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PFI2021-00157 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT s COMMUNITY DEVELOPMENT Permit#: PF12021-00157 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 05/04/2021 Parcel: 2S114AB05300 Jurisdiction: Tigard Site address: 9385 SW MILLEN DR Subdivision: KNEELAND ESTATES Lot: 40 Project: Anderson Sewer Project Description: 9385 SW Millen. Replace 10 feet of sanitary sewer from on property to face of curb via trenching. Class of Work: FEES Description Date Amount Type 2-Sidewalk/Driveway Approach PFI Permit Fee 05/04/2021 $300.00 Owner: Total $300.00 REQUIRED INSPECTIONS Call 503-639-4175 for the IVR inspection request line or visit the City of PHONE: Tigard website at A±n .tiaard-or.00v to schedule inspections online. Contractor: 3 MOUNTAINS PLUMBING 5304 N ALBINA AVE PORTLAND, OR 97217 PHONE: 5036701342 Applicant: ANDREA BASILE 5304 N ALBINA AVE PORTLAND, OR 97217 PHONE: 5036701342 Please sign below to indicate acceptance of conditions and return a copy with the proposed work schedule along with names and contact information of responsible parties before beginning work. Permittee/Applicant Signature: see application Issued By: Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PF12021-00157 Tvue: Condition Name: Status: Severity: PFI_Sidewalk/[ 01 -WORK SITE REQUIREMENTS Applied Notice Applicant must comply with all applicable provisions of federal and state law,the Tigard Municipal Code, and the terms of any agreement with the City of Tigard regarding work to be done pursuant to this permit. PFI_Sidewalk/[ 02-WORK SITE AREA Applied Notice The work area and approach roads shall be maintained in a clean condition, free from obstructions and hazards. The spreading of mud or debris or storage of materials or equipment of any kind upon any public roadway is strictly prohibited and violation shall be cause for immediate cancellation of the permit. The City may at any time order immediate clean-up and suspension of work to accomplish clean-up. PFI_Sidewalk/[ 03-WORK SITE EROSION CONTROL Applied Notice Prior to starting work,effective and approved erosion control devices must be installed and maintained meeting the Clean Water Services and DEQ requirements. The City may at any time order corrective action and suspension of work to accomplish effective erosion control. PFI—Sidewalk/1 04-WORK SITE REPAIRS Applied Notice Disturbed landscaped areas shall be restored or replaced. Existing signs, pavement markings, mailboxes,etc. shall be reinstalled or replaced, with like kind of material. Obtain City approval of restoration work. PFI_Sidewalk/[ 05-TRAFFIC CONTROL SPECIFICATIONS Applied Notice Applicant shall provide traffic control according to the current edition of the"Manual on Uniform Traffic Control Devices [MUTCD]for Streets and Highways", U.S. Dept. of Transportation, FHWA,current edition, American Traffic Safety Services Association [ATSSA], and Oregon Temporary Traffic Control Handbook[OTTCH]. PFI—Sidewalk/1 06-TRAFFIC CONTROL PLAN Applied Notice Submit a job specific traffic control plan. A copy of the approved traffic control plan shall be readily available at the work area.Traffic control devices, flag persons,etc., shall be in place prior to initiation of construction work and shall be effectively maintained. PFI_Sidewalk/[ 07-TRAFFIC CONTROL ROAD CLOSURE Applied Notice Public roadway shall not be closed to traffic, at any time,without obtaining written approval from the City Engineer. The applicant is responsible to provide 48 hour advance notice of traffic flow disruptions to affected businesses, residents and area wide Emergency Services:503-629-0111 (Tigard Police Dept.,Tualatin Fire& Rescue)and to 503-962-8140 (Tri-Met) and 503-431-2345(Tigard School District) and other service providers impacted by such closure. PFI_Sidewalk/[ 08-TRAFFIC CONTROL ADVANCE WARNING Applied Notice Advance warning of traffic disruption shall be provided to the public by placement of an approved advance notification sign at each end of the construction area 72 hours (min.) before initiation of construction work. PFI_Sidewalk/[ 09-TRAFFIC CONTROL PROPERTY ACCESS Applied Notice Access to existing properties shall be maintained at all times, including normal delivery service and mail service. Obtain City approval of any access closures. PFI—Sidewalk/1 10-TRAFFIC CONTROL WORK HOURS Applied Notice Work is permitted in daylight between the hours of 7:00 a.m. to 7:00 p.m. Mon-Fri unless otherwise authorized by the City. PFI—Sidewalk/1 11 -TRAFFIC CONTROL LIMITED WORK HOURS Applied Notice Hours of construction work on collector and arterial roads will be limited to 9:00 a.m.to 3:00 p.m. unless authorized by the City Engineer. Work will not be permitted on collector and arterial roads between 3:00 p.m. to 9:00 a.m. unless authorized by the City Engineer. PFI_Sidewalk/[ 12-TRAFFIC CONTROL MODIFICATION Applied Notice The City reserves the right to add to or modify traffic control requirements as necessary to effectively control traffic and to assure public safety. PFI—Sidewalk/1 13-DRAINAGE CONTROL Applied Notice Drainage shall be controlled within the work site and shall not adversely affect adjacent private property, public property and the receiving system. The City may at any time order corrective action and suspension of work to accomplish effective drainage control. PFI_Sidewalk/[ 14-UTILITY NOTIFICATION Applied Notice Oregon law requires following the rules adopted by the Oregon Utility Notification Center. Said rules are set forth in OAR 952-001-0100 through OAR 952-001-0080. Copies of said rules may be obtained from the Center by calling 503-246-1987. If you have any question about the rules,contact the Center. NOTE: Damage to utilities shall be corrected at the permit holder's expense PFI_Sidewalk/[ 15-UTILITY LOCATION CONFLICT Applied Notice Applicant must verify all existing utilities for both vertical elevation and horizontal location prior to start of work(pothole before digging if necessary). Should conflicts arise and redesign or relocation of facilities be necessary, it shall be done at the applicant's expense. Changes must be approved by the City in advance of work.Applicant shall coordinate the work with affected utility agencies. PFI_Sidewalk/[ 16-TEMPORARY PATCH Applied Notice A temporary hard-surface patch shall be placed on trenches within roadways at the end of each work shift. Obtain advance approval of patching method. No trench shall be left at any time in an un-safe condition. Applicant is responsible for and is liable for hazards or damage resulting from the prosecution of the work. PFI_Sidewalk/[ 17-REPAIR OF EXISTING FACILITIES Applied Notice Work under this permit shall include repair of existing facilities(roads, ditches, etc.)as may be necessary,as determined by the Inspector,to overcome deterioration or damage which occurred in conjunction with the work authorized by the permit. Corrective work shall be done at the applicant's expense. PFI—Sidewalk/1 18-SEWER SYSTEM TEST Applied Notice A sewer system air-test and/or DVD T.V.test report and one set of"As-Builts° shall be provided for review and approval. PFI—Sidewalk/1 19-PRECONSTRUCTION MEETING Applied Notice Before initiating any construction activity,the applicant shall coordinate with the City's inspector, <Trent Brickey>at <971-228-9269>,to establish a preconstruction meeting. Please call 503-639-4175 to schedule inspection, use code 738 PFI_Sidewalk/[ 20 -NOTICE TO COMMENCE WORK Applied Notice The applicant shall notify the City's Inspector twenty-four(24) hours prior to commencing work, prior to any staged inspection, and after completing work covered by the permit. PFI—Sidewalk/1 21 -PERMIT/PLAN ON SITE Applied Notice A copy of the permit including a Certificate of Insurance, and all attachments, and a copy of the approved construction plan and all amendments shall be readily available at the work area. All work shall conform to the permit terms, conditions and provisions and to the City approved permit plans, and approved plan amendments and to the City's standards and specifications and to these General Conditions. Changes to any of these must be approved by the City, in advance of work performance. PFI—Sidewalk/1 22-DAILY INSPECTION REPORTS Applied Notice Applicant shall submit daily inspection reports, on a weekly basis,to the City's Inspector. PFI_Sidewalk/[ 23-MONUMENT PROTECTION Applied Notice Existing monuments, property comers, and survey markers shall be protected. Replacement shall be at the permit holder's expense. PFI—Sidewalk/1 24-VALIDATION OF MATERIAL/CONSTRUCTION Applied Notice The City's Inspector may, at his discretion, require tests and or reports from the applicant to validate claims of material or construction adequacy/compliance. Such tests/reports shall be provided at the applicant's expense. PFI_Sidewalk/[ 25-EMERGENCY CONTACTS Applied Notice Provide to the City inspector, in writing,the names and 24 hour emergency telephone number of two(2)persons who have authority to resolve problems,take corrective action and, in general,will be responsible in case of any emergency. The applicant shall notify the City Inspector, in writing,of any/all assignment changes. PFI_Sidewalk/[ 26-RIGHT OF ENTRY/EASEMENTS Applied Notice Applicant to obtain proper right-of-entry and/or easements prior to starting work. Proof of right-of-entry or properly executed easements, shall be provided to the City. The City shall in no way be construed to be liable for the applicant's failure to obtain or provide for proof of right-of-entry or easements. PFI_Sidewalk/[ 27-PRIVATE PROPERTY AGREEMENTS Applied Notice Provide the City a copy of an executed agreement[s]from the owner for each private property disturbed by construction activity. PFI—Sidewalk/1 28-AS-BUILT DRAWING Applied Notice One as-built drawing showing all new public improvements, including any revision made to the previously approved construction plans and, also, any improvement which may impact an existing public system or facility, shall be provided to the City by a registered civil engineer along with an engineer's certification of installation compliance (Certificate of Compliance). PFI_Sidewalk/[ 31 -OTHER Applied Notice Other City of Tigard PFI#: 2021-00157 ENGINEERING DEPARTMENT Public Facilities Improvement (PFI) Permit PROJECT INFORMATION TYPE OF WORK Project name: Michele Anderson ❑ TYPE 1—Franchise Utility Wodc Brief description of project: Replacing 1 Oft of sanitary sewer from on performed by NWN,PGE, or utility icy property to face of curb via trenching 0 TYPE 2-ROW Sidewalk/Driveway/Sewer Work performed for the purpose of: • Sidewalk installation or repair • Driveway approach installation and repair SITE INFORMATION • Sanitary sewer lateral installation and Location (address if available): 9385 SW Millen Dr,Tigard OR main line tap ❑ TYPE 3—Null Scale Development Work performed with land use approval which includes any of the following. • Subdivisions or Partitions APPLICANT INFORMATION • Strectwidening Name: Contractor-3 Mountains Plumbing • Mainline installation for sanitary sewer, storm sewer, Tigard water, and Tigard Mailing address: 5304 N Albina Ave water service area City/State: Portland Oregon gip; 97224 ❑ TYPE 4—Small Cell Technology Phone: 503-455-8838 ❑ TYPE 5—Tigard Triangle Email. Permits@3mountainsplumtlgo.com ne: NOTE: Type 1 and 2 applications may be Contact name: Andrea Basile - Excavation Coordinator emailed to rowpermitsnnti�d-oor.gov. Phone: Same as Above I-,mail: Same as Above CONTRACTOR INFORMATION ® Same as applicant Name: CCB Number: 169499 PB - 99 Mailing address: City/State: Zip: Phone: Email: ENGINEER INFORMATION Name: Mailing address: City/State: Zip: Phone: Email: ADDITIONAL INFORMATION Estimated value of work is required(if over$5,000):$ NA (within the public right-of-way) Is work related to a LAND USE DECISION? ❑Yes 0 No Case number: City of Tigard • 13125 SW Hall Blvd. 9 Tigard,Oregon 97223 • uwcutigard-or.gov 503-7118-2421 Page 1 of 4 APPLICANTS NOTE: Person specified as`Applicant"shall be designated"Permittee"and shall provide financial assurance for work,if required by the city pursuant to TMC 15.04.140. * With the exception of a utility operating pursuant to a valid franchise or license with the City of Tigard,when the owner and the applicant are different people,the applicant must be the purchaser of record or a lessee in possession with written authorization from the owner or an agent of the owner. The owner must sign this application in the space provided or submit a written authorization with this application. Franchised or Licensed Utilities are not required to obtain the owner's signature on the application. I,the applicant, certify that: • To the best of my knowledge,all the information provided within this application package is complete and accurate. • The above request does not violate any recorded deed restrictions that may be attached to or imposed upon the subject property. • If the application is granted,I will exercise the rights granted in accordance with the terms and subject to all the conditions and limitations of the approval. Andrea Basile- Excavation Coordinator .rQr t4-- C3a z& 04/30/2021 Applicant's or authorized agent's signature Print name Date Property owner's signature (if required) Print name Date Case No: PF12021-00157 Permit fee: 30," Reccived by: AL Date: 4/30/2021 TA Approved by: 7i r><-t Date: �� �2`Z� Notified by: AL Date: `5 �� City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 wwwtigard-orgov • 503-718-2421 • Page 2 of 4 DEVELOPMENT ENGINEERING FEES Public Facility Improvement(PFI)Permit: INITIAL PFI PERMIT FEE Part 1: Required submittal fee is 10%of the Net PFI Permit Fee.See below for calculations.Minimum of$300. NET PFI PERMIT FEE Part 2: All non-water system improvements engineer's estimate X 7% (less the initial PFT Pertnit Fee). WATER LINE CONSTRUCTION FEE Part 3: All public water system improvements engineer's estimate X 12%. FOR ONLY • . STAFF USE ONLY TYPE 4: SMALL WIRELESS FACILITY TYPE 1—3:DETAILED SUBMITTAL REQUIREMENTSCHECKLIST Does applicant have a right-of-way license? ❑Yes ❑No TYPE 1 AND TYPE 2-Must include a sketch showing: Under the wireless facilities standards,is the proposal ❑ Dimensions considered?(check all that apply): ❑Small Cell ❑Macro ❑ Street Name How many install sites are proposed as part of this permit ❑ Site Address application? TYPE 3-Must provide 4 sets of plans (sized 24 x 36 or 22 x 34) and an electronic version of all submittal The proposed equipment is located on which of the following: items. The plans must that include: ❑Public Right-of-Way ❑Private Property ❑ Cover—Site,Vicinity,Abbreviation,Legend If equipment is to be located on private property,describe the ❑ General Notes(City,Water,Sewer,etc.) type&use: ❑ Street(Plan,Profile) ❑ Water,Storm and Sanitary(Plan Profile) ❑ Water Quality Facilities ❑ Grading ❑ Landscaping/Tree Plan ❑ Composite Utility Plan(Electrical,Phone,Gas, Storm, Sanitary,Water,Signage,Street Lights,etc) ❑ Details ❑ Traffic Sight Distance ❑ Signing and Striping ❑ Street Light Plan and Photometric ❑ Engineers seal/signature ❑ Sheet label(project land use name,revision and plan log block,dates and sheet numbers.) ❑ Engineers Construction Estimate Additional Submittals (per land use conditions,if applicable) ❑ Traffic Report ❑ Storm water Drainage Calculations ❑ Geotechnical Report ❑ Preliminary Access Report(Sight Distance) ❑ Proposed Plat ❑ Pathway Design ❑ Water Provider Approval Cityof Tigard 13125 SW Hall Blvd. Tigard,Oregon 97223 • www.tigard-orgov • 503-715-2421 • Page 3 of 4 �� X11 .. l •• Si Edge of Pavement I f— Ultch ---1x` Streetlight I ........... —t—•— , I 1111 01 � 1 iT �10 9W01 llll!__ 1 , I Q� I u •; � Existing House I �a I Existing i Driveway I -511 Ile UI �IWfe ; a� le � FqtingSh,pPower` 9nlart. li a"—.—.—.L.—. F,re Hyarr n[(FH) I I I I I I Scale 1'=30' � I I TYPE 1 � � I � I I I � � I 1 TYPE 2: REQUIREMENTSMINIUM SKETCH / applicable) North arrow Property lines&dimensions _Existing utilities locations (sewer,storm,water) Street&street names All existing structures Proposed work Existing curb or edge of pavement Utility&street light poles Existing S/W or D/W apron Slope of property Trees Cityof Tigard 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www6gard-or.gov • 503-718-2421 • Pdge 4 of 4 10 h sanitary sewer replacement via trenching.From on property to curb. Figure 6H-28. Sidewalk Detour or Diversion (TA-28) t m. r 1�)N LSOi. - 03S^'S MIYUOIC now PUO mm (M int MIN SID ALK CLOSED s.xra'K c+esto rpm NEW i ACTAD .116 C001 k lIOA1ry + It IUli11on:;ll SIDEWALK DETOUR SIDEWALK DIVERSION Typical Application 28 N:.e. See fables 61-1-2 and 61-4-31-31 the meaning of the symbols rand;or ktler codes used 1n this ttgure FEDERATED INSURANCE7@ Dear Policyholder, Thank you for choosing Federated Insurance to handle your insurance and risk management needs. The attached certificate document(s) have been issued or updated. Please feel free to contact us with any additional changes, additions or deletions that may be needed by contacting the Federated Client Contact Center at: Phone: 1-888-333-4949 Fax: 507-446-4664 E-mail: clientcontactcenter@fedins.com Thank you for your business! Client Contact Center Enclosed: Certificate Document(s) MISC-0829 (04-13) ACOKOa DATE ILRAADN'YYYI ii.� CERTIFICATE OF LIABILITY INSURANCE 12/17/= 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'. N the certificate holder is an ADDITIONAL INSURED, the policytles) mart have ADDITIONAL INSURED prwislons or be endorsed. II SUBROGATION IS WAIVED, wb)ect to the terms and conditions of the policy, certain policies may require an endersernentA statement on this certificate does not confer ri Ms to the certificate holder in lieu of such en(Drser11en1 s. PRODUCER C. FEDERATED MUTUAL INSURANCE COMPANY NAxTME. CONTACT CENTER _. HOME OFFICE:P.O.BOX 328 .,. We Eat:8 34949 nJXc Ne:507 1984 OWATONNA,MN 55080 E-MaLgi N INEURER(S)APPORONIG COVERAGE EuICR INURER A:FEDERATED MUTUAL INSURANCE COMPANY 13ws INSURED 369 432 0 INSURER e: TREBLE SEVEN LLC,3 MOUNTAINS PLUMBING IxwpeR w 5304 N ALBINA AVE PORTLAND,OR 97217-2302 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:63 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 TYPE OF INSURANCE ADDL USR POLICY NUMBER POLICY[FP POLICY EXP-LTP LIMITS -21111101190=-2111ILROMEw— X OOMMERCI WNERALLIABILDY EACH OCCURRENCE $1,OD0,0DO CVBAS-NAD[ ❑X OCCUR iREM 6E5Ea.. re'., en¢ $100,000 MED[aP IMV pate perTml EXCLUDED A Y N 9130297 08/21/2020 08/21/2021 PERSONALS ADV INJURY $1,000,1700 NT. UWT APPLIE PG: GENERAL AGGREGATE $2,000,000 X POD" ACT ❑SOD PRODUCTS-COMP)OP woo $2,000,000 OTHER: AUTOMOWLE LMMIW COMNNEDSIWUUMIT $1000000 NON BODILY INJURY MIAGerE erwi A my AUTO ALTOS N N 9130297 D8121/202C 08/21221 EOULY INJURY(Per xdwn 4 HIRED AUTOS ONLY WTOIS ONLYOWNED o AUTOS X UMBRELLA LIM X I OCCUR EACH OCCURRENCE $1,0001000 AEme$LWB CLWMs-MADE N N 9''30299 09212020 08212021 Aoop[OATE $1,000,000 DED RETENTION WORKERS COMPENSATION OETRH- AND EMPLOYERS'LIARIUTY Y/■ PER STATUTE ANY PROPRIETORIPARTNERIEXECUTVE I E.L.EACH ACCIDENT OFTICERIMEMBEREXCLUDED+ NIA fYe,dNon,k NHI E.L.DISEASE-EA EMPLOYEE N M.ee,cnte under DESCRIPTION OF OPERATIONS SIF L dSEASE-POLICY DMT I OESCRIPTON Dr OPERATIONS I LOCATIONS l VEHICLES(ACORD 101,ARIUMM Re, '5(NeeJie,mey 11•m,Ered It more ape¢it THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. CERTIFICATE HOLDER CANCELLATION 369-432-0 COOT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES HE CANCELLED BEFORE ACCESS&UTILITY PERMIT UNIT THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 455 AIRPORT RD BE BLDG K ACCORDANCE WITH THE POLICY PROVISIONS. SALEM,OR 973015348 AOTHORIZED RLPRL6ENTAlIN: / ' `"✓a 1,6 V 4VI/ V 1988-2015 ACORD CORPORATION.All rigtxs reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG 20 33 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN A WRITTEN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II - Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured any person or additional insureds, the following additional organization for whom you are performing exclusions apply: operations when you and such person or This insurance does not apply to: organization have agreed in writing in a contract 1. "Bodily injury", "property damage" or or agreement that such person or organization be added as an additional insured on your policy. "personal and advertising injury" arising out Such person or organization is an additional of the rendering of, or the failure to render, insured only with respect to liability for "bodily any professional architectural, engineering or injury", "property damage" or "personal and surveying services, including: advertising injury" caused, in whole or in part, by: a. The preparing, approving, or failing to 1. Your acts or omissions; or prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, 2. The acts or omissions of those acting on your change orders or drawings and behalf; specifications; or in the performance of your ongoing operations for b. Supervisory, inspection, architectural or the additional insured. engineering activities. However, the insurance afforded to such This exclusion applies even if the claims additional insured: against any insured allege negligence or other 1. Only applies to the extent permitted by law; wrongdoing in the supervision, hiring, and employment, training or monitoring of others 2. Will not be broader than that which you are by that insured, if the "occurrence" which required by the contract or agreement to caused the "bodily injury" or "property provide for such additional insured. damage", or the offense which caused the A person's or organization's status as an "Personal and advertising injury", involved the additional insured under this endorsement ends rendering of or the failure to render any when your operations for that additional insured professional architectural, engineering or are completed. surveying services. © Insurance Services Office, Inc., 2018 Page 1 of 2 CG 20 33 12 19 Policy Number: 9130297 Transaction Effective Date:08-21-2020 2. "Bodily injury" or "property damage" C. With respect to the insurance afforded to these occurring after: additional insureds, the following is added to a. All work, including materials, parts or Section III - Limits Of Insurance; equipment furnished in connection with The most we will pay on behalf of the additional such work, on the project (other than insured is the amount of insurance: service, maintenance or repairs) to be 1. Required by the contract or agreement you performed by or on behalf of the additional have entered into with the additional insured; insured(s) at the location of the covered or operations has been completed; or 2. Available under the applicable limits of b. That portion of 'your work" out of which insurance; the injury or damage arises has been put whichever is less. to its intended use by any person or organization other than another contractor This endorsement shall not increase the or subcontractor engaged in performing applicable limits of insurance. operations for a principal as a part of the same project. Page 2 of 2 © Insurance Services Office, Inc., 2018 CG 20 33 12 119 Policy Number: 9130297 Transaction Effective Date:08-21-2020