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16-097.00 Cascade Cable Constructors: Conduit Connection CONSTRUCTION AGREEMENT Contract No. 16-097 Conduit Connection Project Cascade Cable Constructors,Inc. THIS CONSTRUCTION AGREEMENT (the"Agreement") is made by and between the City of Spokane Valley, a code City of the State of Washington ("City") and Cascade Cable Constructors, Inc., ("Contractor")jointly referred to as the"Parties". IN CONSIDERATION of the terms and conditions contained herein the Parties agree as follows: 1.Work to Be Performed. Contractor shall do all work and furnish all labor,supervision,tools,materials, supplies, and equipment and other items necessary for the construction and completion of the Conduit Connection Project(the"Work")in accordance with documents described in Exhibit A and in accordance with this Agreement(which are by this reference incorporated herein and made part hereof and referred to as the "Contract Documents"), and shall perform any changes in the work in accordance with the Contract Documents. The terms and provisions in this Agreement shall control over any inconsistent or incompatible terms in any other Contract Document. Contractor shall,for the amount set forth in paragraph 4,below,assume and be responsible for the cost and expense of all work required for constructing and completing the Work and related activities provided for in the Contract Documents to City's satisfaction,within the time limits prescribed in the Contract Documents. The City Manager or designee shall administer and be the primary contact for Contractor. Upon notice from City,Contractor shall promptly commence work,complete the same in a timely manner,and cure any failure in performance under this Agreement. Unless otherwise directed by City,all work shall be performed in conformance with the Contract Documents, and all City,state,and federal standards,codes,ordinances,regulations,and laws as now existing or as may be adopted or amended. 2. Time for Performance. Contractor shall commence the Work within 10 days of receipt of a notice to proceed and shall complete the Work within the times specified in the Contract Documents, as may be extended in accordance with this Agreement and the Contract Documents. 3.Liquidated Damages. No Liquidated Damages will apply to this contract. 4. Compensation. In consideration of Contractor performing the Work, City agrees to pay Contractor in accordance with the Contract Documents the sum of$9,916.80 plus Washington State Sales Tax of$862.76 (8.7%), for a total of$ 10,779.56, based on the bid submitted by Contractor (Exhibit B), and as may be adjusted in accordance with the Contract Documents. 5.Payment. Contractor may elect to be paid in monthly installments,upon presentation of an application for payment in a form satisfactory to City. Applications for payment shall be sent to the City Finance Department at the address stated in paragraph 6. Pursuant to chapter 60.28 RC W,five percent of the compensation due Contractor shall be retained by City. City reserves the right to withhold payment under this Agreement for that portion of the work(if any)which is determined in the reasonable judgment of the City Manager or designee to be noncompliant with the Contract Documents, City standards,City Code, state standards,or federal standards. 6.Notice. Notice other than applications for payment shall be given in writing as follows: TO THE CITY: TO THE CONTRACTOR: Name:Christine Bainbridge,City Clerk Name: Cascade Cable Constructors,Inc. Phone:(509)921-1000 Phone: 509 244-2501 Address: 11707 East Sprague Ave., Suite 106 Address: P.O.Box 638 Spokane Valley, WA 99206 Spokane, WA 99210 7. Applicable Laws and Standards. The Parties, in the performance of this Agreement, agree to comply with all applicable federal,state,and local laws,codes, and regulations. 8. Certification Regarding Debarment, Suspension, and Other Responsibility Matters — Primary Covered Transactions. A.By executing this Agreement,the Consultant certifies to the best of its knowledge and belief,that it and its principals: 1. Are not presently debarred,suspended,proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal department or agency; 2. Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public(federal, state, or local)transaction or contract under a public transaction;violation of federal or state antitrust statutes or commission of embezzlement,theft,forgery,bribery,falsification or destruction of records,making false statements,or receiving stolen property; 3. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph(A)(2)of this certification;and 4. Have not within a three-year period preceding this application/proposal had one or more public transactions(federal, state,or local)terminated for cause or default. B. Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this Agreement. 9.Prevailing Wages on Public Works. Contractor,any subcontractor,or other person doing work under this Agreement, shall comply with the requirements of chapter 39.12 RCW, and shall pay each employee an amount not less than the Prevailing Rate of Wage,as specified by the Industrial Statistician of the Washington State Department of Labor and Industries("L&I"). If employing labor in a class not shown,Contractor shall request a determination of the correct wage ratefor the class and locality from the Industrial Statistician. Contractor shall provide a copy of any such determinations to City. Before commencing,during,and upon completion of the work,Contractor shall file all forms and pay all fees required by L&I and shall indemnify and hold City harmless from any claims related to its failure to comply with chapter 39.12 RCW. The following information is provided pursuant to RCW 39.12.030: Construction Agreement—Conduit Connection Project—Contract No. 16-097 Page 2 of 7 A. State of Washington prevailing wage rates applicable to this public works project,published by L&I,are located at the L&I website address: https://fortress.wa.gov/lni/wagelookup/pry Wagelookup.aspx B. This Project is located in Spokane County. C. The effective prevailing wage date is the same date as the bid due date as referenced in the original request for bids and as may be revised by addenda. A copy of the applicable prevailing wage rates is also available for viewing at the City Public Works Department located at 11707 East Sprague,Suite 106,Spokane Valley,WA 99206. Upon request,City will mail a hard copy of the applicable prevailing wages for this project. 10. Relationship of the Parties. It is understood and agreed that Contractor shall be an independent contractor and not the agent or employee of City,that City is interested only in the results to be achieved,and that the right to control the particular manner, method, and means in which the services are performed is solely within the discretion of Contractor. Any and all employees who provide services to City under this Agreement shall be deemed employees solely of Contractor. Contractor shall be solely responsible for the conduct and actions of all its employees under this Agreement and any liability that may attach thereto. 11.Ownership of Documents. All drawings,plans,specifications,and other related documents prepared by Contractor under this Agreement are and shall be the property of City, and may be subject to disclosure pursuant to chapter 42.56 RCW,or other applicable public record laws. 12.Records. The City or State Auditor or any of their representatives shall have full access to and the right to examine during normal business hours all of Contractor's records with respect to all matters covered in this Agreement. Such representatives shall be permitted to audit,examine,make excerpts or transcripts from such records,and to make audits of all contracts, invoices,materials,payrolls,and record of matters covered by this Agreement for a period of three years from the date final payment is made hereunder. 13.Warranty. Unless provided otherwise in the Contract Documents,Contractor warrants that all Work and materials performed or installed under this Agreement are free from defect or failure for a period of one year following final acceptance by City, unless a supplier or manufacturer has a warranty for a greater period, which warranty shall be assigned or transferred to City. In the event a defect or failure occurs in work or materials,Contractor shall,within the warranty period,remedy the same at no cost or expense to City. This warranty provision shall not be construed to establish a period of limitation with respect to Contractor's other obligations under this Agreement. 14. Contractor to Be Licensed and Bonded. Contractor shall be duly licensed,registered,and bonded by the State of Washington at all times this Agreement is in effect. 15. Contractor to Provide Performance and Payment Bonds. Contractor shall provide a payment bond and a performance bond in the full amount of the Agreement on the City's bond forms. Alternatively, Contractor may elect to have the City retain 50%of the Agreement amount in lieu of providing the City with a payment bond and a performance bond,pursuant to RCW 39.08.010(3). 16. Insurance. Contractor shall procure and maintain for the duration of the Agreement insurance against Construction Agreement—Conduit Connection Project—Contract No. 16-097 Page 3 of 7 claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by Contractor,its agents,representatives,or employees. A.Minimum Scope of Insurance. Contractor shall obtain insurance of the types described below: 1.Automobile liability insurance covering all owned,non-owned,hired,and leased vehicles. Coverage shall be written on Insurance Services Office(ISO)form CA 00 01 or a substitute form providing equivalent liability coverage. If necessary,the policy shall be endorsed to provide contractual liability coverage. 