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16-084.00 T LaRiviere: Appleway Shared Use Path Pines to Evergreen Contract • This agreement is entered into this day of2017, between the City of Spokane Valley ("City") and T. LaRiviere Equipment& Exca�Inc. ("Contractor"), pursuant to Title 35 RCW, as adopted or amended. In consideration of the terms and conditions contained herein and attached and made a part of this agreement,the parties agree as follows: I. The Contractor shall do all work and furnish all tools,materials,and equipment for: Appleway Shared Use Path Project#0227 Contract#16-084 in accordance with and as described in the project plans and specification, and the standard specification of the Washington State of Department of Transportation which are by this reference incorporated herein and made part hereof and, shall perform any changes in the work in accord with the Contract Documents. The Contractor shall provide and bear the expense of all equipment, work, and labor, of any sort whatsoever that may be required for the transfer of materials and for constructing and completing the work provided for in these Contract Documents except those items mentioned therein to be furnished by the City. II. The City hereby promises and agrees with the Contractor to employ, and does employ the Contractor to provide the materials and to do and cause to be done the above described work and to complete and finish the same in accord with the project plans and specification and the terms and conditions herein contained and hereby contracts to pay for the same according to the referenced specifications and the schedule of unit or itemized prices at the time and in the manner and upon the conditions provided for in this contract. III. The Contractor for himself/herself, and for his/hers heirs, executors, administrators, successors, and assigns, does hereby agree to full performance of all covenants required of the Contractor in the contract. IV. It is further provided that no liability shall attach to the City by reason of entering onto this contract,except as provided herein. V. The project was awarded for the bid amount of$1,680,981.00. City of Spokane Valley 20 Contract Forms Appleway Shared Use Path Project Contract No.:16-084 IN WITNESS WHEREOF, the Contractor has executed this instrument, on the date below, and the City has caused this instrument to be executed on the date stated above. Executed by Contractor \ 4-1 ,__. Date --ACCUMPfriVid f‘Cfc. Printed Name Title ignature City of Spokane Valley Mark Calhoun Printed Name City Manager Tit eCatthAy • Si ature Revised 1-8-16 • City of Spokane Valley 21 Contract Forms Appleway Shared Use Path Project Contract No.:16-084 l \1111111h l YOF71---_ - iiiey' BOND NO: BD749684 Effective Date: First Day of the Contract CONTRACTOR'S PAYMENT BOND(FEDERALLY FUNDED PROJECT) to City of Spokane Valley,Washington The City of Spokane Valley, Washington, in Spokane County, has awarded to T. LaRiviere Equipment& Excavation, Inc. (Contractor),as Principal,a contract for the construction of the project designated as Applewav Shared Use Path Project#227, in Spolcane Valley, Washington, and said Principal is required under the terms of the Contract to furnish a payment bond in accordance with chapter 39.08 Revised Code of Washington(RCW)and chapter 60.28 RCW. The Principal, and Nationwide Mutual Insurance Company (Surety), a corporation organized under the laws of Ohio and licensed to do business in the State of Washington as surety and named in the current list of"Surety Companies Acceptable in Federal Bonds"as published in the Federal Register by the Audit Staff Bureau of Accounts,U.S.Treasury Dept.,are jointly and severally held and firmly bound to the City of Spokane Valley,as Obligee,in the sum of$1.680.981.00 total Contract amount,subject to the provisions herein. This payment bond shall cover any and all taxes incurred pursuant to Titles 50 and 51 RCW,taxes imposed on the Principal pursuant to Title 82 RCW,and any additional sales taxes. This payment bond shall'become null and void, if and when the Principal, its heirs, executors, administrators, successors, or assigns 'shall pay all persons in accordance with chapters 39.08, 39.12, and 60.28 RCW, including all workers, laborers, mechanics, subcontractors, and materialmen, and all persons who shall supply such contractor or subcontractor with provisions and supplies for the carrying on of such work;shall pay all taxes due pursuant to Titles 50,51,.and 82 RCW;and shall indemnify and hold harmless the Obligee from all loss,cost or damage which Obligee may suffer by reason of the failure of Principal to make such required payments; and if such payment obligations have not been fulfilled,this bond shall remain in full force and effect. The Surety for value received agrees that no change, extension of time, alteration or addition to the terms of the Contract, the specifications accompanying the Contract,or to the work to be performed under the Contract shall in any way affect its obligation on this bond,except as provided herein,and waives notice of any change,extension of time,alteration or addition to the terms of the Contract or the work performed.The Surety agrees that modifications and changes to the terms and conditions of the Contract that increase the total amount to be paid the Principal shall automatically increase the obligation of the Surety on this bond and notice to Surety is not required for such increased obligation. This bond may be executed in two original counterparts, and shall be signed by the parties' duly authorized officers.This bond will only be accepted if it is accompanied by a fully executed and original power of attorney for the officer executing on behalf of the surety. T. LaRiviere Equipment&Excavation, Inc. Nationwide Mutual Insurance Company PR1NC" ' (CONTRACTOR) URETY iiitidi , • Q, ,01/2`672,017.'rincipal Signature Date Surety Signature ..`.�,%•'Date`' _ ` ' ^�tYM(�-5, \�f Cherie M. Boadle `` - Tinted Name Printed Name F. ;, - _ Attorney-In-Fact r . :.• 1 • Z. Title Title :-.. -- - 27:‘:•1„, .-.., e..,,. , Name,address,and telephone of local office/agent of Surety Company is: "a c�✓'r _ y ..-.. Inland Insurance,Inc./Jim Dinneen . '- .r.