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18-063.01 AM Landshaper: CenterPlace West Lawn Ph 1 CONTRACT AMENDMENT TO THE AGREEMENT BETWEEN THE CITY OF SPOKANE VALLEY AND AM LANDSHAPER,INC. Spokane Valley Contract#18-063.01 For good and valuable consideration,the legal sufficiency of which is hereby acknowledged,City and the Contractor mutually agree as follows: 1. Purpose: This Amendment is for the Contract for CenterPlace West Lawn— Phase 1 Project by and between the Parties,executed by the Parties on April 9,2018,and which terminates on June 1,2018. Said contract shall be referred to as the"Original Contract"and its terms are hereby incorporated by reference. Total compensation under the Original Contract is not to exceed$147,057.34. 2.Original Contract Provisions:The Parties agree to continue to abide by those terms and conditions of the Original Contract and any amendments thereto which are not specifically modified by this Amendment. 3.Amendment Provisions: This Amendment is subject to the following amended provisions,which are as follows. All such amended provisions are hereby incorporated by reference herein and shall control over any conflicting provisions of the Original Contract,including any previous amendments thereto. -Accept Alternate)#2 in the amount of$12,809.02. This alternate includes the installation of three pedestrian lights. -Extend time of completion until July 6.2018. 4. Compensation Amendment History: This is Amendment#1 of the Original Contract. The history of amendments to the compensation on the Original Contract and all amendments is as follows: Date Compensation Original Contract Amount 4/9/18 $ 147,057.34 Amendment#1 5/7/18 $ 12,809.02 Total Amended Compensation S 159,866.36 The parties have executed this Amendment to the Original Contract this q-th day of May,2018. CITY O,FSPOKANE VALLEY: CONTRACTOR: A.M.LANrDSINC. AAA/ (\ iA '\K—c9 C. �V 3 Mark Calhoun 13y: Mark C. Albin City Manager Its: President A vii/ APP'OVED A ' ORM: 1101161..6, , JrAi Christine Bainbridge,City ClerkI Offic-di the City tt.•i ey 1 • �--.41 AMLANDS-01 BSOUDER A�ROn • DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 04/05/2018 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(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 eTTnppdorsement(s). PRODUCER NAME:CT Spokane Office PHONE (AIC,E Ext):(509)8383501 I(ivC,No):(509)838-3511 p PayneWest Insurance,Inc. Uplifts: 501 N.Riverpoint Blvd.,Ste 403 aopl(Ess: Spokane,WA 99202 INSURER(S)AFFORDING COVERAGE NAIL B _INSURER A:T h e Cincinnati Insurance Company 10677 INSURED INSURER B: A.M.Landshaper,Inc. INSURER C: • Mark Albin INSURER D 8004 North Market Spokane,WA 99217 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 OTSER 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. INRTYPEADDL SUBR POLICY EFF POLICY EXP LIMITS LTR OF INSURANCE INSD WVD POLICY NUMBER jMMIDDATCY)4MMIDDrYYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 3 1,000,000 CLAIMS-MADE n OCCUR X X EPP0128051 02124/2018 02/24/2019 pREMISES(ERa of r�rencel $ 500,000 MED EXP(My one person) $ 10,000 • PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 2,000,000 — POLICY n fa LOC PRODUCTS-WA STOP GAP COMP/OP AGG $ 1,000,000 OTHER: COMBINED SINGLE LIMIT 1,000,000 A AUTOMOBILE LIABILR Y (Ea accident) $ X ANY AUTO X X EBA0128051 02/2412018 02!2412019 BODILY INJURY(Per person) $ — — OWNED SCHEDULED BODILY INJURY(Peracddent) $ AUTOS�� ONLY _ AUTOS p PROPERTY DAMAGE AUTOS ONLY — AUTOS ONLY (Peracddent) $ $ A X UMBRELLA UAB X OCCUR EACH OCCURRENCE / 1,000,000 EXCESS UAB CLAIMS-MADE EPP0128051 02124/2018 02/24/2019 AGGREGATE $ DED I X RETENTION$ 0 $ WORKERS COMPENSATION PER UTE ER AND EMPLOYERS'LIABIUTY Y IN ANY PROPRIETOR/PARTNER/EXECUTIVE —1 E.L EACH ACCIDENT $ OFFICEBER EXCLUDED? 1 I N!A (Mandatory In n NH) EL DISEASE-EA EMPLOYEE $ If yes,describe under EL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below A Equipment Floater EPP0128051 02124/2018 02/24/2019 Leased and Rented 250,000 A Equipment Floater EPP0128051 02124/2018 02/2412019 Deductible 1,000 . DESCRIPTION OF OPERATIONS!LOCATIONS 1 VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) RE:Centerpiece West Lawn-Phase I Project!Project No.18-063.00 City of Spokane Valley is additional insured as per the attached forms.Coverage is primary and non contributory.Waiver of subrogation and per project aggregate applies per attached forms. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Spokane Valley ACCORDANCE WITH THE POLICY PROVISIONS. Attn:Christine Bainbridge,City Clerk 10210 East Sprague AVe Spokane,WA 99206 AUTHORIZED REPRESENTATIVE 1 6449441JS6zacb'- ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.- • CONTRACTORS' COMMERCIAL GENERAL LIABILITY BROADENED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Endorsement-Table of Contents: Coverage: Begins on Page: 1. Employee Benefit Liability Coverage 2 2. Unintentional Failure to Disclose Hazards 7 3. Damage to Premises Rented to You 8 4. Supplementary Payments 9 5. Medical Payments 9 6. Voluntary Property Damage(Coverage a.)and Care,Custody or Control Liability Coverage(Coverage b.) 9 7. 180 Day Coverage for Newly Formed or Acquired Organizations 10 8. Waiver of Subrogation 10 9. Automata Additional Insured-Specified Relationships: 10 • Managers or Lessors of Premises; • Lessor of Leased Equipment; • Vendors; • State or Political Subdivisions-Permits Relating to Premises; • State or Political Subdivisions-Permits;and • Contractors'Operations 10. Broadened Contractual Liability-Work Within 50'of Railroad Property 14 11. Property Damage to Borrowed Equipment 14 12. Employees as Insureds-Specified Health Care Services: 14 . • Nurses; • Emergency Medical Technicians;and • Paramedics 13. Broadened Notice of Occurrence 14 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 5. Medical Payments Medical Expense Limit: $ 10,000 Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 1 of 15 6. Voluntary Property Damage (Coverage a.)and Care,Custody or Control Liability Coverage (Coverage b.) Limits of Insurance(Each Occurrence) Coverage a.$1,000 Coverage b.$5,000 unless otherwise stated $ Deductibles(Each Occurrence) Coverage a.$250 Coverage b.