2.Commercial general liability insurance shall be written on ISO occurrence form CG 00 01 and shall cover liability arising from premises, operations, independent contractors, products-completed operations, stop gap liability, personal injury, advertising injury, and liability assumed under an insured contract. The commercial general liability insurance shall be endorsed to provide a per project aggregate limit using ISO form CG 25 03 05 09 or an equivalent endorsement. There shall be no endorsement or modification of the commercial general liability insurance for liability arising from explosion, collapse, or underground property damage. City shall be named as an additional insured under Contractor's commercial general liability insurance policy with respect to the work performed for City using ISO Additional Insured endorsement CG 20 10 10 01 and Additional Insured- Completed Operations endorsement CG 20 37 10 01 or substitute endorsements providing equivalent coverage. 3.Workers'compensation coverage as required by the industrial insurance laws of the State of Washington. B.Minimum Amounts of Insurance. Contractor shall maintain the following insurance limits: 1. Automobile liability insurance with a minimum combined single limit for bodily injury and property damage of no less than$1,000,000 per accident. 2.Commercial general liability insurance shall be written with limits no less than$1,000,000 each occurrence, $2,000,000 general aggregate, and no less than a $2,000,000 products- completed operations aggregate limit. C.Other Insurance Provisions. The insurance policies are to contain,or be endorsed to contain,the following provisions for automobile liability and commercial general liability insurance: 1. Contractor's insurance coverage shall be primary insurance with respect to City. Any insurance,self-insurance,or insurance pool coverage maintained by City shall be excess of Contractor's insurance and shall not contribute with it. 2.Contractor shall fax or send electronically in.pdf format a copy of insurer's cancellation notice within two business days of receipt by Contractor. 3. If Contractor maintains higher insurance limits than the minimums shown above, City shall be insured for the full available limits of commercial general and excess or umbrella liability maintained by Contractor, irrespective of whether such limits maintained by Contractor are greater than those required by this Agreement or whether any certificate of insurance furnished to the City evidences limits of liability lower than those maintained by Construction Agreement—Conduit Connection Project—Contract No. 16-097 Page 4 of 7 Contractor. 4.Failure on the part of Contractor to maintain the insurance as required shall constitute a material breach of this Agreement, upon which the City may, after giving at least five business days' notice to Contractor to correct the breach, immediately terminate the Agreement, or at its sole discretion, procure or renew such insurance and pay any and all premiums in connection therewith, with any sums so expended to be repaid to City on demand, or at the sole discretion of the City, offset against funds due Contractor from the City. D.Acceptability of Insurers. Insurance is to be placed with insurers with a current A.M.Best rating of not less than A:VII. E. Evidence of Coverage. As evidence of the insurance coverages required by this Agreement, Contractor shall furnish acceptable insurance certificates to City at the time Contractor returns the signed Agreement,which shall be Exhibit C. The certificate shall specify all of the parties who are additional insureds,and shall include applicable policy endorsements,and the deduction or retention level. Insuring companies or entities are subject to City acceptance. If requested,complete copies of insurance policies shall be provided to City. Contractor shall be financially responsible for all pertinent deductibles,self-insured retentions, and/or self-insurance. F.Subcontractor Insurance. Contractor shall cause each and every subcontractor to provide insurance coverage that complies with all applicable requirements of the Contractor-provided insurance as set forth herein,except Contractor shall have sole responsibility for determining the limits of coverage to be required to be obtained by subcontractors. Contractor shall ensure that the City is an additional insured on each and every subcontractor's commercial general liability insurance policy using an endorsement at least as broad as ISO additional insured endorsement CG 20 38 04 13. 17.Indemnification and Hold Harmless. Contractor shall,at its sole expense,defend,indemnify,and hold harmless City and its officers,agents,and employees,from any and all claims,actions,suits,liability,loss, costs,attorney's fees and costs of litigation,expenses,injuries,and damages of any nature whatsoever relating to or arising out of the wrongful or negligent acts,errors,or omissions in the services provided by Contractor, Contractor's agents, subcontractors, subconsultants, and employees to the fullest extent permitted by law, subject only to the limitations provided below. Contractor's duty to defend,indemnify,and hold City harmless shall not apply to liability for damages arising out of such services caused by or resulting from the sole negligence of City or City's agents or employees. Contractor's duty to defend, indemnify, and hold City harmless against liability for damages arising out of such services caused by the concurrent negligence of(a) City or City's agents or employees, and (b) Contractor,Contractor's agents,subcontractors,subconsultants,and employees shall apply only to the extent of the negligence of Contractor,Contractor's agents, subcontractors, subconsultants,and employees. Contractor's duty to defend, indemnify, and hold City harmless shall include, as to all claims, demands, losses, and liability to which it applies, City's personnel-related costs, reasonable attorneys' fees, and the reasonable value of any services rendered by the office of the City Attorney,outside consultant costs,court costs,fees for collection, and all other claim-related expenses. Contractor specifically and expressly waives any immunity that may be granted it under the Washington State Industrial.Insurance Act,Title 51 RC W. These indemnification obligations shall not be limited in any way by Construction Agreement—Conduit Connection Project—Contract No. 16-097 Page 5 of 7 any limitation on the amount or type of damages,compensation,or benefits payable to or for any third party under workers' compensation acts, disability benefit acts, or other employee benefits acts. Provided,that Contractor's waiver of immunity by the provisions of this paragraph extends only to claims against Contractor by City,and does not include,or extend to,any claims by Contractor's employees directly against Contractor. Contractor hereby certifies that this indemnification provision was mutually negotiated. 18.Waiver. No officer,employee,agent,or other individual acting on behalf of either party has the power, right,or authority to waive any of the conditions or provisions of this Agreement. No waiver in one instance shall be held to be waiver of any other subsequent breach or nonperformance. All remedies afforded in this Agreement or by law shall be taken and construed as cumulative and in addition to every other remedy provided herein or by law. Failure of either party to enforce at any time any of the provisions of this Agreement or to require at any time performance by the other party of any provision hereof shall in no way be construed to be a waiver of such provisions nor shall it affect the validity of this Agreement or any part thereof. 19. Assignment and Delegation. Neither party shall assign, transfer, or delegate any or all of the responsibilities of this Agreement or the benefits received hereunder without first obtaining the written consent of the other party. 20.Confidentiality. Contractor may,from time-to-time,receive information which is deemed by City to be confidential. Contractor shall not disclose such information without the prior express written consent of City or upon order of a Court of competent jurisdiction. 21. Disputes. All disputes arising under or related to this Agreement that cannot be resolved through informal discussion and negotiations shall be resolved by litigation filed in the Superior Court of the State of Washington for Spokane County,unless otherwise required by applicable federal or state law. 22. Subcontractor Responsibility. As required by RCW 39.06.020,Contractor shall verify responsibility criteria for each first tier subcontractor and its subcontractors of any tier that hires other subcontractors shall verify responsibility criteria for each of its subcontractors. Verification shall include that each subcontractor, at the time of subcontract execution, meets the responsibility criteria listed in RCW 39.04.350(1) and possesses an electrical contractor license,if required by chapter 19.28 RCW,or an elevator contractor license if required by chapter 70.87 RCW. This verification requirement shall be included in every subcontract of every tier. 23.Jurisdiction and Venue. This Agreement is entered into in Spokane County,Washington. Venue shall be in Spokane County, State of Washington. 24.Entire Agreement. This Agreement constitutes the entire and complete agreement between the parties and supercedes any prior oral or written agreements. This Agreement may not be changed, modified, or altered except in writing signed by the Parties. 25.Anti-kickback. No officer or employee of City,having the power or duty to perform an official act or action related to this Agreement, shall have or acquire any interest in this Agreement, or have solicited, accepted,or granted a present or future gift,favor,service,or other thing of value from any person with an interest in this Agreement. 