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09-233.00 Western Dance Association: Sullivan Park Western Dance Activities 1 fl ( 01 .133 SULLIVAN PARK DANCE HALL LEASE AGREEMENT -M THIS AGREEMENT, made and entered this 1I day of , 2009, by and between City of Spokane Valley, a political subdivision of the State of Washi-/_ on, h,ving offices for the transaction of business at 11707 East Sprague Avenue, Suite 106, Spokane Valley, Washington 99206, hereinafter referred to as "CITY," and Western Dance Association of Spokane, a non-profit organization having offices for the transaction of business at 1901 North Sullivan, Spokane Valley, Washington 99216, hereinafter referred to as"LESSEE,"jointly hereinafter referred to as the"PARTIES." WITNESSETH: WHEREAS, pursuant to the provisions of RCW 35A.11.020, a city may lease or sell any park property,buildings or facilities surplus to its needs, or no longer suitable for park purposes; and WHEREAS, a certain portion of Sullivan Park was previously declared surplus to the present and foreseeable need of Spokane County by the Board of County Commissioners of Spokane County; and WHEREAS, the recreational dance hall located at 1901 North Sullivan Road, Spokane Valley, Washington was originally constructed by the Western Dance Association of Spokane, pursuant to a Lease Agreement executed on the 30th day of September, 1958, however such facility vested in the Spokane County upon termination of said Agreement on the 29th day of September, 1993; and WHEREAS, pursuant to Resolution No. 99-0454, the Board of County Commissioners authorized execution of the Sullivan Park Dance Hall Lease Agreement with the Western Dance Association of Spokane pursuant to which the Western Dance Association leased a portion of Sullivan Park for a period of ten(10)years for western dance activities and related purposes; and WHEREAS, ownership of Sullivan Park, including the recreational dance hall,transferred to the City upon incorporation in 2003. NOW THEREFORE, for and in consideration of the mutual promises set forth hereinafter and as provided for in the above-referenced recitals,the Parties do hereby mutually agree as follows: SECTION NO. 1: SUBJECT AND PURPOSE The CITY leases to the LESSEE, subject to the terms and conditions herein contained, certain real property located in Sullivan Park, Spokane Valley,Washington and legally described as follows: A portion of land, being approximately one and one-half(1 Y2) acres, located South and West of a point approximately 175 feet South of the North property line of the property hereinafter described and approximately 250 feet West of the center line of Sullivan Road,said above portion located within the following described property: The following portions of Government Lots 8 and 9 in Section 11, Township 25 North,Range 44 East,W.M., in the County of Spokane and State of Washington, described as follows: • Beginning at the Southeast corner of Section 11, Township 25 North, Range 44 East, W.M., thence North 0° 47' West 925.08 feet along the East line of Section Sullivan Park Dance Hall Lease Agreement Page 1 of 7 • F 11; thence North 55° 50' West 36.60 feet to the Westerly right-of way line of Sullivan Road and the True Point of Beginning; thence North 55° 50' West 916.30 feet; thence North 89° 13' East 751.04 feet to the Westerly right-of-way line of Sullivan Road; thence South 0° 47' East 524.91 feet along the Westerly right-of-way line of Sullivan Road to the True Point of Beginning; hereinafter referred to as the "Premises" for the purposes of western dance activities put on by the LESSEE or sponsored by the LESSEE and related to western dance activities, during daytime and evening hours on weekends and ONLY after 5:00 p.m. on weekdays. Provided, it is understood that the continuance by the LESSEE of the support and sponsorship of activities by the various clubs that make up the LESSEE, scheduling them for certain times and dates with them contributing to the expenses of maintenance and upkeep, heat, lights, etc., of the Premises, is a proper use of the Premises. LESSEE needs city permission to use Premises prior to 5:00 p.m. on weekdays. The LESSEE agrees that the CITY may administer and conduct any activities on the Premises during daytime hours of 6:00 a.m. to 5:00 p.m. on weekdays. CITY agrees that such activities will be restricted to those that will assure maintenance, care, and safeguarding of the dance floor. The Premises include the recreational dance hall, storage building at the rear of the hall and the carport area on the south side of the hall. The LESSEE shall additionally be entitled to the non-exclusive use of the parking lot east of the hall and the natural landscape areas around the perimeter of the structures, during the term of this Agreement. The CITY will ensure that the Premises are left in neat, clean and orderly condition and that the recreational dance hall is secure at the conclusion of each such activity session. SECTION NO.2: TERMS AND CONDITIONS The term of this Agreement shall commence on the 151 day of June 2009, and shall run for ten(10)years. This Agreement, at the mutual option of the parties, may be renewed for up to two (2) additional five (5) year terms. For and in consideration of the use of the Premises as set forth herein, the LESSEE shall pay the following amount on or before the 5th of each month for that month. First year to end of Lease $500.00 per month The parties agree to review this lease amount after ten(10) years. All late payments shall be subject to a $25.00 late fee due with the following month's payment.Payments shall be considered late if they are not received by the City of Spokane Valley having offices at 11707 East Sprague Avenue, Suite 106,Spokane Valley, Washington 99206, by the 15°i of the month. Payments post marked before such date shall be considered received timely. SECTION NO.3: INSURANCE During the period of this Agreement, the LESSEE shall carry and keep in force, at its sole expense, a commercial general liability insurance policy with the minimum limits of$1,000,000 per occurrence with a$2,000,000 aggregate for bodily injury,and$1,000,000 per occurrence for property damage. Said policy • shall be written by a reliable insurance company or companies and shall provide that said policy shall not be canceled,materially changed or not renewed without thirty(30)days' prior notice thereof to the CITY. The CITY reserves the right to approve the LESSEE's insurance carrier(s). The CITY shall be named as an additional named insured in all such policies and the LESSEE shall provided the CITY with certified copies of said coverage prior to commencement of use of the Premises. Sullivan Park Dance Hall Lease Agreement 0 Page 2 of 7 F The LESSEE shall provide all fire insurance on personal property that the LESSEE moves onto the Premises and a casualty insurance desired by LESSEE both at the sole expense of LESSEE; and the CITY shall have no responsibility whatsoever therefore. The CITY assumes responsibility for property damage to building roofs, walls, and foundations of the recreational dance hall. In addition, the CITY agrees to indemnify and hold harmless the LESSEE from any liability for bodily injury occurring to any participants in those activities directly administered by the CITY during its weekday sessions. SECTION NO. 4: Indemnification and Hold Harmless. LESSEE shall defend, indemnify, and hold harmless the CITY, its officers, officials, employees and volunteers from and against any and all claims, suits, actions, or liabilities for injury or death of any person, or for loss or damage to property, which arises out of LESSEE's use of Premises, or from the conduct of LESSEE's business, or from any activity,work or thing done, permitted, or suffered by LESSEE in or about the Premises, except only such injury or damage as shall have been occasioned by the sole negligence of the CITY. SECTION NO. 5: OWNERSHIP OF IMPROVEMENTS Any improvements and permanent fixtures made or placed on the Premises by LESSEE during the term of this Agreement shall be and remain the property of the CITY. SECTION NO. 6: TERMINATION In addition to all other rights and remedies which the parties may have herein or at law, the Parties may terminate this Agreement as follows: A. By LESSEE: This Agreement may be terminated by the LESSEE upon 180 days' written notice to the City without cause. B. By CITY: (1) This Agreement may be terminated by the City of Spokane Valley upon one (1)year written notice to the LESSEE without cause. (2) This Agreement may be terminated by the CITY upon five(5) days written notice to the LESSEE on the happening of any one of the following events: a. The default of the LESSEE in the performance of any terms, conditions or covenants herein required to be performed by the LESSEE and the failure of the LESSEE to remedy such default in a period of thirty (30) days after receipt from the CITY of written notice to remedy the same. Provided, however, that no notice of termination as herein provided shall be of any force or effect if the LESSEE shall have remedied the default prior to the expiration of such thirty-day period, or if the nature of such default is such that a period in excess of thirty (30) days is necessary in order for the LESSEE to cure such default, and the LESSEE shall have commenced to cure the default and shall diligently continue its efforts to correct such default. In such event, the LESSEE shall have such time as is reasonably required to cure the default. Sullivan Park Dance Hall Lease Agreement Page 3 of 7 (-\ `. SECTION NO.7: WASTE AND NUISANCE PROHIBITED