$250 unless otherwise stated $ COVERAGE PREMIUM BASIS RATE ADVANCE PREMIUM (a) Area (For Limits in Excess of (For Limits in Excess of (b) Payroll $5,000) $5,000) (c) Gross Sales (d) Units (e) Other b. Care, Custody $ or Control TOTAL ANNUAL PREMIUM $ 11. Property Damage to Borrowed Equipment Each Occurrence Limit: $ 10,000 Deductible: $ 250 • C. Coverages: have used up the ap- plicable limit of insur- 1. Employee Benefit Liability Coverage ance in the payment of a. The following is added to SECTION Ijudgments or settle- - COVERAGES: Employee Benefit ments. Liability Coverage. No other obligation or liabil- ity to pay sums or perform acts or services is covered (a) We will pay those sums that unless explicitly provided for the insured becomes legally under Supplementary Pay- obligated to pay as dam- ments. ages caused by any act,er- (b) This insurance applies to ror or omission of the in- damages only if the act, er- sured, or of any other per- ror or omission, is negli- • son for whose acts the in- sured is legally liable, to "administration" of your which this insurance ap- plies. We will have the rightt gram";and and duty to defend the in- sured against any "suit" 1) Occurs during the pol- seeking those damages, icy period;or However, we will have no duty to defend against any 2) Occurred prior to the "suit" seeking damages to effective date of this which this insurance does endorsement provided: not apply. We may, at our a) You did not have • discretion, investigate any knowledge of a report of an act, error or claim or "su " on omission and settle any claim or "suit" that may re- or before date the f this ef- sult. But: fectivendorsement. 1) The amount we will pay You will be deemedouto have for damages is limited as described in SEC- knowledge hoa TION Ill - LIMITS OF claim or "suit INSURANCE;and when any 2) Our right and duty to "authorized repre- defend ends when we sentative"; • Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 2 of 15 • i) Reports all, or formance of investment any part,of the vehicles;or act, error or 3) Advice given to any omission to us person with respect to or any other that person's decision insurer; • to participate or not to ii) Receives a participate in any plan written or ver- included in• the "em- bal demand or ployee benefit pro- claim for dam- gram • ages becauseo (f) Workers' Compensation ror or orris- the act, er- and Similar Laws • sion;and Any claim arising out of b) There is no other your failure to comply with applicable insur- the mandatory provisions of ance, any workers'compensation, unemployment' compensa- • (2) Exclusions tion insurance, social secu- rity or disability benefits law This insurance does not apply or any similar law. to: (g) ERISA (a) Bodily Injury, Property Damage or Personal and Damages for which any in- Advertising Injury sured is liable because of liability imposed on a fiduci- "Bodily injury", "property ary by the Employee Re- damage" or "personal and tirement Income Security advertising injury". Act of 1974, as now or (b) Dishonest, Fraudulent, hereafter amended, or by any similar federal, state or Criminal or Malicious Act local laws. Damages arising out of any (h) Available Benefits intentional, dishonest, fraudulent, criminal or mali- Any claim for benefits to the cious act, error or omission, extent that such benefits committed by any insured, are available, with reason- including the willful or reck- able effort and cooperation • less violation of any statute. of the insured, from the ap- (c) Failure to Perform a Con- plicable funds accrued or tract other collectible insurance. Damages arising out of fail- • (i) Taxes, Fines or Penalties ure of performance of con- . Taxes, fines or penalties, tract by any insurer, including those imposed (d) Insufficiency of Funds under the Internal Revenue Code or any similar state or Damages arising out of an local law. insufficiency of funds to (j) Employment-Related meet any obligations under • Practices any plan included in the employee benefit pro- Any liability arising out of gram". • any: (e) Inadequacy of Perform- (1) Refusal to employ; ance of Investment / Ad- vice Given With Respect (2) Termination of em- to Participation ployment; Any claim based upon: (3) Coercion, demotion, evaluation, reassign- 1) Failure of any invest- ment, discipline, defa- ment to perform; mation, harassment, 2) Errors in providing in- humiliation, discrimina- formation on past per- tion or other employ- Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 3 of 15 , ment related practices, (e) A trust,you are an insured. ,. acts or omissions;or 'Your trustees are also in- sureds, but only with re- (4) Consequential liability spect to their duties as as a result of(1), (2) or trustees. (3)above. (2) Each of the following is also an • This exclusion applies insured: whether the insured may be held liable as an employer (a) Each of your "employees" or in any other capacity and who is or was authorized to to any obligation to share administer your "employee • damages with or repay benefit program". someone else who must (b) Any persons, organizations pay damages because of or "employees" having the injury. or temporary authori- (3) Supplementary Payments zation to administer your "employee benefit program" SECTION I - COVERAGES, if you die, but only until your SUPPLEMENTARY PAY- legal representative is ap- MENTS - COVERAGES A AND pointed. B also apply to this Coverage.' (c) Your legal representative if b. Who is an Insured you die, but only with re- spect to duties as such. As respects Employee Benefit Liabil- That representative will • ity Coverage, SECTION II -WHO IS have all your rights and du- AN INSURED is deleted in its en- ties under this Coverage tirety and replaced by the following: • Part. (1) If you are designated in the (3) Any organization you newly ac- Declarations as: quire or form, other than a part- (a) An individual, you and your nership, joint venture or limited spouse are insureds, but liability company, and over only with respect to the which you maintain ownership conduct of a business of or majority interest, will qualify which you are the sole as a Named Insured if no other owner. similar insurance applies to that organization. However, cover- (b) A partnership or joint ven- age under this provision: ture, you are an insured. Is onlyuntil the Your members, your part- (a) afforded ners, and their spouses are 180th day after you acquire also insureds but only with or form the organization or respect to the conduct of the end of the policy period, your business. whichever is earlier;and (c) A limited liability company, (b) Does not apply to any act, you are an insured. Your error or omission that was . members are also insureds, committed before you ac- but only with respect to the quired or formed the or- conduct of your business. ganization. Your managers are in- c. Limits of Insurance sureds, but only with re- spect to their duties as your As respects Employee Benefit Liabil- managers. ity Coverage, SECTION III - LIMITS (d) An organization other than OF INSURANCE is deleted in its en- a partnership, joint venture tirety and replaced by the following: or limited liability company, (1) The Limits of Insurance shown you are an insured. Your in Section B. Limits of Insur- "executive officers" and di- ance, 1. Employee Benefit Li- rectors are insureds, but ability Coverage and the rules • only with respect to their below fix the most we will pay duties as your officers or di- regardless of the number of: rectors. Your stockholders are also insureds, but only (a) Insureds; with respect to their liability as stockholders. • Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 4 of 15 (b) Claims made or "suits" (b) The deductible amount brought; stated in the Declarations applies to all damages (c) Persons or organizations sustained by any one "em- making claims or bringing ployee", including such "suits"; "employee's" dependents (d) Acts,errors or omissions;or and beneficiaries, because of all acts, errors or omis- (e) Benefits included in yoursions to which this insur- "employee benefit pro- ance applies. gram". (c) The terms of this insurance, (2) The Aggregate Limit shown in including those with respect Section B. Limits of Insurance, to: 1. Employee Benefit Liability 1) Our right and duty to • Coverage of this endorsement defend the insured is the most.we will pay for all against any "suits" • damages because of acts, er- seeking those dam- rors or omissions negligently • committed in the "administra- tion" of your "employee benefit 2) Your duties, and the program". duties of any other(3) in- Subject to the limit described in volved insured, in the (2) above, the Each Employee event of an act,error or Limit shown in Section B. Limits omission,or claim, of Insurance, 1. Employee apply irrespective of the Benefit Liability Coverage of application of the deductible this endorsement is the most we amount. will pay for all damages sus- tained by any one "employee", (d) We may pay any part or all including damages sustained by of the deductible amount to such "employee's" dependents effect settlement of any and beneficiaries,as a result of: claim or "suit" and, upon notification of the action (a) An act,error or omission;or taken, you shall promptly (b) A series of related acts, er- reimburse us for such part rof the deductible amount as ors or omissions, regard- we have paid. less of the amount of time that lapses between such d. Additional Conditions acts,errors or omissions, As respects Employee Benefit Li- negligently committed in the ability Coverage, SECTION IV - administration of your "em- COMMERCIAL GENERAL LIABIL- ployee benefit program". ITY CONDITIONS is amended as However, the amount paid un- follows: der this endorsement shall not (1) Item 2. Duties in the Event of • exceed, and will be subject to Occurrence, Offense, Claim or the limits and restrictions that Suit is deleted in its entirety and apply to the payment of benefits replaced by the following: in any plan included in the "em- ployee benefit program". 2. Duties in the Event of an Act, Error or (4) Deductible Amount Omission,or Claim or Suit Our obligation to paydam- a. You must see to it that we are noti- (a) 9 fled as soon as practicable of an act, ages on behalf of the in- error or omission which may result in sured applies only to the a claim. To the extent possible, no- amount of damages in ex- tice should include: cess of the deductible amount stated in the Decla- (1) What the act, error or omission rations as applicable to was and when it occurred;and Each Employee. The limits (2) The names and addresses of reducedof insurance shall not ofe anyone who maysuffer dam- thisd by the amount ages as a result othe act, error this deductible. or omission. Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 5 of 15 b. If a claim is made or"suit"is brought b. Method of Sharing against any insured,you must: If all of the other insur- (1) Immediately record the specifics ance permits contribu- of the claim or "suit" and the tion by equal shares, date received;and we will follow this method also. Under (2) Notify us as soon as practicable. this approach each in- You must see to it that we receive surer contributes equal amounts until it has written notice of the claim or"suit"as practicable. paid its applicable limit soon as of insurance or none of . c. You and any other involved insured the loss remains, must: whichever comes first. (1) Immediately send us copies of If any of the other in- any demands, notices, sum- surance does not per- monses or legal papers re- mit contribution by ceived in connection with the equal shares, we will claim or"suit"; contribute by limits. Under this method, (2) Authorize.us to obtain recordseach insurer's share is and other information; based on the ratio of its applicable limit of in- (3) Cooperate with us in the investi- surance to the total ap- • gation or settlement of the claim � plicable limits of insur- or defense against the "suit"; ance of all insurers. and (4) Assist us, upon our request, in - c. No Coverage the enforcement of any right This insurance shall not against any person or organiza- cover anyloss for tion which may be liable to the which the insured is insured because of an act, error entitled to recovery un-. or omission to which this insur- der any other insur- ance may also apply. ance in force previous • d. No insured will, except at that in- to the effectiveeragdate of P this Coverage Part. sured's own cost, voluntarily make a • payment, assume any obligation, or e. Additional Definitions incur any expense without our con- sent. As respects Employee Benefit Li- ability ,Coverage, SECTION V - (2) Item 5. Other Insurance is de- DEFINITIONS is amended as fol- leted in its entirety and replaced lows: by the following: • (1) The following definitions are 5. Other Insurance added: If other valid and collectible 1. "Administration"means: insurance is available to the insured for a loss we cover a. Providing information to under this Coverage Part, "employees", including our obligations are limited their dependents and • as follows: beneficiaries, with re- spect to eligibility for or a. Primary Insurance scope of "employee This insurance is pri- benefit programs"; mary except when c. b. Interpreting the "em- below applies. If this ployee benefit pro- insurance is primary, grams"; our obligations are not affected unless any of c. Handling ••records in the other insurance is connection with the also primary.. Then,we "employee benefit pro- will share with all that grams";or other insurance by the d. Effecting, continuing or • method described in b. terminating any "em • - below, ployee's" participation Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 6 of 15 in any benefit included benefits, workers' corn- • • in the "employee bene- • pensation and disability • fit program". benefits;and However, "administration" d. Vacation plans, includ- • does not include: ing buy and sell pro- grams; leave of ab- a. Handling payroll de- sence programs, in- • ductions;or cluding military, mater- • vil b. The.failure to effect or leave;nitytuitioniti and assis- maintaincany insurance plans; transpor- or adequate limits of tationtance• Covera a of insurance, subsi and health club including but not limited • subsidies. to unemployment in- (2) The following definitions are surance,social security deleted in their entirety and re- benefits, workers' corn- placed by the following: pensation and disability • benefits. 