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16-112.00 ICON: CenterPlace Roof Repair CONSTRUCTION AGREEMENT ICON Corporation 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 ICON Corporation,("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 CenterPlace Roof Repair 2016 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 by August 31,2016. 3. Liquidated Damages. Time is of the essence for this Agreement. Delays cause inconvenience to the residents of City and cost taxpayers undue sums of money,adding time needed for administration,engineering, inspection, and supervision. It is impractical for City to calculate the actual cost of delays. Accordingly, Contractor agrees to pay liquidated damages for failure to achieve Substantial Completion(as defined in the Contract Documents) which shall be in the amount of$150 per day. These liquidated damages are not a penalty,but are fixed and agreed upon by and between Contractor and City because of the impracticability and difficulty of fixing and ascertaining the actual damages that City would sustain in the event that the Work is not completed in accordance with the Contract Documents. Liquidated damages may be retained by City and deducted from payments otherwise due to the Contractor. 4. Compensation. In consideration of Contractor performing the Work, City agrees to pay Contractor in accordance with the Contract Documents the sum of $41,830.00, plus Washington State Sales Tax of $3,639.21 (if applicable),for a total of$45,469.21,based on the bid submitted by Contractor(Exhibit B),and as may be adjusted in accordance with the Contract Documents. Items selected are Areas A,B,C,D#2,E and the main entrance. 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 Construction Agreement Page 1 of 7 at the address stated in paragraph 6. Pursuant to chapter 60.28 RCW, 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: ICON Corporation Phone: (509)921-1000 Phone: (509) 532-1761 Address: 11707 East Sprague Ave., Suite 106 Address: P.O. Box 10 Spokane Valley, WA 99206 Greenacres,WA 99016-0010 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&P'). If employing labor in a class not shown,Contractor shall request a determination of the correct wage rate for the class and locality from the Industrial Statistician. Contractor shall provide a copy of any such determinations to City. Construction Agreement Page 2 of 7 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: 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: • haps://fortress.wa.gov/lni/wagelookup/pry W agelookup.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 Construction Agreement Page 3 of 7 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 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 Construction Agreement Page 4 of 7 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 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. Construction Agreement Page 5 of 7 Contractor specifically and expressly waives any immunity that may be granted it under the Washington State Industrial Insurance Act,Title 51 RCW. These indemnification obligations shall not be limited in any way by 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 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 and Cost Statement C. Insurance Endorsements 41A The Parties have executed this Agreement this I 9 — day of j c,2016. CITY OF SPOKANE VALLEY: Contract : Mark alhoun,Acting City Manager 13y: Its: Authorized Representative ATTEST: _ %.e 1 .�___. I AF41. Christine Bainbridge,City Clerk 1 APPROVED AS TO FORM: Office o the City Attorney Construction Agreement Page 7 of 7 Pi.'" , . * '' V ,,-$.*7t4. ''' i. 4w, • y V as a 0. '� i•LI '`� -,� � s a x- CU '' . r - ' ' ". '' - , ,,,:::::,, ,,,,.:„..,,,;:i..,..,,--4,z,:„.„: .. ---- , j; , .. ,.../.,.., ,,,,, , (Ni • , ——''-- ,.:4, — 101,..:-.7,,,,,i -' ''.' ir-' '' '''''-. 414 i cU rts .1 ir , ' U �$ tA.„,„„iii. ' ,s, ',, ....-.4.- t f 01a) O _ O cc ea t1 �C = - ++ v rts .0 i s , �p�; n II .., l m II II II Il v a ..� >, >� V 0 w w 2 c' a) Q) co — co m co i C,. R3 c� Q) 2 iJ N c i:`. Q Q Q Q w II I mown May 26, 2016 Mr.Michael Stone Parks&Recreation Director Re: Center Place 2 Mr. Stone: Please find outlined below, for your review and acceptance, our quote to make repairs to various locations of the existing tile roof I have attached a Google picture identifying the areas where I was shown the active leaks. The areas marked in red identify the one valley located on the back side and the main entrance to the building which was quoted last year. The bright blue area is over the area where persistent leaks occur down the interior wall and out into the ceiling area. While on site yesterday,I went into the ceiling area and found where the facility personnel have been mitigating the leaks with buckets. All pricing includes Washington State prevailing wages and fees associated with reporting requirements. All Pricing includes Washington State Prevailing wages. All pricing excludes WSST. Valley Repair Area A-above Executive Conference Room Work scope: 1. Icon to mobilize the site with materials, equipment and set up safety. 2. Icon to remove approximately two feet of the existing tile from the 3/12 slope side of the valley, and set aside for re-installation. 3. Icon to cut back the exiting wood furring strips that are currently extending into the existing valley metal and obstructing the flow of water down over the metal valley. 4. Icon to clean the area of mud, dirt and debris and install new high temperature ice and water shield at locations where there is damage to the existing 901b asphalt roofing materials that line the valley below the valley pan. 5. In re-assembling the valley, as needed, Icon will replace any felt or furring strips that are rotting or deficient, along with sealing any holes found in the valley metal as a result of the furring strips being nailed in through the valley metal. In repairing any nail holes we propose using Suprema Alsan Flashing or Eternabond butyl tape. 6. Icon to provide and install new lead flashing, or galvanized sheet metal, at the end of the existing valley metal to extend it out over the tile and transition detail, between the insulated portion of the roof and non-insulated. . 7. Icon to re-install the existing tile at valley. 8. Icon to remove offsite all debris associated with this work scope. Price Area A: $3,400.00 PO Box 10 Greenacres, WA 99016-0010, Phone: 509-532-1761, Cell: 509-7.10-5022 lane@icomoofing.com, www.iconroofing.com 2 Main Entrance-barrel roof and radius valley repair Work Scope: 1. Icon to mobilize the site with materials,equipment and set up safety. 2. Icon to provide 3/4 inch plywood over the skylights,below the entry barrel roof entry, for protection against falling tile or debris. 3. Icon to remove the existing metal roof and associated flashings over the barrel roof and dispose of offsite. 4. Icon to remove three to four courses of the existing tile,as needed, at the valley below the tile roof,where it interfaces with the entry barrel roof,and set aside to re-install. Once the tile is removed,Icon can inspect and determine the condition of any existing valley metal, and search out the leak sources prior to removing any existing valley metal for replacement. 5. Icon to remove any existing valley metal and install new high temperature ice and water shield directly to the plywood substrate. The new ice and water shield will extend up the roof,under the felt for the tile roof, and extend out over the plywood substrate above the barrel roof where Icon will install new high temp. ice and water shield throughout the deck substrate. 6. Icon to provide and install new 24 gauge"W"profile valley metal with a two inch high rib in the center to mitigate any water runoff from the tile roof above overshooting the center of the valley. 7. Icon to re-install or replace any wood furring strips they encounter where the tile is removed. 8. Icon to provide and install a new flat seam metal roof in 24 gauge pre-finished metal in standard color choices. 9. Icon to provide and install new two inch by 1/8 inch butyl mastic between the metal roofing and valley flashing to provide a watertight seal. 10. Icon to have a new radius metal fascia fabricated with a snap seam connection to provide a more aesthetic appearance and watertight assembly at the rake of the metal roof. 11. Icon to re-install the existing tile above the new valley. 12. Icon to remove off site all debris associated with this work scope. Price Main Entrance: $24,730.00 Area B- bottom of valley exterior patio stains at down spout and gutter interface Work Scope: 1. Icon to remove the existing down spout completely and verify that the downspout, and ground level piping, is not obstructed. We will also examine the end cap at the wall and verify that it is sealed. 2. If the down spout and drain are clear, icon to remove tile from the roof to wall out five feet over the step down soffit area and make repairs as needed with new ice and water underlayment that will extend up the wall behind the metal flashing and re-install the existing tile. Price Area B: Not to Exceed$3,200.00 Area C-stains at exterior wall above double doors exiting onto exterior patio Work Scope: 1. Remove the existing tile over the step down soffit area,an area approximately six feet by ten. 2. Inspect the existing conditions with regard to felt underlayment, furring strips and metal flashing. 