During the term of this Agreement, the LESSEE shall comply with all applicable laws affecting the premises,the breach of which might result in any penalty on the CITY or forfeiture of the CITY's title to the premises. The LESSEE shall not commit, or suffer to be committed, any waste or nuisance on the premises. SECTION NO. 8: NOTICES All notices, demands, or other writings in this Agreement provided to be given or made or sent, or which may be given, or made or sent by either party hereto to the other, shall be deemed to have been fully given, or made or sent when made in writing and deposited in the United States Mail, certified, postage pre-paid and return receipt requested, and addressed as follows: To CITY: CITY OF SPOKANE VALLEY Parks&Recreation Director 2426 North Discovery Place Spokane Valley, Washington 99216 To LESSEE: WESTERN DANCE ASSOCIATION OF SPOKANE 1901 North Sullivan Spokane Valley, Washington 99216 The address to which any notice, demand or any other writing may be given, or made or sent to any party as provided for herein above, may be changed by written notice given by such party as provided for herein above. SECTION NO. 9: REPAIRS • The LESSEE shall,throughout the term of this Agreement, at its own cost and without any expense to the CITY, keep and maintain the premises, including the recreational dance hall, storage building and carport, all improvements and fixtures of every kind which may be a part thereof, and all appurtenances thereto, including sidewalks adjacent thereto, in good, sanitary and neat order, condition and repair, except as provided for to the contrary herein.The CITY shall not be obligated to make any repairs,replacements,or renewals of any kind, nature, or description, whatsoever to the premises, or any buildings or improvements thereon. Any alterations, replacements or renewals, the total cost of which exceeds $1,000.00 shall receive prior written approval of the CITY. The LESSEE shall provide for snow removal from the walking areas which the LESSEE has the right to use under the terms of this Agreement. The CITY shall additionally remove snow accumulation from the roofs of the recreational hall, attached carport and storage building as necessary to prevent structural damage and ice dams. The CITY may inspect the Premises at any reasonable time for the purpose of reviewing compliance by the LESSEE with the terms of this Agreement. Sullivan Park Dance Hall Lease Agreement Page 4 of 7 n • SECTION NO. 10: LIENS The LESSEE shall keep the Premises free and clear form all mechanics' and materialmens' and other liens from work or labor done, services performed, materials, appliances, teams or power contributed, used or furnished or to be used in or about the Premises for or in connection with any operations of the LESSEE, or any alteration, improvement, repairs, or additions which the LESSEE may make or permit or cause to be made, or any work or construction by, for, or permitted by the LESSEE on or about the Premises. SECTION NO. 11: UTILITIES The LESSEE shall initiate, contract for, and obtain in its own name, and fully and promptly pay for all electricity,heat,lights,power,telephone service,garbage and all other public and private utilities of every kind furnished to the Premises throughout the term hereof. LESSEE shall be responsible for the purchase of building supplies for janitorial rest rooms,kitchen and similar uses. SECTION NO. 12: COMPLIANCE WITH LEASEHOLD EXCISE TAX The LESSEE hereby acknowledges that it is responsible for paying the "Leasehold Excise Tax," as set forth by chapter 82.29A RCW, as now or hereinafter amended, which is applicable to this Agreement. The LESSEE shall be not only be solely responsible for paying such tax, but shall also be responsible for representing itself in any challenge to the amount of such tax that the Washington State Department of Revenue determines is due or any penalty associated with the tax. The LESSEE agrees to promptly pay when due all taxes, rates, charges and assessments, special or otherwise and public charges of every kind and nature which may be lawfully imposed or assessed in any way on the LESSEE with reference to the Premises. The LESSEE shall also comply with and abide by all federal, state, county, municipal and other governmental statutes, ordinances, laws and regulations affecting the premises, the improvements thereon,or any activity conducted on or in such Premises. SECTION NO. 13: NON-LIABILITY OF CITY The CITY shall not be liable in any manner for any loss, injury or damage incurred by the LESSEE from acts of theft, burglary, or vandalism, committed by either identified or unidentified parties. The LESSEE shall be responsible for providing, and all expenditures relating thereto, any security precaution that the LESSEE deems necessary to protect the premises and all improvements thereon. The LESSEE shall be solely responsible for providing, and all expenditures relating to, any safety and security precautions that the LESSEE deems necessary for the safety of the personnel, guests, employees, patrons, or users of the premises, or property of the LESSEE located on the premises. The LESSEE shall implement security measures sufficient to secure the Premises after hours and prevent unauthorized use. SECTION NO. 14: INSPECTION The LESSEE shall make available to the CITY or its duly authorized representative at any time from Monday through Friday, during normal business hours, all records, books or pertinent information which the LESSEE shall have kept in conjunction with this Agreement and which the CITY may be required by law to include or make part of auditing procedures or audit trails. Sullivan Park Dance Hall Lease Agreement Page 5 of 7 SECTION NO. 15: VENUE STIPULATION This Agreement has been and shall be construed as having been made and delivered within the State of Washington and it is mutually understood and agreed by each party hereto that this Agreement shall be governed by the laws of the State of Washington,both as to interpretation and performance. Any action at law, suit in equity, judicial proceeding for the enforcement of this Agreement or any provision hereof shall be instituted and maintained only in any of the courts of competent jurisdiction in Spokane County, Washington. SECTION NO. 16: ASSIGNMENT Each party to this Agreement binds themselves, their partners, successors, executors, administrators, and assigns to the other party of this Agreement and to the party's successors, executors, administrators and assigns of each other party with respect to all terms, conditions and covenants set forth herein. The LESSEE may not sublet the Premises; allow its use by any other person or entity, nor assign, transfer in whole or part its interest in this Agreement without the same being first authorized in writing by the CITY. In the event of an assignment, the assignee shall assume all liability of the assignor. Any unauthorized voluntary or involuntary assignment or sub-lease shall be void, and shall terminate this Lease at the CITY's option. Provided, that it is understood that the continuance by the LESSEE of the support and sponsorship of activities by the various clubs that make up the Association, scheduling them for certain times and dates with them contributing to the expenses of maintenance and upkeep, heat, lights,etc.,of the Premises,does not amount to or consist of subletting as provided in this Section. SECTION NO. 17: WAIVER No officer, employee, agent or otherwise of the CITY has the power, right or authority to waive any of the conditions or provisions of this Agreement. The waiver of any breach of this Agreement shall not be held to be a waiver of any other or subsequent breach.All remedies afforded in this Agreement or at law shall be taken and construed as cumulative, that is, in addition to every other remedy provided herein or by the law. The failure of the CITY to enforce, at any time, any of the provisions of this Agreement or to require, at any time, performance by the LESSEE of any of the provisions hereof, shall be in no way construed to be a waiver of such provisions, nor any way affect the validity of this Agreement or any part hereof or the right of the CITY to thereafter enforce each and every such provision. SECTION NO. 18: MODIFICATION There shall be no modification of this Agreement, except in writing, executed with the same formalities of this present instrument. SECTION NO. 19: SEVERABILITY It is understood and agreed by the Parties that if any part, term or provision of this Agreement is held by the court to be illegal, the validity of the remaining portions or provisions shall not be affected, and the rights and obligations of the parties shall be construed and enforced as if this Agreement did not contain a particular part,term or provision held to be invalid. If it should appear that any part, term or provision hereof is in conflict with any statutory provisions of Washington, then the part, term, or provision thereof which may conflict therewith shall be deemed inoperative, null and void insofar as it may be in conflict therewith, and shall be deemed to modify to conform to such statutory provisions. Sullivan Park Dance Hall Lease Agreement Page 6 of 7 , C SECTION NO.20:NON-DISCRIMINATION The LESSEE specifically agrees that it shall comply with all applicable Federal and state laws relating to non-discrimination for any program or activity conducted by the LESSEE on the Premises SECTION NO.21:HEADINGS The section headings appearing in this Agreement have been inserted solely for the purpose of convenient and ready-reference. In no way do they purport to, and shall not be deemed to define, limit or extend the scope or intent of the sections to which they are pertaining. SECTION NO.22: TIME OF THE ESSENCE Time is of the essence of each and every provision herein. SECTION NO.23: ALL WRITINGS CONTAINED HEREIN This Agreement contains all the terms and conditions agreed upon by the Parties. No other understandings, oral or otherwise, regarding the subject matter of this Agreement shall be deemed to exist or to bind any of the Parties. The LESSEE has read and understands the whole of the above Agreement and now states that no representation, promise or agreement not expressed in this Agreement has been made to induce the LESSEE to enter it. SECTION NO.24. EXHIBITS— A.Insurance certificates IN WITNESS WHEREOF, the PARTIES have caused this Agreement to be executed on the date and year set for above. CIT e 'KANE VALLEY: WESTERN DANCE ASSOCIATION: /1 , itry/A, A/z-- ik—Ag David i'ercie,, City Manager Name e4,t�J Q. Title: /,a-•0:14. fresh en7/ Catop`e.-- Tax ID No._. R FDACTED • T: APPROVED AS TO FORMc hristine Bainbri ge,City Cler Office the City rney This document contains confidential tax information and has been redacted pursuant to RCW 82.32.330. You may petition for a review of our findings pertaining to any redacted or{SvicIilield documents pursuant to Spokane Valley Municipal Code (SVMC) 2.75.080; and obtain judicial review pursuant to RCW 42.56.550. Sullivan Park Dance Hall Lease Agreement Page 7 of 7 g.ec'g- ilia 102. P13 • • ACORD. CERTIFICATE. JF. LIABILITY INSURiAN. �� °' "��' > s� -,..15126/09.,= t . PRODUCER THIS CERIFICATE IS O AS A MATTER'OF INFORMATION Starr, Starr & Totton ONLY AND CONFERS RTGFfl S UPON THE CERTIFICATE Insureco, Inc HOIDER;THIS C TCATEDOES NOT ND EXTEND OR. 219 N Pines Rd ALTER THE COVERAGE AFFORDED; ' TS_ BELOW. Spokane WA 99206 • • Phone:509-928-2121 Fax:509-928-8379 INSURERSAFFORDTI�SGCOVERA xis INSURED LYSURER.a`:. men_ � c e a e INSURER a Western Dance Assoc of Spokane Dist.jilER `1S• Becky Obernolte P.O. Box 417 Fairfield WA 99012 D` `INSURER E COVERAGES • T _ t + THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PER CD TE7 0:073)'8 iS'1 /' - ANY REQUIREMENT,TERM OR CONDfIION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CHt'tIFICATE LtA'YBE tSSUID QR .• . •: MAY PERTAIN,THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECTTO ALI,THE TERMS.EXCLUSIONS AND COfROT/IONS OF SUCH" POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INsRICCID1p�ATTE(M EFFECTIVE DATE DDI EXPIRATION LTR INSRCL TYPE OF INSURANCE • POLICY NUMBER LIMITS GENERAL UABIUTY EACH OCCURRENCE $1,000,000 A X COMMERCIAL GEJNERALUABluIY 02CC8831740— 11715/8 -11/15/09 •:PRIEMISEs ,ce) s 1,000,000 CLAIMS MADE n OCCUR MED EXP(Any one person) S 10,000 - PERSONAL bADV INJURY .• -s 1,000,000 X Stop Gap GENERAL AGGREGATE s 2,000,000 "-1 GENt AGGREGATE UMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 7 POLICY n JECaT n LOC AUTOMOBILE LIABItJTY A ANY AUTO 02CC8831740 11/15/08 11/15/09 COMBINED SINGLE LIMIT $1,000,000 (Ea aaiderd) • All OWNED AUTOS BODILY INJURY •_ SCHEDULED AUTOS ( ). X HIRED AUTOS • BODILY INJURY. s ' ' X NON-OWNED AUTOS - (Per accident) - PROPERTY DAMAGE (Per accident) GARAGE UABIUTY AUTO ONLY-EA ACCIDENT $ _ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG EXCESS/UMBRELLA UABIUTY EACH OCCURRENCE S —I OCCUR n CLAIMS MADE AGGREGATE _ $ . — s ` DEDUCTIBLE s — RETENTION WORKERSCOMPENSATIONAND CSIAI S it BILI • •EMPLOYERS'.LWY - • - TWORYLIMRS Nit - -- ANY PROPRIETOR/PARTNERIEXECUTIVE EL EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? EL DISEASE-EA EMPLOYEE s (Eyes.desabe under SPEIAL PROVISIONS below EL DISEASE-POUCY UNIT $ OTHER • • DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES!EXCLUSIONS ADDED BY ENDORSEMENT!SPECIAL PROVISIONS , • Certificate holder is named as additional insured in regards to operations • of the named insured. . • CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION • DATE THEREOF,THE ISSUING INSURER WILL.ENDEAVOR TO MAIL DAYS WRITTEN City of Spokane Valley NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Parks sc Recreation CeIIterplace IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Mike Stone (Fax - 688 0188) 2426 N. Discovery Place REPR ENTATIVES• Spokane Valley WA 99216 A ''" REPREs / ACORD 25(2001/08) ©ACORD CORPORATION 1988 .„----, f' WESTDAI OP ID:CR ACORO' DATE(MMIDUmYY) ' CERTIFICATE OF LIABILITY INSURANCE ` 1 Y. �� 11/2912016 . ' THIS CERTIFICATE IS-ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS No RIGHTS UPON THE CERTIFICATE HOLDER.y THIS* CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,;EXTENID,OR,ALTER THE'COVERAGE�AFFORDED'rBYxTHE''POL'ICIES BELOW( THISkCEIITIFICATE OF INSURANCE,DOES,NOT,CONSTIJUTE A CONTRACT(BETWEEN THE'ISSUINGINStJRER(S), AUTHORIZED SENT i1VEsORpPRODUCER,ANI)TIIE CERTIFIpATE HOLDE,. T.; x �,; � `•;` " ''Li �� ,;;°3 ' -' REPRE ' IMPORTA ,Njeal the eeirlificate'holdelli..e. i DITIO L INSURECI,the policy(es us `e end sed`If SUCR GATIO sWA1VED. 0,,j0,,0 0 the tens andc•ndlUons f'1��•ohc .•,� i�•• �' •�iie n e•do�seme"t� e eiton'�hl�certlficate doessnot,conf�er nghts,to the ?: 3_:'ri A. Y.. iw' A,Y'*.fN,51 vu d {'v ^rf rh 'FA.. LT t "^` <certifica ho..er n j¢ Qf c do a!as :E s � .'s � ��x� � acs �` ._ .,..-',..a xm v �C� ONTACT .sve,R; '^.1,p *rawwr`* ,=, %,9 ig 'e,o ",2fv,ti P U -'f .,owe:, �` ,- a�' ?fAME. 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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. (LTR TYPE OF INSURANCE ANSA SUER POLICY NUMBER (MM/DDIYYYY) (MMIIDDIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS MADE X OCCUR X BL056798477AMAGE TO RENTED 11/15/2016 11/15/2017 PREM SES Ea occurrence) $ 1,000,000 MED EXP(Any one person) $ 15,000 X Stop Gap PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY 7C LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) _ A ANY AUTO X BAA56798477 11/15/2016 11/15/2017 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS (Per accident) _ UMBRELLA UAB — OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY `a'I N OTH- PER ER ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 5 A Commercial Applica BLO56798477 11/15/2016 11/15/2017 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate holder is named as additional insured in regard to operations of the named insured. • 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. Parks&Recreation Centerplace 2426 N. Discovery Place AUTHORIZED REPRESENTATIVE Spokane Valley,WA 99216 C:!.2. (..._ f " I ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD 4114 .33 --- SQUA&FO-01 JZAGORSKI ACORCY DATE(MM/DD/YYYY) `.----- CERTIFICATE OF LIABILITY INSURANCE 08/01/2018 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(les)must have ADDITIONAL INSURED provisions or 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 fhez t0iutrof such endorsement(s). CONTACT PRODUCER NAME: McDonald Zaring Insurance,Inc. AUG3 20 i3 (ac°°,No,Eat):(509)525-5730 I FAX No):(509)525-5705 22 E Main St ( MAIL Walla Walla,WA 99362 ADDRESS:info@mcdonaldzaring.com INSURER(S)AFFORDING COVERAGE NAIC# PARKS & RECRFCT''" 1 INSURER A:The Cincinnati Insurance Company 10677 • INSURED INSURER B: Square&Folk Dance Federation of Washington,Inc. INSURER C: 5612 S Napa St INSURER D: Spokane,WA 99223 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE I$ 1,000,000 CLAIMS-MADE X OCCUR EPP 0346268 09/01/2018 09/01/2019 DAMAGETORENFED 500,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 II 28, 2,000,000 i POLICY JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILECOMBINED SINGLE LIMIT LIABILITY �Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED 1I AUTEO�S ONLY —AUTOS yyN p BODILY INJURY (Per accident) $ AUTOS ONLY — AUTOS ONLY (Per acEcident)DAMAGE $ $ A X UMBRELLA UAB X OCCUR EACH OCCURRENCE I$ 1,000,000 EXCESS LIAB CLAIMS-MADE EPP 0346268 09/01/2018 09/01/2019 AGGREGATE $ II DED X RETENTIONS 0 $ 1,000,000 WORKERS COMPENSATION PER PERTUJ� ETH AND EMPLOYERS'LIABILITY ANY PROPRIIETOR�/PARTNER/EXECUTIVE Y/N N/A E.L.EACH ACCIDENT $ (MFandatoryin NH)EXCLUDED9 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) 1 Square and Round Dancing for the dance season of 2017-2018 at Western Dance Center,1901 N Sullivan,Spokane Valley,WA 99216. Certificate holder is named as additional insured In regard to operations of the named insured. I • CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE • Ci of Spokane ValleyTHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City P ACCORDANCE WITH THE POLICY PROVISIONS. Parks and Recreation Centerplace I 2426 N Discovery Place Spokane Valley,WA 99216 AUTHORIZED REPRESENTATIVE 1 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. . The ACORD name and loco are reaistered marks of ACORD o9 -z b a,/ -2,33,o( i--.1 SQUAJIFO-01 SANTHONY A��RO CERTIFICATE OF LIABILITY INSURANCE DAsa/2o01e I 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 INSU RED,the policy(ies)must have ADDITIONAL INSURED provisions or 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 CNE CT McDonald Zaring Insurance,Inc. Fjai ,NxoAX INCCs(509)525-5705 22 E Main St Ed) (5119)5255730 ,No 30 -- - EMAIL 9 mc info donaldzadn .com Walla Walla,WA 99362 ADDRESS ~_ INSURER(SI AFFORDING COVERAGE _ NAIC# IINSURERA The Cincinnati Insurance Company 10677 INSURED INSURER Square B Folk Dance Federation of Washington,Inc. INSURER 5612$Napa St INSURERo- Spokane,WA 99223 INSURERE_ 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 _- L3R DL SUER POLICY EFF I POLIOY EXP TR TYPE OF INSURANCE IVSD WJD POLICY NUMBER IMMIDWYYYYI'IMMIDD'YYYYI LIMITS A X I COMMERCIAL GENERAL LIABILITY ' EACH OCCURRENCE 1'000.000 DAMAGE TO RENTED 500,000 