21. "Suit" means a civil pro- • • • ceeding in which money 2. "Cafeteria plans" means damages because of an plan authorized by applica- act, error or omission to • ble law to allow "employ- which this insurance applies ees" to elect to pay for cer- are alleged. "Suit"includes: tain benefits with pre-tax dollars. a. An arbitration pro- ceeding in which such 3. "Employee benefit pro- damages are claimed grams" means a program and to which the in- providing some or all of the sured must submit or following benefits to "em- • does submit with our ployees", whether provided consent; through a"cafeteria plan"or otherwise: b. Any other alternative dispute resolution pro- a. Group life insurance; ceeding in which such group ' accident or • damages are claimed • health insurance; den- and to which the in- • tal, vision and hearing sured submits with our plans; and flexible consent;or • spending ' accounts; provided that no one c. An appeal of a civil other than an "em- proceeding. • • • ployee" may subscribe B. "Employee" means a per- to such benefits and • son actively employed, for- such benefits are made generally available to merly employed, on leave those"employees"who of absence or disabled, or satisfy the plan's eligi- retired. "Employee" in- cludes a "leased worker". bility requirements; "Employee" does not in- b. Profit sharing plans, clude a"temporary worker". employee savings plans, employee stotockk 2. Unintentional Failure to Disclose Haz- ownership plans, pen- ards • sion plans and stock SECTION IV-COMMERCIAL GENERAL subscription plans, LIABILITY CONDITIONS, 7. Represen- provided that no one tations is hereby amended by the add- ' other than an "em- tion of the following: ployee" may subscribe to such benefits and Based on our dependence upon your such benefits are made representations as to existing hazards, if • generally available to unintentionally you should fail to disclose all "employees" who all such hazards at the inception date of are eligible under the your- policy, we will not reject coverage plan for such benefits; under this Coverage Part based solely on c. Unemployment insur- such failure. ance, social security Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 7 of 15 • 3. Damage to Premises Rented to You e) Settling, cracking, . shrinking or ex- a. The last Subparagraph of Paragraph pansion;or 2. SECTION I - COVERAGES, COVERAGE A. - BODILY INJURY f) Nesting or infesta- AND PROPERTY DAMAGE, 2. LI- tion, or discharge ABILITY Exclusions is hereby de- or release of leted and replaced by the following: waste products or secretions, by in- Exclusions c.through q.do not apply sects, birds, ro- to damage by fire, explosion, light- dents or other ning, smoke or soot to premises animals. while rented to you or temporarily occupied by you with permission of (b) Loss caused directly or indi- the owner. rectly by any of the follow- 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 (1) As respects Water Damage Le- sewer,drain or sump; gal Liability, as provided in 3) Water under the Paragraph 3.b.above: ground surface press- The exclusions under SECTION ing on, or flowing or I - COVERAGES, COVERAGE seeping through: A. BODILY INJURY AND Foundations, PROPERTY DAMAGE LIABI! a) FouFoun, floors or ITY,2. Exclusions, other than I. wallpaved surfaces; War and the Nuclear Energy . Liability Exclusion, are deleted b) Basements, and the following are added: •whether paved or This insurance does not apply not;or to: c) Doors,windows or (a) "Property damage": other openings. 1) Assumed in any con- (c) Loss caused by or resulting tract;or from water that leaks or flows from plumbing, heat- 2) Loss caused by or re- ing, air conditioning, or fire suiting from any of the protection systems caused following: by or resulting from freez- ing,unless: a) Wear and tear; 1) You did your best to b) Rust, corrosion, maintain heat in the fungus, decay, building or structure;or deterioration, hid- den or latent de- 2) You drained the feet or any quality equipment and shut off in property that the water supply if the causes it to dam- heat was not main- age or destroy it- tained. self; (d) Loss to or damage to: c) Smog; 1) Plumbing, heating, air d) Mechanical conditioning, fire pro- breakdown in- tection systems, or cluding rupture or other equipment or ap- bursting caused pliances;or by centrifugal 2) The interior of any force; • building or structure, or to personal property in the building or structure Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 8 of 15 • caused by or resulting 5. Medical Payments from rain, snow, sleet The Medical Expense Limit of Any One or ice, whether driven Person as stated in the.Declarations is by wind or not. amended to the limit shown in Section B. c. Limit of Insurance Limits of Insurance, 5. Medical Pay- ments of this endorsement. The Damage to Premises Rented to • You Limit as shown in the Declare- 6. Voluntary Property.Damage and Care, tions is amended as follows: Custody or Control Liability Coverage (2) Paragraph 6. of SECTION III - a. Voluntary Property Damage Coy- LIMITS OF INSURANCE is erage • hereby deleted and replaced by We will pay for"property damage" to the following: property of others arising out of op- 6. Subject to 5. above, the erations incidental to the insured's • Damage to Premises business when: Rented to You Limit is the most we will pay under (1) Damage is caused by the in- COVERAGE A. BODILY sured;or • INJURY AND PROPERTY (2) Damage occurs while in the in- DAMAGE LIABILITY, for sured's possession. • damages because of. "property damage" to With your consent, we will make premises while rented to these payments regardless of fault you or temporarily occupied by you with permission of b. Care, Custody or Control Liability the owner, arising out of Coverage any one "occurrence" to SECTION I - COVERAGES, COV- which this insurance ap- ERAGE A. BODILY INJURY AND plies. PROPERTY DAMAGE LIABILITY,2. (3) The amount we will pay is lim- Exclusions,j. Damage to Property, • ited as described in Section B. Subparagraphs (3), (4) and (5) do Limits of Insurance, 3. Dam- not apply to "property damage" to age to Premises Rented to the, property of others described You of this endorsement. therein. 