• ;" 9016 E.Indiana.Suite A.Spokane Valley WA 99212 Revised 1.14.13 City of Spokane Valley 22 Contract Forms Appleway Shared Use Path Project Contract No.:16-084 -A. Power of Attorney KNOW ALL MEN BY THESE PRESENTS THAT: Nationwide Mutual Insurance Company,an Ohio corporation AMCO Insurance Company,an Iowa corporation Farmland Mutual Insurance Company,an Iowa corporation Allied Property and Casualty Insurance Company,an Iowa corporation Nationwide Agribusiness Insurance Company,an Iowa corporation Depositors Insurance Company,an Iowa corporation hereinafter referred to severally as the"Company"and collectively as the"Companies,"each does hereby make,constitute and appoint: JAMES P.DINNEEN JOHN L.GREEN CHARLA M.BOADLE each in their individual capacity,its true and lawful attorney-in-fact,with full power and authority to sign,seal,and execute on its behalf any and all bonds and undertakings, and other obligatory instruments of similar nature,in penalties not exceeding the sum of FIVE MILLION AND NO/100 DOLLARS $5,000,000.00 and to bind the Company thereby,as fully and to the same extent as if such instruments were signed by the duly authorized officers of the Company;and all acts of said Attorney pursuant to the authority given are hereby ratified and confirmed. This power of attorney is made and executed pursuant to and by authority of the following resolution duly adopted by the board of directors of the Company: "RESOLVED,that the president,or any vice president be,and each hereby is,authorized and empowered to appoint attorneys-in-fact of the Company,and to authorize them to execute and deliver on behalf of the Company any and all bonds,forms,applications,memorandums,undertakings,recognizances,transfers,contracts of indemnity,policies,contracts guaranteeing the fidelity of persons holding positions of public or private trust,and other writings obligatory in nature that the business of the Company may require;and to modify or revoke,with or without cause,any such appointment or authority;provided,however,that the authority granted hereby shall in no way limit the authority of other duly authorized agents to sign and countersign any of said documents on behalf of the Company." "RESOLVED FURTHER,that such attorneys-in-fact shall have full power and authority to execute and deliver any and all such documents and to bind the Company subject to the terms and limitations of the power of attorney issued to them,and to affix the seal of the Company thereto;provided,however,that said seal shall not be necessary for the validity of any such documents." This power of attorney is signed and sealed under and by the following bylaws duly adopted by the board of directors of the Company. Execution of Instruments. Any vice president,any assistant secretary or any assistant treasurer shall have the power and authority to sign or attest all approved documents,instruments,contracts,or other papers In connection with the operation of the business of the company in addition to the chairman of the board,the chief executive officer,president,treasurer or secretary;provided,however,the signature of any of them may be printed,engraved,or stamped on any approved document, contract,instrument,or other papers of the Company. IN WITNESS WHEREOF,the Company has caused this instrument to be sealed and duly attested by the signature of its officer the 13th day of February,2014. '' d?` !;a. Terrance Williams,President and Chief Operating Officer of Nationwide Agribusiness Insurance Company / / traiset and Farmland Mutual Insurance Company;and Vice President of Nationwide Mutual Insurance Company, � LSEA '•d ,. *ff AMCO Insurance Company,Allied Property and Casualty Insurance Company,and Depositors Insurance vmaco.. Company ',m:� ',\erg iig_` ACKNOWLEDGMENT i. isillmilh. :: , ! STATE OF IOWA,COUNTY OF POLK: ss " /� I/ /�� . � On this 13"'day of February,2014,before me came the above-named officer for the Companies aforesaid,to f SEA .L)g ,��j, j me personally known to be the officer described in and who executed the preceding instrument,and he ''•.• $ Y acknowledged the execution of the same,and being by me duly sworn,deposes and says,that he is the officer '* "' I i 'ii► of the Companies aforesaid,that the seals affixed hereto are the corporate seals of said Companies,and the ,� \`=fie said corporate seals and his signature were duly affixed and subscribed to said instrument by the authority and .���\ ir \ direction of said Companies. ,t ar/oft*", $ Sandy Alitz G / 4'7"--,--j-- it ��T /? Notarial Seal-Iowa 0 al SEAL ' 0 (SEAL Commission Number 152785 '•. �`•. *� My Commission Expires March,24,2017 Notary Public ti• •ap.. �,4r•••••••ipj" My Commission Expires `\�� ��� CERTIFICATE March 24,2017 I,Robert W Homer III,Secretary of the Companies,do hereby certify that the foregoing is a full,true and correct copy of the original power of attorney issued by the Company;that the resolution included therein is a true and correct transcript from the minutes of the meetings of the boards of directors and the same has not been revoked or amended in any manner;that said Terrance Williams was on the date of the execution of the foregoing power of attorney the duly elected officer of the Companies,and the corporate seals and his signature as officer were duly affixed and subscribed to the said instrument by the authority of said board of directors;and the foregoing power of attorney is still in full force and effect. IN WITNESS WHEREOF,I have hereunto subscribed my name as Secretary;anc,affixed the corporaCei.seals of said Companies this 25 th day of January ,20 17 .. . ` ,%../".....,..-: )4_4z 3' - - �- ."-Sec[etary . - �- ~' - , This Power of Attorney Expires 03/09/2017 _ ` .. _ BDJ 1(03-14)00 • +`'_` 46-26535 /f .