culMSMADE X OCCUR X EPP 0346268 9/1/2019 9/1/2020 PREMSESffnocD,me 1_ $ MED PX, one Vers] $ 5.000 PERSONAL 3_ADV INJURY $ _ 1,000,000 GEM_AGGREGATE PRGATE LIMIT APPLIES PER [I GENERAL AGGREGATE IS 2,O00,000 Ta,POLICY JECT - - j LOC PRODUCTS-COMP/OP ACO 2,000,000 OTHER EAUTOMOBILE LIABILITY COMBINED SINGLE LIMIT I 'LEe amamtL----- - -_— - I I ANY AUTO BODILY INJURY(per persanL iI I _ _ OWNED SCHEDULED AUTOS ONLY (AAUUTTOp$µN[p I BODIL Y INJURY pneciUWII, I AVTVS ONLYI AUTOSONLV I PROPERTY DAMAGE A X UMBRELLA UAB X'OCCUR EACH OCCURRENCE 1,000,000 EXCESSLIABCLAIMI X EPP 0346268 9/1/2019 9/1/2020 � S-MADE AGGREGATE I DED I X RETENTION 0 I 1,000,000 WORKERS COMPENABILI PER I J OTH- ANDEMPLOYERS'UABILEYTIN i STATUTE-' ER_ ANY ANY�PROP ETORpE%CWDEDiECUTIVE ! IN IA I E L EACH ACCIDENT ImeMMnryin NN) - - I1 ye EL DISEASE.EA EMPLOYEE DESCRIPTION under RIPTION OF OPERATIONS below E L DISEASE•POLICY LIMIT DESCRIPTION OF OPERAIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Rem ado Schedule,my be attached Ir more space M Iareired) Square and Round Dancing for the dance season of 2019-2020 at Western Dance Center,1901 N Sullivan,Spokane Valley,WA 99216 Certificate holder Is named as additional insured in regard to operations of the named insured CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CityO(S Kane ValleyTHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Spokane ACCORDANCE WITH THE POLICY PROVISIONS. Parks and Recreation Centerpiece 2426 N Discovery Place Spokane Valley,WA 99216 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION All rights reserved The ACORD name and logo are registered marks of ACORD SQUA&FO-01SANTHONY DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 9/1/2020 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 have ADDITIONAL INSURED provisions or 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). CONTACT PRODUCER NAME: PHONEFAX McDonald Zaring Insurance, Inc. (509) 525-5730(509) 525-5705 (A/C, No, Ext):(A/C, No): 22 E Main St E-MAIL info@mcdonaldzaring.com Walla Walla, WA 99362 ADDRESS: INSURER(S) AFFORDING COVERAGENAIC # The Cincinnati Casualty Company28665 INSURER A : INSURED INSURER B : INSURER C : Square & Folk Dance Federation of Washington, Inc. 5612 S Napa St INSURER D : Spokane, WA 99223 INSURER E : INSURER F : COVERAGESCERTIFICATE 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. INSRADDLSUBRPOLICY EFFPOLICY EXP TYPE OF INSURANCEPOLICY NUMBERLIMITS LTRINSDWVD(MM/DD/YYYY)(MM/DD/YYYY) 1,000,000 A COMMERCIAL GENERAL LIABILITY X EACH OCCURRENCE$ DAMAGE TO RENTED 500,000 CLAIMS-MADEOCCUR X EPP 03462689/1/20209/1/2021 $ PREMISES (Ea occurrence) X 5,000 MED EXP (Any one person)$ 1,000,000 PERSONAL & ADV INJURY$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- 2,000,000 POLICYLOC PRODUCTS - COMP/OP AGG$ JECT OTHER:$ COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY $ (Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNEDSCHEDULED AUTOS ONLYAUTOSBODILY INJURY (Per accident)$ PROPERTY DAMAGE HIREDNON-OWNED (Per accident)$ AUTOS ONLYAUTOS ONLY $ 1,000,000 A XX UMBRELLA LIABOCCUR EACH OCCURRENCE$ EPP 03462689/1/20209/1/2021 EXCESS LIABCLAIMS-MADE X AGGREGATE$ 1,000,000 0 X DEDRETENTION$ $ PEROTH- WORKERS COMPENSATION STATUTEER AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ N / A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under DESCRIPTION OF OPERATIONS belowE.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Square and Round Dancing for the dance season of 2020-2021 at Western Dance Center, 1901 N Sullivan, Spokane Valley, WA 99216. Certificate holder is named as additional insured in regard to operations of the named insured. CERTIFICATE HOLDERCANCELLATION 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. Parks and Recreation Centerplace 2426 N Discovery Place AUTHORIZED REPRESENTATIVE Spokane, WA 99216 ACORD 25 (2016/03)© 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SQUA&FO-01SBARNETT DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 8/30/2021 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 have ADDITIONAL INSURED provisions or 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). CONTACT PRODUCER NAME: PHONEFAX McDonald Zaring Insurance, Inc. (509) 525-5730(509) 525-5705 (A/C, No, Ext):(A/C, No): 22 E Main St E-MAIL info@mcdonaldzaring.com Walla Walla, WA 99362 ADDRESS: INSURER(S) AFFORDING COVERAGENAIC # The Cincinnati Casualty Company28665 INSURER A : INSURED INSURER B : INSURER C : Square & Folk Dance Federation of Washington, Inc. 5612 S Napa St INSURER D : Spokane, WA 99223 INSURER E : INSURER F : COVERAGESCERTIFICATE 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. INSRADDLSUBRPOLICY EFFPOLICY EXP TYPE OF INSURANCEPOLICY NUMBERLIMITS LTRINSDWVD(MM/DD/YYYY)(MM/DD/YYYY) 1,000,000 A COMMERCIAL GENERAL LIABILITY X EACH OCCURRENCE$ DAMAGE TO RENTED 500,000 CLAIMS-MADEOCCUR X EPP 03462689/1/20219/1/2022 $ PREMISES (Ea occurrence) X 5,000 MED EXP (Any one person)$ 1,000,000 PERSONAL & ADV INJURY$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- 2,000,000 POLICYLOC PRODUCTS - COMP/OP AGG$ JECT OTHER:$ COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY $ (Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNEDSCHEDULED AUTOS ONLYAUTOSBODILY INJURY (Per accident)$ PROPERTY DAMAGE HIREDNON-OWNED (Per accident)$ AUTOS ONLYAUTOS ONLY $ 1,000,000 A XX UMBRELLA LIABOCCUR EACH OCCURRENCE$ EPP 03462689/1/20219/1/2022 EXCESS LIABCLAIMS-MADE X AGGREGATE$ 1,000,000 0 X DEDRETENTION$ $ PEROTH- WORKERS COMPENSATION STATUTEER AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ N / A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under DESCRIPTION OF OPERATIONS belowE.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Square and Round Dancing for the dance season of 2021-2022 at Western Dance Center, 1901 N Sullivan, Spokane Valley, WA 99216. Certificate holder is named as additional insured in regard to operations of the named insured. CERTIFICATE HOLDERCANCELLATION 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. Parks and Recreation Centerplace 2426 N Discovery Place AUTHORIZED REPRESENTATIVE Spokane, WA 99216 ACORD 25 (2016/03)© 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SQUA&FO-01SBARNETT DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 8/19/2022 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 have ADDITIONAL INSURED provisions or 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). CONTACT PRODUCER NAME: PHONEFAX McDonald Zaring Insurance, Inc. (509) 525-5730(509) 525-5705 (A/C, No, Ext):(A/C, No): 22 E Main St E-MAIL info@mcdonaldzaring.com Walla Walla, WA 99362 ADDRESS: INSURER(S) AFFORDING COVERAGENAIC # The Cincinnati Casualty Company28665 INSURER A : INSURED INSURER B : INSURER C : Square & Folk Dance Federation of Washington, Inc. 5612 S Napa St INSURER D : Spokane, WA 99223 INSURER E : INSURER F : COVERAGESCERTIFICATE 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. INSRADDLSUBRPOLICY EFFPOLICY EXP TYPE OF INSURANCEPOLICY NUMBERLIMITS LTRINSDWVD(MM/DD/YYYY)(MM/DD/YYYY) 1,000,000 A COMMERCIAL GENERAL LIABILITY X EACH OCCURRENCE$ DAMAGE TO RENTED 500,000 CLAIMS-MADEOCCUR X EPP 034 62 689/1/20229/1/2023 $ PREMISES (Ea occurrence) X 5,000 MED EXP (Any one person)$ 1,000,000 PERSONAL & ADV INJURY$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- 2,000,000 POLICYLOC PRODUCTS - COMP/OP AGG$ JECT OTHER:$ COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY $ (Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNEDSCHEDULED AUTOS ONLYAUTOSBODILY INJURY (Per accident)$ PROPERTY DAMAGE HIREDNON-OWNED (Per accident)$ AUTOS ONLYAUTOS ONLY $ 1,000,000 A XX UMBRELLA LIAB OCCUR EACH OCCURRENCE$ EPP 034 62 689/1/20229/1/2023 EXCESS LIAB CLAIMS-MADE X AGGREGATE$ 1,000,000 0 X DEDRETENTION$ $ PEROTH- WORKERS COMPENSATION STATUTEER AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ N / A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under DESCRIPTION OF OPERATIONS belowE.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Square and Round Dancing for the dance season of 2022-2023 at Western Dance Center, 1901 N Sullivan, Spokane Valley, WA 99216. Certificate holder is named as additional insured in regard to operations of the named insured. CERTIFICATE HOLDERCANCELLATION 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. Parks and Recreation Centerplace 2426 N Discovery Place AUTHORIZED REPRESENTATIVE Spokane, WA 99216 ACORD 25 (2016/03)© 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD nn 33 SQUA&FO-01 SBARNETT ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) `� 9/8/2025 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 have ADDITIONAL INSURED provisions or 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: McDonald-Zaring Insurance, a Marsh & McLennan Agency LLC company "HONE (509) 525-5730 FAX No): Marsh McLennan Agency LLC E-MAIL 22 E. Main ADORES • mmanwmziinfo@marshmma.com Walla Walla, WA 99362 _ , , „-, INSURED Square & Folk Dance Federation of Washington, Inc. 5612 S Napa St Spokane, WA 99223 INSURER F : Cincinnati rn%1P 7AnI7Q CERTIFICATE Ml IRARFR• REVISION MHURFR• 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 NUMBER POLICDY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FXI OCCUR X EPP 0346268 9I1(2025 9/1/2026 EACH OCCURRENCE $ 1,000,000 DpRMMG ESO RENTED n 500,000 MED EXP (Any oneperson) 5,000 PERSONAL & ADV INJURY 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY 0 jECOT LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG 2,000,000 AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY Perperson) $ BODILY INJURY Per accident $ PPe�PEciRdent AMAGE $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE X .EPP 0346268 9/1/2025 9/1/2026 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ DIED I X RETENTION$ 0 1,000,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROP R I ETO RIPARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N f A PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Club: Western Dance Association Event: Rental of the Western Dance Center located @ 1901 N Sullivan Rd, Spokane Valley, WA 99216 from 9/1/2025 to 8/31/2026 City of Spokane Valley Parks and Recreation Centerplace 2426 N Discovery Place Spokane, WA 99216 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016103) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NOTICE TO POLICYHOLDERS ADDITIONAL INSURED ENDORSEMENTS This is a summary of the major changes found in new editions of additional insured endorsements. NO COVERAGE IS PROVIDED BY THIS SUMMARY. Nor can it be construed to replace any provision of your policy. YOU SHOULD READ YOUR POLICY AND REVIEW YOUR DECLARATIONS PAGE CAREFULLY for complete information on the coverages that you are provided. If there is any conflict, between the policy and this summary, THE PROVISIONS OF THE POLICY SHALL PREVAIL. The major areas within the endorsements that broaden or reduce coverage, and other changes, are highlighted below. This notice does not reference every editorial change made in the endorsements. Clarification of Coverage: The following additional insured endorsements are revised to indicate that when these endorsements are attached to a policy, if coverage provided to the additional insured is required by contract or agreement, coverage to the additional insured will be afforded to the extent permitted by law and to the extent the named insured is required by the contract or agreement to provide insurance available under the applicable Limits of Insurance shown in the Declarations, whichever is less: • CG 20 03 0413 ADDITIONAL INSURED - CONCESSIONAIRES TRADING UNDER YOUR NAME • CG 20 05 0413 ADDITIONAL INSURED - CONTROLLING INTEREST • CG 20 07 04 13 ADDITIONAL INSURED - ENGINEERS, ARCHITECTS OR SURVEYORS • CG 20 10 0413 ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION • CG 20 11 0413 ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES • CG 20 12 04 13 ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS • CG 2013 0413 ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS RELATING TO PREMISES • CG 20 15 04 13 ADDITIONAL INSURED -VENDORS • CG 20 18 0413 ADDITIONAL INSURED - MORTGAGEE, ASSIGNEE OR RECEIVER • CG 20 23 04 13 ADDITIONAL INSURED - EXECUTORS, ADMINISTRATORS, TRUSTEES OR BENEFICIARIES • CG 20 24 04 13 ADDITIONAL INSURED - OWNERS OR OTHER INTERESTS FROM WHOM LAND HAS BEEN LEASED • CG 20 26 04 13 ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION • CG 20 27 04 13 ADDITIONAL INSURED - CO-OWNER OF INSURED PREMISES • CG 20 28 0413 ADDITIONAL INSURED - LESSOR OF LEASED EQUIPMENT • CG 20 29 04 13 ADDITIONAL INSURED - GRANTOR OF FRANCHISE • CG 20 30 04 13 OIL OR GAS OPERATIONS - NONOPERATING, WORKING INTERESTS • CG 20 31 04 13 ADDITIONAL INSURED - ENGINEERS, ARCHITECTS OR SURVEYORS • CG 20 32 04 13 ADDITIONAL INSURED - ENGINEERS, ARCHITECTS OR SURVEYORS NOT ENGAGED BY THE NAMED INSURED • CG 20 34 04 13 ADDITIONAL INSURED - LESSOR OF LEASED EQUIPMENT - AUTOMATIC STATUS WHEN REQUIRED IN LEASE AGREEMENT WITH YOU • CG 20 35 04 13 ADDITIONAL INSURED - GRANTOR OF LICENSES - AUTOMATIC STATUS WHEN REQUIRED BY LICENSOR GA 4496 09 18 Pagel of 2 • CG 20 36 0413 ADDITIONAL INSURED - GRANTOR OF LICENSES • CG 20 37 0413 ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS • CG 29 35 04 13 ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS • GA42480917 ADDITIONAL INSURED - PICK UP OR DELIVERY - SCHEDULED PERSON OR ORGANIZATION • GA 4397 09 17 ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION (VICARIOUS LIABILITY) GA 472 09 18 CONTRACTORS ADDITIONAL INSURED - AUTOMATIC STATUS AND AUTOMATIC WAIVER OF SUBROGATION WHEN REQUIRED IN WRITTEN CONTRACT, AGREEMENT, PERMIT OR AUTHORIZATION GA 4255 09 18 CONTRACTORS ADDITIONAL INSURED - AUTOMATIC STATUS AND AUTOMATIC WAIVER OF SUBROGATION WHEN REQUIRED IN WRITTEN CONTRACT OR AGREEMENT The above forms have the following changes: Broadening of Coverage: • Coverage is no longer restricted to entities for whom work is performed by you. Reduction of Coverage: • Coverage has been removed for oral oontracts. Clarification of Coverage: • Expressly address, in part, claims alleging negligence or other wrongdoing in the hiring, employment, training, supervision or monitoring of others by any insured. • Expressly states the exclusion applies only in your capacity as an engineer, architect or surveyor and not within construction means, methods, techniques, sequences and procedures employed by you in connection with your operations in your capacity as a construction contractor. CG 20 08 0413 ADDITIONAL INSURED - USERS OF GOLFMOBILES The above form has the following change: Reduction of Coverage: • Golfmobile was added as a defined term. GA 4496 09 18 Page 2 of 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENDED LIABILITY ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Endorsement -Table of Contents: Coverage: Begins on Page: 1. Employee Benefit Liability Coverage................................................................................................. 2 2. Unintentional Failure to Disclose Hazards......................................................................................... 8 3. Damage to Premises Rented to You................................................................................................. 8 4. Supplementary Payments..................................................................................................................9 5. 180 Day Coverage for Newly Formed or Acquired Organizations..................................................... 9 6. Waiver of Subrogation....................................................................................................................... 9 7. Automatic Additional Insured - Specified Relationships: ................................................................. 10 • Managers or Lessors of Premises; • Lessor of Leased Equipment; • Vendors; and • State or Political Subdivisions - Permits Relating to Premises 8. Property Damage to Borrowed Equipment........................................................................................12 9. Employees as Insureds - Specified Health Care Services: .............................................................13 • Nurses; - Emergency Medical Technicians; and • Paramedics 10. Broadened Notice of Occurrence...................................................................................................... 13 B. Limits of Insurance: The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorse- ment, except as provided below: 1. Employee Benefit Liability Coverage Each Employee Limit: $ 1,000,000 Aggregate Limit: $ 3,000,000 Deductible: $ 1,000 3. Damage to Premises Rented to You The lesser of: a. The Each Occurrence Limit shown in the Declarations; or b. $500,000 unless otherwise stated $ 4. Supplementary Payments a. Bail bonds: $ 1,000 b. Loss of earnings: $ 350 8. Property Damage to Borrowed Equipment Each Occurrence Limit $ 10,000 Deductible $ 250 Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 1 of 13 C. Coverages 2) Occurred prior to the ef- fective date of this en- 1. Employee Benefit Liability Coverage dorsement provided: a. The following is added to SECTION I a) You did not have - COVERAGES: Employee Benefit knowledge of a Liability Coverage. claim or "suit" on or (1) Insuring Agreement before the effective date of this en - (a) We will pay those sums that dorsement. the insured becomes legally obligated to pay as dam- You will be ages caused by any act, er- ror or omission of the in- knowledge of a claim or "suit' sured, or of any other per- when any "author- son for whose acts the in- sured is legally liable, to ized representa- which this insurance applies. tive"; We will have the right and i) Reports all, or duty to defend the insured any part, of the against any "suit" seeking act, error or those damages. However, omission to us we will have no duty to de- or any other fend against any "suit" seek- insurer; ing damages to which this insurance does not apply. ii) Receives a We may, at our discretion, written or ver- investigate any report of an bal demand or act, error or omission and claim for dam - settle any claim or "suit" that ages because may result. But: of the act, er- 1) The amount we will pay ror or omis- sion; and for damages is limited as described in SEC- b) There is no other TION III - LIMITS OF applicable insur- INSURANCE; and ance. 2) Our right and duty to (2) Exclusions defend ends when we have used up the appli- This insurance does not apply to: cable limit of insurance (a) Bodily Injury, Property in the payment of judg- Damage or Personal and ments or settlements. Advertising Injury No other obligation or liabil- "Bodily injury", "property ity to pay sums or perform damage" or "personal and acts or services is covered advertising injury". unless explicitly provided for under Supplementary Pay- (b) Dishonest, Fraudulent, ments. Criminal or Malicious Act (b) This insurance applies to Damages arising out of any damages only if the act, er- intentional, dishonest, ror or omission, is negli- fraudulent, criminal or mali- gently committed in the cious act, error or omission, "administration" of your "em- committed by any insured, ployee benefit program"; including the willful or reck- and less violation of any statute. 