3. Replace as needed,the felt underlayment and furring strips and re-install the existing tile. Price Area C:Not to exceed $2,900.00 PO Box 10 Greenacres,WA 99016-0010, Phone: 509-532-1761, Cell: 509-710-5022 lane@iconroofing.com,www.iconroofing.com 3 Area D-Kitchen area,leaking vent pipe area below mechanical units Work Scope Options (Option#1) 1. Icon to remove the existing tile from around the vent pipe and reseal with asphalt mastic or Soprema Alsan flashing. Price Area D,Option 1: $700.00 (Option#2) 1. Remove the existing tile in and around the mechanical units up slope from the vent pipe and replace underlayment with new ice and water shield. Approximate area of twelve by fifteen. 2. Replace wood furring strips as needed. Price Area D,Option 2: $3,300.00 Area E-small dining area below the valley that was replaced last year Work Scope: 1. Icon to remove the existing tile from the area between the roof to wall, approximately six feet wide at the top and extend down to the bottom of the valley in a triangular configuration exposing the one side of the valley at the eave where the valley dumps into scupper. The linier feet up slope along the wall will be approximately 20 feet. 2. Icon to replace the area with new Ice and water shield that will extend up the wall behind the metal step flashing. 3. Icon to inspect the one exposed side of the valley metal for any deficiencies and make sure the furring strips are in adequate condition and not extended into the valley impeding water flow. 4. Icon to re-install the existing tile. There are several tiles that are broken and caulked within this foot print comprising our work scope. Replacement tile will be provided by the owners. Price Area E: $4,300.00 Area F-exterior stains above Senior Way near skylights Work Scope: 1. Remove the existing tile over the step down soffit area, an area approximately six feet by ten. 2. Inspect the existing conditions with regard to felt underlayment,furring strips and metal flashing. 3. Replace as needed,the felt underlayment and furring strips and re-install the existing tile. Price Area F: Not to exceed$2,800.00 Assumptions: All plywood substrate is in good condition. There are adequate furring strips below the tile on the upper roof,above the barrel roof. Additions: Plywood replacement$4.50/sgft Icon's Time and Materials rates for additional work required outside the work scope is$80.00 per hour including the prevailing wage requirements for the state of Washington. We appreciate the opportunity to be of service. Please call if you have any questions. cpne/eatton Service Maintenance& Small Works Contract Manager PO Box 10 Greenacres,WA 99016-0010, Phone: 509-532-1761, Cell: 509-710-5022 lane@iconroofing.com,www.iconroofing.com *orkane Valler BOND NO: 106538235 CONTRACTOR'S PERFORMANCE BOND to City of Spokane Valley,Washington The City of Spokane Valley, Washington, in Spokane County, has awarded to Icon Corporation (Contractor),as Principal,a contract for the construction of the project designated as CenterPlace Roof Repair 2016 Project , ProjectNo.4089 in Spokane Valley,Washington,and said Principal is required to furnish a bond for performance of all obligations under the Contract. The Principal,and Travelers Casualty and Surety Company of America (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 Forty Five Thousand Four Hundred Sixty Nine Dollars and 21/100 US Dollars($45,469.21 ) Total Contract Amount,subject to the provisions herein. The statutory performance bond shall become null and void, if and when the Principal, its heirs, executors, administrators,successors,or assigns shall well and faithfully perform all of the Principal's obligations under the Contract and fulfill all the terms and conditions of all duly authorized modifications,additions,and changes to said Contract that may hereafter be made, at the time and in the manner therein specified; and if such performance obligations have not been fulfilled,this bond shall remain in full force and effect. The Surety for value received agrees that no change,extension of time, alteration or addition to the terms of the Contract,the specifications accompanying the Contract,or to the work to be performed under the Contract shall in any way affect its obligation on this bond,and waives notice of any change,extension of time,alteration or addition to the terms of the Contract or the work performed.The Surety agrees that modifications and changes to the terms and conditions of the Contract that increase the total amount to be paid the Principal shall automatically increase the obligation of the Surety on this bond and notice to Surety is no required for such increased obligation. This bond may be executed in two (2)original counterparts,and shall be signed by the parties' duly authorized officers.This bond will only be accepted if it is accompanied by a fully executed and original power of attorney for the officer executing on behalf of the surety. PRINCIPAL(CONTRACTOR) SURETY 451inwitU11$U� Icon Corporation Travelers .- alty and Surety Company of An i3SUA i �Qy oo�� (1A- rL—. 2- 6-/ ' Prim tp Signatur Date Sure ature :: cent Je 1 (}�UL � �►� J, n Drummey, Jr. ,, 4 F hilow Printed Name \ Printed Name Fc—t'_S\a€-C T Attorney-in-Fact Title Title Name,address,and telephone of local office/agent of Surety Company is: Wells Fargo Insurance Services, Inc. 999 3rd Avenue, Ste. 4100, Seattle,WA 98104 206-731-1200 Approved as to form: City of Spokane Valley Attorney,County of Spokane Date CRY 0 .Valles BOND NO: 106538235 CONTRACTOR'S NON-FEDERAL PAYMENT BOND to City of Spokane Valley,Washington The City of Spokane Valley, Washington, in Spokane County, has awarded to Icon Corporation (Contractor),as Principal,a contract for the construction of the project designated as CenterPlace Roof Repair 2016 Project ,Project No4089 in Spokane Valley,Washington,and said Principal is required under the terms of the Contract to furnish a payment bond in accord with Title 39.08 Revised Code of Washington(RCW). The Principal,and Travelers Casualty and Surety Company of America (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 Forty Five Thousand Four Hundred Sixty Nine Dollars and 211100 US Dollars (S45,469.21 )Total Contract Amount,subject to the provisions herein. The statutory 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 RCW 39.08 and 39.12 including all workers,laborers,mechanics,subcontractors,and materiatmen,and all persons who shall supply such contractor or subcontractor with provisions and supplies for the carrying on of such work,and all taxes incurred on said Contract under Title 50 and 51 RCW and all taxes imposed on the Principal under Title 82 RCW 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 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 � vokii"meq"'�`, Icon Cori oration Travel- and Surety Company of ��,. `" ci.. i.. IIIA ' -7:-7:tC .J.., Prin ipa ignature, Date Sure ig,.''re410' .' bmon J. n Drumme , Jr. 11,010"i"0 Printed Name rinted Name ?[--e- , o A( 31--- Attorney-in-Fact Title Title Name,address,and telephone of local office/agent of Surety Company is: Wells Fargo Insurance Services, Inc. 999 3rd Avenue, Ste.4100, Seattle, WA 98104 206-731-1200 Approved as to form: City of Spokane Valley Attorney,County of Spokane • Date TFAVEIJERSJ POWER OF ATTORNEY Farmington Casualty Company St.Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St.Paul Guardian Insurance Company Surety Bond No. 106538235 Principal: Icon Corporation OR Project Description:CenterPlace Roof Repair 2016 Project Obligee: The City of Spokane Valley KNOW ALL MEN BY THESE PRESENTS: That Farmington Casualty Company, St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company, are corporations duly organized under the laws of the State of Connecticut, that Fidelity and Guaranty Insurance Company is a corporation duly organized under the laws of the State of Iowa, and that Fidelity and Guaranty Insurance Underwriters, Inc. is a corporation duly organized under the laws of the State of Wisconsin (herein collectively called the"Companies"),and that the Companies do hereby make,constitute and appoint John Drummey,Jr. of the City of Seattle ,State of WA ,their true and lawful Attorney-in-Fact,to sign,execute,seal and acknowledge the surety bond(s)referenced above. IN WITNESS WHEREOF,the Companies have caused this instrument to be signed and their corporate seals to be hereto affixed,this 24th day of June, 2016. Farmington Casualty Company St.Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St.Paul Guardian Insurance Company or,�vs�yw�Fi yss5sttr ��• ' FL�s O`* IASL 4J.i'M'Yi�� /.�awo ' 4 y ,�tty'{� 3' ' t n ' { ria+C m:, g9�gXti" '-' a �_„� 2 �°"t...*�'t Co !ZVI I 4Sr' ' �1912 a �y'�+zcis ' i 1951 *t �OSEALa�b' i ,� _, • State of Connecticut • By. City of Hartford ss. Robert L.Raney,Senior Vice President On this the 24th day of June, 2016, before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior Vice President of Farmington Casualty Company,Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc.,St.Paul Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America,and United States Fidelity and Guaranty Company,and that he,as such,being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. In Witness Whereof,I hereunto set my hand and official seal. a7 My Commission expires the 30th day of June,2021. 