� _ . .. error � a11ey. BOND NO: BD749684 Effective Date: First Day of the Contract CONTRACTOR'S PERFORMANCE BOND to City of Spokane Valley,Washington The City of Spokane Valley, Washington, in Spokane County, has awarded to T. LaRiviere Equipment& Excavation, Inc. (Contractor), as Principal, a contract for the construction of the project Applewav Shared Use Path Project#227 in Spokane Valley,Washington,and said Principal is required under the terms of the Contract to furnish a performance bond in accordance with chapter 39.08 Revised Code of Washington(RCW). The Principal, and Nationwide Mutual Insurance Company (Surety), a corporation, organized under the laws of Ohio and licensed to do business in the State of Washington as surety and named in the current list of"Surety Companies Acceptable in Federal Bonds"as published in the Federal Register by the Audit Staff Bureau of Accounts,U.S.Treasury Dept.,are jointly and severally held and firmly bound to the City of Spokane Valley,as Obligee,in the sum of$1,680,981.00 total Contract amount(including Washington State sales tax),subject to the provisions herein. This 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;shall warranty the work as provided in the Contract and shall indemnify and hold harmless the Obligee from any defects in the workmanship and materials incorporated into the work for the period identified in the Contract;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 not required for such increased obligation. This bond may be executed in two original counterparts, and shall be signed by the parties' duly authorized officers.This bond will only be accepted if it is accompanied by a fully executed and original power of attorney for the officer executing on behalf of the surety. T. LaRiviere Equipment&Excavation, Inc. Nationwide Mutual Insurance Company P',i I'AL(CONTRACTOR) URETY • . IC��0- J -- ,Q1/25/2047 rincipal Signature Date Surety SignatureDat ~-1-ftinPrA41VneQ- !J Charla M. Boadle 2.1 Printed Name Printed Name `�_ ` Attorney-I n-Fact x Title Title = ' Name,address,and telephone of local office/agent of Surety Company is: = v „ `: Inland Insurance. Inc./Jim Dinneen " � � r : 9016 E. Indiana,Suite A, Spokane Valley WA 99212 ' Revised 1.14.13 City of Spokane Valley 23 Contract Forms Appleway Shared Use Path Project Contract No.:16-084 l Power of Attorney KNOW ALL MEN BY THESE PRESENTS THAT: Nationwide Mutual Insurance Company,an Ohio corporation AMCO Insurance Company,an Iowa corporation Farmland Mutual Insurance Company,an Iowa corporation Allied Property and Casualty Insurance Company,an Iowa corporation Nationwide Agribusiness Insurance Company,an Iowa corporation Depositors Insurance Company,an Iowa corporation hereinafter referred to severally as the'Company"and collectively as the"Companies,"each does hereby make,constitute and appoint: JAMES P.DINNEEN JOHN L.GREEN CHARLA M.BOADLE each in their individual capacity,its true and lawful attorney-in-fact,with full power and authority to sign,seal,and execute on its behalf any and all bonds and undertakings, and other obligatory instruments of similar nature,in penalties not exceeding the sum of FIVE MILLION AND NO/100 DOLLARS $5,000,000.00 and to bind the Company thereby,as fully and to the same extent as if such instruments were signed by the duly authorized officers of the Company;and all acts of said Attorney pursuant to the authority given are hereby ratified and confirmed. This power of attorney is made and executed pursuant to and by authority of the following resolution duly adopted by the board of directors of the Company: "RESOLVED,that the president,or any vice president be,and each hereby is,authorized and empowered to appoint attorneys-in-fact of the Company,and to authorize them to execute and deliver on behalf of the Company any and all bonds,forms,applications,memorandums,undertakings,recognizances,transfers,contracts of indemnity,policies,contracts guaranteeing the fidelity of persons holding positions of public or private trust,and other writings obligatory in nature that the business of the Company may require;and to modify or revoke,with or without cause,any such appointment or authority;provided,however,that the authority granted hereby shall in no way limit the authority of other duly authorized agents to sign and countersign any of said documents on behalf of the Company." `RESOLVED FURTHER,that such attorneys-in-fact shall have full power and authority to execute and deliver any and all such documents and to bind the Company subject to the terms and limitations of the power of attorney issued to them,and to affix the seal of the Company thereto;provided,however,that said seal shall not be necessary for the validity of any such documents." This power of attorney is signed and sealed under and by the following bylaws duly adopted by the board of directors of the Company. Execution of Instruments. Any vice president,any assistant secretary or any assistant treasurer shall have the power and authority to sign or attest all approved documents,instruments,contracts,or other papers in connection with the operation of the business of the company in addition to the chairman of the board,the chief executive officer,president,treasurer or secretary;provided,however,the signature of any of them may be printed,engraved,or stamped on any approved document, contract,instrument,or other papers of the Company. IN WITNESS WHEREOF,the Company has caused this instrument to be sealed and duly attested by the signature of its officer the 13"' day of February,2014. �� a c V 1' Terrance Williams,President and Chief Operating Officer of Nationwide Agribusiness Insurance Company / i� / '" ' and Farmland Mutual Insurance Company;and Vice President of Nationwide Mutual Insurance Company, 0;:,.�'.AI.;+/ 0 SEAL.a AMCO Insurance Company,Allied Property and Casualty Insurance Company,and Depositors Insurance •:...tea,.::' 44 4. $ Company �_,` _ ACKNOWLEDGMENT • At A0.! 7i. �umi t,1 O:�• O' � STATE OF IOWA,COUNTY OF POLK: ss / / / arw On this 13"'day of February,2014,before me came the above-named officer for the Companies aforesaid,to /.�L;.a •a SEAL j me personally known to be the officer described in and who executed the preceding instrument,and he `•., ,� 0 : . acknowledged the execution of the same,and being by me duly sworn,deposes and says,that he is the officer VAv ♦ V,� �i*AV of the Companies aforesaid,that the seals affixed hereto are the corporate seals of said Companies,and the said corporate seals and his signature were duly affixed and subscribed to said instrument by the authority and �4�►�, +meq,, direction of said Companies. % MALI e i o '$0 Notarial al- Seal Iowa ` 6� ('A V." ;•� $EAL, commission Number 152785 e `•.. 