1) Occurs during the policy period; or Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 2 of 13 (c) Failure to Perform a Con- effort and cooperation of the tract insured, from the applicable funds accrued or other col - Damages arising out of fail- lectible insurance. ure of performance of con- tract by any insurer. (i) Taxes, Fines or Penalties (d) Insufficiency of Funds Taxes, fines or penalties, in - cluding those imposed un- Damages arising out of an der the Internal Revenue insufficiency of funds to Code or any similar state or meet any obligations under local law. any plan included in the "employee benefit program". (j) Employment -Related Prac- tices (e) Inadequacy of Perform- ance of Investment / Ad- Any liability arising out of vice Given with Respect to any: Participation (1) Refusal to employ; Any claim based upon: (2) Termination of employ- 1) Failure of any invest- ment; ment to perform; (3) Coercion, demotion, 2) Errors in providing in- evaluation, reassign - formation on past per- ment, discipline, defa- formance of investment mation, harassment, vehicles; or humiliation, discrimina- tion or other employ- 3) g y ment - related practices, person with respect to acts or omissions; or that person's decision to participate or not to par- (4) Consequential liability ticipate in any plan in- as a result of (1), (2) or cluded in the "employee (3) above. benefit program". This exclusion applies (f) Workers' Compensation whether the insured may be and Similar Laws held liable as an employer or in any other capacity and An claim arising out of our y g y to any obligation to share failure to comply with the damages with or repay mandatory provisions of any someone else who must pay workers' compensation, un- damages because of the in - employment compensation jury insurance, sodal security or disability benefits law or any (3) Supplementary Payments similar law. SECTION I - COVERAGES, (g) ERISA SUPPLEMENTARY PAYMENTS - COVERAGES A AND B also Damages for which any in- apply to this Coverage. sured is liable because of li- ability imposed on a fiduci- b. Who is an Insured ary by the Employee Re- tirement Income Security As respects Employee Benefit Liabil- Act of 1974, as now or ity Coverage, SECTION II - WHO IS hereafter amended, or by AN INSURED is deleted in its entirety any similar federal, state or and replaced by the following: local laws. (1) If you are designated in the Dec- (h) Available Benefits larations as: Any claim for benefits to the (a) An individual, you and your extent that such benefits are spouse are insureds, but available, with reasonable only with respect to the con - Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 3 of 13 duct of a business of which liability company, and over which you are the sole owner. you maintain ownership or major- ity interest, will qualify as a (b) A partnership or joint ven- Named Insured if no other similar ture, you are an insured. insurance applies to that organi- Your members, your part- zation. However, coverage un- ners, and their spouses are der this provision: also insureds but only with respect to the conduct of (a) Is afforded only until the your business. 180th day after you acquire or form the organization or (C) A limited liability company, the end of the policy period, you are an insured. Your y whichever is earlier; and members are also insureds, but only with respect to the (b) Does not apply to any ad, conduct of your business. error or omission that was Your managers are insur- committed before you ac- eds, but only with respect to quired or formed the organi- their duties as your manag- zation. ers. c. Limits of Insurance (d) An organization other than a partnership, joint venture or As respects Employee Benefit Liabil- limited liability company, you ity Coverage, SECTION III - LIMITS are an insured. Your "ex_ OF INSURANCE is deleted in its en- ecutive officers" and direc- tirety and replaced by the following: tors are insureds, but only (1) The Limits of Insurance shown in with respect to their duties Section B. Limits of Insurance, as your officers or directors. 1. Employee Benefit Liability Your stockholders are also Coverage and the rules below fix insureds, but only with re- the most we will pay regardless spect to their liability as of the number of: stockholders. (a) Insureds; (e) A trust, you are an insured. Your trustees are also in- (b) Claims made or "suits" sureds, but only with respect brought; to their duties as trustees. (c) Persons or organizations (2) Each of the following is also an making claims or bringing insured: "suits"; (a) Each of your "employees" (d) Acts, errors or omissions; or who is or was authorized to "employee (e) Benefits included in your administer your benefit program". "employee benefit program". (b) Any persons, organizations (2) The Aggregate Limit shown in or "employees" having Section B. Limits of Insurance, proper temporary authoriza- 1. Employee Benefit Liability tion to administer your "em- Coverage of this endorsement is ployee benefit program" if the most we will pay for all dam - you die, but only until your ages because of acts, errors or legal representative is ap- omissions negligently committed pointed. in the "administration" of your "employee benefit program". (c) Your legal representative if die, but only with re- (3) Subject to the limit described in you sped to duties as such. (2) above, the Each Employee That representative will have Limit shown in Section B. Limits all your rights and duties of Insurance, 1. Employee under this Coverage Part. Benefit Liability Coverage of this endorsement is the most we (3) Any organization you newly ac- will pay for all damages sus - quire or form, other than a part- tained by any one "employee", nership, joint venture or limited including damages sustained by Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 4 of 13 such "employee's" dependents (d) We may pay any part or all and beneficiaries, as a result of. of the deductible amount to effect settlement of any a An act, error or omission; or () claim or "suit" and, upon no- (b) A series of related acts, er- tification of the action taken, rors or omissions, regard- you shall promptly reim- less of the amount of time burse us for such part of the that lapses between such deductible amount as we acts, errors or omissions. have paid. negligently committed in the d. Additional Conditions "administration" of your "em- As respects Employee Benefit Li- ployee benefit program". ability Coverage, SECTION IV - However, the amount paid under COMMERCIAL GENERAL LIABIL- this endorsement shall not ex- ITY CONDITIONS is amended as fol- ceed, and will be subject to the lows: limits and restrictions that apply (1) Item 2. Duties in the Event of to the payment of benefits in any Occurrence, Offense, Claim or plan included in the "employee Suit is deleted in its entirety and benefit program." replaced by the following: (4) Deductible Amount 2. Duties in the Event of an (a) Our obligation to pay dam- Act, Error or Omission, or ages on behalf of the in- Claim or Suit sured applies only to the a. You must see to it that amount of damages in ex- we are notified as soon cess of the deductible as practicable of an act, amount stated in the Decla- error or omission which rations as applicable to may result in a claim. Each Employee. The limits To the extent possible, of insurance shall not be re- notice should include: duced by the amount of this deductible. (1) What the act, error (b) The deductible amount or omission was and when it oc- stated in the Declarations curred; and applies to all damages sus- tained by any one "em- (2) The names and ployee", including such "em- addresses of any- ployee's" dependents and one who may suf- beneficiaries, because of all fer damages as a acts, errors or omissions to result of the act, which this insurance applies. error or omission. (c) The terms of this insurance, b. If a claim is made or including those with respect "suit" is brought against to: any insured, you must: 1) Our right and duty to (1) Immediately record defend the insured the specifics of the against any "suits" claim or "suit" and seeking those dam- the date received; ages; and and 2) Your duties, and the du- ties of any other in- volved insured, in the event of an act, error or omission, or claim, apply irrespective of the ap- plication of the deductible amount. (2) Notify us as soon as practicable. You must see to it that we receive written no- tice of the claim or "suit" as soon as practicable. c. You and any other in- volved insured must: Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 5 of 13 (1) Immediately send method described in b. us copies of any below. demands, notices, b. Method of Sharing summonses or le- gal papers re- If all of the other insur- ceived in connec- ance permits contribu- tion with the claim tion by equal shares, or "suit"; we will follow this (2) Authorize us to ob- method also. Under tain records and this approach each in - other information; surer contributes equal amounts until it has (3) Cooperate with us paid its applicable limit in the investigation of insurance or none of or settlement of the the loss remains, claim or defense whichever comes first. against the "suit"; and If any of the other in- surance does not permit (4) Assist us, upon our contribution by equal request, in the en- shares, we will contrib- forcement of any ute by limits. Under this right against any method, each insurer's person or organi- share is based on the zation which may ratio of its applicable be liable to the in- limit of insurance to the sured because of total applicable limits of an act, error or insurance of all insur- omission to which ers. this insurance may c. No Coverage also apply. d. No insured will, except This insurance shall not at that insured's own cover any loss for which cost, voluntarily make a the insured is entitled to payment, assume any recovery under any obligation, or incur any other insurance in force expense without our previous to the effective consent. date of this Coverage Part. (2) Item 5. Other Insurance is de- leted in its entirety and replaced by the following: 5. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is pri- mary except when c. below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the e. Additional Definitions As respects Employee Benefit Li- ability Coverage, SECTION V - DEFINITIONS is amended as follows: (1) The following definitions are added: 1. "Administration" means: a. Providing information to "employees", including their dependents and beneficiaries, with re- spect to eligibility for or scope of "employee benefit programs"; b. Interpreting the "em- ployee benefit pro- grams", c. Handling records in connection with the Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 6 of 13 "employee benefit pro- benefits and such bene- grams"; or fits are made generally available to all "employ- d. Effecting, continuing or ees" who are eligible terminating any "em- under the plan for such ployee's" participation in benefits; any benefit included in the "employee benefit c. Unemployment insur- program". ance, social security benefits, workers' com- However, "administration" pensation and disability does not include: benefits; and a. Handling payroll deduc- d. Vacation plans, indud- tions; or ing buy and sell pro- b. The failure to effect or grams; leave of ab- maintain any insurance sence programs, indud- or adequate limits of ing military, maternity, coverage of insurance, family, and civil leave; including but not limited tuition assistance plans; to unemployment insur- transportation and ance, social security health club subsidies. benefits, workers' com- (2) The following definitions are de- pensation and disability leted in their entirety and re - benefits. placed by the following: 2. "Cafeteria plans" means 21. "Suit' means a civil proceed - plans authorized by applica- ing in which money dam- ble law to allow "employees" ages because of an act, er- to elect to pay for certain ror or omission to which this benefits with pre-tax dollars. insurance applies are al- 3. "Employee benefit pro- leged. "Suit" includes: grams" means a program a. An arbitration proceed - providing some of all of the ing in which such dam - following benefits to "em- ages are claimed and to ployees", whether provided which the insured must through a "cafeteria plan" or submit or does submit otherwise: with our consent; a. Group life insurance; b. Any other alternative group accident or health dispute resolution pro - insurance; dental, vision ceeding in which such and hearing plans; and damages are claimed flexible spending ac- and to which the in - counts; provided that no sured submits with our one other than an "em- consent; or ployee" may subscribe to such benefits and c. An appeal of a civil pro - such benefits are made ceeding. generally available to those "employees" who 8. "Employee" means a person satisfy the plan's eligibil- actively employed, formerly ity requirements; employed, on leave of ab- sence or disabled, or retired. b. Profit sharing plans, "Employee" includes a employee savings "leased worker". "Em- plans, employee stock ployee" does not include a ownership plans, pen- "temporary worker". sion plans and stock subscription plans, pro- 2. Unintentional Failure to Disclose Haz- vided that no one other ands than an "employee" SECTION IV - COMMERCIAL GENERAL may subscribe to such LIABILITY CONDITIONS, 7. Representa- Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 7 of 13 tions is hereby amended by the addition to damage or de - of the following: stroy itself; Based on our dependence upon your rep- c) Smog; resentations as to existing hazards, if un- d) Mechanical break - intentionally you should fail to disclose all such hazards at the inception date of your down including policy, we will not reject coverage under rupture or bursting this Coverage Part based solely on such caused by cen- failure. trifugal force; 3. Damage to Premises Rented to You e) Settling, cracking, shrinking or ex - a. The last Subparagraph of Paragraph pansion; or SECTION I - COVERAGES, COV- ERAGE A BODILY INJURY AND f) Nesting or char PROPERTY DAMAGE LIABILITY 2., tion, or discharge Exclusions is hereby deleted and or release of waste replaced by the following: products or secre- tions, by insects, Exclusions c. through q. do not apply birds, rodents or to damage by fire, explosion, light- other animals. ning, smoke or soot to premises while rented to you or temporarily occupied (b) Loss caused directly or lo - by you with permission of the owner. rectly by any of the follow- ing: b. The insurance provided under SEC- TION I - COVERAGES, COVERAGE 1) Earthquake, volcanic A. BODILY INJURY AND PROP- eruption, landslide or ERTY DAMAGE LIABILITY applies any other earth move - to "property damage" arising out of ment; water damage to premises that are 2) Water that backs up or both rented to and occupied by you. overflows from a sewer, (1) As respects Water Damage Le- drain or sump; gal Liability, as provided in Para- 3) Water under the ground graph 3.b. above: surface pressing on, or The exclusions under SECTION I flowing or seeping - COVERAGES, COVERAGE A. through: BODILY INJURY AND PROP- a) Foundations, walls, ERTY DAMAGE LIABILITY, 2. floors or paved Exclusions, other than L War surfaces; and the Nuclear Energy Liabil- ity Exclusion, are deleted and b) Basements, the following are added: whether paved or not; or This insurance does not apply to: c) Doors, windows or damage": (a) "Property " g other openings. 1) Assumed in any con- (c) Loss caused by or resulting tract; or from water that leaks or 2) Loss caused by or re- flows from plumbing, heat- sulting from any of the ing, air conditioning, or fire following: protection systems caused by or resulting from freezing, a) Wear and tear; unless: b) Rust, corrosion, 1) You did your best to fungus, decay, de- maintain heat in the terioration, hidden building or structure; or or latent defect or any quality in prop- 2) You drained the equip- erty that causes it ment and shut off the Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 8 of 13 water supply if the heat was not maintained. (d) Loss to or damage to: 1) Plumbing, heating, air conditioning, fire protec- tion systems, or other equipment or appli- ances; or 2) The interior of any building or structure, or to personal property in the building or structure caused by or resulting from rain, snow, sleet or ice, whether driven by wind or not. c. Limit of Insurance The Damage to Premises Rented to You Limit as shown in the Declara- tions is amended as follows: (2) Paragraph 6. of SECTION III - LIMITS OF INSURANCE is hereby deleted and replaced by the following: 6. Subject to 5. above, the Damage to Premises Rented to You Limit is the most we will pay under COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY for damages because of "prop- erty damage" to premises while rented to you or tem- porarily occupied by you with permission of the owner, arising out of any one "occurrence" to which this insurance applies. (3) The most we will pay is limited as described in Section B. Limits of Insurance, 3. Damage to Prem- ises Rented to You of this en- dorsement. 4. Supplementary Payments Under SECTION I - COVERAGE, SUP- PLEMENTARY PAYMENTS - COVER- AGES A AND B: a. Paragraph 2. is replaced by the fol- lowing: the use of any vehicle to which the Bodily Injury Liability Coverage ap- plies. We do not have to furnish these bonds. b. Paragraph 4, is replaced by the fol- lowing: All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to the limit shown in Sec- tion B. Limits of Insurance, 4.b. Loss of Earnings of this endorsement per day because of time off from work. 5. 180 Day Coverage for Newly Formed or Acquired Organizations SECTION II - WHO IS AN INSURED is amended as follows: Subparagraph a. of Paragraph 4. is hereby deleted and replaced by the fol- lowing: a. Insurance under this provision is af- forded only until the 180th day after you acquire or form the organization or the end of the policy period, which- ever is earlier; 6. Waiver of Subrogation SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 9. Transfer of Rights of Recovery Against Others to Us is hereby amended by the addition of the following: We waive any right of recovery we may have because of payments we make for injury or damage arising out of your ongo- ing operations or "your work" done under a written contract requiring such waiver with that person or organization and in- cluded in the "products -completed opera- tions hazard". However, our rights may only be waived prior to the "occurrence" giving rise to the injury or damage for which we make payment under this Cov- erage Part. The insured must do nothing after a loss to impair our rights. At our re- quest, the insured will bring "suit" or trans- fer those rights to us and help us enforce those rights. 7. Automatic Additional Insured - Speci- fied Relationships Up to the limit shown in Section B. a. The following is hereby added to Limits of Insurance, 4.a. Bail Bonds SECTION II -WHO IS AN INSURED: of this endorsement for cost of bail bonds required because of accidents (1) Any person or organization de - or traffic law violations arising out of scribed in Paragraph 7.a.(2) be - Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 9 of 13 low (hereinafter referred to as demolition operations additional insured) whom you are performed by or on be - required to add as an additional half of such additional insured under this Coverage Part insured. by reason ot: (b) Any person or organization (a) A written contract or agree- from which you lease ment; or equipment with whom you have agreed per Paragraph (b) An oral agreement or con- 7.a.(1) above to provide in- tract where a certificate of surance. Such person(s) or insurance showing that per- organization(s) are insureds son or organization as an solely with respect to their a additional insured has been liability arising out of the issued, maintenance, operation or is an insured, provided: use by you of equipment leased to you by such per - (a) The written or oral contract son(s) or organization(s). or agreement is: However, this insurance does not apply to any "oc- 1 Current in effect or currence' which takes place becomes effective dur- after the equipment lease ing the policy period; expires. and (c) Any person or organization 2) Executed prior to an (referred to below as ven- "occurrence" or offense dor) with whom you have to which this insurance agreed per Paragraph would apply; and 7.a.(1) above to provide in- (b) They are not specifically surance, but only with re- named as an additional in- spect to "bodily injury" or sured under any other provi- "property damage" arising sion of, or endorsement out of "your products" which added to, this Coverage are distributed or sold in the Part. regular course of the ven- dor's business, subject to (2) Only the following persons or or- the following additional ex- ganizations are additional insur- clusions: eds under this endorsement, and insurance coverage provided to 1) The insurance afforded such additional insureds is lim- the vendor does not ited as provided herein: apply to: (a) The manager or lessor of a a) "Bodily injury" or premises leased to you with "property damage" whom you have agreed per for which the ven- Paragraph 7.a.(1) above to dor is obligated to provide insurance, but only pay damages by with respect to liability aris- reason of the as- ing out of the ownership, sumption of liability maintenance or use of that in a contract or part of a premises leased to agreement. This you, subject to the following exclusion does not additional exclusions: apply to liability for damages that the This insurance does not ap- vendor would have ply to: in the absence of ) y �� 1 An occurrence" which the contract or agreement; takes place after you cease to be a tenant in b) Any express war - that premises. ranty unauthorized by you; 2) Structural alterations, new construction or Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 10 of 13 c) Any physical or nying or containing chemical change in such products; or the product made intentionally by the b) When liability in - vendor; cluded within the "products- d) Repackaging, completed opera - unless unpacked tions hazard" has solely for the pur- been excluded un- pose of inspection, der this Coverage demonstration, Part with respect to testing, or the sub- such products. stitution of parts under instructions (d) Any state or political subdi- from the manufac- vision with which you have turer, and then re- agreed per Paragraph packaged in the 7.a.(1) above to provide in - original oontainer; surance, subject to the fol- lowing additional provision: e) Any failure to make such inspections, This insurance applies only adjustments, tests with respect to the following or servicing as the hazards for which the state vendor has agreed or political subdivision has to make or nor- issued a permit in connec- mally undertakes tion with premises you own, to make in the rent or control and to which usual course of this insurance applies: business, in con- 1) The existence, mainte- nection with the nance, repair, oonstruc- distribution or sale tion, erection, or re - of the products; moval of advertising f) Demonstration, in- signs, awnings, cano- stallation, servicing pies, cellar entrances, or repair opera- coal holes, driveways, tions, except such manholes, marquees, operations per- hoist away openings, formed at the ven- sidewalk vaults, street dor's premises in banners, or decorations connection with the and similar exposures; sale of the product; or g) Products which, af- 2) The construction, erec- ter distribution or tion, or removal of ele- sale by you, have vators; or been labeled or re- 3) The ownership, mainte- labeled or used as nance, or use of any a container, part or elevators covered by ingredient of any this insurance. other thing or sub- stance by or for the (3) Any insurance provided to vendor. an additional insured desig- nated under Paragraph 2 This insurance does not 7.a.(2) Subparagraphs (a), apply to any insured (b) and (d) does not apply to person or organization: "bodily injury", "property a) From whom you damage" or, "personal and have aoquired advertising injury" arising out such products, or of the sole negligence or any ingredient, part willful misconduct of the ad - or container, enter- ditional insured or their ing into, accompa- agents, "employees" or any Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 11 of 13 other representative of the (1) The Limits of Insurance shown in additional insured. the Declarations are replaced by the limits designated in Property b. SECTION IV - COMMERCIAL GEN- Damage to Borrowed Equip- ERAL LIABILITY CONDITIONS is ment Section B. Limits of In - hereby amended as follows: surance, 8. Property Damage Condition 5. Other Insurance is to Borrowed Equipment of this amended to include: endorsement with respect to coverage provided by this en- (1) Where required by a written con- dorsement. These limits are in - tract or agreement, this insur- clusive of and not in addition to ance is primary and / or noncon- the limits being replaced. The tributory as respects any other Limits of Insurance shown in insurance policy issued to the Section B. Limits of Insurance, additional insured, and such 8. Property Damage to Bor- other insurance policy shall be rowed Equipment of this en - excess and / or noncontributing, dorsement fix the most we will whichever applies, with this in- pay in any one 'occurrence" re- surance. gardless of the number of: (2) Any insurance provided by this (a) Insureds; endorsement shall be primary to other insurance available to the (b) Claims made or "suits" additional insured except: brought; or (a) As otherwise provided in (c) Persons or organizations SECTION IV - COMMER- making daims or bring CIAL GENERAL LIABILITY "suits". CONDITIONS, 5. Other In- (2) Deductible Clause surance, b. Excess Insur- ance; or (a) Our obligation to pay Jam- ages on your behalf applies b For an other valid and col- () y only to the amount of dam- lectible insurance available ages for each 'occurrence" to the additional insured as which are in excess of the an additional insured by at- deductible amount stated in tachment of an endorsement Section B. Limits of Insur- to another insurance policy ance, 8. Property Damage that is written on an excess to Borrowed Equipment of basis. In such case, the this endorsement. The lim- coverage provided under its of insurance will not be this endorsement shall also reduced by the application be excess. of such deductible amount. 8. Property Damage to Borrowed Equip- (b) SECTION I -COMMERCIAL ment LIABILITY CONDITIONS 2. a. The following is hereby added to Ex- Duties in the Event of Oc- clusion j. Damage to Property of currence, Offense, Claim Paragraph 2., Exclusions SECTION or Suit, applies to each - COVERAGES, COVERAGE A. - claim or "suit" irrespective of BODILY INJURY AND PROPERTY the amount. DAMAGE LIABILITY: (c) We may pay any part or all Paragraphs (3) and (4) of this exclu- of the deductible amount to sion do not apply to tools or equip- effect settlement of any ment loaned to you, provided they are claim or "suit' and, upon no - not being used to perform operations tification of the action taken, at the time of loss. you shall promptly reim- burse us for such part of the b. With respect to the insurance pro- deductible amount as has vided by this section of the endorse- been paid by us. ment, the following additional provi- 9. Employees as Insureds - Specified sions apply: Health Care Services Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 12 of 13 It is hereby agreed that Paragraph 2.a.(1) a. You must see to it that we are notified (d) of SECTION II - WHO IS AN IN- as soon as practicable of an "occur- SURED, does not apply to your "employ- rence" or an offense which may result ees" who provide professional health care in a claim. To the extent possible, services on your behalf as duly licensed: notice should include: a. Nurses; (1) How, when and where the "oc- b. Emergency Medical Technicians; or currence" or offense took place; C. Paramedics, (2) The names and addresses of any injured persons and wit - in the jurisdiction where an "occurrence" nesses; and or offense to which this insurance applies (3) The nature and location of any takes place. iryury or damage arising out of 10. Broadened Notice of Occurrence the "occurrence" or offense. Paragraph a. of Condition 2. Duties in the This requirement applies only when Event of Occurrence, Offense, Claim or the "occurrence" or offense is known Suit (SECTION IV - COMMERCIAL to an "authorized representative". GENERAL LIABILITY CONDITIONS) is hereby deleted and replaced by the fol- lowing: Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 13 of 13