3 M Lt. C. ' o, S Marie C.Tetreault,Notary Public This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters,Inc.,St. Paul Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company, which resolutions are now in full force and effect, reading as follows: RESOLVED,that the Chairman,the President,any Vice Chairman,any Executive Vice President,any Senior Vice President,any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds,recognizances,contracts of indemnity,and other writings obligatory in the nature of a bond,recognizance,or conditional undertaking,and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her;and it is FURTHER RESOLVED,that the Chairman,the President, any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary;and it is FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when(a)signed by the President,any Vice Chairman,any Executive Vice President, any Senior Vice President or any Vice President,any Second Vice President,the Treasurer,any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary; or(b)duly executed (under seal, if required) by one or more Attorneys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority;and it is FURTHER RESOLVED,that the signature of each of the following officers: President,any Executive Vice President,any Senior Vice President, any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof,and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached. I, Kevin E. Hughes,the undersigned,Assistant Secretary,of Farmington Casualty Company,Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc.,St.Paul Fire and Marine Insurance Company,St. Paul Guardian Insurance Company,St.Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company, do hereby certify that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies, which is in full force and effect and has not been revoked. ZN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this 5th day of July 2.016 Kevin E.Hughes,Assistant Secretary 1a, C) e ice*-sezm +4 e 1 ?SEA;brB t s.r.; I s11D g. N r c�-� ✓ 5' n..x11 • ' r f}N To verify the authenticity of this Power of Attorney, call 1-800-421-3880 or contact us at www.traveiersbond com.Please refer to the Attorney-In-Fact number,the above-named individuals and the details of the bond to which the power is attached. ICONCOR-02 WCHRISTESON Co/2Cr CERTIFICATE OF LIABILITY INSURANCE DATDNYYY) 6//30/230/2016 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 PHONE FAX PayneWest Insurance,Inc. (A/C.No.Ext):(509)838-3501 (A/c,No): (509)838-3511 AIL 501 N.Riverpoint Blvd.,Ste 403 ADDRESS: Spokane,WA 99202 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:The Continental Insurance Company INSURED INSURER B:American Casualty Co of Reading PA 20427 Icon Corporation INSURER C:Transportation Insurance Co. 20494 PO Box 10 INSURER D: Greenacres,WA 99016 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ITR ADDL SPOLICY EFF POLICY EXP TYPE OF INSURANCE NSD WVD POLICY NUMBER L (MM/DD/YYW) (MMlDD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _ $ 1,000,000 CLAIMS-MADE X OCCUR X X C2074781294 10/07/2015 10/07/2016 DAMAGES( RENTED 100,000 PREMISES(Ea occurrence) $ � X Riggers$1,000,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X 1218: LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: WA STOP GAP $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) B X ANY AUTO X X C2074781313 10/07/2015 10/07/2016 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X X NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS (Per accident) X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 C EXCESS LIAB CLAIMS-MADE 02074781327 10/07/2015 10/07/2016 AGGREGATE _ $ 5,000,000 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION PER 0TH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Project: Center Place Roof Repair 2016 Icon Corp Job#4089 The City of Spokane Valley is included as Additional insured provided under the contract as per the attached forms. Coverage is primary/non-contributory and includes completed operations and waiver of subrogation in favor of the additional insureds.A per project aggregate applies per the attached forms. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE of THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Cityof Spokane Valley Ct Spokane Bainbridge ACCORDANCE WITH THE POLICY PROVISIONS. • 11707 East Sprague Ave.,Suite 106 Spokane,WA 99206 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD CNA G-140331-D (Ed. 01/13) BLANKET ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS — WITH PRODUCTS-COMPLETED OPERATIONS COVERAGE It is understood and agreed that this endorsement amends the COMMERCIAL GENERAL LIABILITY COVERAGE PART as follows: SCHEDULE (OPTIONAL) Name of Additional Insured Persons Or Organizations (As required by"written contract" per Paragraph A. below.) Locations of Covered Operations (As per the"written contract," provided the location is within the"coverage territory"of this Coverage Part.) A. Section II-Who Is An Insured is amended to include as an additional insured: 1. Any person or organization whom you are required by "written contract" to add as an additional insured on this Coverage Part; and 2. The particular person or organization, if any, scheduled above. B. The insurance provided to the additional insured is limited as follows: 1. The person or organization is an additional insured only with respect to liability for "bodily injury," "property damage,"or"personal and advertising injury"caused in whole or in part by: a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your ongoing operations specified in the"written contract"; or b. "Your work" that is specified in the "written contract" but only for "bodily injury" or "property damage" included in the"products-completed operations hazard,"and only if: (1) The"written contract" requires you to provide the additional insured such coverage; and (2) This Coverage Part provides such coverage. 2. If the "written contract" specifically requires you to provide additional insurance coverage via the 10/01 edition of CG2010 (aka CG 20 10 10 01), or via the 10/01 edition of CG2037 (aka CG 20 37 10 01), or via the 11/85 edition of CG2010 (aka CG 20 10 11 85), then in paragraph B.1. above, the words 'caused in whole or in part by' are replaced by the words'arising out of'. 3. We will not provide the additional insured any broader coverage or any higher limit of insurance than: a. The maximum permitted by law; b. That required by the"written contract"; c. That described in B.1.above; or d. That afforded to you under this policy, whichever is less. 4. Notwithstanding anything to the contrary in Condition 4. Other Insurance (Section IV), this insurance is excess of all other insurance available to the additional insured whether on a primary, excess, contingent or G-140331-D (Ed. 01/13) Page 1 of 2 Copyright,CNA All Rights Reserved. G-140331-D CNA (Ed. 01/13) any other basis. But if required by the "written contract" to be primary and non-contributory, this insurance will be primary and non-contributory relative to insurance on which the additional insured is a Named Insured. 5. The insurance provided to the additional insured does not apply to "bodily injury," "property damage," or "personal and advertising injury"arising out of: a. The rendering of, or the failure to render, any professional architectural, engineering, or surveying services, including: (1) The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and (2) Supervisory, inspection, architectural or engineering activities; or b. Any premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached to this Coverage Part. C. SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: 1. The Duties In The Event of Occurrence, Offense, Claim or Suit condition is amended to add the following additional conditions applicable to the additional insured: An additional insured under this endorsement will as soon as practicable: (1) Give us written notice of an "occurrence" or an offense which may result in a claim or"suit" under this insurance, and of any claim or"suit"that does result; (2) Except as provided in Paragraph B.4. of this endorsement, agree to make available any other insurance the additional insured has for a loss we cover under this Coverage Part; (3) Send us copies of all legal papers received, and otherwise cooperate with us in the investigation, defense, or settlement of the claim or"suit"; and (4) Tender the defense and indemnity of any claim or"suit" to any other insurer or self insurer whose policy or program applies to a loss we cover under this Coverage Part. But if the "written contract" requires this insurance to be primary and non-contributory, this provision (4) does not apply to insurance on which the additional insured is a Named Insured. We have no duty to defend or indemnify an additional insured under this endorsement until we receive from the additional insured written notice of a claim or"suit." D. Only for the purpose of the insurance provided by this endorsement, SECTION V— DEFINITIONS is amended to add the following definition: "Written contract" means a written contract or written agreement that requires you to make a person or organization an additional insured on this Coverage Part, provided the contract or agreement: 1. Is currently in effect or becomes effective during the term of this policy; and 2. Was executed prior to: a. The"bodily injury"or"property damage"; or b. The offense that caused the"personal and advertising injury," for which the additional insured seeks coverage under this Coverage Part. All other terms and conditions of the Policy remain unchanged. Material used with permission of ISO Properties, Inc. G-140331-D (Ed. 01/13) Page 2 of 2 Copyright,CNA All Rights Reserved. G-18652-J CNA (Ed. 07-12) CONTRACTORS'GENERAL LIABILITY EXTENSION ENDORSEMENT It is understood and agreed that this endorsement amends the COMMERCIAL GENERAL LIABILITY COVERAGE PART as follows. The changes this endorsement makes do not apply with respect to any coverage that has been excluded or amended by another endorsement attached to this policy. SCHEDULE Coverage is summarized below. For particulars and limitations affecting each coverage, please refer to the corresponding policy provisions in the body of this endorsement. 