0 •. */ My Commission Expires March,24,2017 Notary Public �••••••,iai• �'' ••viojMy Commission Expires ,\ � ,�►�� CERTIFICATE March 24,2017 1,Robert W Homer III,Secretary of the Companies,do hereby certify that the foregoing is a full,true and correct copy of the original power of attorney issued by the Company;that the resolution included therein is a true and correct transcript from the minutes of the meetings of the boards of directors and the same has not been revoked or amended in any manner;that said Terrance Williams was on the date of the execution of the foregoing power of attorney the duly elected officer of the Companies,and the corporate seals and his signature as officer were duly affixed and subscribed to the said instrument by the authority of said board of directors;and the foregoing power of attorney is still in full force and effect. IN WITNESS WHEREOF,I have hereunto subscribed my name as Secretary,and affixed the corporate-ealls of said Companies this 25th day of January 20 17 =` -LI. ✓ 4` w j S&cretary A . ;.- .. r - r•— s - n This Power of Attorney Expires 03/09/2017 = .`' • �, �` • . - '= • -;, r- - y t BDJ 1(03-14)00 46-26535 .,-, - .,�� -- - , , , t TLARI-1 OP ID:MH ACCIFIZ Er CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) iii......----- 01/25/2017 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 pollcy(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: Inland Insurance Inc. PHONE FAX 9016 E Indiana Ave.,Suite A (A/C.No.Eat): (A/c,No): Spokane Valley,WA 99212 A E-MADRIESS: James P Dinneen INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Alaska National Ins Co 38733 INSURED T.La Riviera Equipment INSURER B:Idaho State Insurance Fund &Excavation Inc PO Box 100 INSURER C C. Athol,ID 83801-0897 INSURER D: 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXPM/ LIMITS LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MDD/YYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR X X 16D PS 08913 04/10/2016 04/10/2017 DAMAGE TO RENTED 100,000 PREMISES(Ea occrrence) $ X Contractual MED EXP(Any one person) $ 5,000 X XCU Separ of Insd PERSONAL S ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 N/ X OTHER:Waterborne 50' Pollution $ 1,000,000 AUTOMOBILE UABIUTY COMBINED SINGLE LIMIT $ 1000000 (Ea accident) , , A X ANY AUTO X X 16D AS 08913 04/10/2016 04/10/2017 BODILY INJURY(Per person) $ — ALL OWNED AUTOS X ) $ SCHEDULED BODILY INJURY(Per accident AUTOS X HIRED AUTOS X NON OWNED PROPERTY DAMAGE $ gUTOS (Per accident) X MCS90 )( Hired PD $ X UMBRELLA LAB X OCCUR EACH OCCURRENCE $ 6,000,000 A EXCESS UAB CLAIMS-MADE 16D LU 08913 04/10/2016 04/10/2017 AGGREGATE $ 6,000,000 DED X RETENTION$ 10000 $ WORKERS COMPENSATION OTH- AND EMPLOYERS'LIABILITY STATUTE ER B AONY PRR/MEMBER OPRIETORPARTNEEXCLUDIECUTIVE Y/N N/A 614860 CONTINUOUS 04/10/2016 04/10/2017 E.L.EACH ACCIDENT $ 1,000,000 A (Mandatory In NH) 16D PS 08913-STOP GAP 04/10/2016 04/10/2017 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 Hyes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Leased&Rented Eq 16D PS 08913 04/10/2016 04/10/2017 Limit 250,000 A Scheduled Equipmen 16D PS 08913 04/10/2016 04/10/2017 Limit 2,785,072 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) RE:Appleway Shared Use Path Project#0227/Contract#16-084 The City of Spokane Valley is primary non-contributory additional insured as respects the above project only per insuring forms ANIC GLI061 0308;ANIC 1162 1215; CG2503 0509;and ANIC CA1150 1013 attached. CERTIFICATE HOLDER CANCELLATION CITYOI2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cit of Spokane ValleyTHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y P ACCORDANCE WITH THE POLICY PROVISIONS. Public Works Department 11707 E Sprague AVe#106 AUTHORIZED REPRESENTATIVE Spokane Valley,WA 99206 L ..OmEkn.«✓Prnia.nt I ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD • --A-gc. , . Alaska INSURANCNatCOional NY ADDITIONAL INSURED (CONTRACTORS) - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. Who Is An Insured (Section II) is amended to ii. supervisory, inspection, or engineering include as an insured any person or organization services. (herein referred to as an additional insured), but only if you are required to add that person or c. The insurance provided to the additional organization as an insured to this policy by a insured, referred to in paragraph 1. of this written contract that is in effect prior to the "bodily endorsement, does not cover"bodily injury"or injury", "property damage", or "personal and "property damage" caused by your negligent advertising injury". acts and omissions in the performance of "your work" that occurs within the "products- 2. The insurance provided to the additional insured completed operations hazard," unless the is limited as follows: written contract, referred to in paragraph 1. of this endorsement, contains a specific a. That person or organization is only an requirement that you procure completed additional insured if, and only to the extent operations coverage or coverage within the that, the injury or damage is caused by "products-completed operations hazard" for negligent acts or omissions of you or your the additional insured. However, even if subcontractor in the performance of "your coverage within the "products-completed work" to which the written contract applies. operations hazard" is.required by the written The person or organization does not qualify contract, such coverage is available to the as an additional insured with respect to injury additional insured only if the "bodily injury" or or damage caused in whole or in part by "property damage" occurs prior to the end of independent negligent acts or omissions of the time period during which you are required such person or organization. by the written contract to provide such coverage or the expiration date of the policy, b. The insurance provided to the additional whichever comes first. insured does not apply to "bodily injury", "property damage", or "personal and 3. If other valid and collectible insurance, whether on advertising injury"arising out of an architect's, a primary, excess, contingent or any other basis, engineer's, or surveyor's rendering of or is available to the additional insured for a loss we failure to render any professional services • cover under this endorsement, then the insurance including: provided by this endorsement is excess over that other insurance. However, the.insurance provided i. the preparing, approving, or failing to by this endorsement will be primary to other prepare or approve maps, drawings, insurance on which the additional insured is a