4. Supplementary Payments With respect to the insurance provided by this section of the endorsement, the fol- Under SECTION I - COVERAGE, SUP- lowing additional provisions apply: PLEMENTARY PAYMENTS - COVER- AGES A AND B: a. The Limits of Insurance shown in the Declarations are replaced by the lim- a. Paragraph 2. is replaced by the fol- its designated in Section B.Limits of lowing: Insurance, 6. Voluntary Property Upto the limit shown in Section B. Damage and Care, Custody or Control Liability Coverage of this Limits of Insurance,4.a.Bail Bonds endorsement with respect to cover- of this endorsement for cost of bail age provided by this endorsement. bonds required because of accidents These limits are inclusive of and not or traffic law violations arising out of in addition to the limits being re- the use of any vehicle to which the placed. The Limits of Insurance Bodily Injury Liability Coverage ap- shown in Section B. Limits of Insur- plies. We do not have to furnish ance, 6. Voluntary Property Dam- these bonds, age and Care, Custody or Control b. Paragraph 4. is replaced by the fol- Liability Coverage of this endorse- lowing: ment fix the most we will pay in any one "occurrence" regardless of the All reasonable expenses incurred by number of: the insured at our request to assist 1 Insureds; us in the investigation or defense of (1) the claim or "suit", including actual (2) Claims made or"suits" brought; loss of earnings up to the limit shown or • in Section B. Limits of Insurance, • 4.b. Loss of Earnings of this en- (3) Persons or organizations mak- dorsement per day because of time ing claims or bringing"suits". off from work. Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 9 of 15 ' b. Deductible Clause 9. Automatic Additional Insured - Speci- 4 fled Relationships (1) Our obligation to pay damages on your behalf applies only to a. The SECTION Ilfollowing WHO IS Ais N INSURED: added to the amount of damages for each "occurrence" which are in ex- cess of the deductible amount (1) Any person or organization de- stated scribed in Paragraph 9.a.(2) • stated in Section B. Limits of below(hereinafter referred to as Insurance, 6. Voluntary Prop- additional insured) whom you erty Damage and Care, Cus- are required to add as an addi- erage of this endorsement. The tody or Control Liability Cov- tional insured under this Cover- limits of insurance will not be re- age Part by reason of: duced by the application of such (a) A written contract or deductible amount. agreement;or (2) Condition 2. Duties in the Event (b) An oral agreement or con- of Occurrence, Offense, Claim tract where a certificate of or Suit, applies to each claim or insurance showing that per • - "suit"irrespective of the amount, son or organization as an (3) We may pay any part or all of additional insured has been the deductible amount to effect issued, settlement of any claim or "suit" is an insured, provided: and, upon notification of the ac- tion taken, you shall promptly (a) The written or oral contract reimburse us for such part of the or agreement is: deductible amount as has been 1) Currently in effect or paid by us, becomes effective 7. 180 Day Coverage for Newly Formed or during the policy pe- Acquired Organizations riod;and SECTION II - WHO IS AN INSURED is 2) Executed prior to an amended as follows: "occurrence"or offense to which this insurance Subparagraph a. of Paragraph 4. is would apply;and hereby deleted and replaced by the fol- lowing: (b) They are not specifically named as an additional in- a. Insurance under this provision is af- sured under any other pro- forded only until the 180th day after vision of, or endorsement you acquire or form the organization added to, this Coverage or the end of the policy period, Part. whichever is earlier; (2) Only the following persons or 8. Waiver of Subrogation organizations are additional in- SECTION IV-COMMERCIAL GENERAL sureds under this endorsement, LIABILITY CONDITIONS, 9. Transfer of and insurance coverage pro- Rights of Recovery Against Others to vided to such additional in- Us is hereby amended by the addition of sureds is limited as provided the following: herein: • We waive any right of recovery we may (a) The manager or lessor of a have because of payments we make for premises leased to you with P Y, whom you have agreed per injury or damage arising out of your on- Paragraph 9.a.(1)veabove to going operations or"your work"done un- Paragraph but only der a written contract requiring such proviwith respect insurance,liabilitybons- waiver with that person or organization ingwith outs of s- and included in the "products-completed maintenance the use of ownership,p operations hazard". However, our rights t only, prior, , par, subjectart of aemi es leasedt maybe waived to the "occur-rence" giving rise to the injury or damage additionaloueto the following for which we make payment under this Coverage Part. The insured must do This insurance does not nothing after a loss to impair our rights. apply to: At our request,the insured will bring "suit" or transfer those rights to us and help us 1) Any "occurrence" enforce those rights. which takes place after Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 10 of 15 r you cease to be a ten- c) Any physical or • ant in that premises. chemical change in the product 2) Structural alterations, made intentionally new construction or by the vendor; demolition operations • performed by or on be- d) Repackaging, un- half of such additional less unpacked insured, solely for the pur- pose of inspection, (b) Any person or organization demonstration, from which you lease testing, or the • equipment with whom you substitution of have agreed per Paragraph parts under in- 9.a.(1) above to provide in- structions from the surance. Such person(s)or manufacturer, and organization(s)are insureds then repackaged solely with respect to their in the original • liability arising out of the container; maintenance, operation or use by you of equipment e) Any failure to - leased to you by such per- make such in- son(s) or organizations(s). spections, adjust- However, this insurance ments, tests or does not apply to any "oc- servicing as the currence"which takes place vendor has after the equipment lease agreed to make or expires. normally under- takes to make in • (c) Any person or organization the. usual course (referred to)below as ven- of business, in dor) with whom you have connection with agreed per Paragraph the distribution or 9.a.(1) above to provide in- sale of the prod- surance, but only with re- ucts; spect to "bodily injury" or "property damage" arising f) Demonstration, in- out of"your products"which stallation, servic- are distributed or sold in the ing or repair op- regular course of the ven- erations, except dor's business, subject to such operations the following additional ex- performed at the clusions: vendor's premises in connection with 1) The insurance afforded the sale of the the vendor does not product; • apply to: Products hich, a) "Bodily injury" or • g) after distribution or "property damage" sale by you, have for which the ven- been labeled or dor is obligated to relabeled or used • pay damages by as a container, reason of the as- part br ingredient sumption of Habil- of any other thing ity in a contract or or substance by or agreement. This for the vendor. exclusion does not apply to liability for 2) This insurance does damages that the not apply to any in- vendor would sured person or or- have in the ab- ganization: sence of the con- a) From whom you tract or agree- . ment; have acquired • such products, or b) Any express war- any ingredient, ranty unauthorized part or container, by you; . entering into, ac- Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 11 of 15 • com an ing or 2) This insurance does containing such not apply to "bodily in- products;or jury", "property dam- age" or "personal and b) When liability in- advertising injury" aris- cluded within the ing out of operations "products- performed for the state completed opera- or political subdivision. tions hazard" has been excluded (f) Any person or organization under this Cover- with which you have agreed age Part with re- per Paragraph 9.a.