1. Additional Insureds Seven additional insured extensions. 2. Bodily Injury—Expanded Definition 3. Broad Knowledge of Occurrence/Notice of Occurrence 4. Broad Named Insured 5. Broadened Liability Coverage For Damage To"Your Product"And "Your Work" Limit: $100,000. 6. Contractual Liability—Railroads Expanded definition of"insured contract." 7. Contractual Liability For Personal And Advertising Injury 8. Electronic Data Liability Loss of Electronic Data Limit: $100,000. 9. Expanded Personal And Advertising Injury-Discrimination Or Humiliation 10. Expected Or Intended Injury Reasonable force—"bodily injury"or"property damage." 11. General Aggregate Limits Of Insurance-Per Project 12. In Rem Actions 13. Incidental Health Care Malpractice Coverage 14. Joint Ventures/Partnership/Limited Liability Companies Coverage for your interest in such terminated or ended organizations. 15. Legal Liability/Alienated Premises/Borrowed Equipment Coverage Extended perils. Default limit increased to$500,000 for Damage to Premises Rented To You. $25,000 limit for"property damage"to borrowed tools or equipment at a jobsite. 16. Liberalization Clause 17. Liquor Liability Coverage Extension 18. Medical Payments Limits increased to$15,000. Reporting increased to three years from the date of accident. 19. Non-owned Aircraft Coverage 20. Non-owned Watercraft Increased to 75 feet. 21. Primary And Non-Contributory To Other Insurance 22. Property Damage-Elevators 23. Supplementary Payments Cost of bail bonds increased to$5,000. Daily loss of earnings increased to$1,000. 24. Unintentional Failure To Disclose Hazards 25. Waiver of Subrogation -Blanket Waiver of subrogation where required by written contract or written agreement. 26. Wrap-Up Extension G-18652-JE 07-12) 1 Page 1 of 12 Copyright,CNA All Rights Reserved. G-18652-J CNA (Ed. 07-12) 1. ADDITIONAL INSURED 2. With respect to the insurance afforded to SECTION II—WHO IS AN INSURED is amended to these additional insureds, this insurance include as an insured any person or organization does not apply to any "occurrence" which (called additional insured) described in paragraphs takes place after the equipment lease A.through G. below whom you are required to add expires. as an additional insured on this policy under a D. Lessor-Land written contract or written agreement, provided the An owner or other interest from whom land has written contract or written agreement: been leased by you but only with respect to i. Is currently in effect or becomes effective liability arising out of the ownership, during the term of this policy; and maintenance or use of that specific part of the ii. Was executed prior to the "bodily injury," land leased to you and subject to the following additional exclusions: "property damage" or "personal injury and advertising injury" for which the additional This insurance does not apply to: insured seeks coverage. 1. •Any "occurrence" which takes place after However, we will not provide the additional you cease to lease that land; or insured any broader coverage or any higher 2. Structural alterations, new construction or limit of insurance than the least that is: demolition operations performed by or on a. The maximum permitted by law; behalf of such additional insured. b. Required in the written contract or written E. Lessor-Premises agreement; A manager or lessor of premises but only with c. Afforded to you under this policy; or respect to liability arising out of the ownership, maintenance or use of that specific part of the d. Described in the applicableparagraphs A. premises leased to you and subject to the through G. below. following additional exclusions: A. Controlling Interest This insurance does not apply to: Any persons or organizations with a controlling 1. Any "occurrence" which takes place after interest in you but only with respect to their you cease to be a tenant in that premises; liability arising out of: or 1. Their financial control ofY ou; or 2. Structural alterations, new construction or 2. Premises they own, maintain or control demolition operations performed by or on while you lease or occupy these premises. behalf of such additional insured. This insurance does not apply to structural F. Mortgagee,Assignee or Receiver alterations, new construction and demolition A mortgagee, assignee or receiver but only with operations performed by or for such additional respect to their liability as mortgagee, assignee, insured. or receiver and arising out of the ownership, B. Co-owner of Insured Premises maintenance, or use of a premises by you. A co-owner of a premises co-owned by you and This insurance does not apply to structural covered under this insurance but only with alterations, new construction or demolition respect to the co-owner's liability as co-owner of operations performed by or for such additional such premises. insured. C. Lessor-Equipment G. State or Governmental Agency or 1. Any person or organization from whom you Subdivision or Political Subdivisions lease equipment, but only with respect to A state or governmental agency or subdivision liability for "bodily injury," "property or political subdivision subject to the following damage" or "personal and advertising provisions: injury" caused, in whole or in part, by your 1. This insurance applies only with respect to maintenance, operation or use of the following hazards for which the state or equipment leased to you by such person or organization. governmental. agency or subdivision or. G-18652-J (Ed. 07-12) Page 2 of 12 Copyright,CNA All Rights Reserved. CNA G-186 52-J (Ed. 07-12) political subdivision has issued a permit or A. BROAD KNOWLEDGE OF OCCURRENCE authorization in connection with premises You must give us or our authorized you own, rent, or control and to which this representative notice of an "occurrence," insurance applies: offense, claim, or "suit" only when the a. The existence, maintenance, repair, "occurrence," offense, claim or "suit" is known construction, erection, or removal of to: advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, (1) You, if you are an individual; manholes, marquees, hoistaway (2) A partner, if you are a partnership; openings, sidewalk vaults, street banners, or decorations and similar (3) An executive officer or the employee exposures; or designated by you to give such notice, if you are a corporation; or b. The construction, erection, or removal of elevators; or (4) A manager, if you are a limited liability company. c. The ownership, maintenance or use of B. NOTICE OF OCCURRENCE any elevators covered by this insurance. Your rights under this Coverage Part will not be 2. This insurance applies only with respect to prejudiced if you fail to give us notice of an operations performed by you or on your "occurrence,"offense, claim or"suit" and that behalf for which the state or governmental failure is solely due to your reasonable belief agency or subdivision or political that the"bodily injury"or"property damage" is subdivision has issued a permit or not covered under this Coverage Part. authorization. However, you shall give written notice of this "occurrence," offense, claim or"suit"to us as 3. This insurance does not apply to: soon as you are aware that this insurance may a. "Bodily injury," "property damage" or apply to such "occurrence,"offense claim or "personal and advertising injury" arising "suit." out of operations performed for the 4. BROAD NAMED INSURED federal government, state or municipality; or A. Any subsidiary or affiliate organization, other than a partnership, joint venture or limited b. "Bodily injury" or "property damage" liability company, in which a Named Insured included within the"products-completed specifically shown in the Declarations has operations hazard." management control, directly or through one or A governmental permit which requires you to more subsidiary organizations, at the time of add the governmental entity as an additional loss will qualify as a Named Insured but only if insured will trigger this Provision 1.as if the there is no other similar insurance available to permit were a written contract. such organization, nor similar insurance which would be available but for exhaustion of its 2. BODILY INJURY—EXPANDED DEFINITION limits. For the purpose of this provision, similar SECTION V—DEFINITIONS, the definition of insurance means general liability or equivalent "bodily injury" is changed to read: insurance, no matter whether its coverage is broader or narrower than that provided by this "Bodily injury" means bodily injury, sickness or insurance. But if the only other similar insurance disease sustained by a person, including death, is for a "consolidated (wrap-up) program," then humiliation, shock, mental anguish or mental injury a subsidiary that qualifies as a Named Insured by that person at any time which results as a on such project-specific insurance can still consequence of the bodily injury, sickness or qualify as a Named Insured on this insurance, disease. but not for projects covered by the 3. BROAD KNOWLEDGE OF OCCURRENCE/ "consolidated (wrap-up) program." NOTICE OF OCCURRENCE [Please see Item 26.C. of this endorsement for the definition of"consolidated (wrap-up) Condition 2. Duties in The Event of Occurrence, program."] Offense, Claim or Suit of SECTION IV— COMMERCIAL GENERAL LIABILITY B. This endorsement does not apply to any CONDITIONS is amended to add the following organization for which coverage is excluded by provisions: another endorsement attached to this policy. G-18652-J (Ed. 07-12) Page 3 of 12 Copyright,CNA All Rights Reserved. G-18652-J CNA (Ed. 07-12) C. Only for the purpose of this endorsement: (4) Explosion. 