opinions, reports, surveys, change orders, named insured for the covered loss, if the written design or specifications; and contract, referred to in paragraph 1. of this ANIC GL 1061 03 08 Page 1 of 2 Alaska National 4 INSURANCE COMPANY endorsement, contains a specific requirement that this insurance be primary or primary and non- contributory. In that case we will not share with that other insurance on a pro-rata or other basis. If the other insurance available to the additional insured,whether on a primary, excess, contingent or any other basis, is coverage for which it has been named as an additional insured, then the coverage provided by this endorsement is excess over that other insurance. • • This endorsement changes the policy to which it is attached and, unless otherwise stated, is effective on the date issued at 12:01 A.M. standard time at your mailing address shown in the policy. The information below is required only when this endorsement is issued subsequent to commencement of the policy. Endorsement Effective Policy No. Insured Endorsement No. 13 Countersigned By ANIC GL 1061 03 08 Page 2 of 2 r onal INSURANCE COMPANY COMMERCIAL GENERAL LIABIUTY COVERAGE ENHANCEMENT ENDORSEMENT • THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Various provisions in this endorsement restrict (b) Not being used to carry persons or coverage. Read the entire policy carefully to property for a charge. determine rights, duties, and what is and is not covered. SUPPLEMENTARY PAYMENTS — COVERAGES A AND B,Paragraph 1.b.is replaced by the following: Throughout this policy, the words "you" and 'your' refer to the Named Insured shown in the b. Up to$10,000 for mist of bail bonds required Declarations. The words"we",'us",and`our refer to because of accidents or traffic law violations the company providing this insurance. arising out of the use of any vehicle to which the Bodily injury Liability Coverage applies. Other words and phrases that appear in quotation We do not have to furnish these bonds. marks have special meaning. Refer to SECTION V— DEFINITIONS In. the.Commercial General Liability SUPPLEMENTARY PAYMENTS—COVERAGES A Coverage Form. AND B,Paragraph 1.d.is replaced by the following: The coverages provided by this endorsement apply d. All reasonable expenses incurred by the per°occurrence'and, unless otherwise specified, are insured at our request to assist us in the subject to all of the terms, conditions,.exclusions and investigation or defense of the claim or suit, deductible provisions of the policy, to which It is Including actual loss of earnings up to$500 a attached. day because of time off from work. NON-OWNED WATERCRAFT AMENDMENT SECTION•it-WHO IS AN INSURED,paragraph 2.e. is added as follows: A. If endorsement CG 21 09, CG 21 10, CG 24 50, or CG 24 51 Is attached to the policy, Paragraph e. Any person(s) or organizations) (referred to A.2.9.(2)(b)Isleplaced by the following: throughout this coverage form as vendor)for whom you have agreed in writing to provide (b) A watercraft that you do not own that insurance such as is afforded by this is: coverage form but only with respect to"bodily injury" or "property damage` arising out of (I) Less than 50 feet long:and "your products"which are distributed or sold in the regular course of the vendor's (ii) Not being used to carry persons business. or property for a charge. However: B. If Paragraph A. does not apply,.Paragraph g. (2) of 2. EXCLUSION under SECTION I — (1) The insurance afforded to such vendor COVERAGES, COVERAGE A — BODILY only applies to the extent permitted by INJURY AND PROPERTY DAMAGE UABiLITY law;and is replaced by the following: (2) A watercraft that you do not own that is: (a) Less than 50 feet long;and ANIC GL 11621215 Page 1 of 4 LL Alaska National t3 � � INSURANCE COMPANY (2) If coverage provided to the vendor is (1) The exceptions contained 1n Sub- required by a contract or agreement, the paragraphs d.or f.;or insurance afforded to such vendor will not be broader than that which you are (2) Such inspections, adjustments, tests or required by the contract or agreement to servicing as the vendor has agreed to provide for such vendor. make or normally undertakes to make in the usual course of business, in With respect to the insurance afforded to connection with the distribution or sale of these vendors, the following additional the products. exclusions apply: This insurance does not apply to any insured The insurance afforded the vendor does not apply person or organization, from whom.you have to: acquired such products, or any ingredient; part or container, entering into, accompanying or a. "Bodily injury"or"property damage"for which containing such products. the vendor is obligated to pay damages by reason of the assumption of liability in a SECTION II—WHO IS AN INSURED,paragraph 2.f. contract or agreement. This exclusion does is added as follows: not apply to liability for damages that the vendor would have in the absence of the f. Any person(s) or organization(s) for whom contract or agreement; you have agreed in writing to provide insurance as is afforded by this coverage b. Any express warranty unauthorized by you; form but only with respect to liability arising out of the ownership, maintenance or use of c. Any physical or chemical change in the that part of the premises leased to you by product made intentionally by the vendor such person(s)or organization(s). d. Repackaging, except when unpacked solely This insurance does not apply to: for the purpose of inspection, demonstration, testing, or the substitution of parts under (1) Any"occurrence"which takes place after instructions from the manufacturer, and then you cease to be a tenant in that repackaged In the original container; premises. e. Any failure to make such inspections, (2) Structural alterations,new construction or adjustments, tests or servicing as the vendor demolition operations performed by or on has agreed to make or normally undertakes behalf of such person(s) or to make in the usual course of business, in organization(s). connection with the distribution or sale of the products; However: f. Demonstration,installation,servicing or repair (1) The Insurance afforded to such additional operations, except such operations . insured only applies to the extent performed at the vendor's premises in permitted by law;and connection