(1) spect to such above to provide insurance, products. but only with respect to li- ability arising out of "your (d) Any state or political subdi- work" performed for that vision with which you have additional insured by you or agreed per Paragraph on your behalf. A person or 9.a.(1) above to provide in- organization's status as an surance, subject to the fol- insured under this provision lowing additional provision: of this endorsement contin- This insurance applies only ues for only the period of pp time required by the written with respect to the following contract or agreement, but hazards for which the state in no event beyond the ex- or political subdivision has piration date of this Cover- issued a permit in connec- age Part. If there is no tion with premises you own, written contract or agree- rent or control and to which meet, or if no period of time this insurance applies: is required by the written 1) The existence, mainte- contract or agreement, a Hance, repair, con- person or organization's struction, erection, or • status as an insured under removal of advertising this endorsement ends signs, awnings, cano- when your operations for pies, cellar entrances, that insured are completed. coal holes, driveways, (3) Any insurance provided to an manholes, marquees, additional insured designated hoist away openings, sidewalk vaults, street under Paragraph 9.a.(2): banners, or decora- (a) Subparagraphs (e) and (f) tions and similar expo- does not apply to "bodily sures;or injury"or"property damage" 2) The construction, erec- included within the "prod- tion, or removal of ele- ucts-completed operations vators;or hazard"; 3) The ownership, main- (b) Subparagraphs (a), (b), (d), tenance, p (e)and (f)does not apply to elevators covered or use any "bodily injury", "property by damage" or "personal and this insurance, advertising injury" arising (e) Any state or political subdi- out of the sole negligence vision with which you have or willful misconduct of the agreed per Paragraph additional insured or their 9.a.(1) above to provide in- agents, "employees"or any surance, subject to the fol- other representative of the lowing provisions: additional insured;or 1) This insurance applies (c) Subparagraph (f) does not only with respect to op- apply to "bodily injury", erations performed by "property damage" or "per- you or on your behalf sonal and advertising injury" for which the state or arising out of: political subdivision has 1) Defects in design fur- issued a permit: nished by or on behalf Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 12 of 15 of the additional in- • spects any other insurance sured;or tional insured, and such policy issued to the addi- 2 The rendering of, or other insurance policy shall failure to render, any be excess and /or noncon- professional architec- tributing,whichever applies, tural, engineering or with this insurance. surveying services, in- cluding: (b) Any insurance provided by this endorsement shall be a) The preparing, primary to other insurance approving or fail- available to the additional ing to prepare or insured except: approve maps, shop drawings, 1) As otherwise provided opinions, reports, in SECTION IV - surveys, field or- COMMERCIAL GEN- * ders, change or- ERAL LIABILITY ders or drawings CONDITIONS,5.Other • and specifications; Insurance, b. Excess and Insurance;or b) Supervisory, .in- 2) For any other valid and spection, archi- collectible insurance tectural or engi- available to the addi- neering activities. tional insured as an additional insured by 3) "Your work"for which a attachment of an en- consolidated (wrap-up) dorsement to another insurance program has insurance policy that is been provided by the written on an excess primecontractor-project basis. In such case, manager or owner of the coverage provided the construction project under this endorse- in which you are in- ment shall also be ex- volved. cess. b. Only with regard to insurance pro- (2) Condition 11. Conformance to vided to an additional insured desig- Specific Written Contract or nated under Paragraph 9.a.(2) Sub- • Agreement is hereby added: paragraph (f) above, SECTION III - LIMITS OF INSURANCE is amended 11. Conformance to Specific to include: Written Contract or The limits applicable to the additional Agreement insured are those specified in the With respect to additional written contract or agreement or in insureds described in Para- the Declarations of this Coverage graph 9.a.(2)(f)above only: • Part,whichever are less. If no limits If a written contract or are specified in the written contract agreement between you or agreement,or if there is no written g contract or agreement, the limits ap- and the additional insured plicable to the additional insured are specifies that coverage for those specified in the Declarations of the additional insured: . this Coverage Part. The limits of in- a. Be provided by the In- surance are inclusive of and not in surance Services Of- addition to the 'limits of insurance fice additional insured shown in the Declarations. form number CG 20 10 c. SECTION IV- COMMERCIAL GEN- or CG 20 37 (where ERAL LIABILITY CONDITIONS is edition specified);or hereby amended as follows: b. Include coverage for • (1) Condition 5. Other Insurance is completed operations; amended to include: or (a) Where required by a written c. Include coverage for contract or agreement, this "your work'; insurance is primary and / and where the limits or cov- • or noncontributory as re- erage provided to the addi- Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 13 of 15 tional insured is more re- 11. of this endorsement fix the strictive than was specifi- most we will pay in any one "oc- cally required in that written currence" regardless of the contract or agreement, the number of: terms of Paragraphs (a) Insureds; 9.a.(3)(a), 9.a.(3)(b) or 9.b. above, or any combination (b) Claims made or "suits" thereof, shall be interpreted brought;or as providing the limits or coverage required by the (c) Persons or organizations • terms of the written contract making claims or bring or agreement, but only to "suits". the extent that such limits or (2) Deductible Clause coverage is included within the terms of the Coverage (a) Our obligation to pay dam- Part to which this endorse- ages on your behalf applies ment is attached. If, how- only to the amount of dam- ever, the written contract or ages for each "occurrence" agreement specifies the In- which are in excess of the surance Services Office Deductible amount stated in additional insured form Section B. Limits of Insur- • number CG 20 10 but does ance, 11. of this endorse- not specify which edition,or ment. The limits of insur- specifies an edition that ance will not be reduced by does not exist, Paragraphs• the application of such De- 9.a.(3)(a) and 9.a.(3)(b) of ductible amount. this endorsement shall not apply and Paragraph 9.b.of (b) Condition 2. Duties in the this endorsement shall ap- Event of Occurrence, Of- ply. fense, Claim or Suit, ap- 10. Broadened Contractual Liability-Work plies to each claim or"suit" irrespective of the amount. Within 50'of Railroad Property It is hereby agreed that Paragraph f.(1) of (c) We may pay any part or all of the deductible amount to Definition 12. "Insured contract" (SEC- TION V-DEFINITIONS)is deleted. effect settlement of any claim or "suit" and, upon 11. Property Damage to Borrowed Equip- notification of the action ment taken, you shall promptly reimburse us for such part a. The following is hereby added to Ex- of the deductible amount as clusion j. Damage to Property of has been paid by us. Paragraph 2., Exclusions of SEC- TION I -COVERAGES, COVERAGE 12. Employees as Insureds - Specified A. BODILY INJURY AND PROP- Health Care Services ERTY DAMAGE LIABILITY: It is hereby agreed that Paragraph Paragraphs (3) and (4) of this exclu- 2.a.(1)(d) of SECTION II - WHO IS AN sion do not apply to tools or equip- INSURED, does not.apply to your "em- ment loaned to you, provided they ployees" who provide professional health are not being used to perform opera- care services on your behalf as duly li- tions at the time of loss. censed: b. With respect to the insurance pro- a. Nurses; vided by this section of the en- b. Emergency Medical Technicians;or dorsement, the following additional provisions apply: c. Paramedics, (1) The Limits of insurance shown in the jurisdiction where an "occurrence" in the Declarations are replaced or offense to which this insurance applies by the limits designated in Sec- • takes place. tion B. Limits of Insurance, 11. of this endorsement with respect 13. Broadened Notice of Occurrence to coverage provided by this Paragraph a. of Condition 2. Duties in endorsement. These limits are the Event of Occurrence, Offense, • inclusivehelimits of and not inadditioneto Claim or Suit(SECTION IV- COMMER- CIAL GENERAL LIABILITY CONDI- - Limits of Insurance shown in Section B. Limits of Insurance, • Includes copyrighted material of Insurance . GA 233 02 07 Services Office, Inc.,with its permission. Page 14 of 15 • TIONS) is hereby deleted and replaced (2) The names and addresses of by the following: any injured persons and wit- a. You must see to•it that we are noti- nesses;and fied as soon as practicable of an (3) The nature and location of any "occurrence" or an offense which injury or damage arising out of may result in a claim. To the extent the"occurrence"or offense. possible,notice should include: This requirement applies only when (1) How, when and where the "oc- the"occurrence"or offense is known currence"or offense took place; • to an"authorized representative". • • • • Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 15 of 15 • you or while performing duties related to d. Your legal representative if you die, but the conduct of your business. However, . only with respect to duties as such That none of these "employees" or "volunteer representative will have all your rights workers"are insureds for: and duties under this Coverage Part. (1) "Bodily injury" or "personal and ad 3. Any organization you newly acquire or form, vertising injury": other than a partnership, joint venture or lim ited liability company, and over which you (a) To you, to your partners or maintain ownership or majority interest, will members (if you are a partner- qualify as a Named Insured if there is no other ship or joint venture), to your similar insurance available to that organiza- members (if you are a limited Ii tion. However: ability company), to a co- "employee" while in the course a Insurance under this provision is afforded of his or her employment or only until the 90th day after you acquire performing duties related to the or form the organization or the end of the conduct of your business, or to policy period,whichever is earlier; your other "volunteer workers" b. COVERAGE A. BODILY INJURY AND while performing duties related PROPERTY DAMAGE LIABILITY does to the conduct of your business; not apply to "bodily injury" or "property (b) To the spouse, child, parent, damage" that occurred before you ac- brother or sister of that co quired or formed the organization;and "employee" or "volunteer c COVERAGE B. PERSONAL AND AD- worker' as a consequence of Paragraph(1)(a)above; VERTISING INJURY LIABILITY does not apply to "personal and advertising injury" (c) For which there is any obligation arising out of an offense committed be to share damages with or repay fore you acquired or formed the organi- someone else who must pay zation. damages because of the injury No person or organization is an insured with re describedin Paragraphs (1)(a) spect to the conduct of any current or past or(b)above;or part- nership, joint venture or limited liability company (d) Arising out of his or her provid- that is not shown as a Named Insured in the Dec- ing or failing to provide profes- larations. • sional health care services. SECTION III-LIMITS OF INSURANCE (2) "Property damage"to property: 1. The Limits of Insurance shown in the Declare- (a) Owned,occupied or used by;or tions and the rules below fix the most we will pay regardless of the number of: (b) Rented to, in the care, custody or control of, or over which a Insureds; • physical control is being exer b. Claims made or"suits"brought;or cised for any purpose by, you, any of your employees c. Persons or organizations making claims , "vol- • unteer workers", any partner or or bringing"suits". member (if you are a partnership or 2 a. The General Aggregate Limit is the most joint venture), or any member (if you we will pay for the sum of: are a limited liability company). • (1) Medical expenses under COVER- • b. Any person (other than your "employee" AGE C.MEDICAL PAYMENTS; or "volunteer worker"), or any organiza . tion while acting as your real estate man- (2) Damages under COVERAGE A. ager. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, except dam c. Any person or organization having proper ages because of "bodily injury" or temporary custody of your property if you "property damage" included in the die,but only: "products-completed operations (1) With respect to liability arising out of hazard";and the maintenance or use of that prop- (3) Damages under COVERAGE B. erty; and PERSONAL AND ADVERTISING • (2) Until your legal representative has INJURY LIABILITY. • been appointed. This General Aggregate Limit will not ap ply if either the Location.General Aggre- Includes copyrighted material of Insurance GA 101 12 04 Services Office,Inc',with its permission. Page 12 of 22 gate Limit of Insurance, Paragraph 2 b, your behalf at the same location for or the Construction Project General Ag- the same persons or organizations, gregate Limit of Insurance, Paragraph no matter how often or under how 2 c applies. many different contracts, will be b. A separate Location General Aggregate deemed Limit to be a single construction p Limit of Insurance,equal to the amount of the General Aggregate Limit shown in the 3. The Products Completed Operations Aggre Declarations,shall apply to each location gate Limit is the most we will pay under COV- owned by, or rented or leased to you and ERAGE A. BODILY INJURY AND PROP- is the most we will pay for the sum of: ERTY DAMAGE LIABILITY for damages be AGE A. cause of "bodily injury" and "property dam (1) DODIDamages under COVERRAGERTY age".included in the "products-completed op- • DAMAGE LIABILITY, except dam erations hazard". ages because of "bodily injury" or 4 Subject to.2.a. above, the Personal and Ad- "property damage" included in the vertising Injury Limit is the most we will pay "products completed operations ,under COVERAGE B. PERSONAL AND AD- hazard";and VERTISING INJURY LIABILITY for the sum of expensesunder COVER- all damages because of all "personal and ad- (2) Medical vertising injury"sustained by any one person AGE C.MEDICAL PAYMENTS, or organization. which can be attributed to operations at 5 Subject to 2 or 3 above,.whichever applies, only a single location owned by,or rented the Each Occurrence Limit is the most we will or leased to you. pay for the sum of: c. A separate Construction Project General a Damages under COVERAGE A. BODILY Aggregate Limit of Insurance, equal to INJURY AND PROPERTY DAMAGE LI- the amount of the General Aggregate ABILITY;and Limit shown in-the-Declarations,shall ap- ply to each construction project and is the b Medical expenses under COVERAGE C most we will pay for the sum of: MEDICAL PAYMENTS; (1) Damages under COVERAGE A. because of all "bodily injury" and "property BODILY INJURY AND PROPERTY damage"arising out of any one"occurrence". . DAMAGE LIABILITY, except dam ages because of "bodily injury" or 6 Subject to 5 above, the Damage to Premises "property damage" included in the Rented to You Limit is the most we will pay "products completed operations under. COVERAGE A. BODILY INJURY AND • hazard";and PROPERTY DAMAGE LIABILITY for dam- ages because of "property damage" to any (2) Medical expenses under COVER- one premises, while rented to you, or in the AGE C.MEDICAL PAYMENTS; case of damage by fire or explosion, while which can be attributed onlyto ongoing rented to you or temporarily occupied by you 9 g with permission of the owner. operations and only at a single construc- tion project. 7 Subject to 5 above, the Medical Expense d. Onlyfor the purpose of determiningwhich Limit is the most we will pay under COVER- d. P P AGE C. MEDICAL PAYMENTS for all medical General Aggregate Limit of Insurance, expenses because of"bodily injury"sustained 2 a,2 b.,or 2 c ,applies: by any one person. (1) Location means premises involving The Limits of Insurance of this Coverage Part ap- the same or connecting lots, or ply separately to each"coverage term". premises,whose connection is inter rupted only by a street, roadway, SECTION IV COMMERCIAL GENERAL LI waterway or right of way of a rail ABILITY CONDITIONS road. 1. Bankruptcy (2) Construction project means a loca tion you do not own, rent or lease Bankruptcy or insolvency of the insured or of where ongoing improvements, al the insured's estate will not relieve us'of our terations, installation, demolition or obligations under this Coverage Part. U maintenance work is performed by 2. Duties in the Event of Occurrence, Offense, you or on your behalf. All connected Claim or Suit ongoing improvements, alterations, installation, demolition or mainte- a You must see to it that we are notified as nance work performed by you or on soon as practicable of an"occurrence" or Includes copyrighted material of Insurance GA 101 12 04 Services Office,Inc,with its permission Page 13 of 22 lb)L C F:Vzut,fl Cor:tar t `Search L&I I USN A 7.Iride\ ',1e11e My 1.&i Safety&Health Claims&Insurance Workplace Rights Trades&Licensing oft Washington State Department of Labor & Industries A M LANDSHAPER INC 8004 N.MARKET Owner or tradesperson SPOKANE,WA 99217 Principals 509-468-4335 ALBIN,MARK C,PRESIDENT SPOKANE County MCGEE,TYE CYRIL,SECRETARY Doing business as A M LANDSHAPER INC WA UBI No. Business type 601 701 273 Corporation Governing persons MARK C ALBIN TYE C MC GEE; License Verify the contractor's active registration/license/certification(depending on trade)and any past violations. Construction Contractor Active. Meets current requirements. License specialties GENERAL License no. AMLAN1•971 DO Effective—expiration 03/20/2003—04/12/2020 Bond North American Spec Ins Co $12,000.00 Bond account no. 2181927 • Received by L&I Effective date 07/1612014 09/24/2014 Expiration date Until Canceled RLI INS CO $12,000.00 Bond account no. SSB397618 Received by L&I Effective date 10/02/2009 09/24/2009 Expiration date Until Canceled Insurance Help us improve Cincinnati Ins Co $1,000,000.00 Policy no. EPP225013 Received byL8.1 Effective date 02/22/2018 02/24/2012 Expiration date 0212412019 Insurance history Savings No savings accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. L&l Tax debts No L&i tax debts are recorded for this contractor license during the previous 6 year period,but some debts may be recorded by other agencies. License Violations No license violations during the previous 6 year period. Workers' comp Do you know if the business has employees?If so,verify the business is up-to-date on workers'comp premiums. L&I Account ID Account is current. 816,366-01 Doing business as A M LANDSHAPER INC Estimated workers reported Quarter 4 of Year 2017"11 to 20 Workers" L&I account contact TO I KRISTI LINN(360)902-4620-Email:LINB235@ini.wa.gov Public Works Strikes and Debarments Verify the contractor is eligible to perform work on public works projects. Contractor Strikes No strikes have been issued against this contractor. Contractors not allowed to bid No debarments have been issued against this contractor. Workplace safety and health No inspections during the previous 6 year period. tO Washington State Dept.of Labor&Industries.Use of this site is subject to the laws of the state of Washington. Help us improve