1. Management control means: I. Damage to Your Work a. Ownership interest representing more "Property damage"to"your work"arising out of than 50% of the voting, appointment, or it, or any part of it and included in the"products- designation power for the subsidiary completed operations hazard." organization's governing body; or This exclusion does not apply: b. Having the right, pursuant to a written (1) If the damaged work or the work out of contract, or pursuant to the by-laws, which the damage arises was charter, operating agreement, or similar document of a specifically shown performed on your behalf by a Named Insured or controlled subsidiary subcontractor; or organization to select, appoint, or (2) If the cause of loss to the damaged designate a majority of the subsidiary work arises as a result of: organization's governing body. Such contract or document must have been (a) Fire; created prior to the time of loss; or (b) Smoke; c. Having the right, pursuant to a written (c) Collapse; or trust agreement, to protect, control the use of, encumber or transfer and sell (d) Explosion. property held by a trust. B. The following paragraph is added to SECTION 2. Governing body means the Board of III—LIMITS OF INSURANCE: Directors of a corporation. Subject to 5.above, $100,000 is the most we 3. Loss means: will pay under Coverage A for the sum of damages arising out of any one"occurrence" a. The occurring of the "bodily injury" or because of"property damage"to"your product" "property damage"; or and "your work"that is caused by fire, smoke, b. The committing of the offense that collapse or explosion and is included within the caused the "personal and advertising "product-completed operations hazard." This injury." sublimit does not apply to"property damage"to "your work" if the damaged work or the work out i policyapplies The insurance provided by this app es to of which the damage arises was performed on Named Insureds when trading under their own your behalf by a subcontractor. names, or under such trading names or doing- business-as (DBA) names as any should C. This Provision 5. Broadened Liability choose to employ. Coverage For Damage To "Your Product" And "Your Work" does not apply if an 5. BROADENED LIABILITY COVERAGE FOR endorsement of the same name is attached to DAMAGE TO "YOUR PRODUCT" AND "YOUR this policy. WORK" 6. CONTRACTUAL LIABILITY—RAILROADS A. Under SECTION I — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE With respect to operations performed within 50 feet LIABILITY, Paragraph 2. Exclusions is of railroad property, the definition of"insured amended to delete exclusions k. and I. and contract" in SECTION V—DEFINITIONS is replace them with the following: replaced by the following: [This insurance does not apply to:] "Insured Contract" means: k. Damage to Your Product a. A contract for a lease of premises. However, that portion of the contract for a lease of "Property damage"to"your product"arising premises that indemnifies any person or out of it, or any part of it except when organization for damage by fire to premises caused by or resulting from: while rented to you or temporarily occupied by you with permission of the owner is not an (1) Fire; "insured contract"; (2) Smoke; b. A sidetrack agreement; (3) Collapse; or.. c. Any easement or license agreement; - G-18652-J (Ed. 07-12) Page 4 of 12 Copyright,CNA All Rights Reserved. CNA (Edd.. 0 07-12)G7-12) d. An obligation, as required by ordinance, to Damages arising out of the loss of, loss of use indemnify a municipality, except in connection of, damage to, corruption of, inability to access, with work for a municipality; or inability to manipulate "electronic data" that e. An elevator maintenance agreement; does not result from physical injury to tangible property. f. That part of any other contract or agreement However, this exclusion does not apply to pertaining to your business (including an liability for damages because of"bodily injury." indemnification of a municipality in connection with work performed for a municipality) under B. The following paragraph is added to SECTION which you assume the tort liability of another III—LIMITS OF INSURANCE: party to pay for "bodily injury" or "property Subject to 5.above, $100,000 is the most we damage" to a third person or organization. Tort will pay under Coverage A for all damages liability means a liability that would be imposed arising out of any one"occurrence"because of by law in the absence of any contract or "property damage" that results from physical agreement. injury to tangible property and arises out of Paragraph f. does not include that part of any "electronic data." contract or agreement: C. The following definition is added to the (1) That indemnifies an architect, engineer or SECTION V—DEFINITIONS: surveyor for injury or damage arising out of: "Electronic data" means information, facts or (a) Preparing, approving or failing to programs stored as or on, created or used on, prepare or approve maps, shop or transmitted to or from computer software drawings, opinions, reports, surveys, (including systems and applications software), field orders, change orders or drawings hard or floppy disks, CD-ROMS, tapes, drives, and specifications; or cells, data processing devices or any other (b) Giving directions or instructions, or media which are used with electronically controlled equipment. failing to give them, if that is the primary cause of the injury or damage; D. For the purposes of the coverage provided by (2) Under which the insured, if an architect this endorsement, the definition of "property engineer or surveyor, assumes liability for damage" in SECTION V — DEFINITIONS is re laced bythe following: an injury or damage arising out of the p 9 insured's rendering or failure to render 17. "Property damage" means: professional services, including those listed a. Physical injury to tangible property, in (1) above and supervisory, inspection, architectural or engineering activities. including all resulting loss of use of that property. All such loss of use shall be 7. CONTRACTUAL LIABILITY FOR PERSONAL deemed to occur at the time of the AND ADVERTISING INJURY physical injury that caused it; Under SECTION I—COVERAGE B—PERSONAL b. Loss of use of tangible property that is AND ADVERTISING INJURY LIABILITY, not physically injured. All such loss of Paragraph 2. Exclusions is amended to delete use shall be deemed to occur at the exclusion e. Contractual Liability. time of the "occurrence" that caused it; This provision 7. does not apply to any person or or organization who otherwise qualifies as an c. Loss of, loss of use of, damage to, additional insured on this Coverage Part. corruption of, inability to access, or 8. ELECTRONIC DATA LIABILITY inability to properly manipulate "electronic data," resulting from A. Under SECTION I — COVERAGE A — BODILY physical injury to tangible property. All INJURY AND PROPERTY DAMAGE, such loss of "electronic data" shall be Paragraph 2. Exclusions is amended to delete deemed to occur at the time of the exclusion p. Electronic Data and replace it with "occurrence"that caused it. the following: For the purposes of this insurance, [This insurance does not apply to:] "electronic data" is not tangible property. p. Electronic Data E. If Electronic Data Liability is provided at a higher limit by another endorsement attached to G-18652-J (Ed. 07-12) Page 5 of 12 Copyright,CNA All Rights Reserved. CNA G-18 652-J (Ed. 07-17-1 2) this policy, then the $100,000 limit provided by amended to delete exclusion a. Expected or this Provision 8. Electronic Data Liability is Intended Injury and replace it with the part of, and not in addition to, that higher limit. following: 9. EXPANDED PERSONAL AND ADVERTISING [This insurance does not apply to:] INJURY-DISCRIMINATION OR HUMILIATION a. Expected or Intended Injury A. SECTION V — DEFINITIONS is amended to "Bodily injury" or"property damage" add the following to the definition of "Personal and advertising injury": expected or intended from the standpoint of the insured. This exclusion does not apply h. Discrimination or humiliation that results in to"bodily injury"or"property damage" injury to the feelings or reputation of a resulting from the use of reasonable force natural person, but only if such to protect persons or property. discrimination or humiliation is: 11. GENERAL AGGREGATE LIMITS OF (1) Not done intentionally by or at the INSURANCE -PER PROJECT direction of: A. For each construction project away from (a) The insured; or premises you own or rent, a separate (b) Any "executive officer," director, Construction Project General Aggregate stockholder, partner, member or Limit, equal to the amount of the General manager (if you are a limited Aggregate Limit, is the most we will pay for liability company) of the insured; the sum of: and 1. All damages under Coverage A, except (2) Not directly or indirectly related to the damages because of "bodily injury" or employment, prospective employment, property damage" included in the past employment or termination of "products-completed operations hazard"; and employment of any person or persons by any insured. 2. All medical expenses under Coverage B. Under SECTION I — COVERAGE B— C' PERSONAL AND ADVERTISING INJURY that arise from "occurrences" or LIABILITY, Paragraph 2. Exclusions is accidents which can be attributed solely amended to add the following additional to ongoing operations at that exclusions: construction project. Such payments [This insurance does not apply to:] shall not reduce the General Aggregate Limit shown in the Declarations, nor the Discrimination Relating To Room, Construction Project Aggregate Limit of Dwelling or Premises any other construction project. "Personal or advertising injury" caused by B. All: discrimination directly or indirectly related to 1. Damages under Coverage B, regardless of the sale, rental, lease or sub-lease or the number of locations or construction prospective sale, rental, lease or sub-lease projects involved; of any room, dwelling or premises by or at the direction of any insured. 