with the sale of the product (2) The coverage to the additional insured g. Products which, after distribution or sale by will not be broader than that which you •you, have been•labeled or relabeled or used are required by the contract or agreement as a container,part or ingredient of any other to provide for such additional Insured. thing or substance by or for the vendor or h. Bodily injury" or "property'damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: ANIC GL 11621215 Page 2 of 4 r:-s National i _ INSURANCE COMPANY SECTION Ill—LIMITS OF INSURANCE, Paragraph SECTION IV—COMMERCIAL GENERAL LIABILITY 6.1s replaced by the following: CONDITIONS—Paragraph 4. —Other insurance is amended to add: 6. Subject to Paragraph 5. above, the Damage to Premises Rented to You Limit is the most we will d. Primary and Noncontributory Insurance pay under Coverage A for damages because of 'property damage' to any one premises, while This insurance is primary to and will not seek rented to you, or in the case of damage by fire, contribution from any other Insurance while rented to you or temporarily occupied by available to an additional insured under your you with permission of the owner. policy provided that If a limit is shown for Damage to Premises (1) The additional insured is a Named Rented to You the most we will pay under Insured under such other insurance;and Coverage A for damages because or 'property damage'to any one premises is the Limit shown (2)'You'have agreed in writing in a contract in the Declarations or $500,000, whichever Is or agreement that this insurance would greater. be primary and would not seek contribution from any other insurance SECTION III —LIMITS OF INSURANCE, Paragraph available to the additional insured. 7.Is replaced by the following: This Paragraph d. supersedes any provision 7. Subject to Paragraph 5. above, the Medical to the contrary in Paragraphs a. through c. Expense Limit is the most we will pay under above. Coverage C for all medical expenses because of 'bodily Injury'sustained by any one person. SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS —Paragraph 6.— Representations Is If a limit is shown for Medical Expense in the replaced by the following: Declarations the most we will pay under Coverage C for all medical expenses because of 6. Representations 'bodily injury'sustained by any one person is the Limit shown In the Declarations or $15,000, By accepting this policy,you agree: whichever is greater. a. The statements in the Declarations are SECTION III — LIMITS OF INSURANCE, the accurate and complete; following is added: b. Those statements are based upon With respect to the insurance afforded to the Insureds representations you made to us;and described in Paragraphs 2.e.and 2.f. of Section II— Who Is An Insured, If coverage provided to such c. We have issued this policy in reliance upon insured is required by a contract or agreement, the your representations. most we will pay on behalf of such Insured Is the amount of insurance: The unintentional omission of, or unintentional !� error In, any Information you provided to us (1) Required by the contract or agreement which we relied upon in issuing this policy will or not prejudice your rights under this Insurance. However,this provision does not affect our right (2) Available under the applicable Limits of to collect additional premium.or to exercise our Insurance shown in the Deciarations; rights of cancellation or nonrenewal in accordance with applicable laws and regulations. whichever is less. This provision shall not increase the applicable Limits of insurance shown in the Declaration. ANIC GL 1162 12 15 Page 3 of 4 National t Alaska I y INSURANCE COMPANY SECTION IV-COMMERCIALGENERAL LABILITY SECTION V - DEFINITIONS - Paragraph 3. - CONDITIONS-is amended to add Paragraph 10. '.Bodily Injury"is replaced by the following: 10. Blanket Waiver of Transfer of Rights of 'Bodily injury" means bodily injury, sickness or Recovery Against Others disease sustained by a person including death or mental anguish resulting from any of these. Mental We waive any right of recovery we may have anguish means any type of mental or emotional against any person or organization as required in illness or disease a written contract because of payments we make for injury or damage arising out of 'your work' done under a written contract. The waiver applies only to the person or organization required by written contract and then only if the contract requires you to obtain this agreement from us. This endorsement changes the policy to which it is attached and. unless otherwise stated, is effective on the date issued at 12:01 A.M. 'standard time at your mailing address shown'ir the policy. The Information below Is required only when this endorsement Is Issued subsequent to commencement of the policy. Endorsement Effective Policy No. Insured Endorsement No. 14 Countersigned By Includes copyrighted material of Insurance Services Office,Inc.,with Its permission ANICGL11621215 Page4of4 Alaska It .bonal INSURANCE COMPANY DESIGNATED CONSTRUCTION PROJECT(S)GENERAL AGGREGATE LIMIT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): All Projects Information required to complete this Schedule,if not shown above,will be shown in the Declarations. A. For all sums which the insured becomes legally 3. Any payments made under Coverage A for obligated to pay as damages caused by damages or under Coverage C for medical "occurrences" under Section I—Coverage A, and expenses shall reduce the Designated for all medical expenses caused by accidents Construction Project General Aggregate Limit under Section I — Coverage C, which can be for that designated construction project. Such attributed only to ongoing operations at a single payments shall not reduce the General designated construction project shown in the Aggregate Limit shown in the Declarations nor Schedule above: shall they reduce any other Designated 1. A separate Designated Construction Project Construction Project General Aggregate Limit General Aggregate Limit applies to each for any other designated construction project designated construction project, and that limit shown in the Schedule above. is equal to the amount of the General 4. The limits shown in the Declarations for Each Aggregate Limit shown in the Declarations. Occurrence, Damage To Premises Rented To 2. The Designated Construction Project General You and Medical Expense continue to apply. Aggregate Limit is the most we will pay for the However, instead of being subject to the sum of all damages under Coverage A, except General Aggregate Limit shown in the damages because of "bodily injury" or Declarations, such limits will be subject to the "property damage" included in the "products- applicable Designated Construction Project completed operations hazard", and for medical General Aggregate Limit. expenses under Coverage C regardless of the number of: • a. Insureds; b. Claims made or"suits"brought;or c. Persons or organizations making claims or bringing"suits". CG 25 03 05 09 Page 1 of 2 Mask ait _1loaat INSURANCE COMPANY B. For all sums which the insured becomes legally. C. When coverage for liability arising out of the obligated to pay as damages caused by "products-completed operations hazard" is "occurrences" under Section I — Coverage A, and provided, any payments for damages because of for all medical expenses caused by accidents "bodily injury"or"property damage"included in the under Section I — Coverage C, which cannot be "products-completed operations hazard" will attributed only to ongoing operations at a single reduce the Products-completed Operations designated construction project shown in -the Aggregate Limit, and not reduce the General Schedule above: Aggregate Limit nor the Designated Construction 1. Any payments made under Coverage A for Project General Aggregate Limit. damages or under Coverage C for medical D. If the applicable designated construction project expenses shall reduce the amount available has been abandoned, delayed,or abandoned and under the General Aggregate Limit or the then restarted, or if the authorized contracting Products-completed Operations Aggregate parties, deviate from plans, blueprints, designs, Limit,whichever is applicable;and specifications or timetables, the project will still be 2. Such payments shall not reduce any deemed to be the same construction project Designated Construction Project General E. The provisions of Section III—Limits Of Insurance Aggregate Limit not otherwise modified by this endorsement shall continue to apply as stipulated. • • • This endorsement changes the policy to which it is attached and, unless otherwise stated, is effective on the date issued at 12:01 A.M. standard time at your mailing address shown In the policy. The Information below Is required only when this endorsement Is Issued subsequent to commencement of the policy. Endorsement Effective Policy No. . Insured Endorsement No. 19 Countersigned By O Insurance Services Office, Inc.,2008 CG 25 03 05 09 Page 2 of 2 • 114/7 Alaska Na oral. INSURANCE COMPANY BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM Various provisions in this endorsement restrict SECTION IV — Business Auto Conditions, coverage. Read the entire policy carefully to Paragraph A. 5. — Transfer of Rights of Recovery determine rights, duties, and what is and is not Against Others To Us is amended to include: covered. • 5. Transfer of Rights of Recovery Against Throughout this policy, the words "you" and "your" Others to Us refer to the Named Insured shown in the Declarations. The words "we", "us", and "our"refer to This condition does not apply to any the company providing this insurance. person(s) or organization(s)to the extent that subrogation against that person or Other words and phrases that appear in quotation organization is waived prior to the "accident" marks have special meaning. Refer to SECTION V— or the"loss"under a contract with that person DEFINITIONS in the Business Auto Coverage Form. or organization. The coverages provided by this endorsement apply SECTION II — COVERED AUTO LIABILITY per "accident" and, unless otherwise specified, are COVERAGE, Paragraph A.2.a. (2)—Supplementary subject to all of the terms, conditions, exclusions and Payments is replaced by the following: deductible provisions of the policy, to which it is attached. (2) Up to $10,000 for cost of bail bonds (including bonds for related traffic law SECTION II — COVERED AUTO LIABILITY violations) required because of an COVERAGE, Paragraph A.1. Who Is An Insured is "accident"we cover. We do not have amended to include: to furnish these bonds. d. Any "employee" of yours while operating SECTION Il COVERED AUTO LIABILITY an "auto" hired or rented under a COVERAGE, Paragraph A.2.a. (4)—Supplementary contract or agreement in an"employee's" Payments is replaced by the following: name, with your permission, while performing duties related to the conduct (4) All reasonable'expenses'incurred by of your business. the"insured"at our request, including actual loss of earnings up to $500 a e. Any person or organization for whom you day because of time off from work. have agreed in writing to provide insurance such as 'is afforded by this Coverage Form, but only with respect to liability arising out of the ownership, maintenance or use of"autos"covered by this policy. If such person or organization has other insurance then this insurance is primary to and we will not seek contribution from the other insurance. ANIC CA 1150 10 13 Producer Copy Page 1 of 4 I1f Alaska NaoMPANY anal C. "Loss" caused by falling objects or SECTION II — COVERED AUTO LIABILITY missiles. COVERAGE, Paragraph A.2.c.—Voluntary Property Damage is added as follows: However, you have the option of having glass breakage caused by 2 covered "auto's" c. Voluntary Property Damage collision or overturn considered a"loss"under Collision Coverage. At your written request, we may make a voluntary payment for Property Damage Glass Repair—Waiver of Deductible caused by an "insured", but without liability to a third party, up to$25,000.We No deductible applies to glass breakage, if will not make a Voluntary Property the glass is repaired rather than replaced. Damage payment.to anyone who is an "insured"under this policy. SECTION III — PHYSICAL DAMAGE COVERAGE, Paragraph A.4.a. — Transportation Expenses is SECTION III — PHYSICAL DAMAGE COVERAGE, replaced by the following: Paragraph A.2.—Towing is replaced by the following: a. Transportation Expenses Towing We will pay up to $200 per day to a We will pay up to $500 for towing and labor maximum of $1,500 for temporary costs incurred each time a covered "auto" transportation expense incurred by you that is a: because of the total theft of a covered °auto"that is a: a. Private passenger; (1) Private passenger; b. Truck; (2) Truck; c. Pick-up truck; (3) Pick-up truck; d. Panel;or (4) Panel; or e. Van (5) Van type vehicle under 20,000 lbs. of Gross Vehicle Weight is disabled. However, the type.vehiple under 20,000 lbs. of Gross labor must be 'performed at place of Vehicle Weight: We will pay only for disablement. those covered"autos"for which you carry SECTION III — PHYSICAL DAMAGE COVERAGE, either Comprehensive or Specified Paragraph A.3: —.Glass.Breakage — Hitting a Bird Causes of Loss Coverage. We will pay or Animal—Falling Objects or Missiles is replaced for temporary transportation expenses by the following: incurred during the period beginning 48 hours after the theft and ending, Glass Breakage—Hitting a Bird or Animal regardless of the policy's expiration, —Fading Objects or Missiles when the covered "auto" is returned to use or we pay fo'r its"loss". If you carry Comprehensive Coverage for the damaged covered "auto", we will pay the following under Comprehensive Coverage: a. Glass Breakage; b. "Loss" caused by hitting a bird or animal; and ANIC CA 1150 10 13 Producer Copy Page 2 of 4 e. r e 747 Alaska Na. anal INSURANCE ANY (2) Specified Causes of Loss only if the SECTION III - PHYSICAL DAMAGE COVERAGE, Declarations indicate that Specified Paragraph A.4.b. — Loss of Use Expenses is Causes of Loss Coverage is provided replaced by the following: for the"auto"withdrawn from service; or b. Loss of Use Expenses—Hired, Rented, (3) Collision only if the Declarations or Borrowed Automobiles indicate that Collision Coverage is provided for the "auto" withdrawn We will pay expenses for which an from service. "insured" becomes legally responsible to pay for loss of use of a vehicle hired, SECTION III — PHYSICAL DAMAGE COVERAGE, rented or borrowed without a driver under Paragraph A.4.d. — Airbag Coverage is added as a written rental contract or agreement. follows: We will pay for loss of use expenses, if caused by: d. Airbag Coverage (1) Other than Collision, only if the We will pay for the cost to repair, replace, Declarations indicate that or reset an airbag that inflates for any Comprehensive Coverage is provided reason other than as a result of a for the vehicle withdrawn from collision, if the Declarations indicate that service. the covered "auto" has Comprehensive Coverage or Specified Causes of Loss (2) Specified Causes of Loss`only if the Coverage. Declaration's indicate that .Specified Causes of Loss Coverage is provided SECTION III — PHYSICAL DAMAGE COVERAGE, for the vehicle withdrawn from Paragraph A.4.e. — Rental Reimbursement service. Coverage is added as follows: (3) Collision only if the Declarations_ e. Rental Reimbursement Coverage indicate that Collision Coverage is provided for the vehicle withdrawn We will pay up to $75 per day for rental from service, reimbursement expenses incurred by you for the rental of an "auto" because of However, the most we will pay for any "loss"to a covered"auto"that is a: expenses for loss of use is $200 per day, to a maximum of$1,500. (1) Private Passenger; SECTION III — PHYSICAL DAMAGE COVERAGE, (2) Truck; Paragraph A.4.c.—Non-Transportation Loss of Use Expenses is added as follows: (3) Pick-up truck; c. Non-Transportation Loss of Use (4) Panel; or Expenses (5) Van We will pay up to $2,000 for non- transportation expense incurred by you, type vehicle under 20,000 lbs. of Gross because of "loss" to a covered "auto", if Vehicle Weight: Payment applies in caused by: addition to the otherwise applicable amount of each coverage you have on a (1) Other than Collision, only if the covered "auto"; No deductibles apply to Declarations indicate that this coverage. Comprehensive Coverage is provided for the"auto"withdrawn from service; ANIC CA 1150 10 13 Producer Copy Page 3 of 4 ff44! Alaska Nao oral CMPANY (1) We will pay only for those expenses SECTION IV — BUSINESS AUTO CONDITIONS — incurred during 'the policy period Paragraph B.5.b. — Other Insurance is replaced by beginning 24 hours after the "loss" the following: and ending, regardless of the policy's expiration, with the lesser of the b. For Hired Auto Physical Damage following number of days: Coverage, the following are deemed to be covered"autos"you own: (a).The number of days reasonably required to repair or replace the (1) Any covered '`auto" you lease, hire, covered"auto". rent,or•borrow; and (b) 30 days. (2) Any covered "auto"" hired or rented by•your "employee" under a contract (2) This coverage does not apply while in that individual "employee's" name, there are spare or reserve "autos" with your permission, while available to you for your operations. performing duties related to the • conduct of your business. (3) The Rental Reimbursement Coverage.described above does not However, any"auto"that is leased, hired, apply to a covered "auto" that is rented or borrowed with a driver is not a described or designated as a covered covered "auto". "auto" on Rental Reimbursement Coverage Form CA 99 23. SECTION V — DEFINITIONS — Paragraph C. — "Bodily injury"`is replaced by the following: SECTION IVT BUSINESS AUTO CONDITIONS — Paragraph B.2. —Concealment, Misrepresentation Or C. "Bodily injury" means bodily injury, sickness or Fraud is amended by adding Unintentional Failure disease sustained by a person including death or to Disclose Hazards at the end of Paragraph B.2. as mental anguish resulting from any of these. follows: Mental anguish means any type of mental or emotional illness or disease Unintentional Failure to Disclose Hazards If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Formbecause of such failure. However, this provision does not affect our right to collect additional premium or exercise •• our right of cancellation or non-renewal. This endorsement changes the policy to which it is attached and,, unless otherwise stated, is effective on the date issued at 12:01 A.M. standard time at your mailing address shown in the policy. The information below is required only'when this'endorsement is issued subsequent to commencement of the policy. Endorsement Effective Policy,No. Insured Endorsement No. 3 Countersigned By • ©Insurance Services Office, Inc., 2009 ANIC CA 1150 10 13 Producer Copy Page 4 of 4