or organization which may be liable to the insured because of an act, error or omission to which this insurance may also apply. d. No insured will, except at that insured's own cost, voluntarily make a payment, assume any obligation, or incur any expense without our consent. (2) As respects Employee Benefit Liability Coverage, SECTION III - COMMON BUSINESSOWNERS COVERAGE FORM CONDITIONS, C. Other Insurance, Paragraph 2. is deleted and replaced by the following: 2. If other valid and collectible insurance is available to the insured for a loss we cover under this Coverage Form, our obligations are limited as follows: a. Primary Insurance This insurance is primary except when c. 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 b. below. b. Method of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. Indudes copyrighted material of Insurance GB 227 06 23 Services Office, Inc., with its permission. Page 6 of 13 Docusign Envelope ID: 1 DC9EBCF-5EAD-8FOE-83E2-9AD8ABB77C74 If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. c. No Coverage This insurance shall not cover any loss for which the insured is entitled to recovery under any other insurance in force previous to the effective date of this Coverage Form. e. Additional Definitions As respects Employee Benefit Liability Coverage, SECTION II - LIABILITY, F. Liability and Medical Expenses Definitions is amended as follows: (1) The following definitions are added: 1. "Administration" means: a. Providing information to "employees", including their dependents and beneficiaries, with respect to eligibility for or scope of "employee benefit programs'; b. Interpreting the "employee benefit programs' c. Handling records in connection with the "employee benefit programs"; or d. Effecting, continuing or terminating any "employee's" participation in any benefit included in the "employee benefit program". However, "administration" does not include: a. Handling payroll deductions; or b. The failure to effect or maintain any insurance or adequate limits of coverage of insurance, including but not limited to unemployment insurance, social security benefits, workers' compensation and disability benefits. 2. "Biometric information" means any: a. Biological measurement or physical characteristic of an individual, including but not limited to a retina or iris scan, fingerprint, palmprint, voiceprint, hand or face geometry, vein pattern, genetic data, movement, or any other information that can be used as a form of identification or authentication: or b. Information, regardless of how it is captured, converted, stored or shared, based on an individual's biological measurement or physical characteristic. 3. "Cafeteria plans" means plans authorized by applicable law to allow "employees" to elect to pay for certain benefits with pretax dollars. 4. "Computer attack" means: a. Unauthorized access or authorized access for an unauthorized purpose; b. A'Imalwareattack'; or c. A "denial of service attack'; against any computer, computer system or network of computers or computer systems, including any other machinery or equipment, including their control systems, which are accessed by or integrated into a computer, computer system or network of computers or computer systems. 5. "Denial of service attack" means an attack against a target computer or network of computers designed to overwhelm the capacity of the target computer or network in order to deny or impede users from gaining access to the target computer or network through the internet. 6. "Employee benefit programs" means a program providing some or all of the following benefits to "employees", whether provided through a "cafeteria plan" or otherwise: Includes copyrighted material of Insurance GB 227 06 23 Services Office, Inc., with its permission. Page 7 of 13 Docusign Envelope ID: 1 DC9EBCF-5EAD-8FOE-83E2-9AD8ABB77C74 a. Group life insurance; group accident or health insurance; dental, vision and hearing plans; and flexible spending accounts; provided that no one other than an "employee" may subscribe to such benefits and such benefits are made generally available to those "employees" who satisfy the plan's eligibility requirements; b. Profit sharing plans, employee savings plans, employee stock ownership plans, pension plans and stock subscription plans, provided that no one other than an "employee" may subscribe to such benefits and such benefits are made generally available to all "employees" who are eligible under the plan for such benefits; c. Unemployment insurance, social security benefits, workers' compensation and disability benefits; and d. Vacation plans, including buy and sell programs; leave of absence programs, including military, maternity, family, and civil leave; tuition assistance plans; transportation and health club subsidies. 7. "First effective date" means the date upon which coverage was first effected in a series of uninterrupted renewals of insurance coverage. 8. "Malware attack" means an attack that damages a computer, computer system or network of computers or computer systems, including any other machinery or equipment, including their control systems, which are accessed by or integrated into a computer, computer system or network of computers or computer systems, or data contained therein arising from malicious code, including, but not limited to, viruses, worms, Trojans, spyware, keyloggers and ransomware. 9. "Network security incident" means a security failure or weakness with respect to a computer, computer system or network of computers or computer systems which allowed one or more of the following to happen: a. The propagation or forwarding of malware, including, but not limited to, viruses, worms, Trojans, spyware, keyloggers and ransomware; b. The abetting of a "denial of service attack" against one or more other systems; c. The loss, release or disclosure of data; d. The inability to access a computer system; e. The unauthorized access to a computer system. 10. "Privacy law" means any law, statute or regulation enacted or promulgated by or on behalf of any federal, state, local or foreign governmental entity in such entity's regulatory or official capacity that creates legally enforceable responsibilities with respect to: a. The collection, use, storage, disdosure, disposal, sharing or disseminating as well as correction or supplementation of personally identifying information, including, but not limited to, "biometric information"; or b. The adoption and communication of, as well as compliance with, a "privacy policy". "Privacy laws" include, but are not limited to, the European Union General Data Protection Regulation, the California Consumer Privacy Act and the Illinois Biometric Information Privacy Act. 11. "Privacy policy" means an entity's policy for collection, use, storage, disdosure, disposal, sharing, disseminating and correction or supplementation of personally identifying information, including, but not limited to, "biometric information". 12. "Privacy violation" means failure to comply for any reason with a "privacy law" or "privacy policy". (2) The following definitions are deleted in their entirety and replaced by the following: 8. "Employee" means a person actively employed, formerly employed, on leave of absence or disabled, or retired. "Employee" includes a "leased worker". "Employee" does not include a "temporary worker". Includes copyrighted material of Insurance GB 227 06 23 Services Office, Inc., with its permission. Page 8 of 13 Docusign Envelope ID: 1 DC9EBCF-5EAD-8FOE-83E2-9AD8ABB77C74 21. "Suit" means a civil proceeding in which money damages because of an act, error or omission to which this insurance applies are alleged. "Suit" includes: a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent; b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent; or c. An appeal of a civil proceeding. 2. Unintentional Failure to Disclose Hazards SECTION II - LIABILITY, E. Liability and Medical Expenses General Conditions is amended by the addition of the following condition: Unintentional Failure to Disclose Hazards Based on our dependence upon your representations as to existing hazards, if unintentionally you should fail to disclose all such hazards at the inception date of your policy, we will not reject coverage under this Coverage Form based solely on such failure. 3. 180 Day Coverage for Newly Formed or Acquired Organizations SECTION II - LIABILITY, C. Who is an Insured is amended as follows: Subparagraph a. of Paragraph 3. is replaced by the following: a. Is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; 4. Waiver of Subrogation SECTION III - COMMON BUSINESSOWNERS COVERAGE FORM CONDITIONS, D. Transfer of Rights of Recovery Against Others to Us, Paragraph 2. is amended by the addition of the following: We waive any right of recovery we may have against any person or organization against whom you have agreed to waive such right of recovery in a written contract or agreement because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a written contract or agreement with that person or organization and included in the "products - completed operations hazard". However, our rights may only be waived prior to the 'occurrence" giving rise to the injury or damage for which we make payment under this Coverage Form. The insured must do nothing after a loss to impair our rights. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce those rights. 5. Automatic Additional Insured -Specified Relationships a. The following is added to SECTION II - LIABILITY, C. Who is an Insured: (1) Any person(s) or organization(s) described in Paragraph 5.a.(2) of this endorsement (hereinafter referred to as additional insured) whom you are required to add as an additional insured under this policy by reason of a written contract, written agreement, written permit or written authorization. (2) Only the following persons or organizations are additional insureds under this endorsement, and insurance coverage provided to such additional insureds is limited as provided herein: (a) Managers or Lessors of Premises The manager or lessor of a premises leased to you with whom you have agreed per Paragraph 5.a.(1) of this endorsement to provide insurance, but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you, subject to the following additional exclusions: This insurance does not apply to: 1) Any 'occurrence" which takes place after you cease to be a tenant in that premises; 2) Structural alterations, new construction or demolition operations performed by or on behalf of such additional insured. Indudes copyrighted material of Insurance GB 227 06 23 Services Office, Inc., with its permission. Page 9 of 13 Docusign Envelope ID: 1 DC9EBCF-5EAD-8FOE-83E2-9AD8ABB77C74 (b) Lessor of Leased Equipment Any person or organization from whom you lease equipment when you and such person(s) or organization(s) have agreed per Paragraph 5.a.(1) of this endorsement to provide insurance. Such person(s) or organization(s) are insureds only with respect to liability for "bodily injury', "property damage" or "personal and advertising injury' caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s). A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. However, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. (c) Vendors Any person or organization (referred to below as vendor) with whom you have agreed per Paragraph 5.a.(1) of this endorsement to provide insurance, 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, subject to the following additional exclusions: 1) The insurance afforded the vendor does not apply to a) "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; b) Any express warranty unauthorized by you; c) Any physical or chemical change in the product made intentionally by the vendor; d) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; e) 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; f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; g) 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 h) "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: (i) The exceptions contained in Paragraphs (c)(i)4) or 6) of this endorsement; or (ii) 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. 2) This insurance does not apply to any insured person or organization: a) From whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products; or b) When liability included within the "products -completed operations hazard" has been excluded under this policy with respect to such products. (d) State or Governmental Agency or Subdivision or Political Subdivision - Permits or Authorizations Relating to Premises Indudes copyrighted material of Insurance GB 227 06 23 Services Office, Inc., with its permission. Page 10 of 13 Docusign Envelope ID: 1 DC9EBCF-5EAD-8FOE-83E2-9AD8ABB77C74 Any state or governmental agency or subdivision or political subdivision with which you have agreed per Paragraph 5.a.(1) of this endorsement to provide insurance, subject to the following additional provision: This insurance applies only with respect to the following hazards for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization in connection with premises you own, rent or control and to which this insurance applies: 1) 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 exposures; or 2) The construction, erection or removal of elevators; or 3) The ownership, maintenance or use of any elevators covered by this insurance. (e) Mortgagee, Assignee or Receiver Any person or organization with whom you have agreed per Paragraph 5.a.(1) of this endorsement to provide insurance, but only with respect to their liability as mortgagee, assignee, or receiver and arising out of the ownership, maintenance, or use of the premises by you. However, this insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. (3) The insurance afforded to additional insureds described in Paragraph 5.a.(1) of this endorsement: (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, written agreement, written permit or written authorization to provide for such additional insured; and (c) Does not apply to any person, organization, vendor, state, governmental agency or subdivision or political subdivision, specifically named as an additional insured under any other provision of, or endorsement added to, this policy, provided such other provision or endorsement covers the injury or damage for which this insurance applies. b. With respect to the insurance afforded to the additional insureds described in Paragraph 5.a.(1) of this endorsement, the following is added to SECTION II - LIABILITY, D. Liability and Medical Expenses Limits of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: (1) Required by the written contract, written agreement, written permit or written authorization described in Paragraph 5.a.(1) 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. c. SECTION II - LIABILITY, E. Liability and Medical Expenses General Conditions is amended to add the following: Automatic Additional Insured Provision This insurance applies only if the "bodily injury' or "property damage" occurs, or the "personal and advertising injury" offense is committed: (1) During the policy period; and (2) Subsequent to your execution of the written contract or written agreement, or the issuance of a written permit or written authorization, described in Paragraph 5.a.(1). d. SECTION III - COMMON BUSINESSOWNERS COVERAGE FORM CONDITIONS is amended as follows: Includes copyrighted material of Insurance GB 227 06 23 Services Office, Inc., with its permission. Page 11 of 13 Docusign Envelope ID: 1 DC9EBCF-5EAD-8FOE-83E2-9AD8ABB77C74 Condition C. Other Insurance, Paragraph 2. is amended to include: Primary and Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured per Paragraph 5.a.(1) of this endorsement provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract, agreement, permit or authorization described in 5.a.(2) of this endorsement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. 6. Property Damage to Borrowed Equipment a. The following is added to SECTION II - LIABILITY, B. Exclusions, 1. Applicable to Business Liability Coverage, k Damage to Property: Paragraphs (3) and (4) of this exclusion do not apply to tools or equipment loaned to you, provided they are not being used to perform operations at the time of loss. b. With respect to the insurance provided by this section of the endorsement, the following additional provisions apply: (1) SECTION II - LIABILITY, D. Liability and Medical Expenses Limit of Insurance is amended to include the following: Subject to SECTION II - LIABILITY, D. Liability and Medical Expenses Limit of Insurance, Paragraph 2., the Property Damage to Borrowed Equipment Limit, stated in the Schedule of this endorsement, is the most we will pay under Business Liability Coverage for damage to tools or equipment loaned to you, provided they are not being used to perform operations at the time of loss. (2) Deductible Clause (a) Our obligation to pay damages on your behalf applies only to the amount of damages for each "occurrence" which are in excess of the Deductible Amount stated in the Schedule of this endorsement. The limits of insurance will not be reduced by the application of such deductible amount. (b) SECTION II - LIABILITY, E. Liability and Medical Expenses General Conditions, 2. Duties in the Event of Occurrence, Offense, Claim or Suit, applies to each claim or "suit" irrespective of the amount. (c) We may pay any part or all of the deductible amount to effect settlement of any claim or "suit" and, upon notification of the action taken, you shall promptly reimburse us for such part of the deductible amount as has been paid by us. 7. Employees as Insureds -Specified Health Care Services and Good Samaritan Services Paragraph 2.a.(1)(d) under SECTION II - LIABILITY, C. Who is an Insured does not apply to: a. Your "employees" who provide professional health care services on your behalf as a duly licensed nurse, emergency medical technician or paramedic in the jurisdiction where an "occurrence" or offense to which this insurance applies takes place; or b. Your "employees" or "volunteer workers", other than an employed or volunteer doctor, providing first aid or good samaritan services during their work hours for you will be deemed to be acting within the scope of their employment by you or performing duties related to the conduct of your business. 8. Broadened Notice of Occurrence Paragraph a. of Condition 2. Duties in the Event of Occurrence, Offense, Claim or Suit under SECTION II - LIABILITY, E. Liability and Medical Expenses General Conditions is deleted and replaced by the following: a. You must see to it that we are notified as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, notice should include: (1) How, when and where the "occurrence" or offense took place; Indudes copyrighted material of Insurance GB 227 06 23 Services Office, Inc., with its permission. Page 12 of 13 Docusign Envelope ID: 1 DC9EBCF-5EAD-8FOE-83E2-9AD8ABB77C74 (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the "occurrence" or offense. This requirement applies only when the "occurrence" or offense is known to an "authorized representative". 9. Nonowned Aircraft The following is added to SECTION II - LIABILITY, B. Exclusions, 1. Applicable to Business Liability Coverage, g. Aircraft, Auto or Watercraft: This exclusion does not apply to an aircraft you do not own, provided that: a. The pilot in command holds a current effective certificate, issued by a duly constituted authority of the United States of America or Canada, designating that person as a commercial or airline transport pilot; b. The aircraft is rented with a trained, paid crew; and c. The aircraft does not transport persons or cargo for a charge. 10. Bodily Injury Redefined SECTION II - LIABILITY, F. Liability and Medical Expenses Definitions, 4. "Bodily injury" is replaced by the following: 4. "Bodily injury" means bodily harm or injury, sickness, disease, disability, humiliation, shock, fright, mental anguish or mental injury, including care, loss of services or death resulting from any of these at any time. 11. Expected or Intended Injury Redefined Under SECTION II - LIABILITY, B. Exclusions, 1. Applicable to Business Liability Coverage, a. Expected or Intended Injury, the last sentence is deleted and replaced by the following: This exclusion does not apply to "bodily injury' or "property damage" resulting from the use of reasonable force to protect persons or property. 12. Former Employees as Insureds The following is added to Paragraph 2. under SECTION II - LIABILITY, C. Who is an Insured: 2. Each of the following is also an insured: Any of your former "employees", directors, managers, members, partners or "executive officers", including but not limited to retired, disabled or those on leave of absence, but only for acts within the scope of their employment by you or for duties related to the conduct of your business. 13. Supplementary Payments Under SECTION II - LIABILITY, A. Coverages, 1. Business Liability, h. Coverage Extension - Supplementary Payments: Paragraph (2) is deleted and replaced by the following: (2) Up to the limit shown in the Schedule of this endorsement for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which Business Liability Coverage for "bodily injury' applies. We do not have to furnish these bonds. Includes copyrighted material of Insurance GB 227 06 23 Services Office, Inc., with its permission. Page 13 of 13 Docusign Envelope ID: 1 DC9EBCF-5EAD-8FOE-83E2-9AD8ABB77C74 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 shall not operate directly or indirectly to benefit anyone not named in the Schedule. BLANKET WAIVER OF SUBROGATION IF YOU ARE REQUIRED BY A WRITTEN CONTRACT OR AGREEMENT, WHICH IS EXECUTED BEFORE A LOSS, TO WAIVE YOUR RIGHTS OF RECOVERY FROM OTHERS, WE AGREE TO WAIVE OUR RIGHTS OF RECOVERY. THIS WAIVER OF RIGHTS APPLIES TO ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER, BUT SHALL NOT BE CONSTRUED TO BE A WAIVER WITH RESPECT TO ANY OTHER OPERATIONS IN WHICH THE INSURED HAS NO CONTRACTUAL INTEREST. This endorsement changes the policy to which it is attached and is effective on the date issued unless other- wise stated. (The informatIon below is required only en this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 03/11/2026 Policy No.SBW0043597-00 Endorsement No, Insured GSG ARCHITECTURE, INC. Insurance Company THE CINCINNATI CASUALTY COMPANY Premium $INCL Counter -signed by @ 1983 National Council on Compensation Insurance. Docusign Envelope ID: 1 DC9EBCF-5EAD-8FOE-83E2-9AD8ABB77C74 is THE� STATE OF WYOMIN Insurance Department 106 East 6 1h Avenue * Cheyenne, Wyoming 82002 DATE: July 1, 2014 SUB11ECT: Certificates of Insurance Matthew H. It Governor The Wyoming Legislature recently enacted a new section of the Wyoming Insurance Code, § 26-13-125 regarding the filing and use of certificates of insurance. 'this memorandum advises insurance companies and producers of the new legislation to be effective July 1, 2014, and supersedes Memorandum 01-2007 Certificates of Insurance. The provisions of this section shall apply to all certificate holders, third party certificate administrators, policy holders, insurers, and insurance producers and certificate of insurance forms, that are prepared or issued as evidence of property or casualty insurance coverages on property, operations or risks located in this state, regardless of where the certificate holder, policy holder, insurer or insurance producer is located. It is a violation of Wyoming Statute § 26-13-125 (a) for Any person to prepare, issue or knowingly request the issuance of a certificate of insurance unless the form has been filed and approved in accordance with Wyoming Statute § 26-15-110 which requires that an insurance company or advisory organization on behalf of an insurance company file all policy related forms with the Department for approval prior to use. Certificate of insurance forms, no matter how titled or described, are policy forms. Certificate of insurance forms that have been filed by either the ACORD Corporation (ACORD) or the Insurance Services Office, Inc. (ISO) and approved are not required to be filed again by an insurance company. In that situation, an insurance company is only required to submit to the Wyoming Insurance Department a filing that indicates adoption by that company of a particular ACORD or ISO form. Pursuant to Wyoming Statute § 26-13-125 (b) the Commissioner shall disapprove the use of, or prohibit the use of, any filed form if the Commissioner finds that it is (i) unfair, misleading or deceptive; (ii) violates public policy; or (iii) fails to comply with the requirements of W.S. § 26-13-125 or any other law of this state. Insurance companies filing certificate of insurance forms will be required to certify that the form complies with Wyoming law. Wyoming Statute § 26-13-125 (d) requires that each certificate of insurance shall contain the following or similar statement: "This certificate of insurance is issued as a matter of information only and confers no Administration (307) 777-7401 + Fax (307) 777-2446 h Licensing (307) 777-7319 * Fax (307) 777-5895 Docusign Envelope ID: 1 DC9EBCF-5EAD-8FOE-83E2-9AD8ABB77C74 Wyoming Insurance Department Memorandum: 01-2014 rights upon the certificate holder. This certificate does not alter, amend or extend the coverage, terms, exclusions and conditions afforded by the policies referenced herein." Wyoming Statute § 26-13-125 (e) prohibits AU person from knowingly demanding or requesting the issuance of a certificate of insurance or other document, record or correspondence that contains any false or misleading information or that purports to affirmatively or negatively alter, amend or extend the coverage provided by the policy of insurance to which the certificate makes reference. Wyoming Statute § 26-13- 125 (h) prohibits reference to contracts other than the underlying contracts of insurance, including construction or service contracts. Also, Wyoming Statute § 26-13-125 (k) states that any certificate of insurance or other document, record or correspondence prepared, issued or requested in violation of this section shall be null and void and of no force and effect. Pursuant to Wyoming Statute § 26-13-125 (g) a certificate of insurance is not a policy of insurance and does not affirmatively or negatively alter, amend or extend the coverage afforded by the policy to which the certificate of insurance makes reference. A certificate of insurance shall not confer to a certificate holder any new or additional rights beyond what is provided by the referenced insurance policy. 'rhe certificate of insurance shall accurately reflect the coverages and limits of the referenced insurance policy. Pursuant to Wyoming Statute § 26-13-125 0) a person is entitled to receive notice of cancellation, nonrenewal or any material change or any similar notice concerning a policy of insurance only if the person has notice rights under the terms of the policy or any endorsement to the policy. 'rhe terms and conditions of the notice, including the required timing of the notice, are governed by the policy of insurance or endorsement and may not be altered by a certificate of insurance. Each insurance company is strongly requested to provide all individuals authorized to issue certificates with clear procedures regarding their authority to issue certificates in this state. 'rhe procedures shall be available to the Department upon request. Violations of other provisions of the Wyoming Insurance Code where such violations are associated with the issuance of a certificate of insurance are subject to administrative, criminal and/or civil penalties. These violations include but are not limited to W.S. § 26-9-211 (a)(v) (illegal for a producer to misrepresent the terms of an insurance contract), W.S. § 26-13-103 (a)(i) (illegal for a person to make, issue or circulate or cause to be made, issued or circulated a statement misrepresenting the terms of any policy), W.S. § 26-13-201 (a) (iii) (illegal for a person to prepare, make or subscribe a false or fraudulent certificate, or other document with the intent that the certificate or other document be presented in support of a claim) Any questions regarding the information in this memorandum should be directed to Donna Stuart, Property and Casualty Division at: donna...stewartL� or (307) 777-7308. ........................................... ................................................ I