2. Damages under Coverage A, caused by Fines Or Penalties "occurrences" which cannot be attributed solely to ongoing operations at a single Fines or penalties levied or imposed by a construction project, except damages governmental entity because of because of "bodily injury" or "property discrimination. damage" included in the "products- This provision 9. does not apply to any person completed operations hazard"; and or organization who otherwise qualifies as an 3. Medical expenses under Coverage C additional insured on this Coverage Part. caused by accidents which cannot be 10. EXPECTED OR INTENDED INJURY attributed solely to ongoing operations at a single construction project, Under SECTION I—COVERAGE A—BODILY will reduce the General Aggregate Limit shown INJURY AND PROPERTY DAMAGE in the Declarations. LIABILITY, Paragraph 2. Exclusions is G-18652-J (Ed. 07-12) Page 6 of 12 Copyright,CNA All Rights Reserved. CNA G-18 652-J (Ed. 07-17-1 2) C. The limits shown in the Declarations for Each (a) "Bodily injury" caused by a "health Occurrence, for Damage To Premises Rented care incident" will be considered To You and for Medical Expense continue to caused by an "occurrence"; and apply, but will be subject to either the Construction Project Aggregate Limit or the (b) All acts, errors or omissions that General Aggregate Limit, depending on whether are logically connected by any the "occurrence" can be attributed solely to common fact, circumstance, ongoing operations at a particular construction situation, transaction, event, advice project. or decision will be considered to constitute a single"occurrence"; D. When coverage for liability arising out of the (2) The "bodily injury" occurs during the "products-completed operations hazard" is provided, any payments for damages because policy period. All "bodily injury" arising of"bodily injury" or "property damage" included from an "occurrence" will be deemed to in the "products-completed operations hazard," have occurred at the time of the first regardless of the number of locations involved act, error, or omission that is part of the will reduce the Products-Completed Operations occurrence ; and Aggregate Limit shown in the Declarations. B. With respect only to the insurance provided by E. If a single construction project away from this Provision 13., Exclusion 2.e. Employer's premises owned by or rented to the insured has Liability of SECTION I — COVERAGE A— been abandoned and then restarted, or if the BODILY INJURY AND PROPERTY DAMAGE, authorized contracting parties deviate from is amended to append the following: plans, blueprints, designs, specifications or Only for "bodily injury" not covered by other timetables, the project will still be deemed to be liability insurance (including state-sanctioned the same construction project. self insurance) available to the insured (or F. The provisions of SECTION III — LIMITS OF which would be available but for exhaustion of INSURANCE not otherwise modified by this its limits), this exclusion does not apply to endorsement shall continue to apply as "bodily injury" that arises out of a "health care stipulated. incident. 12. IN REM ACTIONS C. SECTION V — DEFINITIONS is amended to add the following new definition: Any action in rem against any vessel owned or operated by or for you, or chartered by or for you "Health care incident" means a negligent act, will be treated in the same manner as though the error or omission by your "employees" or action were in personam against you. "volunteer workers" working on your behalf in the rendering of or failure to render professional In rem is a term used to designate actions instituted health care services in any of the following against the thing, as distinct from actions against capacities, or the related furnishing of food, the person, which are said to be in personam. beverages, medical supplies or appliances: 13. INCIDENTAL HEALTH CARE MALPRACTICE a. Physician; COVERAGE b. Nurse; A. With respect only to "bodily injury" that arises out of a "health care incident," COVERAGE A— c. Emergency medical technician; BODILY INJURY AND PROPERTY DAMAGE d. Paramedic; LIABILITY OF SECTION I — COVERAGES is amended to replace Insuring Agreement e. Chiropractor; Paragraphs 1.b.(1) and 1.b.(2) with the f. Dentist; following: g. Athletic trainer; b. This insurance applies to "bodily injury"only if you are not in the business of providing h. Audiologist; professional health care services, and only i. Physical therapist; if: (1) The "bodily injury" is caused by an j. Psychologist; "occurrence" that takes place in the k. Speech therapist; "coverage territory." For the purpose of I. Other allied health professional; or this insurance: G-18652-J (Ed. 07-12) Page 7 of 12 Copyright,CNA All Rights Reserved. CNA (Ed. 07-12) 07-12) m. Provider of first aid or Good Samaritan a. "bodily injury" to a co-"volunteer services rendered in an emergency and for worker" while performing duties related which no payment is demanded or to the conduct of your business; and received. b. "bodily injury" to an "employee"while in D. SECTION I — COVERAGE A — BODILY the course of the "employee's" INJURY AND PROPERTY DAMAGE, employment by you or while performing Paragraph 2. Exclusions is amended to add the duties related to the conduct of your following additional exclusions. These new business; exclusions apply only to this Incidental Health when such "bodily injury"arises out of a Care Malpractice Coverage: "health care incident." [This insurance does not apply to:] 3. Paragraphs 2.a. (1)(a), (b) and (c) of Dishonesty or Crime SECTION II — WHO IS AN INSURED do Any dishonest, criminal or malicious act, error not apply to "bodily injury" for which insurance is provided this Provision 13. or omission. Clinical Trials/Product Testing 4. Paragraph 2.a.(1)(d) of SECTION II —WHO IS AN INSURED is deleted. Acts, errors or omissions that occur in the G. With respect to the insurance provided by this course of human clinical trials or product Provision 13., the following is added to testing. Paragraph 4.b.(1) of SECTION IV— Medicare/Medicaid Fraud COMMERCIAL GENERAL LIABILITY Medicare or Medicaid fraud or abuse. CONDITIONS: Services Excluded by Endorsement To the extent this insurance applies, it is excess over any of the other insurance (including Any "health care incident" for which coverage is qualified self insurance), whether primary, excluded by endorsement. excess, contingent or on any other basis, E. SECTION V — DEFINITIONS is amended to except for insurance purchased specifically by you to be excess of this policy. add the following subparagraph to Paragraph f. of the definition of"insured contract": 14. JOINT VENTURES / PARTNERSHIP / LIMITED LIABILITY COMPANIES Paragraph f. does not include that part of any contract or agreement: A. The following is added to SECTION II — WHO IS AN INSURED: (4) Under which you assume another's tort liability for "bodily injury" arising out of the 4. You are an insured when you had an rendering of or failure to render professional interest in a joint venture, partnership or health care services. limited liability company which terminated F. SECTION II — WHO IS AN INSURED is or ended prior to or during this policy period, but only to the extent of your amended to add the following provisions: interest in such joint venture, partnership or 1. Your"employees" are insureds with respect limited liability company. This coverage to: does not apply: a. "bodily injury" to a co-"employee" while a. Prior to the termination date of any joint in the course of the co-"employee's" venture, partnership or limited liability employment by you or while performing company; duties related to the conduct of your b. If there is other valid and collectible business; and insurance purchased specifically to b. "bodily injury" to a "volunteer worker" insure the partnership, joint venture or while performing duties related to the limited liability company; or conduct of your business; c. To a joint venture, partnership or limited when such "bodily injury" arises out of a liability company which is or was "health care incident." insured under a "consolidated (wrap- up) insurance program." 2. Your "volunteer workers" are insureds with respect to: [Please see Item 26.C. of this endorsement G-18652-J (Ed. 07-12) Page 8 of 12 Copyright,CNA All Rights Reserved. CNA G-18652-J (Ed. 07-12) for the definition of"consolidated (wrap-up) Paragraphs (1), (3) and (4) of this exclusion program."] do not apply to "property damage" (other B. The last paragraph of SECTION II — WHO IS than damage by fire) to premises rented to AN INSURED is deleted and replaced by the you or temporarily occupied by you with the following: permission of the owner, or to the contents of premises rented to you for a period of 7 Except as provided under the Contractors' or fewer consecutive days. A separate limit General Liability Extension Endorsement or by of insurance applies to Damage To the attachment of another endorsement(if any), Premises Rented To You as described in no person or organization is an insured with SECTION III—LIMITS OF INSURANCE. respect to the conduct of any current or past Paragraphs (3), (4), (5) and (6) of this partnership, joint venture or limited liability exclusion do not apply to liability assumed company that is not shown as a Named Insured under a sidetrack agreement. in the Declarations. 