26.Business Registration. Prior to commencement of Work under this Agreement,Contractor shall register Construction Agreement—Conduit Connection Project—Contract No. 16-097 Page 6 of 7 with the City as a business if it has not already done so. 27.Severability. If any section,sentence,clause,or phrase of this Agreement should be held to be invalid for any reason by a court of competent jurisdiction, such invalidity shall not affect the validity of any other section,sentence,clause, or phrase of this Agreement. 28. Exhibits. Exhibits attached and incorporated into this Agreement are: A. Scope of Work(Plan Sheet titled"0215—Conduit Connection,dated 06/07/2016) B. Cost Statement C. Insurance Endorsements The Parties have executed this Agreement this 5 day of u IY ,2016. CITY OF SPOKANE VALLEY: Contractor: Mar Calhoun,Acting City Manager By: Cli vedten !! Its: President ATTEST e 40, ristine Bainbridge, ity Clerk APPROVED AS TO FORM: Offic f the Ci A orney Construction Agreement—Conduit Connection Project—Contract No. 16-097 Page 7 of 7 , r Valley BOND NO:23032043 CONTRACTOR'S PERFORMANCE BOND to City of Spokane Valley,Washington The City of Spokane Valley, Washington, in Spokane County, has awarded to Cascade Cable Constructors, Inc. (Contractor),as Principal,a contract for the construction of the project designated as Conduit Connection Project , Project No.16-097 in Spokane Valley,Washington,and said Principal is required to furnish a bond for performance of all obligations under the Contract. The Principal,and Liberty Mutual Insurance Company (Surety),a corporation,organized under the laws of the State of Washington and licensed to do business in the State of Washington as surety and named in the current list of"Surety Companies Acceptable in Federal Bonds" as published in the Federal Register by the Audit Staff Bureau of Accounts,U.S.Treasury Dept.,are jointly and severally held and firmly bound to the City of Spokane Valley,in the sum of Ten Thousand Seven Hundred Seventy Nine Dollars and 56/100 US Dollars($10,779.56 ) Total Contract Amount,subject to the provisions herein. The statutory performance bond shall become null and void, if and when the Principal, its heirs, executors, administrators, successors,or assigns shall well and faithfully perform all of the Principal's obligations under the Contract and fulfill all the terms and conditions of all duly authorized modifications,additions,and changes to said Contract that may hereafter be made, at the time and in the manner therein specified; and if such performance obligations have not been fulfilled,this bond shall remain in full force and effect. The Surety for value received agrees that no change, extension of time, alteration or addition to the terms of the Contract,the specifications accompanying the Contract,or to the work to be performed under the Contract shall in any way affect its obligation on this bond,and waives notice of any change,extension of time,alteration or addition to the terms of the Contract or the work performed.The Surety agrees that modifications and changes to the terms and conditions of the Contract that increase the total amount to be paid the Principal shall automatically increase the obligation of the Surety on this bond and notice to Surety is no required for such increased obligation. This bond may be executed in two (2) original counterparts, and shall be signed by the parties' duly authorized officers.This bond will only be accepted if it is accompanied by a fully executed and original power of attorney for the officer executing on behalf of the surety. PRINCIPAL(CONTRACTOR) SURETY Cascade Cable Constructors, Inc. Liberty Mutual Insuranc- Company �_--- Ycteek Zf-/,G 11111.; 11/ ` 6/27/2016 Principal i^ature Date Surety Si iia � Date l4 P I veat Peggy A. Firth Printed Name Printed Name Fh5Attorney-in-Fact Title Title Name,address,and telephone of local office/agent of Surety Company is: Wells Fargo Insurance Services USA, Inc. 601 W. First Avenue, Suite 800, Spokane, WA 99201 509-358-3800 Approved as to form: City of Spokane Valley Attorney,County of Spokane Date 0 � Spokane Valley. w=#t^ BOND NO: 23032043 CONTRACTOR'S PAYMENT BOND(NON-FEDERALLY FUNDED PROJECT) to City of Spokane Valley,Washington The City of Spokane Valley, Washington, in Spokane County, has awarded to Cascade Cable Constructors, Inc., as Principal,a contract for the construction of the project designated as CONDUIT CONNECTION PROJECT,Contract No: 16-097 in Spokane Valley, Washington,and said Principal is required under the terms of the Contract to furnish a payment bond in accordance with chapter 39.08 Revised Code of Washington(RCW). The Principal, and Liberty Mutual Insurance Company (Surety), a corporation organized under the laws Massachusetts and licensed to do business in the State of Washington as surety and named in the current list of"Surety Companies Acceptable in Federal Bonds"as published in the Federal Register by the Audit Staff Bureau of Accounts,U.S.Treasury Dept.,are jointly and severally held and firmly bound to the City of Spokane Valley,as Obligee,in the sum of$ 10,779.56 total Contract amount (including Washington State sales tax), subject to the provisions herein. This payment bond shall become null and void,if and when the Principal, its heirs,executors,administrators,successors,or assigns shall pay all persons in accordance with chapters 39.08 and 39.12 RCW,including all workers,laborers,mechanics, subcontractors, and materialmen, and all persons who shall supply such contractor or subcontractor with provisions and supplies for the carrying on of such work; and shall indemnify and hold harmless the Obligee from all loss,cost or damage which Obligee may suffer by reason of the failure of Principal to make such required payments; and if such payment obligations have not been fulfilled,this bond shall remain in full force and effect. The Surety for value received agrees that no change,extension of time,alteration or addition to the terms of the Contract,the specifications accompanying the Contract, or to the work to be performed under the Contract shall in any way affect its obligation on this bond,except as provided herein,and waives notice of any change,extension of time,alteration or addition to the terms of the Contract or the work performed. The Surety agrees that modifications and changes to the terms and conditions of the Contract that increase the total amount to be paid the Principal shall automatically increase the obligation of the Surety on this bond and notice to Surety is not required for such increased obligation. This bond may be executed in two original counterparts, and shall be signed by the parties' duly authorized officers. This bond will only be accepted if it is accompanied by a fully executed and original power of attorney for the officer executing on behalf of the surety. Cascade Cable Constructors, Inc. Liberty Mutual Insurance Company PRINC AL(CONTRACTOR) SW TY 1Y �I•'� ' 6 /27/2016 Principal Signa re Date Surety SignDate l.a V� Peggy A. Firth Printed Name Printed Name 1Ye&fdl Attorney-in-Fact Title Title Name,address,and telephone of local office/agent of Surety Company is: Wells Farqo Insurance Services USA, Inc. 601 W. First Avenue, Suite 800, Spokane, WA 99201 (509) 358-3800 THIS POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND. This Power of Attorney limits the acts of those named herein,and they have no authority to bind the Company except in the manner and to the extent herein stated. Certificate No. 7319024 American Fire and Casualty Company Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That American Fire&Casualty Company and The Ohio Casualty Insurance Company are corporations duly organized under the laws of the State of New Hampshire,that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts,and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana(herein collectively called the"Companies"),pursuant to and by authority herein set forth,does hereby name,constitute and appoint, Deanna K.Nakashima;Debbie Lindstrom;Gail E.Tsuboi;John Drummey Jr;Kathleen M.Mitchell;Peggy A.Firth;Scott Alderman;Simone Rae Frederick;Timothy S. Buhite all of the city of Seattle ,state of WA each individually if there be more than one named,its true and lawful attorney-in-fact to make,execute,seal,acknowledge and deliver,for and on its behalf as surety and as its act and deed,any and all undertakings,bonds,recognizances and other surety obligations,in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF,this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed I thereto this 7th day of April 2016 , c SG €: : zv ln1s04tNsu - ytNsoqAmerican Fire-and Casualty Company - %9`). 1/„. es,c( ,7cc.,` ,4 a0a0�r;(:,ms o 0I e > 1 0 1991. .I ,E� �.''6', - yam')°SA \ e`er7' '4 " t'yA ✓�,AN' * * * By: .01 > �'' David M.Care ,Assistant Secretary C STATE OF PENNSYLVANIA ss to cti 4-I-- COUNTY OF MONTGOMERY C 0 d 0 On this 7th day of April , 2016, before me personally appeared David M. Carey,who acknowledged himself to be the Assistant Secretary of American Fire and v 1- 0 0 Casualty Company,Liberty Mutual Insurance Company,The Ohio Casualty Insurance Company,and West American Insurance Company,and that he,as such,being authorized so to do, W 1 0- execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. ` w > IN WITNESS WHEREOF,I have hereunto subscribed m name and affixed my notarial seal at Plymouth Meeting,Pennsylvania,on the day and year first above written. 0 C. Z 9p pgsT COMMONWEALTH OF PENNSYLVANIA Z M, Q��1+,o Ey F!� Notarial Seal , , ,��) q y�J%/J� .... C'N til C. <Z y Teresa Pastella,Notary Public By: il-t "" K�Q'��"`1 O i OF Plymouth Twp.,Montgomery County Teresa Pastella,Notary Public d 0 L ��v My Commission Expires March 28,2017 MI yJP ��' Member,Pennsylvania Association of Notaries C40. -7ARyi d n C co This Power of Attorney is made and executed pursuant to ane by authority of the following By-laws and Authorizations of American Fire and Casualty Company,The Ohio Casualty Insurance N o i ai Company,Liberty Mutual Insurance Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows: c 1 two L ARTICLE IV—OFFICERS—Section 12.Power of Attorney.Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President,and subject 0 c 2 to such limitation as the Chairman or the President may prescribe,shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Corporation to make,execute,seal, Zt d 0 c acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Such attorneys-in-fact,subject to the limitations set forth in their respective A ,•E y^ powers of attorney,shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so To d executed,such instruments shall be as binding as if signed by the President and attested to by the Secretary.Any power or authority granted to any representative or attorney-in-fact under > il4- 1— the provisions of this article may be revoked at any time by the Board,the Chairman,the President or by the officer or officers granting such power or authority. r+N 71 C ARTICLE XIII—Execution of Contracts—SECTION 5.Surety Bonds and Undertakings.Any officer of the Company authorized for that purpose in writing by the chairman or the president, E ao 1> E and subject to such limitations as the chairman or the president may prescribe,shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Company to make,execute, L M O is seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Such attorneys-in-fact subject to the limitations set forth in their c ao 'Z 0 respective powers of attorney,shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so O o executed such instruments shall be as binding as if signed by the president and attested by the secretary. 0 c0 Certificate of Designation—The President of the Company,acting pursuant to the Bylaws of the Company,authorizes David M.Carey,Assistant Secretary to appoint such attorneys-in- I ' fact as may be necessary to act on behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Authorization—By unanimous consent of the Company's Board of Directors,the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company,wherever appearing upon a certified copy of any powerof attorney issued by the Company in connection with surety bonds,shall be valid and binding upon the Company with the same force and effect as though manually affixed. I,Gregory W.Davenport,the undersigned,Assistant Secretary,of American Fire and Casualty Company,The Ohio Casualty Insurance Company,Liberty Mutual Insurance Company,and West American Insurance Company do hereby certify that the original power of attorney ofwhich the foregoing is a full,true and correct copy of the Power of Attorney executed by said Companies,is in full force and effect and has not been revoked. 1 IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies thisal— day of \�1 . / ,20 t 0,,o CgSG .TY 1%4, ytNS uq ;iNSUR,F.cpuPo2.arFc96L J v..0 sr 1,-,0,t1,1 oRAr��C F�`c�Q c T r� n a 1906 0 0 1919 r, > 1912 2 Q 1991 o By: d 3 z ." `%,.,., /. 2 y , Gregory W.Davenport,Assistant Secretary yfv °?•da O+'y`1`NnMv'''''a? �''sA ,SE' ' �/ n,. !_ ‘y6 Nt.MPS F� y1 1`1 ) ClV F OiAN° 119 of 250 LMS 12873 122013 Cascade CableConstructors, Inc. 400004, 01. QUOTE Cascade Cable Constructors Inc. P.O.Box 638 INVOICE NO. Spokane,WA 99210 DATE May 4,2016 509-244-2501 CUSTOMER ID ctvedten@cascadecable.com EXPIRATION DATE To Pete Fisch City of Spokane Valley Publics Works 11707 E. Sprague Ave,Suite 106 Spokane,WA 99206 C 509.714.7133 pfisch@spokanevalley.org SALESPERSON JOB PAYMENT TERMS DUE DATE Cliff Tvedten Appleway Blvd&Dartmouth Rd,Spokane Valley QUANTITY DESCRIPTION UNIT PRICE LINE TOTAL 140.00 Bore 3-2"HDPE,labor and material included 64.72 9,060.80 1.00 Traffic control 460.00 460.00 1.00 Mob&demob 396.00 396.00 Quote prepared by:C-41, Aeg To accept this quote,sign here eturrn: SUBTOTAL $ 9,916.80 SALES TAX(8.7%) 862.76 TOTAL $ 10,779.56 THANK YOU FOR YOUR BUSINESS! ___i..IN CASCCAB-01 JESH ACOREY DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 6/8/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Spokane Office PHONE509 838-3501 FAX 509 838-3511 PayneWest Insurance,Inc. IA/C,No,Ext):PHONE / ) (NC,No):( ) 501 N.Riverpoint Blvd.,Ste 403 ADDRESS: Spokane,WA 99202 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:The Cincinnati Insurance Co. 10677 INSURED /�` }',fa°,,,5, INSURER B:Technology Insurance Company Cascade Cab n'structtls Inc; INSURER C P.O.Box„638 .' INSURER D: Spokane,WA 99210 � INSURER E: ,re '`� _ �'` I `,-. I .: INSURER F: COVERAGES itc ,' CEggRTIFICATE,NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT,,THE POLICES OF.IN.S(JRANCE-LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY'°REQUIREMENT(TERM Ok,CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, TIlE INSURANCE,AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH PpL`ICIES.LIMITS SHO MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR 'K,""ADDL SUBR 1 POLICY EFF POLICY EXP LTR TYPE OF INSURANCE "-/INSD WVO°., ' POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY , t '1, °.•t\ ''.,�J ,., EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR X EPP0113053 r� 11/26/2015 11/26/2016 DAMAGEaRaEo rr 100,000 PREMISES(Ea occurrence) $ X WA Stop Gap 1 r` ' MED EXP(Any one person) $ 10,000 "'-._-.-rte-' / ./ PERSONAL&ADV INJURY $ 1,000,000 GE AGGREGATE LIM APPLIES PEii2- "" _/ GENERAL AGGREGATE $ 2,000,000 POLICY 1 1 E o([J 4v L�C V ( j / PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: I/• , /f EMPLOYERS LIABI $ 1,000,000 AUTOMOBILE LIABILITY N. ',,,. _,,' / COMBINED SINGLE LIMIT $ 1,000,000 f.;t - (Ea accident) A X ANY AUTO, X EBA0113053 ,,, _µ�;,'' A1/26/,2615'"11/26/2016 BODILY INJURY(Per person) $ ALL OWNED , SCHEDULED '- "'4,. �, AUTOS "t- _- a BODILY INJURY(Per accident) $ `a'4aAUTbS . � t . � NON"OWNED/ `t _ ` PROPERTY DAMAGE HIRED AUTOS I:,..AUTOS —`'- :',, �,y t ' ." - (Per accident) $ UMBRELLA LIAB X OCCUR 'sa'' y( - �' • )� / EACHbCCURRENCE $ 2,000,000 A X EXCESS LIAB CLAIMS MADE EFIP0113053 11/26/2015 11/26/2 16'.AGGREGATE $ DED RETENTION$ \ ',' .I j \ $ 2,000,000 WORKERS COMPENSATION * --!'" _I,STATUTE W- AND EMPLOYERS'LIABILITY ),N �� "�C, � " .o B ANY PROPRIETOR/PARTNER/EXECUTIVE .,..^^"'TWC35207�91 - 01/01/2016~,'01/01/2017 `6.L,E CHACCIDEMT;;5, $ 1,000,000 OFFICER/MEMBER EXCLUDED? RTA A °` (Mandatory in NH) / E. ISEASE ,EAEMPLOYES $ 1,000,000 If yes,describe under ,e''r l t L'O1,000,000 DESCRIPTION OF OPERATIONS below - -- J i _ E.L.DISEAS POLICY LIMIT A Commercial Property EPP0113053 }t 11/26/2014 11/26/2015 Business`Property 208,000 ) Ki DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule may,be atiached If'more space Is required) .,,,` / ;/ RE:Conduit Connection Project,SVPW Contract No.:16-097 I .:--^ Certificate Holder is named as Additional Insured as required by contract,pet form GA233(02/07)attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Spokane ValleyTHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P ACCORDANCE WITH THE POLICY PROVISIONS. 11707 E Sprague Ave#106 Spokane,WA 99206 AUTHORIZED REPRESENTATIVE 4004":4.•,, C4.,------ I ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS' COMMERCIAL GENERAL LIABILITY BROADENED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Endorsement-Table of Contents: Coverage Begins on Page: 1. En 1 Yee'Benefit Liability Coverage 2 2. nintentionalaFailure to Disclose Hazards 7 3 , Dama9e;fo Premises Rented to You 8 I. ' SupplemneptaryPaymegts 9 V Medicallayy-ments.. /.. 9 6. Voluntary Property,Damage (Coverage a.)and Care, Custody or Control Liability Coiverace,(Coveragge b.) 9 7. 180 Day Coverage-for Newly Formed or Acquired Organizations 10 8. Waiver of Subrogation; t,-----„, 10 9. Automatic Additional Insured -Specified Relationships: 10 • Managerso 'Lessors of Premises; • Lessor of Lased Equipment;., ./.., • Vendors; \ _ : , \ /. • State or Political subdivisions-Permits Relating to Premises; • State or Political Subdivisions"Periniits;and ,,.-•°' `' Contractors'Operations , ,� 10.,Broadened Contractual Liability-Work Within 0 of.Railroad Property 14 11(Property Damage to Borrowed Equipment.., ,„/ .e' 14 12. Employees as Insureds-Specified Health,Care-Services:`) 14 • EmergencyhMedical Technicians;,and - \ • Paramedics -- -,,, i 3BroadenedNotice of_Occurrence ./"t.': `- .) 1 14 ....:.- ,r `5,4, .1, i I. r B. Limits of Insurance: 1 i i / The Com erc -Genera L ability"L nits•of Insurance apply to the insu ance prodded by this endorse- ment,except as rovided.below 1. Employee Benefit Liability.Coverage i /Each Employee Limiit: 1 $ ,000,000) Aggregate Limit: 3,000,000 Deductible: $ 1,000 / ' <ft 3. Damage to Premises Rented to You /„...,--,,- The lesser of: ,. . /a. The Each Occurrence Limit shown`n the Declarations;or b. $500,000 unless otherwise stated$ 4. Supplementary Payments a. Bail bonds: $ 1,000 b. Loss of earnings: $ 350 5. Medical Payments Medical Expense Limit: $ 10,000 Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 1 of 15 6. Voluntary Property Damage (Coverage a.)and Care, Custody or Control Liability Coverage (Coverage b.) Limits of Insurance (Each Occurrence) Coverage a.$1,000 Coverage b.$5,000 unless otherwise stated $ Deductibles(Each Occurrence) Coverage a.$250 Coverage b.$250 unless otherwise stated $ COVERAGE PREMIUM BASIS RATE ADVANCE PREMIUM (a) Area (For Limits in Excess of (For Limits in Excess of 7 (b) Payroll $5,000) $5,000) (c) Gross Sales (d) Units (e) Other b. Cars; Custod§:, r ortontrol, r'' -, . $ '/ 7 , i ; ``Y\-, TOTAL ANNUAL PREMIUM $ 11. Property.Damage&to Borrowed Equipment Each OccurrencexLimit: $ 10;000 Deductible: $ j.'250 N }k 1 , (C. Coverages: ' %t have used up the ap- plicable plicable limit of insur- 1. Employee Benefit Liability Coverage` r ance in the payment of a. The-following is added to'SECTION i' / judgments or settle- �'COVERAG -ES: Employee Benefit ments. /Liability'Coverage. j No other obligation or liabil i(1) Insuring Agreement .".,1/4„,_ ity to pay sums or perform . e ,, acts or services is covered z (a) We will pay those sums that.,, , rr ,e a unless explicitly provided for \ the insured:becomes legally /� " "under Supplementary Pay- -N, obligated to pay;,as dam- /-.- \,. ments. -.__..---'ages causedby ariy act, er- a- 7� t,. �:(b),This'insurance applies to ror or omission�of'the in- damage's,only if the act, en- sured, or of any.`.other per- ror or- omission, is ne li- eon(for whose aotsthe i 'gently oomfiitted in the cured is legally liable,,to ? administrationof your which'-this_:ina ve th'e ap- °er pl yee \benefit pro plies:,yVe will have theright and duty~~to-defend the' in- gram."; i�d sured against/any, "'suit' 1 1) Occurs during pol- seeking those damages •, icy penod;or "., However, wevwill haveSro � , duty to defend against any','" ,� 2)-°''Occured prior to the "suit" seeking damages to effective date of this which this insurance does ,, endorsement provided: not apply. We may, at our \ did... ' discretion, investigate any a) You did not/have report of an act, error or knowledge` of a omission and settle any .„ claim or "suit" on claim or "suit" that may re- -` or before the ef- sult. But: fective date of this endorsement. 1) The amount we will pay for damages is limited You will be as described in SEC- deemed to have TION III - LIMITS OF knowledge of a INSURANCE;and claim or "suit" when any 2) Our right and duty to "authorized repre- defend ends when we sentative"; Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 2 of 15 i) Reports all, or formance of investment any part, of the vehicles;or act, error or omission to us 3) Advice given to any or any other person with respect to insurer; that person's decision to participate or not to ii) Receives a participate in any plan written or ver- included in the "em- bal demand or ployee benefit pro- claim for dam- gram". ages because of the act, er- (f) Workers' Compensation ror or omis- and Similar Laws sion;and� Any claim arising out of a' b) There is no other your failure to comply with applicable insur- the mandatory provisions of ti ance. any workers'compensation, unemployment compensa- tion insurance, social secu- re/Aity or disability benefits law This ensu ane does not apply or any similar law. to. , a Bodil I Y I Property (g) ERISA ry,, d Damage(or 'Per�sonal and Damages for which any in- °' Advertising Injury, I sured is liable because of ' in ,, r', ert liability imposed on a fiduci- B dilY ju y",‘ .gyp P y ary by the Employee Re- darage" or 'personal and tirement Income Security advertising injury". r'' Act of 1974, as now or \-, _,../ hereafter am a ended, or by ,--------,, (b) Dishonest, Fraudulent, �7,/ Criminal or Malicious'Act local laws. � `'�'� / Damages arisingout of any r/ any similar federal, state or intentional, dishonest, (h) Available Benefits fraudulent, criminal or'Mali-r ',, \ Any claim for benefits to the cious act, error or omission,' extent that such benefits N. ----,--;A 7-committed by any insured, i are available, with reason- ''`,; `f including the willful or reck- -� s able effort and cooperation less violation of any statute. �, /\;of the insured, from the ap- c Failure)? Perform a Con- r placable funds accrued or Con- tract i 1 " :="`.,other collectible insurance. Damages arising' ou of fail- \01 (i) Taxes;Fines or Penalties ure of perfortmian�ce\of con- `Taxes, fines or penalties, 'tract by any'insurer. including°' those imposed e c�' `�, ,.. 'ander fhe lnte iaal Revenue (d) Insufficiency f Funds \ • ,. � Code,orany similar state or Damages arising,outaof'an i local laW. insufficiency of funds to / / meet any obligations under '� !i) Employment-Related any plan included in the: ,',,,..-,.--'\ .'P,ractices "employee benefit pro - AAhy" liability an'"sing out of gram". /,..-"�`" any:- . . (e) Inadequacy of Pe form- (1) Refusal to employ; ance of Investment /.Ad- vice Given With Respect (2) Termination of em- to Participation ployment; Any claim based upon: (3) Coercion, demotion, reassign- 1) Failure of anyinvest- evaluation,ment, discipline, defa- ment to perform; mation, harassment, 2) Errors in providing in- humiliation, discrimina- formation on past per- tion or other employ- Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 3 of 15 ment-related practices, (e) A trust, you are an insured. acts or omissions;or Your trustees are also in- sureds, re- (4) Consequential liability but only with q spect to their duties as as a result of(1), (2) or trustees. (3)above. (2) Each of the following is also an This exclusion applies insured: whether the insured may be held liable as an employer (a) Each of your "employees" or in any other capacity and who is or was authorized to to any obligation to share administer your "employee damages with or repay benefit program". someone else who must pa\rdamages because of (b) Any persons, organizations he injury. or "employees" having proper temporary authori- (3) uppleme to ary Payments zation to administer your # COVERAGES, "employee benefit program" SECTIO1' N I r I you die, but only until your 'SUPPLEMENTARY , PAY- / legal representative is ap- pointed. - COVERAGES.A AND pointed. „IB also apply to this Coverage. . = ' / /x (c) Your legal representative if b. Who is an Insured `'' ,. you die, but only with re- As respects employee Benefit Liabil spect to duties as such. ity CoverageSECTIO,.N !VI- WHO IS That representative will AN INSURED is deleted in its a have all your rights and du- ties tirety and replaced by the following 41Part. under this Coverage .. (1) If you are designated.�a1n- the f (3) Any organization you newly ac- '--.4._ c- Declarations as: `�. >F '°-.4 , ., , �, quire or form, other than a part- (a) An,,individual, you and yournership, joint venture or limited „-- *spo se are insureds, but ' liability company, and over only `with respect to =thewhich you maintain ownership e conduct of a business of . /,,,,fN ormajority interest, will qualify f-, „..,you are the sole ” as a Named Insured if no other owner. M orga / sirmilar insurance applies to that nization. However, cover- b)\A partnership of-,,joint ven age under this provision: -- - •----' ture, :you are an`insured. �; - Your members,Nyour part- -,... (a)/Is afforded only until the Hers; and their spouses are i 180th day..after you acquire also,insureds but only with or f irm the-organization or respect to the/conductoN ,. tthe-end ot#he-policy period,your. business .r r,r ,whichever is ahier;and (c) A limited rliability c mpa y, N, (b) D es,not apply,,#any act, you are an insured: Your -error or,omission-:that was members are aalso.insureds ,. � committed �.�?efore� you `ac- but onlywith es ect to-,they, -) tamed or foruled the or- conduct of your business:--- .` i ganization._/ Your managers are in- - Limits of Insurance e sureds, but only with re- c. / spect to their duties as your --°'> As respects Employee,Benefit-Liabil- managers. .... --" �ity Coverage, SECTION III,-,LIMITS (d) An organization other than OF INSURANCE is deleted-in its en- a partnership, joint venture tirety and replaced by the following: or limited liability company, (1) The Limits of Insurance shown you are an insured. Your in Section B. Limits of Insur- "executive officers" and di- ance, 1. Employee Benefit Li- rectors are insureds, but ability Coverage and the rules only with respect to their below fix the most we will pay duties as your officers or di- regardless of the number of: rectors. Your stockholders are also insureds, but only (a) Insureds; with respect to their liability as stockholders. Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 4 of 15 (b) Claims made or "suits" (b) The deductible amount brought; stated in the Declarations (c) Persons or organizations applies to all damages g sustained by any one "em- making claims or bringing ployee", including such "suits";; "employee's" dependents (d) Acts,errors or omissions;or and beneficiaries, because of all acts, errors or omis- (e) Benefits included in your sions to which this insur- "employee benefit pro- ance applies. gram". (c) The terms of this insurance, (2) The Aggregate Limit shown in including those with respect ection B. Limits of Insurance, to: 13; Employee Benefit Liability 1) Our right and duty to Cisoverage of this endorsement the most we will pay for all defend the insured ,. ma gs because of acts, er- seeking those dam 9eaainst .errors or omissions negligently _committed in,.,the "administra- ages, and `' lion" of y,<ouf "employee benefit 2) Your duties, and the , ) ! „,./ tc/program' duties of any other in- volved insured, in the (3) Subje t toithe )irWt described in event of an act, error or (2) above, the, Each'Employee omission,or claim, Ximit shown in Sections,Limits of %'Insutrance,=_,1. Employee apply irrespective of the Benefit 'Liability Coverage of4 application of the deductible this endorsement.is the most , , amount. will pays for.yall damages ,sus- (d) We maypayanypart or all tained by,any;one.""employee", including damages,sustainedtby of the deductible amount to -•.,such "employee's" dependents _ effect settlement of any and beneficiaries,as a result of: claim or "suit" and, upon notification of the action f + (a) An act, error or Omission;or taken, you shall promptly I ?) A series of related'acts, er- , reimburse us for such part `�, rors-or omissions, re and=' of the deductible amount as g - we have paid. less of'the amount of time T ,, ,:'i that"la ses between such V.. - '�.�,..��=� r;. p , d. .�Addi�nal Conditions acts,errors or omissions, '+. 3 ' - --As respects Employee Benefit Li- 'negligentlycommitted in the � afiilitrCo`verage, SECTION IV' - it\"administration";hof your "em COMMERCIA , GENERAL LIABIL- pioyee benefitro m j b. If a claim is made or "suit" is brought b. Method of Sharing against any insured, you must: If all of the other insur- (1) Immediately record the specifics ance permits contribu- of the claim or "suit" and the tion by equal shares, date received; and we will follow this method also. Under (2) Notify us as soon as practicable. this approach each in- You must see to it that we receive surer contributes equal written notice of the claim or"suit" as amounts until it has soon as practicable. paid its applicable limit of insurance or none of c. You and any other involved insured the loss remains, must: whichever comes first. (1) Immediately send us copies of If any of the other in- riy dema fis: notices, sum- surance does not per- mit:-legal papers re- mit contribution by ceived An .connection with the equal shares, we will claim r"surf; contribute by limits. �' Under this method, (2) Authorize/us]to ob am records each insurer's share is it nd,OtherlinforrnaliaQr based on the ratio of its ' e-- applicable limit of in- (3) Cooperate wit us in the-inv sti, surance to the total ap- gation or settlement of the claim plicable limits of insur- or defense ,against the suit" ; ance of all insurers. • ` / (4) Assist us, upon ,sur reques ; ink c. No Coverage the enforcement.:of any right This insurance shall not against any person or aorganiza- cover any loss for tion_which may be�liable.to the :: / which the insured is insured,because of an act, error"` entitled to recovery un- or orris ion to which this incur- f der any other insur- d , ance ay.also apply. i ance in force previous .`No insured will, except at that in - ` / :�� to the effective date of * -, _ this Coverage Part. sured's own cost, voluntarily make a�, / ,,-,,_; \ payment, assume any obligation, or .e.`` Additional Definitions \incur any expense without.our con- . t 'sent. �- .. As respects� Employee Benefit Li- - s. ability, `Coverage, SECTION V - (2) Item 5 Other Insurance is de- l DEFINITIONS is 'amended as fol- leted,in its entirety and replaced I lows: �' `r` `�, by the o iowing:� „�f '' ` {(1) e following'° defiinitions are 5. Other insurance . added 11 If other valid and, ollectible 1`' Administration7'neans: insurance is available tithe °�, insured for a-loss we''coved. N., . Providingg infomatio-to under this CO�vera a Part,' `=-em loyees , including our obligations are limited r f their°.dependents and as follows: P beneficiaries, with re spept.to eligibility-for-or a. Primary Insurance scope bf.,.,,'eMployee This insurance is pri- benefit pro4grams"; mary except when c. b. Interpreting the "em- below applies. If this °: ployee benefit pro- insurance is primary, grams"; our obligations are not affected unless any of c. Handling records in the other insurance is connection with the also primary. Then, we "employee benefit pro- will share with all that grams"; or other insurance by the d. Effecting, continuing or method described in b. terminating any "em- below. ployee's" participation Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 6 of 15 in any benefit included benefits, workers' corn- in the "employee bene- pensation and disability fit program". benefits;and However, "administration" d. Vacation plans, includ- does not include: ing buy and sell pro- grams; leave of ab- a. Handling payroll sence programs, in- ductions; or cluding military, mater- b. The failure to effect or nity, family, and civil maintain any insurance leave; tuition assis- or adequate limits of tance plans; transpor- coverage of insurance, tation and health club including but not limited subsidies. to unemployment in- (2) The following definitions are f/r surance, social security deleted in their entirety and re- benefits, workers' corn- placed by the following: pensation and disability f' benefits. 21. "Suit" means a civil pro- 2 "Cafeteria plans" means damages in because of moneya planuthorized by applica- act, error or omission to \s"...' / ble�ltoallow "employ- which this insurance applies =, ees"�to elect to payior cer- are alleged. "Suit"includes: 1 ::,tambenefits--with='pre-tax ' dollars , -\ \ a. An arbitration pro- t ceeding in which such 3. "Employee\ benefit/ pro- damages are claimed grams means a program and to which the in- provdi lg some or all of, the"'` sured must submit or following='benefits to'l'ern' does submit with our ployees" whether provided consent; through a "cafeteria plan" or /7,..-------„„„,„„ otherwise: "V b. Any other alternative f /„/">. dispute resolution pro- ./ I a. Group life 4,;insurance; ceeding in which such group accident or 'V / damages are claimed health insurance; den-f and to which the in tal,.vision and hearing sured submits with our ''+ " � pians: and flexible �., � ,,��'`` \ , : consent; or N'''',---,--./ --- spending accounts; , `" i provided that no one _ . Nc. An appeal of a civil other than an "em- - proceeding. ployee"may subscribe ,./..,,,,,, to/Such benefits and r� 18. Employee" means a per- 1 son etively employed, for- strch,benefits;a�e'r ade ' - generally' ayailatsle`� to r merly''employed, on leave hf.absence or disabled, or those�employees';who . in- satisfy the` Ian s 'eli i- etired. "Employee" in- yIh pr 9 Witty r quer merits; ` clude5 a lesed worker". `� Employee" does not in- b. Profit sharing=--plans, f ° ,.c'tude'a temporaryworker . employee savings i1 plans, employee stocks il . „,-2. Unintentionalt Failure Disclose Haz- ownership plans, pen-, ' ards sion plans and stock OM SECTION IV- COMMERCIAL GENERAL subscription 'lads;, LIABILITY CONDITIONS, 7. Represen- provided that no one tations is hereby amended by the addi- other than an no,' tion of the following: ployee” may subscribe to such benefits and Based on our dependence upon your such benefits are made representations as to existing hazards, if generally available to unintentionally you should fail to disclose all "employees" who all such hazards at the inception date of are eligible under the your policy, we will not reject coverage plan for such benefits; under this Coverage Part based solely on c. Unemployment insur- such failure. ance, social security Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 7 of 15 3. Damage to Premises Rented to You e) Settling, cracking, of Paragraph shrinking or ex- a. The last Subparagraph pansion; or 2. SECTION I - COVERAGES, COVERAGE A. - BODILY INJURY f) Nesting or infesta- AND PROPERTY DAMAGE, 2. LI- tion, or discharge ABILITY Exclusions is hereby de- or release of leted and replaced by the following: waste products or Exclusions c.throughdo not I secretions, , in- Exclusions j 9 q. apply sects, birds, ro- to damage by fire, explosion, light- dents or other ning, smoke or soot to premises animals. while rented to you or temporarily occupied by you with permission of (b) Loss caused directly or indi- the owner. \‘'), rectly by any of the follow- b. The i• uran/ce provided under SEC- ing: TIO 1 -.COVERAGES, COVERAGE 1) Earthquake, volcanic A BODILY/INJURY AND PROP- eruption, landslide or RV DAMAGE LIABILITY applies any other earth move- o "propeertyiamage" arising out of ment; ater,,Barr ag&to premises that are 2) Water that backs up or both�redted to hd occupied by you. overflows from a (1) s respects Water' Damage`e- sewer,drain or sump; gal Liability,-yes proviced i Paragraph,3.b.above 3) Water under the '\: •.` ground surface press- The exclusions;under SECTION ing on, or flowing or - COVERAGES,',COVERAGE seeping through: A. BODILY `INJURY) AND / ;°� PROPERTY DAMAGE..LIABIL- a) Foundations, ITY, 2 Exclusions,''otherthan i walls, floors or War-and the Nuclear Energy_��r.: /A;,-‘) � Paved surfaces; ilabtlit Exclusion, are deleted' b) Basements, 7 ,and the following are added:A /I/ _ t whether paved or ck This insurance does not ap ly -. .... . not;or to: "N, /` -'- c) Doors, windows or „ - ., other openings. (a)t Property damage,.": ,, \ A m—d ' "--(c) Loss caused by or resulting 1) Assumed int any con- t w�/from water that leaks or tract;or x flofivsfrom plumbing, heat- 'Loss cause:by or re- ng, air corditioning, or fire salting from.any of the t protectio i s terns caused foliovving by o�*resulting from freez- ,_ dingunles: a)`^-Wear andhear '�� ' b) Rust, corrosion, 1) You did rout best to maintairj liea th fung s, decay,: building orstructure;or deterioration, hid- _ : r ,, den or latent de- -. 2) Yo �°s ddrained the- fect or any quality ' t �_ equipment and shut off in property that r the mater supply if the causes it to dam- , ,, heat was- ,"trot main- age or destroy it- ' '`"` tained. - " self; (d) Loss to or damage to: c) Smog; 1) Plumbing, heating, air d) Mechanical conditioning, fire pro- breakdown in- tection systems, or cluding rupture or other equipment or ap- bursting caused pliances;or by centrifugal force; 2) The interior of any building or structure, or to personal property in the building or structure Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 8 of 15 caused by or resulting 5. Medical Payments from rain, snow, sleet or ice, whether driven The Medical Expense Limit of Any One by wind or not. Person as stated in the Declarations is amended to the limit shown in Section B. c. Limit of Insurance Limits of Insurance, 5. Medical Pay- ments of this endorsement. The Damage to Premises Rented to You Limit as shown in the Declara- 6. Voluntary Property Damage and Care, tions is amended as follows: Custody or Control Liability Coverage (2) Paragraph 6. of SECTION III - a. Voluntary Property Damage Cov- LIMITS OF INSURANCE is erage hereby deleted and replaced by he following: We will pay for"property damage" to property of others arising out of op- 6. Subject to 5. above, the erations incidental to the insured's Damage to Premises business when: Rented to You Limit is the most we will pay under (1) Damage is caused by the in- / COVERAGE A. BODILY sured;or INJURY ID PROPERTY (2) Damage occurs while in the in- - LIABILITY, for sured's possession. damages because of °'irop rty dare age" to With your consent, we will make premises/ wile,;rented to these payments regardless of fault. you or temporarily?ccupied by fifod with permission of b. Care, Custody or Control Liability theQowner arising,,,,Out of... Coverage any°,one "occurrence",.iiiSECTION I - COVERAGES, COV- which this insuranceap ERAGE A. BODILY INJURY AND plies.`. `` ' PROPERTY DAMAGE LIABILITY, 2. "`� li Exclusions, Damage to Property, ,�" (3)�,The amount we will pay is lim- � 1• g p Y, �-, _ited as described in 'Section B. /1/),,, Subparagraphs (3), (4) and (5) do f ''''\ Limits of Insuranc 3. Dam- ,° not apply to "property damage" to �°" ,age to Premises Rented to y:/ the property of others described Cs. ",„You of this endorsement ,_ .\therein. 4. , SupplementaryPayments '-'— With'respect to the insurance provided by this section of the endorsement, the fol- VUnder SECTION-I-- COVERAGE, SUP- ''" ` lowing additional provisions apply: PLEMENTARY PAYMENTS - COVER-� . :,r 7'' AGES+AAND B: l ��r a:''The-Limitssof Insurance shown in the ( Declarations are replaced by the lim- a. Paragraph 2. is replaced y,the fol- .its designat�ed'in Section B. Limits of lowing: ,r/ . i ..Insurance,'-6..''Voluntary Property �`, Damage and/Care, Custody or Up to'the limit_showr- n�Section1B. `Controliabilityoverage of this Limits of Insurance,4 a. Bail Bonds ndors ent with respect to cover- of this endorsemenffor"cost of bail bonds required because of:accidents -The erlimits �e.i_this ivetof ardent. .. �,, , ,, These limits are inclusive Of and not or traffic law violations arising out of in..a i ditio t the limit ;#ieing re- the use of any vehicle to which the .. placed The Limits of 'insurance Bodily Injury Liability Coverage ap- •' shown,in Section B. Limitsrof Insur- plies. We do not have to furnish i ance, 6. loluntaryProperty Dam- these bonds. . ' age and Care Custody or Control b. Paragraph 4. is replaced by the" '"" --' Liability Coverageof this endorse- lowing: V ment fix the most we will pay in any one "occurrence" regardless of the All reasonable expenses incurred by number of: the insured at our request to assist us in the investigation or defense of (1) Insureds; the claim or "suit", including actual (2) Claims made or "suits" brought; loss of earnings up to the limit shown or in Section B. Limits of Insurance, 4.b. Loss of Earnings of this en- (3) Persons or organizations mak- dorsement per day because of time ing claims or bringing"suits". off from work. Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 9 of 15 b. Deductible Clause 9. Automatic Additional Insured - Speci- (1) Our obligation to pay damages fied Relationships on your behalf applies only to a. The following is hereby added to the amount of damages for each SECTION II-WHO IS AN INSURED: "occurrence" which are in ex- cess of the deductible amount (1) Any person or organization de- stated in Section B. Limits of scribed in Paragraph 9.a.(2) Insurance, 6. Voluntary Prop- below (hereinafter referred to as erty Damage and Care, Cus- additional insured) whom you tody or Control Liability Coy- are required to add as an addi- erage of this endorsement. The tional insured under this Cover- limits of insurance will not be re- age Part by reason of: duced by the application of such (a) A written contract or deduc iblle amount. / agreement; or (2) Condition 2.a:Duties in the Event o (b) An oral agreement or con- tract Occurrence)Offense, Claim or'Suit/apt)lies to each claim or , ... tract where a certificate of °'suit"irres ective of the amount. insurance showing that per- 7p son or organization as an , , „,,Nbadditional insured has been (3) We may pay/any/pr all of t'he deductible amount to effect issued, fanyim slemernt;o ;cla ” P rsuit" is an insured, provided: and, upon„notificationA s the act,, tion taken, you shall promptly-` (a) The written or oral contract reimburse us.for such pad of th or agreement is: deductible%amount as has been - paid by us. ,` `' ,rix 1) Currently in effect or ,':__ becomes effective 7. 180 Day Coverage for Newly Formed or /' during the policy pe- Acquired Organizations \\., riod; and ax , SECTION II -`WHO IS AN INSURED/is 2) Executed prior to an amended-asfolllofiws: i "occurrence” or offense 't1 1 to which this insurance Subparagraph a. Sof Paragraph 4.\ is ;,- would apply;and hereby deletedand replaced by the fol- ` lowing: '"�' b)•They are not specifically named as an additional in- a. l i`surahce under this provision is af- t cured under any other pro- forded only�Until the 180th'day after vision.of, or endorsement you acquire or form the organization .,, ,. 't,, 'added foto, this Coverage or the end of the policy -,period, P whichever isearlier; I ��€ / ,i``�, `' �(2) Only the following_ persons or 8. Waiver of Subr gation '''^;, i rganizations are additional in- SECTION / sureds rider this endorsement, SECTION IV- COMMERCIAL/GE NERAL LIABILITY CONDITIONS,"9. Transfer of and insurance covefage, pro- Rights of Recovery Against Others to `diced to such additional w in- Us is hereby amended by he audition� f suecfs, is limited as pr virled the following: �' ., e herein We waive any right of recovery we may (a) The mnaer or lessor f a have because of payments we make for ,,, premises leased to yo with injury or damage arising out of your on- whom yop have agreed/per going operations or"your work" done un- :. ----" Paragrap9 a(1)above to der a written contract requiring such provide insurances but only waiver with that person or organization ;` with respect to liability aris and included in the "products-completed \/'` ing out of the ownership, operations hazard". However, our rights maintenance or use of that may only be waived prior to the "occur- part of a premises leased to rence" giving rise to the injury or damage you, subject to the following for which we make payment under this additional exclusions: Coverage Part. The insured must do This insurance does not nothing after a loss to impair our rights. apply to: At our request,the insured will bring "suit" or transfer those rights to us and help us 1) Any "occurrence" enforce those rights. which takes place after Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 10 of 15 you cease to be a ten- c) Any physical or ant in that premises. chemical change 2) Structural alterations, in the pro made intentionallyuct new construction or by the vendor; demolition operations performed by or on be- d) Repackaging, un- half of such additional less unpacked insured. solely for the pur- pose of inspection, (b) Any person or organization demonstration, from which you lease testing, or the equipment with whom you substitution of have agreed per Paragraph parts under in- 9.a.(1) above to provide in- structions from the surance. Such person(s) or manufacturer, and yrganization(s)are insureds then repackaged solely with respect to their in the original ,� liability arising out of the container; maintenance, operation or use byrou of equipment e) Any failure to leaser! to you by such per- make such in- „\i/// I/ j, sons) or organizations(s). spections, adjust- H�Wever, ..this' insurance ments, tests or does not apply to any "cc- servicing as the currence'iwhich takesAplace vendor has ' ,, after thetequipment lease agreed to make or expires ‘ N, („\il normally under- i ° 7\ takes to make in (c) Any personr;organization the usual course (referredto-below as,yen),/ of business, in dor) with whom you' have connection with 7/ agreed par Paragraph the distribution or /r' �"± 9.a.(1) above torovide in- sale of the prod- �� '\ surance, but only with re- ucts; i spect to "bodily injury" or / C`� i "property damage," arising F' ,_„ f) Demonstration, in out of"your producs' which " , stallation, servic- are:distributed or sold in-the ing or repair op- j. re r''course of the yen- erations, except .-� :°odor'sbusiness, subject to such operations f the following additional ex-'�,,,x i'-----„--/ performed at the 1 clusions svendor's premises y in connection with 1) The insurance afforded the sale of the ' the endor do-as not - `.---apply l product; ';.. `�; \ g) ,Products which, a) "Bodily injury" or '-after'distribution or "property damage" sale ti r you, have for w'hich;the_ven- r".., `been' labeled or dor is obligated to relabeled dor used pay damages by �° as a' container, reason of the as part or:ingredient sumption of Habil-. ,_„..- -- .. of ny;,other thing it in a contract or Y �._-�°- 6rsubstance by or agreement. This ;--=° _for the vendor. exclusion does not'/' apply to Iiability,for 2) This insurance does damages that the not apply to any in- vendor would sured person or or- have in the ab- ganization: sence of the con- tract or agree- a) From whom you menta have acquired such products, or b) Any express war- any ingredient, ranty unauthorized part or container, by you; entering into, ac- Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 11 of 15 companying or 2) This insurance does containing such not apply to "bodily in- products;or jury", "property dam- age"b When liabilityin- or "personal and advertising injury" aris- cluded within the ing out of operations "products- performed for the state completed opera- or political subdivision. tions hazard" has been excluded (f) Any person or organization under this Cover- with which you have agreed age Part with re- per Paragraph 9.a.(1) spect to such above to provide insurance, products. but only with respect to li- ability arising out of "your (d)Ariy4tate or political subdi- work" performed for that vision with which you have additional insured by you or agreed ` Per Paragraph on your behalf. A person or :% 9.a.(1) above to provide in- organization's status as an f� surance,:_subject to the fol- insured under this provision lowingadditional provision: of this endorsement contin- ues for only the period of /This n urap applies only with pepe614O,the following time required by the written hazards'ffor04hich' he tate ccontracto or agreement, beyothe bu butr ,political subdirisiona ' piration date of this Cover- issuedba permit i conneo_ age Part. If there is no tion vwith premises you n w , agewritten contract or agree- rent or corttrol,and to which ment, or if no period of time ` this insuranc appliee "', /' is required by the written 1) The existence _maihte- ' contract or agreement, a nance, repair, con _ ,0 person or organization's struction, erection, or_ .'` status as an insured under -, ,,removal of advertising this endorsement ends signs, awnings, caro .. when your operations for pies, cellar entrances, " .„ _�, , -'` that insured are completed. .coal holes, driveways (3)*,Ary: insurance provided to an manholes, marquees, —�s- /�, additional insured designated -- hQ1st away openings, w.,,_. -� /bidewalk-vaults, street / " _ under Paragraph 9.a.(2): "` fr banners, or ecora- �. (a)tSub ar-agraphs (e) and (f) tions and similar expo- =j does no �,�apply to "bodily sures; or /Injury"mor"property damage" ws tnclu ded' crit iii the "prod- 2)' The constnrctrol erec- ,ucluded pletpt(' operations tion or�em0Val of ele � ha' rd ; vatorsa r d 3) The owners main- s. .(b) .Subparagraphs a) (b) (d), tenance, r u- e o any ;€ (e,)and (f) dode ot'a©p r to elevators\covereddyu, bodily int N P perty this insurance. 1;5' damage' opersonal end adverts ice injury" arising (e) Any state or political subdi- •:. out of the.sole negligence vision with which you have ; or willful misconduct'ofthe agreed per Paragraph , additional'.isure :orR `their 9.a.(1) above to provide in- �; . -°- agents, "employs"or any surance, subject to the fol- r' other representative of the lowing provisions: additional insured;or 1) This insurance applies (c) Subparagraph (f) does not only with respect to op- apply to "bodily injury", erations performed by "property damage" or "per- you or on your behalf sonal and advertising injury" for which the state or arising out of: political subdivision has issued a permit. 1) Defects in design fur- nished by or on behalf Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 12 of 15 of the additional in- spects any other insurance sured; or policy issued to the addi- tional2 The renderingof, insured, and such or other insurance policy shall failure to render, any be excess and / or noncon- professional architec- tributing, whichever applies, tural, engineering or with this insurance. surveying services, in- cluding: (b) Any insurance provided by this endorsement shall be a) The preparing, primary to other insurance approving or fail- available to the additional ing to prepare or insured except: approve maps, shop drawings, 1) As otherwise provided 7/ "›. :^ opinions, reports, in SECTION IV - "" surveys, field or- COMMERCIAL GEN- ders, change or- ERAL LIABILITY / , ders or drawingsCONDITIONS, 5. Other �/ and specifications; Insurance, b. Excess ¢ a Insurance;or If Su erviso in- 2 For anyother valid and ) ;�/Supervisory, ) spectior archi- collectible insurance tectural or engi- available to the addi- neenng idtiuities,/// tional insured as an } additional insured by 3) , Your•work" for which a attachment of an en- consolidated (wrap-up) dorsement to another insurance;program has` insurance policy that is \been_,provided by/the..- written on an excess primecont ctor-project` basis. In such case, manager or owner of the coverage provided the construction project under this endorse- e in which you are in- / ment shall also be ex- „' cess. b. OnlyWith regard to insu a ro- 3 .. 9 », \(2) Condition 11. Conformance to � vided to an additional insured-desig-'' \ Specific Written Contract or ::.- nated under Paragraph 9.a.(2) Sub- `` '. • Agreement is hereby added: paragraph,.(f)„above, SECTION III - \s, - 'LIMIT&OF INSURANCE is amended„. �` 11.,Conformance to Specific to nclude: _ / 1 � t"--- 'Written Contract or / e I Agreement The limits applicable to the additional insured are those specifiedy in the i itespect to additional written;contract or agreemen '-or in \\I insureds described in Para- the 3eclarations`'ofe this-Coveiage graph 9 a (2)(f)above only: Part, whichever are'less. If no^limits - 7 are specified in,the written contra,_ f a written contract or agreeine,to ween you or agreement, or if there is�o w ittcfi �`� art�l;the'n,,-,,.additional insured contract or agreement, theVllimits,ap- , ;t .-<< plicable to the additional insured are r , '',.:i speees that coverage for those specified in the Declarations of r , the`additional insurtted: this Coverage Part. The limits of in „ - a e provided,,by the In- surance are inclusive of and not in "' � . suran °Services Of- addition to the limits of insurance' """- 'floe additional insured shown in the Declarations. form number CG 20 10 c. SECTION IV - COMMERCIAL GEN- or CG 20 37 (where ERAL LIABILITY CONDITIONS is edition specified);or hereby amended as follows: b. Include coverage for (1) Condition 5. Other Insurance is completed operations; amended to include: or (a) Where required by a written c. Include coverage for contract or agreement, this "your work”; insurance is primary and / and where the limits or cov- or noncontributory as re- erage provided to the addi- Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 13 of 15 tional insured is more re- 11. of this endorsement fix the strictive than was specifi- most we will pay in any one "oc- cally required in that written currence" regardless of the contract or agreement, the number of: terms of Paragraphs 9.a.(3)(a), 9.a.(3)(b) or 9.b. (a) Insureds; above, or any combination (b) Claims made or "suits" thereof, shall be interpreted brought; or as providing the limits or coverage required by the (c) Persons or organizations terms of the written contract making claims or bring or agreement, but only to "suits". the extent that such limits or coverage is included within (2) Deductible Clause Ihe`terms of the Coverage (a) Our obligation to pay dam- Part to which this endorse- `°trent i .attached. If, how- ages on your behalf applies r only to the amount of dam- . ever.,16.6.e v ritten contract or ages for each 'occurrence" ag ee�eri(specifies the In- which are in excess of ther Oram _ Services Office Deductible amount stated in �adtioal ins`urf form Section B. Limits of Insur- numb CG 0 1 but does t ance, 11. of this endorse- not spy ci Which edition,„or ment. The limits of insur- ance specifies :an editions f #hat, does;nnot xist Paragraphs ante will not be reduced by 'e the application of such De- g a(3}". ) and 9.443)(b) of -il ductible amount. this en dorsment.shall not t apply and P ragraph9.b. of (b) Condition 2. Duties in the this endorse ment shall ap- .. Event of Occurrence, Of- ply. V '7,., V :_ fense, Claim or Suit, ap- plies to each claim or "suit" 10. Broadened,-Contractual Liebflity.-*orlc Withit50�''o_ f Railroad Property '7 irrespective of the amount. /' '` " (c) We may pay any part or all It-is hereby agkedthat Paragraph f.(1)n/ f� of the deductible amount to Definition 12. insured contract" (SEC TION V-DEFINITIONS)is deleted. .„< ``- V effect settlement of any i •'' �„ , ,�,claim or suit and, upon 11. Property Damage to-Borrowed Equip- \, notification of the action meat ^. - ,; taken, you shall promptly '�;, .. reimburse us for such part a. The-follow,gg is=hereby added to Ex- t ';,. /of the deductible amount as clusion j "Damage to Property of has been_paid by us. Paragraph= , Exclusions of SEC- i .<< /. . TION I - COVERAGES, COVERAGE 12. Employees, as iinsur,ecle Specified A. BODILY INJURY...AND' PROP Health Care Services ERTY DAMAGELIA ILITY .. . .f It is ereby agreed that paragraph Paragraphs (3) and-(4) of-this_ Cclu- 2.a.(1)(d) f SECTIO II WHO-AS AN • sion do not apply to tools or-aeq'bip INSURED.:,dogs not `apply-t'o e r'"em- ment loaned to you,, rovided-he ployees" who provide professiona alth are not beingused to opera--' p,, care services,o '''your iehaif as duly,Ii perform tions at the time of loss. ', censed: ' ` • i b. With respect to the insurance pro- 4 a.V Nurses; • vided by this section of the en- dorsement, the following additional -b. ergency Medical ohnicians or provisions apply: ,,' c. Paramedics, (1) The Limits of insurance shown in the jurisdiction where an "occurrence" in the Declarations are replaced or offense to which this insurance applies by the limits designated in Sec- takes place. tion B. Limits of Insurance, 11. of this endorsement with respect 13. Broadened Notice of Occurrence to coverage provided by this Paragraph a. of Condition 2. Duties in endorsement. Theseot limits are the Event of Occurrence, Offense, inclusive of and not inadditioneto Claim or Suit (SECTION IV- COMMER- Limitsthe limits being replaced. The CIAL GENERAL LIABILITY CONDI- of Insurance shown in Section B. Limits of Insurance, Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 14 of 15 TIONS) is hereby deleted and replaced (2) The names and addresses of by the following: any injured persons and wit- nesses; and a. You must see to it that we are noti- fied as soon as practicable of an (3) The nature and location of any "occurrence" or an offense which injury or damage arising out of may result in a claim. To the extent the"occurrence"or offense. possible, notice should include: This requirement applies only when (1) How, when and where the "oc- the"occurrence" or offense is known currence"or offense took place; to an "authorized representative". I i V r. ,, 3.e.,.........„,, .„, ,,,. 7 , , c() \,, (:)) , , ,. i \\„, .. Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 15 of 15 — "- <_ ,If -.1%,,..`,C1, r� ' * n9 ,4wJ Ire , 1X 1 ilt a C af ti NI ,S pp pp .S 8a O p 1 W a ` ' 4 5 Zii !JItII lii 2 2 —. a7 1 R y w.. a 2 1 q i 7",i). d *4 el f A mi o y>, a P. _ U W N q N A b i H g p, - 9 Ot a 0 RI ' xot CI ^' n i3 V a o O XI 4 J A , 1 � WT+ •a 1 b V O 4e. yy a 4 ,� .fl • m '$d 6 o V ' El '7 a woav u7 1 w E t 8 t, 0 3o a ; -5 .2 « 8,) gAw m N U' 0 CI aa31 e a 'S a� 8�� ^'j 'E r« ;3 B W A' o a 10 2 .p i & . N V w X U o x .5 '81 8 baa f H V a 1� E A1 t .5 a y 01 _ Q 0 _•2 g vn a A V d o , !� r rot _ 0 Ea 2 o 8 .0 t '* 0W a F: 0 a w I f o s o IIIIUIU " i a u o E I a 01_01 ❑ ❑ z Lai a3 >I 73 r. WI . u ji LLI