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Permit No. Permittee: 4) With regard to the Liability insurance required above, excepting any pollution legal liability policy, City, its officers, agents, employees, volunteers, and con trectors shall be named as an additional insured on an endorsement with completed operations and ongoing operations coverage. An endorsement providing that this coverage is primary and non- contributory shell also be provided. 5) Prior to the effective date of this Permit. Permittee shall deliver to City certificates of Insurance and additional insured endorsements in a form reasonably satisfactory to City, evidencing the cave rages required hereunder 6) Permittee's compliance with the provisions of this Section shall in no way relieve or decrease Permiltee's indemnification obligations under this Permit or any of Permittees other obligations hereunder. Notwilhslanding anything to the contrary in this Permit, this Permit shall terminate immediately, Whaul notice to Permittee, upon the lapse of any required insurance coverage. Permittee shall be responsible, at its expense, for separately Insuring Permikee's personal property. 7) Due to the extended term of this Permit. upon request by City. Permittee shall increase the insurance amaunts provided herein to such commercially reasonable minimum limits as may be requested by City. Permittee shall provide evidence of such increased insurance within thirty (30) days of request by City, to a form reasonably satisfactory to City. In submrTdng this appllsefion. APPllcartr(s) agroo(s) to accapf and comply With 8t1 farms and condrTlons sof lodh lrr this pomrrt appllcaflon, and ogmvs (hat sold forms, conditions and provisions shag bo binding on pormrftoo(s), C"Wnors. hairs, assigns, transfereos and successors of inlomsr of every naruro. Applicant(s) Signature(s):� _a__ 2 vy -V Appllcanl(s) Signature(s): (Rosorvod for City's uso) Date: Date.- PERMIT ae: PERMIT GRANTED BY CITY ENGINEER, CITY OF REDWOOD CITY Permit Valid From: To: Fees Paid: Bond/Security: Evidence of Insurance Provided: Address/Location of Activity: Nature of Permitted Activity: Conditions. ""Permit Granted Pursuant To Terms lis Attached 3 ecial Provisions Form— Permit Issued By: On this date. Pormittee's Acceptance of City's Permit Terms and S ociai Provisions: 3 of 9 OAK #4819-4834-1908 v20 Exhibit D