15. LEGAL LIABILITY/ALIENATED PREMISES/ Paragraph (6) of this exclusion does not BORROWED EQUIPMENT apply to "property damage" included in the "products-completed operations hazard." A. Under SECTION I — COVERAGE A — BODILY B. Under SECTION I — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE, INJURY AND PROPERTY DAMAGE the last Paragraph 2. Exclusions is amended to delete paragraph of Paragraph 2. Exclusions is exclusion j. Damage to Property in its entirety deleted and replaced by the following. and replace it with the following: [This insurance does not apply to:] Exclusions c. through n. do not apply to damage by fire to premises while rented to you j. Damage to Property or temporarily occupied by you with permission "Property damage" to: of the owner nor to the contents of premises rented to you for a period of 7 or fewer (1) Property you own, rent, or occupy; consecutive days. (2) Premises you sell, give away or A separate limit of insurance applies to this abandon, if the "property damage" coverage as described in SECTION III—LIMITS arises out of any part of those OF INSURANCE. premises; C. The following paragraph is added to SECTION (3) Property loaned to you; III—LIMITS OF INSURANCE: (4) Personal property in the care, custody Subject to 5. above, $25,000 is the most we will or control of the insured; pay under Coverage A for damages arising out Thatparticularpart of real roe on of any one "occurrence" because of "property (5) property rtY damage"to tools or equipment loaned to you by which you or any contractors or others that occurs while the equipment is being subcontractors working directly or used to perform operations. indirectly on your behalf are performing operations, if the "property damage" D. Paragraph 6. Damage To Premises Rented To arises out of those operations; or You Limit of SECTION III — LIMITS OF INSURANCE is replaced by the following: (6) That particular part of any property that must be restored, repaired or replaced 6. Subject to Paragraph 5. above, (the Each because "your work" was incorrectly Occurrence Limit), the Damage To performed on it. Premises Rented To You Limit is the most we will pay under SECTION — I— Paragraph (2) of this exclusion does not COVERAGE A for damages because of apply if the premises are"your work." "property damage" to any one premises Paragraphs (3) and (4) of this exclusion do while rented to you or temporarily occupied not apply to "property damage" to tools or by you with the permission of the owner, equipment loaned to you. A separate limit including contents of such premises rented of insurance applies to such tools or to you for a period of 7 or fewer consecutive equipment that are damaged while being days. The Damage To Premises Rented To used in your operations. You Limit is the greater of: a.. $500,000; or. G-18652-J (Ed. 07-12) Page 9 of 12 Copyright,CNA All Rights Reserved. CNA (Edd.. 007-12)G7-12) b. The Damage To Premises Rented To This paragraph B. does not apply to medical You Limit shown in the Declarations. expenses incurred in the state of Missouri. E. Paragraph 4.b.(1)(a)(ii) of SECTION IV— 19. NON-OWNED AIRCRAFT COMMERCIAL GENERAL LIABILITY Under SECTION I—COVERAGE A—BODILY CONDITIONS is deleted and replaced by the INJURY AND PROPERTY DAMAGE LIABILITY. following: Paragraph 2. Exclusions is amended such that (ii) That is property insurance for premises exclusion g.Aircraft,Auto or Watercraft does not rented to you, for premises temporarily apply to an aircraft you do not own, provided that: occupied by you with the permission of the 1. The pilot in command holds a currently effective owner; or for personal property of others in certificate issued by the duly constituted your care, custody or control; authority of the United States of America or F. This Provision 15. does not apply if Damage To Canada, designating that person as a Premises Rented To You Liability under commercial or airline transport pilot; SECTION — I COVERAGE A is excluded by 2. The aircraft is rented to you with a trained, paid endorsement. crew; and 16. LIBERALIZATION CLAUSE 3. The aircraft does not transport persons or cargo If we adopt a change in our forms or rules which for a charge. would broaden coverage for contractors under this 20. NON-OWNED WATERCRAFT endorsement without an additional premium charge, your policy will automatically provide the additional Under SECTION I—COVERAGE A—BODILY coverage as of the date the revision is effective in INJURY AND PROPERTY DAMAGE LIABILITY, your state. Paragraph 2. Exclusions is amended to delete 17. LIQUOR LIABILITY subparagraph (2)of exclusion g.Aircraft,Auto or Watercraft and replace it with the following. Under SECTION I—COVERAGE A—BODILY [This exclusion does not apply to:] INJURY AND PROPERTY DAMAGE, Paragraph 2. Exclusions is amended to delete exclusion c. (2) A watercraft you do not own that is: Liquor Liability. (a) Less than 75 feet long; and This provision 17.does not apply to any person or organization who otherwise qualifies as an (b) Not being used to carry persons or property additional insured on this Coverage Part. for a charge. 18. MEDICAL PAYMENTS 21. PRIMARY AND NON-CONTRIBUTORY TO OTHER INSURANCE A. Paragraph 7. Medical Expense Limit, of SECTION III — LIMITS OF INSURANCE is With respect to any person or organization that is deleted and replaced by the following: an additional insured under this Coverage Part, the following is added to Paragraph 4. of SECTION IV— 7. Subject to Paragraph 5. above (the Each COMMERCIAL GENERAL LIABILITY Occurrence Limit), the Medical Expense CONDITIONS: Limit is the most we will pay under SECTION — I — COVERAGE C for all If you have agreed in writing in a contractor medical expenses because of"bodily injury" agreement that this insurance is primary and non- sustained by any one person. The Medical contributory relative to an additional insured's own Expense Limit is the greater of: insurance, then this insurance is primary and we will not seek contribution from that other insurance. For (1) $15,000; or the purpose of this Provision 21.,the additional (2) The amount shown in the Declarations insured's own insurance means insurance on which for Medical Expense Limit. the additional insured is a Named Insured. B. Paragraph 1.a.(3)(b) of SECTION I— This Provision 21. does not apply in situations COVERAGE C MEDICAL PAYMENTS, is where the endorsement on this policy affording replaced by the following: coverage to the additional insured specifies that this insurance is excess over any other insurance (b) The expenses are incurred and reported to available to that additional insured. us within three years of the date of the accident; and 22. PROPERTY DAMAGE—ELEVATORS G-18652-J (Ed. 07-12) Page 10 of 12 Copyright,CNA All Rights Reserved. G-18652-J CNA (Ed. 07-12) A. Under SECTION I — COVERAGE A — BODILY However, this waiver applies only when you have INJURY AND PROPERTY DAMAGE, agreed in writing to waive such rights of recovery in Paragraph 2. Exclusions is amended such that a contract or agreement, and only if the contract or exclusion k. Damage to Your Product, and agreement: subparagraph (3), (4) and (6) of exclusion j. 1. Is in effect or becomes effective during the term Damage to Property do not apply "property damage"that results from the use of elevators. of this policy; and B. With respect only to the coverage provided by 2. Was executed prior to loss. this endorsement, Condition 4. Other 26. WRAP-UP EXTENSION: OWNER CONTROLLED Insurance in SECTION IV — COMMERCIAL INSURANCE PROGRAM, CONTRACTOR GENERAL LIABILITY CONDITIONS is CONTROLLED INSURANCE PROGRAM OR amended to add the following subparagraph CONSOLIDATED (WRAP-UP) INSURANCE b.(1)(a)(v): PROGRAMS 4. Other Insurance Note: The following provision does not apply to any b. Excess Insurance public construction project in the state of Oklahoma, nor to any construction project in the state of (1) This insurance is excess over: Alaska, that is not permitted to be insured under a (a) Any of the other insurance, "consolidated (wrap-up) insurance program" by whether primary, excess, applicable state statute or regulation: contingent or on any other If the endorsement EXCLUSION — basis: CONSTRUCTION WRAP-UP or another (v) That is Property exclusionary endorsement pertaining to Owner covering property insuranceoothers Controlled Insurance Programs (O.C.I.P.) or damaged from the use of Contractor Controlled Insurance Programs elevators. (C.C.I.P.) is attached to this policy, then the following changes apply: 23. SUPPLEMENTARY PAYMENTS A. The following wording is added to the A. Under Section I — Supplementary Payments endorsement: —Coverages A and B, Paragraph 1.b., the limit With respect to a "consolidated (wrap-up) of $250 shown for the cost of bail bonds is insurance program" project in which you are or replaced by$5,000: were involved, this exclusion does not apply to B. In Paragraph 1.d., the limit of $250 shown for those sums you become legally obligated to pay daily loss of earnings is replaced by$1,000. as damages because of: 24. UNINTENTIONAL FAILURE TO DISCLOSE 1. "Bodily injury," "property damage," or HAZARDS "personal or advertising injury"" that occurs should fail to disclose all during your ongoing operations at the If unintentionally youproject, or during such operations of existing hazards at the inception date of your policy, anyone acting on your behalf; nor we will not deny coverage under this Coverage Part because of such failure. 2. "Bodily injury" or "property damage" 25. WAIVER OF SUBGROGATION -BLANKET included within the "products-completed operations hazard" that arises out of those Under SECTION IV—COMMERCIAL GENERAL portions of the project that are not LIABILITY CONDITIONS, The Transfer Of Rights "residential structures." Of Recovery Against Others To Us Condition is B. SECTION IV — COMMERCIAL GENERAL amended by the addition of the following: LIABILITY CONDITIONS is amended to add the We waive any right of recovery we may have following subparagraph 4.b.(1)(c) to Condition against any person or organization because of 4. Other Insurance: payments we make for injury or damage arising out [This insurance is excess over:] of: (c) Any of the other insurance whether primary, 1. Your ongoing operations; or excess, contingent or any other basis that is 2. "Your work" included in the"products completed insurance available to you as a result of operations hazard." your being a participant in a "consolidated (wrap-up) insurance program," but only as G-18652-J (Ed. 07-12) Page 11 of 12 Copyright,CNA All Rights Reserved. CNA (Ed.G 07-1 ) 07-12) respects your involvement in that used or is intended to be used for human "consolidated (wrap-up) insurance residency including but not limited to single or program." multifamily housing, apartments, C. SECTION V — DEFINITIONS is amended to condominiums, townhouses, co-operatives or add the following definition: planned unit developments and also includes their common areas and/or appurtenant "Consolidated (wrap-up) insurance program" structures (including pools, hot tubs, detached means a construction, erection or demolition garages, guest houses or any similar project for which the prime contractor/project structures). When there is no individual manager or owner of the construction project ownership of units, residential structure does has secured general liability insurance covering not include military housing, college/university some or all of the contractors or subcontractors housing or dormitories, long term care facilities, involved in the project, such as an Owner hotels, or motels. Residential structure also Controlled Insurance Program (O.C.I.P.)or does not include hospitals or prisons. Contractor Controlled Insurance Program This provision 26. does not apply to any person (C.C.I.P.). or organization who otherwise qualifies as an "Residential structure" means any structure additional insured on this Coverage Part. where 30%or more of the square foot area is All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. Material used with permission of ISO Properties, Inc G-18652-J (Ed. 07-12) Page 12 of 12 Copyright,CNA All Rights Reserved. POLICY NUMBER: COMMERCIAL AUTO CA 04 44 03 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named insured: Endorsement Effective Date: SCHEDULE N Q § Hangs)Of Person(s)Or Organization(s): ANY PERSON OR ORGANIZATION FOR WHOM OR WHICH YOU ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT TO OBTAIN THIS WAIVER FROM US. YOU MUST AGREE TO THAT i REQUIREMENT PRIOR TO LOSS. Information required to complete this Schedule,if not shown above,will be shown in the Declarations. 1 The Transfer Of Rights Of Recovery AgaInst Others To Us Condition does not apply to the person(s) or • organization(s) shown in the Schedule, but only to. the extent that subrogation is waived prior to the 'accident' or the loss' under a contract with that person or "' organization. s _ e E i m C = Ci CA 0444 0310 Copyright, Insurance Services Office,Inc.,2009 Pagel all POLICY NUMBER: COMMERCIAL AUTO CA 20 48 02 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are ''insureds"under the Who Is An Insured Provision of the Coverage Form.This endorsement does not alter coverage provided in the Coverage Form_ This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: Countersigned By: Named Insured: LAuthorized Representative) SCHEDULE Herne of Person(s)or OrganIzatfon(s): ANY PERSON OR OROANTZATTON AS REQUIRED EY WRITTEN CONTRACT OR AGREEMENT (It no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement) Each person or organization shown in the Schedule is an"insured"for Liability Coverage, but only to the extent that person or organization qualifies as an Insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. 75 MOE EFFIN 111111111 IMIMIM CA 20 48 0289 Copyright,insurance Services Office, Inc., 1998 Pagel of 1 6/20/2016 ICON CORPORATION Hoir,e; k 6p, wi COD;ad Search L&I SEARCH 1=I.Iitd help M l.. i Safety&Heaith Clgims&Insurance Workplace Rights Grades&Licensing Washington State Department of Labor & Industries ICON CORPORATION Owner or tradesperson PO BOX 10 GREENACRES,WA 99016 Principals 509-532-1761 JOHNSON,MAX G SPOKANE County Doing business as ICON CORPORATION WA UBI No. Business type 601 838 594 Corporation License Verify the contractor's active registration/license/certification(depending on trade)and any past violations. Construction Contractor Active. Meets current requirements. License specialties GENERAL License no. ICONC**022M3 Effective—expiration 07/23/1998—07/16/2017 Bond Travelers Cas and Surety Co of America $12,000.00 Bond account no. 105623806 Received by L&I Effective date 07/18/2011 07/16/2011 Expiration date Until Canceled Bond history Insurance Continental Insurance Co $1,000,000.00 Policy no. C2074781294 Received by L&I Effective date 09/29/2015 10/07/2014 Expiration date 10/07/2016 Insurance history Savin s No savings accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. L&I Tax debts No No... &L1 tax debts debts are recorded for this contractor license during the previous 6 year period,but some debts may be recorded by other agencies. https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601838594&LIC=ICONC**022M3&SAW=False 1/3 6/20/2016 ICON CORPORATION License Violations No license violations during the previous 6 year period. Workers' comp Do you know if the business has employees?If so,verify the business is up-to-date on workers'comp premiums. This company has multiple workers'comp accounts. Active accounts L&I Account ID Account is current. 965,948-00 Doing business as ICON CORPORATION Estimated workers reported Quarter 1 of Year 2016"31 to 50 Workers" L&I account representative T4/TERRI MADISON(360)902-4654-Email:KIRT235@Ini.wa.gov Track this contractor Workplace safety and health Check for any past safety and health violations found on jobsites this business was responsible for. Inspection results date 04/14/2016 No violations Inspection no. 317939880 Location 4141 N.Regal St Spokane,WA 99207 Inspection results date 11/06/2013 No violations Inspection no. 316881200 Location 900 E.Yonezawa Blvd Moses Lake,WA 98837 Inspection results date 08/21/2013 No violations Inspection no. 316859776 Location 501 Port Industrial Park Way Quincy,WA 98848 Inspection results date 06/13/2013 No violations Inspection no. 316788066 Location 200 Nat Washington Way Ephrata,WA 98823 Inspection results date 04/02/2013 No violations Inspection no. 316625078 https://secure.lni.wa.gov/verify/Detai l.aspx?U B I=601838594&LIC=ICON C**022M 3&SAW=False 2/3 6/20/2016 ICON CORPORATION Location 940 Yonesawa Moses Lake,WA 98837 Inspection results date 09/12/2012 Violations Inspection no. 316338938 Location 1620 NE Colorado WSU Pullman,WA 99163 Inspection results date 06/08/2011 No violations Inspection no. 314896390 Location French Admin Building WSU Pullman,WA 99164 Inspection results date 09/16/2010 Violations Inspection no. 314486853 Location Johnson Tower and Todd Bldg. Pullman,WA 99163 cIndustries. of thissite is to the laws of the state of Washington. C Washington State Dept.of Labor& dust es.Use subjectg https://secure.lni.wa.gov/verify/Detai I.aspx?U BI=601838594&LIC=IC ON C**022M 3&SAW=False 3/3 __��...N ICONCOR-02 FBALL ACORCr DATE(MM/DD/YYYY) 41........----. CERTIFICATE OF LIABILITY INSURANCE 7/13/2016 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 CONTNAME: Judy Rapp Spokane Office PHONE 838-3501 FAX 509 838-3511 Pa newest Insurance,Inc. (A/C No,Ext): ) (A/C,No): ( ) 501 N.Riverpoint Blvd.,Ste 403 ADDRESS: Spokane,WA 99202 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Montana State Fund 15819 INSURED INSURER B: Icon Corporation INSURER C: PO Box 10 INSURER D: Greenacres,WA 99016 INSURER E: INSURER F: I COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS ' CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR IADDLSUBR I POLICY EFF POLICY EXP TYPE OF INSURANCE LTRI INSD i WVD I POLICY NUMBER (MM/DD/YYYY) (MMIDD/YYYY)I LIMITS COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE I$ DAMAGE TO' CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ I MED EXP(Any one person) $ I • PERSONAL&ADV INJURY I$ GEN'L AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE I$ 7 POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $I OTHER: I $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED • BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS AUTOSOWNED PROPERTY DAMAGE $ Per accident) I UMBRELLA LIAB I OCCUR EACH OCCURRENCE $ EXCESS LIAB � I CLAIMS-MADE AGGREGATE $ I DED I RETENTION$ $ WORKERS COMPENSATION I X I STATUTE I ETH AND EMPLOYERS'LIABILITY A ANY PROPRIETOR/PARTNER/EXECUTIVE YYN N/A :033856352 ! 07/15/2016 07/15/2017 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ' (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE'$ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ 1,000,000 I 1 I , DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Project: Center Place Roof Repair 2016 Icon Corp Job#4089 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Spokane Valley ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Christine Bainbridge 11707 East Sprague Ave.,Suite 106 Spokane,WA 99206 AUTHORIZED REPRESENTATIVE jimitott../..640 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD I