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19-087.00 Big Sky Id: Barker Rd Widening Project
Contract This agreement is entered into this 7 11 day of 4`J/ 2019, between the City of Spokane Valley I"City')and Big Sky Id,Corp. "Contractor"),pursua t to Title 35 RCW,as adopted or amended In consideration of the terms and conditions contained herein and attached and made a part of this agreement,the parties agree as follows: I. The Contractor shall do all work and furnish all tools,materials,and equipment for: Barker Road Widening Project#0276 Contract 19-087 in accordance with and as described in the project plans and specification, and the standard specification of the Washington State of Department of Transportation which are by this reference incorporated herein and made part hereof and, shall perform any changes in the work in accord with the Contract Documents The Contractor shall provide and bear the expense of all equipment, work, and labor, of any son whatsoever that may be required for the transfer of materials and for constructing and completing the work provided for in these Contract Documents except those items mentioned therein to be furnished by the City. IL The City hereby promises and agrees with the Contractor to employ, and does employ the Contractor to provide the materials and to do and cause to be done the above described work and to complete and finish the same in accord with the protect plans and specification and the terms and conditions herein contained and hereby contracts to pay for the same according to the referenced specifications and the schedule of unit or itemized prices at the time and in the manner and upon the conditions provided for in this contract III. The Contractor for himself herself, and for his/hers heirs, executors, administrators, successors, and assigns, does hereby agree to full performance of all covenants required of the Contractor in the contract. IV It is further provided that no liability shall attach to the City by reason of entering onto this contract,except as provided herein. V. The project was awarded for the bid amount of$2,020,197.00,plus applicable sales tax. IN WITNESS WHEREOF, the Contractor has executed this instrument, on the date below,and the City has caused this instrument to be executed on the date stated above City of Spokane Valley 14 Contract Senna Barka Road W ndenmg Prosect Executed by Contractor April 25 .2019. Date Jeremy Tram Pnnted Name President Title Signature City of Spokane Val ey Mark Calhoun Printed Name CiManager Till auk_ a, _ Signature Rt iI.d I-C-Ir Cary of Spokane Valley 15 Contract Forms Harker Road Widening Protect Heyliane BOND NO: 2270137 CONTRACTOR'S PAYMENT BOND(NON-FEDERALLY FUNDED PROJECT) to City of Spokane Valley,Washington The City of Spokane Valley, Washington, in Spokane County, has awarded to Big Sky ID,Corp. (Contractor),as Principal,a contract for the construction of the project designated asRarker Road Widening Project No.Q$$in Spokane Valley, Washington. and said Principal is required under the terms of the Contract to furnish a payment bond in accordance with chapter 39.08 Revised Code of Washington(RCM. The Principal, and North American Specialty Insurance Company (Surety), a corporation organized under the laws New Hampshire and licensed to do business in the State of Washington as surety and named in the current list of"Surety Companies Acceptable in Federal Bonds"as published in the Federal Register by the Audit Staff Bureau of Accounts,U.S.Treasury Dept.,are jointly and severally held and£umly bound to the City of Spokane Valley,as Obligee,in the sum of$ 2,198,840.19 total Contract amount(including Washington State sales tax),subject to the provisions herein. This payment bond shall become null and void, if and when the Principal, its heirs, executors, administrators, successors, or assigns shall pay all persons in accordance with chapters 39.08 and 39.12 RCW, including all workers, laborers, mechanics, subcontractors,and materialmen,and all persons who shall supply such contractor or subcontractor with provisions and supplies for the carrying on of such work and shall indemnify and hold harmless the Obligee from all loss,cost or damage which Obligee may suffer by reason of the failure of Principal to make such required payments;and if such payment obligations have not been fulfilled,this bond shall remain in full force and effect. The Surety for value received agrees that no change, extension of time,alteration or addition to the terms of the Contract,the specifications accompanying the Contract,or to the work to be performed under the Contract shall in any way affect its obligation on this bond,except as provided herein,and waives notice of any change,extension of time,alteration or addition to the terms of the Contract or the work performed.The Surety agrees that modifications and changes to the terms and conditions of the Contract that increase the total amount to be paid the Principal shall automatically increase the obligation of the Surety on this bond and notice to Surety is not required for such increased obligation. This bond may be executed in two original counterparts,and shall be signed by the parties'duly authorized officers. This bond will only be accepted if it is accompanied by a fully executed and original power of attorney for the officer executing on behalf of the surety. PRINCIPM (C RACTO Big Sky ID,Corp. S TYY North nc Sp 'faall7ty)nsrmnce Company 4/25/2019 di/ ` /IA /Al%% _ 4/i512019 Principal Si Date urety Signature - Date (� A.y t2('PP Diana R Williams Printed Name Printed Name 'osnz— Attotney -Fact Tide Title Name,address,and telephone of local office/agent of Surety Company is: HUB International Northwest LLC 999 W.Riverside Ave.,Suite 510,Spokane,WA 99201 509-319-2901 kc,, cd 1141' Cay of Spokane Valley 17 Contract Forms Barker Road W identng Project SWISS RE CORPORATE SOLUTIONS NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY GENERAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS,THAT North American Specialty Insurance Company,a corporation duly organized and existing under laws of the State of New Hampshire,and having its principal office in the City of Overland Park,Kansas.and Washington international Insurance Company.a corporation organized and existing under the laws of the State of New Hampshire and having its principal office m the City of Overland Park.Kansas,each does hereby make,constitute and appoint. H KEITH McNALLY,ERIN L.REPP,WM DINNEEN,CHRIS LARSON, DIANA R.WILLIAMS,VIRGINIA L.WEBER and P M HALLETT JOINTLY OR SEVERALLY Its true and lawful Attorney(sl-m-Fact,to make execute,seal and dclieer,for and on its behalf and as its act and deed,bonds or other writings obligatory in the nature of a bond on behalf of each of said Companies,as surety,on contracts of suretyship as are or may be required or permitted by law,regulation,contract or otherwise,provided that no bond or undertaking or contract or curet)ship executed under this authority shall exceed the amount of FIFTY MILLION($50,000,000.00)DOLLARS This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Board of Directors of both North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held on the 9t of May,2012: "RESOLVED,that any two of the Piesidents.any Managing Director,any Senior Vice President,any Vice President,any Assistant Vice President, the Secretary or any Assistant Secretary be.and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds,undertakings and all contracts of surety,and that each or any of them hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company, and it is FURTHER RESOLVED,that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile,and any such Power of Attorney or certificate beating such facsimile signatures or facsimile seal shall be binding upon the Company when so affixed and in the futile withregardto any bond,undertaking or contract of surety to which it is attached." Je Ut urNico �/A ¢ RL s 1//rLtf,(/..'_ tWON.�t I y igr SEAL Steven P.Anderson,Senior ViaPreOanienWashinemn hiarntuwal InsuranceCnmPany r SEAL BM - &Salar Mae Padua or North Amann SWAP"Masa Cnmwy i 4 p..F1.µ��':A. .:. x I 9 bone r tsaN //{�//,/J \ ilMlllan alt Byto resent NWulun emannal insures t timpani A Michael ho. mw a ee gen n &Scar Via PITS KIWI of North amadou Specialty lnwanee Ctimpany IN WITNESS WHEREOF.North American Specialty Insurance Company and Washington International Insurance Company have caused their official seals to be hereunto affixed,and these presents to he signed by their authorized officers this 9th day of Novcmbet ,2017 North American Specialty Insurance Company Washington International Insurance Company State of Illinois County of Cook ss On this 9th day of November ,2017 ,before me,a Notary Public personally appeared Steven P Andemon ,Senior Vice Piesident of Washington International Insurance Company and Senior Vice President of North Amer can Specialty Insurance Company and Michael A Ito Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company,personally known to me,who being by me duly sworn,acknowledged that they signed the abo'e Power of Attorney as officers of and acknowledged said instrument to be the voluntary act and deed of then respective companies. L OFFICIAL SEAL NOM alit=N Manus N-c'.1-Th \S \ l t. ttimudn MaresM.kenny,Notary PublicN. 12/04111121 1, Jeffrey Goldberg the duly elected Assistant Secretary of North American Specialty Insurance Company and Washington International Insurance Company,do hereby certify that the above and foregoing Is a true awl correct copy of a Power of Attorney gic en by said North American Specialty Insurance Company and Washington International Insurance Company,which is still m full force and effect IN WITNESS WHEREOF.I have set my hand and affixed the seals of the Companies this 25th day of April ,20 19/L Jearey Gvldbc'.MA Pada&Assistant Salary of Wmhmamn inumwowi m=wan,e Cnmpam n NoM Amsnvm Specialty haurma Conant ��' �` BOND NO: 2270137 CONTRACTOR'S PERFORMANCE BOND to City of Spokane Valley,Washington The City of Spokane Valley, Washington, in Spokane County, has awarded to Big Sky ID,Corp. (Contractor),as Principal,a contract for the construction of the project designated as Harker Road Wideninv Project No.Qfl in Spokane Valley, Washington,and said Principal is required under the terns of the Contract to furnish a performance bond in accordance with chapter 39.08 Revised Code of Washington(RCW). The Principal, and North American Specialty Insurance Company (Surety), a corporation, organized under the laws of New Hampshire and licensed to do business in the State of Washington as surety and named in the current list of"Surety Companies Acceptable in Federal Bonds"as published in the Federal Register by the Audit Staff Bureau of Accounts,U.S.Treasury Dept.,are jointly and severally held and firmly bound to the City of Spokane Valley,as Obligee,in the sum of S 2,198,840 19 total Contract amount(including Washington State sales tax),subject to the provisions herein. This perfomtance bond shall become null and void,W and when the Principal, its heirs,executors,administrators,successors,or assigns shall well and faithfully perform all of the Principal's obligations under the Contract and fulfill all the terns and conditions of all duly authorized modifications, additions,and changes to said Contract that may hereafter be made,at the time and in the manner therein specified;shall warranty the work as provided in the Contract and shall indemnify and hold harmless the Obligee from any defects in the workmanship and materials incorporated into the work for the period identified in the Contract'and if such performance obligations have not been fulfilled,this bond shall remain in full force and effect The Surety for value received agrees that no change, extension of time,alteration or addition to the terms of the Contract,the specifications accompanying the Contract,or to the work to be performed under the Contract shall in any way affect its obligation on this bond,and waives notice of any change,extension of time,alteration or addition to the terms of the Contract or the work performed.The Surety agrees that modifications and changes to the terms and conditions of the Contract that increase the total amount to be paid the Principal shall automatically increase the obligation of the Surety on this bond and notice to Surety is not required for such increased obligation. This bond may be executed in two original counterparts,and shall be signed by the paries' duly authorized officers.This bond will only be accepted if it is accompanied by a fully executed and original power of attorney for the officer executing on behalf of the surety. PRINCIPAL WO r CT a' Big Sky ID,Corp. SV ETY North isecciialtyyIInsurrance Company 4/25/2019 I{,`(,6CL (, (G�LIC/ 4/25/2019 Principal SignOF{-- Date Surety Si Date l��r/•11 Aar{ I IE-1i? Diana R.Williams Printed�pName 1 Printed Name i et c p Attorney-in-Fact Title Title Name,address,and telephone of local office/agent of Surety Company is: HUB International Northwest I IC 999 W.Riverside Ave.,Suite 510,Spokane,WA 99201 509-319-2901 E44 44I III: City of Spokane Valley 16 Contract Forms Barker Road Widening Project art® ,�744.'4 " . BOND NO: 2270138 CONTRACTOR'S RETAINAGE BOND to City of Spokane Valley,Washington The City of Spokane Valley,Washington,in Spokane County, has awarded to Big Sky ID,Corp ("Contractor'),as Principal,a contract for the construction of the project designated as Barker Road Widening Project No. QM (the "Contract")in Spokane Valley,Washington. The Principal, existing under and by virtue of the laws of the State of Washington and authorized to do business in the State of Washington, and North American Specialty Insurance Company organized and existing under the laws of the State of New Hamnshirw and authorized to transact business in the State of Washington as Surety, are jointly and severally held and bound unto the City of Spokane Valley, hereinafter called Obligee, and are similarly held and bound unto the beneficiaries of the trust fund created by chapter 60.28 RCW, in the penal sum of 5% of the Contract, which is One Hundred One Thousand Nine and 85/100 dollars(S 101,009 85 ),plus 5%of any increases in the Contract amount that have occurred or may occur, due to change orders, increases in the quantities,or the addition of any new item of work. WHEREAS, on the 25th day of April 2013 the said Principal and Obligee herein executed and entered into the Contract. WHEREAS, said Contract and chapter 60.28 RCW require the Obligee to withhold from the Principal the sum of' 5% from monies earned by the Principal on estimates during the progress of the construction, hereinafter referred to as earned retained funds. WHEREAS,the Principal has requested that the Obligee accept a bond in lieu of earned retained funds as allowed under chapter 60.28 RCW. NOW THEREFORE,the condition of the obligation is such that the Principal and Surety are held and bound unto the beneficiaries of the trust fund created by chapter 60.28 RCW in the aforesaid sum. This bond, including any proceeds therefrom,is subject to all claims and liens and in the same manner and priority as set forth for retained percentages in chapter 60.28 RCW. The condition of this obligation is also such that if the Principal shall satisfy all payment obligations to persons who may lawfully claim under the trust fund purposes of chapter 60.28 RCW to the Obligee,and indemnify and hold the Obligee harmless from any and all loss, costs, and damages that the Obligee may sustain by release of the earned retained funds to the Principal,then upon notification of such satisfaction and release of the Surety by the Obligee.this obligation shall be null and void. PROVIDED HOWEVER,that: 1. The Surety shall be liable under this obligation as Principal. The Surety will not be discharged or released from liability for any act, omission or defenses of any kind or nature that would not also discharge Principal. 2. This obligation shall be binding upon and inure to the benefit of the Principal, the Surety, the Obligee,the beneficiaries of the trust fund created by chapter 60.28 RCW and their respective heirs, executors,administrators,successors and assigns. 3. Any suit under this bond must be instituted within the time provided by applicable law. City of Spokane Valley 18 Contract Forms Barker Road Widening Project This bond may be executed in two original counterparts,and shall be signed by the parties'duly authorized officers. This bond will only be accepted if it is accompanied by a fully executed and original power of attorney for the officer executing on behalf of the surety. PRINCIPAL eN '. OR) Big Sky ID,Corp. SURE North Amer pecialty Insurance Company 4/25/2019 Zajbl412512019 Principal ArmDateSurety Signature /// Date -(;K,(gnl -mire Chns Larson Printed Name 11 Printed Name _VasAttorney-in-Fact _ Title Title Name,address,and telephone of local office/agent of Surety Company is: HUB International Northwest LLC 999 W Riverside Ave ,Suite 510,Spokane,WA 99201 509-319-2901 j.ai I u 1 , City of Spokane Valley 19 Contract Forms Barker Road Widening Project SWISS RE CORPORATE SOLUTIONS NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY WESTPORT INSURANCE CORPORATION GENERAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS,THAT North American Specialty Insurance Company,a corporation duly organized and existing under laws of the State of New Hampshire,and having its principal office in the City of Kansas City,Missouri and Washington International Insurance Company a corporation organized and existing under the laws of the State of New Hampshire and having its principal office m the City of Kansas City,Missouri,and Westport Insurance Corporation,organized under the laws of the State of Missouri,and having its pnncipal office in the City of Kansas City,Missouri does hereby make,constitute and appoint. H.KEITH McNALLY,ERIN L.REPP,WM DINNEEN,CHRIS LARSON,DIANA R. WILLIAMS,VIRGINIA L.WEBER CRISTAL A VIEHMAN IOINTLYOR SEVERALLY Its true and lawful Attorney(sl-in-Fact,to make,execute,seal and deliver,for and on its behalf and as its act and deed,bonds or other writings obligatory in the nature of a bond on behalf of each of said Companies,as surety,on contracts of suretyship as are or may be required or permitted by law,regulation,contract or otherwise,provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the amount of FIFTY MILLION($50,000,000.00)DOLLARS This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held on March 24,2000 and Westport Instil ante Corporation by written consent of its Executive Committee dated July 18,2011 "RESOLVED,that any two of the President,any Senior Vice President,any Vice President,any Assistant Vice President, the Secretary or any Assistant Secretary be,and each or any of them hereby is authonzed to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds,undertakings and all contracts of surety,and that each or any of them hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company: and it is FURTHER RESOLVED,that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearmg such facsimile signatures or facsunile seal shall be binding upon the Company when so affixed and in the future with regard to any bond,undertaking or contract of surety to which it is attached" $pair/A,.. Ket I`�I r r tY' L 8 wPT«dect°I 01womm poor I Itr 1'L,ps . PxI avian P moms.,Smistun inemanonai insurance Company ! SEALAl t SEAL &Senior Vice FgWmla wnporti nn see oNivaboul mpmy 401Se 1975 :mss I &semis«mnamrarAwn'rPam mmrm&camamaan 3'4144.;.Mx4" ,t� B !6,0001,0 fr MIX'A.rm,Senior Vice Pmmem or wvMngtnmtematoan i Mour &Company • wymournoIII &Senior Vice Preside&&North Amemm�spedtlip in ranee Company P«siWestport&Send&Vice de&or ort(simian Caepanaon IN WITNESS WHEREOF,North American Specialty Insurance Company,Washington International Insurance Company and Westport • Insurance Corporation have caused their official seals to be hereunto affixed,and these presents to be signed by their authorized officers this this 5TH day of MAY 20 North American Specialty Insurance Company Washington International Insurance Company State of Illinois Westport Insurance Corporation County of Cook ss On this 5TH day of MAY ,20_,before me,allotary Public pmsonally appeared Steven P Ander son ,Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Senior Vice President of Westport Insurance Corporation and Michael A Ito Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Senior Vice President of Westport Insurance Corpolatron,personally known to me.who bemg by me duly swum,acknowledged that they signed the aboxe Power of Attorney as officers of and acknowledged said instrument to be the voluntary act and deed of their respectise companies. OfF1Oetiat \(\ aaMMyy ion Upon �. )) klc-- to 0042021 M.Kenny,Notary Public \l 1, Jeffrey Goldberg , the duly elected Vice President and Assistant Secretary of North American Specialty Insurance Company,Washington International Insurance Company and Westport Insurance Corporation do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney given by said North American Specialty Insurance Company,Washington International Insurance Company and Westport Insurance Corporation which is still in full force and effect, IN WITNESS WHEREOF,i have set my hand and affixed the seals of the Companies this 25th day of April ,20 19 . r learn Gaidneig Vne Prend&n&Amend Scei.v oe&Alle an Intnnatona&swan&Cmp,ni£ rvunh Annan Specially Insure cc Camwnv&vv e Pnmmt& %WWIIse:rcuryorwatpninanren.c Comorattan ^l BIGSKVD-10 ELEWIS DATE IMMDDIYY'IYI �� CERTIFICATE OF LIABILITY INSURANCE 4/25/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CETIFICATE DOES NOT AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATEFIRMAOff INSURANCE DOES NOT CONSTITUTE AVELY OR NEGATIVELY AMEND, E CND ONTRACT BETWEENOR ALTER THEOVERAGE THE ISSUING ISUR R(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(tes)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of thepolicy,certain policies may require all endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Jr Edie Lewis Hub International Northwest LLC PHONE I FAX C,NO 999 Wes[Riverside Avenue,Sulfa 510 IAM,IL Ertl Spokane,WA 99201 no AeSS edie.lewis@hubintemational.com _ INSURERS)AFFORDING COVERAGE NAIL II INSURER A.Continental Western Insurance Company 10804 INSURED INSURER Zurich American Insurance Company 16535 Big Sky ID,Corp. INSURER C 10063 N.Navion Drive INSURER D Hayden,ID 83835 INSURER! INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS INDICATED CERTIFY THAT THE POLICIES TERMI OR CONDIITOND BELOW AVE BEEN ISSUED TO THE INSURED NAMEBOVE FOR THE OF ANY CONTRACT OR OTHER DOCUMENTWITH RESPECT TOL PERIOD WHICH 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 IN is TYPE OF INSURANCE D WVD.p. D POUCH EFF POLICY EXP POLICY NUMBER IMNJDDIYYYYI IMMNB(YYYI LIMITS . A © COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1,000,000 ■ CLAIMS-MADE I X OCCUR X CPA6024808 6/1/2018 8/1/2019 qMM SER IEe oNrv,Eanre) 300,000 ■ MED EXP(Any ens person) 10,000 El1,010,000 PERSONAL&MEV INJURY 1,000,000 GE NI AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE ■ POLICY X Er I I LOC PRODUCTS-COMP/OP AGO 2,000,000 OTHER COMBINED SINGLE LIMIT 1,000,000 A AUTOMOBILE LIABILnY IFa erdtlentl ©ANY AUTO X CPA6024808 8/1/2018 8/1/2019 BODILY INJURY(Pm pemm) III, AUTOS DONLY n AUTOSUpWµLNNEEDpp BODILY INJURY(Per accident) 0 ALTOS ONLY AUTNeONFCY DAMAGE A N UMBRELLA LMB X OCCUR ((EACH OCCURRENCE 6,000,000 ■ EXCESSUAB CLAIMS-MADE CPA6024808 8/1/2018 8/1/2019 AGGREGATE 5,000,000 0E0 X RETENTIONS 0 PER OTH- B AD EMPLYWSCOMPENSATIONLMBIUT X STATUTE FH qNO EMPLOYERe'LMBIUTY 1,000,000 ANYIN WC8748020 ]/112018 ]11/2018 EL EACH ACCIDENT Yamory inTORNARTNEIllECECUTIVE NIA F 1,000,000 OFFICEgfMEMBER EXCLUDED? EL DISEASE-EA EMPLOYEE Ifs.deeryben NH) DES Re¢nDN Fer E L DISEASE�POLICY LIMIT 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONSVEHICLES(ACORD 101,Additional Ramarlu Schedule,may be attached If more agave a required) CoBarker Road Widening Project#0278 Contract 19-087 Primary additional insured if required In written contract to City of Spokane Valley,Spokane County and their officers,elected officials,employees,and agents and Century West Engineering Corporation as It relates to Liability In accordance with the terms and conditions of the policies. Forms attached 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. 10210 E Sprague Avenue Spokane,WA 99206 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ®1986-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD • COMMERCIAL GENERAL LIABILITY CL CG 00 20 01 12 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTOR GENERAL LIABILITY PLATINUM ENDORSEMENT This endorsement modifies insurance provided under the following' COMMERCIAL GENERAL LIABILITY COVERAGE PART A. PROPERTY DAMAGE TO BORROWED EQUIPMENT 1. Paragraph 2.j. of SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY is amended as follows' Paragraphs (3) and (4) of this exclusion do not apply to tools or equipment loaned to you, provided they are not being used to perform operations at the time of loss 2. SECTION III -LIMITS OF INSURANCE is deleted and replaced by the following The most we will pay in any one 'occurrence" for "property damage" to borrowed equipment is $15,000 This limit of insurance is the most we will pay regardless of the number of a. Insureds, b. Claims made or"suits" brought; or c. Persons or organizations making claims or bringing "suits". 3. Deductible a. Our obligation to pay damages on behalf of the insured applies only to the amount of damages in excess of$250 as applicable to property damage as the result of any one "occurrence", regardless of the number of persons or organizations who sustain damages because of that"occurrence". b. The terms of this insurance, including those with respect to our right and duty to defend the insured against any "suits" seeking those damages, and your duties in the event of an "occurrence", claim, or "suit"apply irrespective of the application of the deductible amount. c. We may pay any part or all of the deductible amount to effect settlement of any claim or suit and, upon notification of the action taken; you shall promptly reimburse us for such part of the deductible amount as we have paid. B. CONSTRUCTION PROJECT GENERAL AGGREGATE LIMIT 1. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under COVERAGE A (SECTION I), and for all medical expenses caused by accidents under COVERAGE C (SECTION I), which can be attributed only to ongoing operations at a single construction project away from premises owned by or rented to the insured: a. A Single Construction Project General Aggregate Limit applies to each construction project away from premises owned by or rented to the insured, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. b. The Single Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A, except damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard", and for medical expenses under COVERAGE C regardless of the number of (1) Insureds, (2) Claims made or"suits"brought, or (3) Persons or organizations making claims or bringing"suits". CL CO 00 20 01 12 Includes copyrighted material of Insurance Services Page 1 of 4 Office, Inc,with its permission c. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the Single Construction Project General Aggregate Limit for that construction project away from premises owned by or rented to the insured. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Single Construction Project General Aggregate Limit for any other separate construction project away from premises owned by or rented to the insured. d. The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Single Construction Project General Aggregate Limit. 2. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under COVERAGE A (SECTION I), and for all medical expenses caused by accidents under COVERAGE C (SECTION I), which cannot be attributed only to ongoing operations at a single designated construction project away from premises owned by or rented to the insured' a. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products-Completed Operations Aggregate Limit, whichever is applicable; and b. Such payments shall not reduce any Single Construction Project General Aggregate Limit. 3. When coverage for liability arising out of the "products-completed operations hazard" is provided, any payments for damages because of"bodily injury"or"property damage" included in the"products-completed operations hazard" will reduce the Products-Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit or the Single Construction Project General Aggregate Limit. 4. If the applicable construction project away from premises owned by or rented to the insured has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. 5. The provisions of Limits Of Insurance (SECTION III) not otherwise modified by this endorsement shall continue to apply as stipulated. C. LIMITED JOB SITE POLLUTION 1. Exclusion f. under Section I -Coverage A is replaced by the following' 2. Exclusions This insurance does not apply to' f. Pollution (1) "Bodily injury" or "property damage" arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of"pollutants" (a) At or from any premises, site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured's behalf are performing operations if the operations are to test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of, "pollutants'; or (b) At or from a storage tank or other container, ducts or piping which is below or partially below the surface of the ground or water or which, at any time, has been buried under the surface of the ground or water and then subsequently exposed by erosion, excavation or any other means if the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of"pollutants" arises at or from any premises, site or location which any insured or any contractors or subcontractors working directly or indirectly on any insured's behalf are performing operations if the "pollutants" are brought on or to the premises, site or location in connection with such operations by such insured, contractor or subcontractor. Subparagraph (b)does not apply to"bodily injury"or"property damage"arising out of heat, smoke or fumes from a"hostile fire". (2) Any loss, cost or expense arising out of any. (a) Request, demand, order or statutory or regulatory requirement issued or made pursuant to any environmental protection or environmental liability statutes or regulations that any insured test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of, "pollutants", or Page 2 of 4 Includes copyrighted material of Insurance Services CL CG 00 20 01 12 Office, Inc,with its permission (b) Claim or suit by or on behalf of a governmental authority for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying, or neutralizing or in any way responding to or assessing the effects of, "pollutants". However, this paragraph does not apply to liability for those sums the insured becomes legally obligated to pay as damages because of"property damage"that the insured would have in the absence of such request, demand, order or statutory or regulatory requirement, or such claim or"suit"by or on behalf of a governmental authority 2. Wth respect to "bodily injury" or "property damage" arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of 'pollutants": a. The"Each Occurrence Limit"shown in the Declarations does not apply. b. Paragraph 7. of Limits Of Insurance (Section III) does not apply. c. Paragraph 1. of Section III -Limits Of Insurance is replaced by the following. The Limits Of Insurance shown in this endorsement, or in the Declarations and the rules below fix the most we will pay regardless of the number of: (1) Insureds; (2) Claims made or"suits" brought, or (3) Persons or organizations making claims or bringing "suits". d. The following are added to Section III -Limits Of Insurance: 8. Subject to 2.or 3. above,whichever applies,the most we will pay for the sum of. a. Damages under Coverage A; and b. Medical expenses under Coverage C because of "bodily injury' or "property damage" arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of"pollutants" is$100,000 aggregate. 9. Subject to 8. above, the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of"bodily injury" sustained by any one person arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of"pollutants". D. VOLUNTARY PROPERTY DAMAGE • 1. The following is added to Section 1 -COVERAGES: We will pay, at your request for"property damage"to that part of any property. a. Which you or any subcontractors working directly or indirectly on your behalf are performing operations; or b. That must be restored, repaired or replaced because "your work"was incorrectly performed on it. This insurance applies only to "property damage' to property of others while in your care, custody, or control, and arising out of operations away from your insured premises and incidental to your business. Exclusions J.(3),(4),(5)and (6) do not apply to this coverage. This insurance does not apply to "property damage" included within the "explosion hazard", the "collapse hazard"or the"underground property damage hazard". 2. For the purposes of the coverage provided by D. VOLUNTARY PROPERTY DAMAGE, SECTION III - LIMITS OF INSURANCE is replaced by the following: A. Limits of Insurance 1. Unless a higher limit is shown in the Declarations, the most we will pay in any one"occurrence"for "property damage" under this endorsement is$15,000. 2. Unless a higher limit is shown in the Declarations, the most we will pay for all covered "occurrences" during any one policy period is$15,000 Aggregate Limit of Insurance. CL CG 00 20 01 12 Includes copyrighted material of Insurance Services Page 3 of 4 Office, Inc.,with its permission The Limits of Insurance of this endorsement apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the policy period is extended after issuance for an additional period of less than 12 months. In that case, the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. 3. Deductible a. Our obligation to pay damages on behalf of the insured applies only to the amount of damages in excess of $250 as the result of any one "occurrence", regardless of the number of persons or organizations who sustain damages because of that"occurrence" b. The terms of this insurance, including those with respect to our right and duty to defend the insured against any"suits" seeking those damages, and your duties in the event of an "occurrence", claim, or"suit" apply irrespective of the application of the deductible amount. c. We may pay any part or all of the deductible amount to effect settlement of any claim or suit and, upon notification of the action taken,you shall promptly reimburse us for such part of the deductible amount as we have paid. 4. For the purposes of the coverage provided by D.VOLUNTARY PROPERTY DAMAGE, SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: a. The following is added to paragraph 2. Duties In The Event Of Occurrence, Offense, Claim or Suit In the event of loss covered by this endorsement, the insured shall, if requested by us, replace the property or furnish the labor and matenals necessary for repairs at actual cost to the insured, excluding prospective profit or overhead charges of any nature. Any property so paid for or replaced shall, at our option, become our property Any payment made by us shall not constitute an admission of liability by an insured, or by us. b. Paragraph 4. Other Insurance is amended as follows' (1) Paragraph 4.a. Primary Insurance is deleted. (2) Subparagraphs (1) and (2) of paragraph 4.b. Excess Insurance are deleted and replaced with the following This insurance is excess over any of the other insurance, whether primary, excess, contingent or on any other basis. All other provisions that apply to paragraph 4. Other Insurance contained in the Commercial General Liability Coverage Form are applicable. 5. For the purposes of the coverage provided by D. VOLUNTARY PROPERTY DAMAGE, the following definitions are added to SECTION V-DEFINITIONS. a. "Collapse hazard" includes "structural property damage" and any resulting "property damage" to any other property at any time b. "Explosion hazard" includes"property damage" arising out of blasting or explosion. The"explosion hazard" does not include "property damage" arising out of the explosion of air or steam vessels, piping under pressure, prime movers, machinery or power transmitting equipment. c. "Structural property damage" means the collapse of or structural injury to any building or structure due to (1) Grading of land, excavating, borrowing, filling, back-filling, tunneling, pile driving, cofferdam work or caisson work; or (2) Moving, shoring, underpinning, raising or demolition of any building or structure or removal or rebuilding of any structural support of that building or structure. d. "Underground property damage hazard" includes "underground property damage" and any resulting"property damage"to any other property at any time e. "Underground property damage" means "property damage" to wires, conduits, pipes, mains, sewers, tanks, tunnels, any similar property, and any apparatus used with them beneath the surface of the ground or water, caused by and occurring during the use of mechanical equipment for the purpose of grading land, paving, excavating, drilling, borrowing, filling, back-filling or pile driving. Page 4 of 4 Includes copyrighted material of Insurance Services CL CG 00 20 01 12 Office, Inc., with its permission COMMERCIAL GENERAL LIABILITY CLCG01140916 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION (ADDITIONAL INSURED) This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART Paragraph (v) is added to Paragraph (1)(a) of Paragraph b. Excess Insurance under Paragraph 4. Other Insurance of Section IV—Commercial General Liability Conditions, as follows (1) This insurance is excess over. (a) Any of the other insurance, whether primary, excess, contingent or on any other basis: (v) That is available to any person or organization who has been added as an additional insured to this policy by endorsement. However,with respect to an additional insured added by endorsement for liability caused, in whole or in part 1. By your acts or omissions, or the acts or omissions of those acting on your behalf (a) In the performance of your ongoing operations, or (b) In connection with your premises, 2. By your maintenance, operation or use of equipment leased to you by such person or organization; or 3. By "your work" performed for that additional insured and included in the "products-completed operations hazard', this insurance shall be primary to and will not seek contribution from the additional insured's own insurance if you and such additional insured have agreed prior to loss in a written contract or written agreement, in effect during this policy period, that this insurance be primary and noncontributory as respects liability described in Subparagraph (1)(a)(v)1., (1)(a)(v)2. or (1)(a)(v)3. above. However, this insurance, in all cases, is excess over any other liability insurance available to the additional insured to which such person or organization has been added as an additional insured CL CG 01 14 09 16 Includes copyrighted material of Insurance Services Office, Inc. Page 1 of 1 with its permission COMMERCIAL GENERAL LIABILITY CL CG 01 74 0916 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF INSURED CONTRACT DEFINITION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LABILITY COVERAGE PART The definition of insured contract" in the Definitions on your behalf are replaced by the words section is replaced by the following: arising out of"your work". 9. "Insured contract" means 3. Any coverage required by a contract or agreement wilt not be broader than that a. A contract for a lease of premises. However, which you are required by the contract or that portion of the contract for a lease of prem- ises that indemnifies any person or organiza- tion agreement to provide. for damage by fire to premises while Paragraph f. does not include that part of any rented to you or temporarily occupied by you contract or agreement: with permission of the owner is not an"insured (1) That indemnifies a railroad for"bodily contract", injury" or "property damage" arising b. A sidetrack agreement; out of construction or demolition oper- ations, within 50 feet of any railroad c. Any easement or license agreement, except in connection with construction or demolition property and affecting any railroad operations on or within 50 feet of a railroad, bridge or trestle,underpass tracks, road-beds,g, tunnel, or crossing, d. An obligation, as required by ordinance,to in- (2) That indemnifies an architect, engi- demnify a municipality, except in connection neer or surveyor for injury or damage with work for a municipality, arising out of e. An elevator maintenance agreement, or (a) Preparing, approving, or failing to f. 1. That part of any other contract or agree- prepare or approve, maps, shop ment pertaining to your business (includ- drawings, opinions, reports, Sur- ing an indemnification of a municipality in veys, field orders, change orders connection with work performed for a mu- or drawings and specifications, or nicipality) under which you assume the (b) Giving directions or instructions, tort liability of another party to pay for or failing to give them, if that is the "bodily injury' or "property damage" to a primary cause of the injury or third person or organization, provided the damage, or "bodily injury or "property damage" is caused, in whole or in part, by you or by (3) Under which the insured, if an archi- those acting on your behalf. tect, engineer or surveyor, assumes However, such part of a contract or agree- liability for an injury or damage arising il- ment shall onlybe considered an"insured out toothe renderinsprofessional rendering or fe ure stedin ) services,nand contract"to the extent your assumption of including those listed in(2)above and the tort liability is permitted by law.Tort Ii- supervisory, inspection, architectural, ability means a liability that would be im- or engineering activities. posed by law in the absence of any con- tract or agreement. 2. If the written contract reference in f.l. above specifically requires indemnffica- tion on an arising out of basis,then in par- agraph f.1. above, the words is caused in whole or in part by you or by those acting CL CG 01 74 09 16 Includes copyrighted material of Insurance Services Page 1 of 1 Office, Inc.,with its permission • COMMERCIAL GENERAL LIABILITY CL CG 04 92 09 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY ULTRA PLUS ENDORSEMENT This endorsement modifies insurance provided under the following. COMMERCIAL GENERAL LIABILITY COVERAGE PART SUMMARY OF COVERAGE EXTENSIONS Provision Name Of Coverage Extension Included or Limit of Insurance A. Miscellaneous Additional Insureds Included B Expected Or Intended Injury Or Damage Included C. Knowledge Of Occurrence Included D. Legal Liability—Damage To Premises Rented To You (Fire, Lightning, $300,000 Explosion, Smoke, Or Leakage From Automatic Fire Protective Systems) E. Medical Payments $10,000 F. Mobile Equipment Redefined Included G. Newly Formed Or Acquired Organization, Partnership Or Limited Liability Included Company And Extended Period Of Coverage H. Who Is An Insured—Amendment Included Non-Owned Watercraft(Increased to maximum length of less than 51 Included feet) J. Supplementary Payments—Increased Limits 1. Bail Bonds $3,000 2. Loss Of Earnings $ 1,000 K. Unintentional Omission Or Unintentional Error In Disclosure Included L. Waiver Of Transfer Of Rights Of Recovery Against Others Included M. Liberalization Clause Included N. Incidental Medical Malpractice Included The above is a summary only. Please consult the specific provisions that follow for complete information on the extensions provided. The provisions of the Commercial General Liability additional insured on your policy, provided Coverage Part apply except as otherwise provided in that this endorsement. This endorsement applies only if a. The written contract or written agreement such Coverage Part is included in this policy is' A. MISCELLANEOUS ADDITIONAL INSUREDS (1) Currently in effect or becoming 1. Section II —Who Is An Insured is amended effective during the term of this to include as an insured any person or policy, and organization (referred to as an additional (2) Fully executed by you and the insured below) described in Paragraphs additional insured prior to the "bodily A.1.c.(1) through A.1.c.(8) below when you injury", "property damaget or "per- and such person or organization have agreed sonal and advertising injury" in writing in a contract or agreement that such person or organization be added as an CL CG 04 92 09 16 Includes copyrighted matenal of Insurance Services Office, Inc., Page 1 of 7 with its permission b. The insurance afforded by this provision performed by or on behalf of does not apply to any person or such additional insured. organization included as an additional (4) Lessor Of Leased Equipment insured by a separate endorsement issued by us and made a part of this Any person(s) or organization(s) policy or coverage part. from whom you lease equipment but only with respect to liability for"bodily c. Only the following persons or organa- injury", "property damage or "per- zations are additional insureds under this provision, with for such sonal and advertising injury" caused, p coverage 9 in whole or in part, by your additional insureds limited as provided maintenance, operation or use of herein equipment leased to you by such (1) Managers Or Lessors Of Premises person(s) or organization(s). A manager or lessor of premises but A person's or organization's status only with respect to liability arising as an additional insured under this out of the ownership, maintenance or endorsement ends when their written use of that part of the premises contract or written agreement with leased to you and subject to the you for such leased equipment ends. following additional exclusions This insurance does not apply to any This insurance does not apply to. "occurrence" which takes place after (a) Any "occurrence" which takes the equipment lease expires. place after you cease to be a (5) State, Municipality, Governmental tenant in that premises. Agency Or Subdivision Or Other Political Subdivision — Permits Or (b) Structural alterations, new con- Authorizations Relating To struction or demolition operations Premises performed by or on behalf of such additional insured Any state, municipality, govern- mental agency or subdivision or (2) Mortgagee, Assignee Or Receiver other political subdivision subject to A mortgagee, assignee, or receiver the following additional provisions. but only with respect to their liability (a) This insurance applies only with as mortgagee, assignee, or receiver respect to and arising out of the ownership, maintenance, or use of a covered (i) The following hazards for premises by you which the state, municipality, governmental agency or This insurance does not apply to subdivision or other political structural alterations, new con- subdivision has issued a struction or demolition operations permit or authorization in performed by or on behalf of such connection with premises additional insured. you own, rent or control and (3) Owners Or Other Interests From to which this insurance Whom Land Has Been Leased applies An owner or other interest from (1.1) The existence, whom land has been leased to you maintenance, repair, but only with respect to liability construction, erection arising out of the ownership, mainte- or removal of adver- nance or use of that pail of the land tising signs, awnings, leased to you and subject to the canopies, cellar following additional exclusions. entrances, coal holes, driveways, manholes, This insurance does not apply to marquees, hoist away (a) Any "occurrence" which takes openings, sidewalk place after you cease to lease vaults, street banners that land. or decorations and similar exposures, or (h) Structural alterations, new con- struction or demolition operations CL CG 04 92 09 16 Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 7 with its permission (1.2) The construction, erec- The insurance afforded the tion or removal of vendor does not apply to- elevators; or (I) "Bodily injury" or "property (1.3) The ownership, main- damage" for which the tenance or use of any vendor is obligated to pay elevators covered by damages by reason of the this insurance. assumption of liability in a written contract or written (II) Operations performed by you agreement. This exclusion or on your behalf for which does not apply to liability for the state, municipality, damages that the vendor governmental agency or would have in the absence of subdivision or other political the written contract or written subdivision has issued a agreement; permit or authorization. This insurance does not apply to (ii) Any express warranty unau- (b) thorized by you; "bodily injury", "property dam- age"or"personal and advertising (iii)Any physical or chemical injury" arising out of operations change in the product made performed for the state, munici- intentionally by the pality, governmental agency or vendor, subdivision or other political (iv) Repackaging, except when subdivision unpacked solely for the (6) Controlling Interest purpose of inspection, Any person(s) or organization(s) with demonstration, testing, or the a controllinginterest in the Named substitution of parts enu- instructions from the menu- Insured Insured but only with respect to their facturer, and then liability arising out of- repackaged in the original (a)Their financial control of you; or container; (b) Premises they own, maintain or (v) Any failure to make such control while you lease or occupy inspections, adjustments, these premises. tests or servicing as the vendor has agreed to make This insurance does not apply to PPY or normally undertakes to structural alterations, new con- make in the usual course of struction or demolition operations business, in connection with performed by or for such person(s) the distribution or sale of the or organization(s). products, (7) Co-Owner Of Insured Premises (vi) Demonstration, installation, A co-owner of a premises co-owned servicing or repair opera- by you and covered under this tions, except such operations insurance but only with respect to the performed at the vendor's co-owner's liability as co-owner of premises in connection with such premises. the sale of the product; (8) Vendors (vll) Products which, after(a) distrl- Anyperson(s) or organization(s) button or sale by you, have P O been labeled or relabeled or (referred to as vendor), but only used as a container, part or with respect to "bodily injury" or ingredient of any other thing "property damage" arising out of or substance by or for the "your products" which are vendor, or distributed or sold in the regular course of the vendor's business CL CG 04 92 09 16 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 7 with its permission (viii)"Bodily injury or "property 3. With respect to the insurance afforded to the damage" arising out of the additional insureds within this Provision A. sole negligence of the Miscellaneous Additional Insureds, the vendor for its own acts or following is added to Section III — Limits Of omissions or those of its Insurance: employees or anyone else The most we will pay on behalf of the acting on its behalf. How- additional insured is the amount of insurance- ever, this exclusion does not apply to a. Required by the written contract or (1.1) The exceptions written agreement; or contained in Sub- b. Available under the applicable Limits Of paragraphs (iv) or (vi); Insurance shown in the Declarations, of whichever is less. (1.2) Such inspections, ad- This endorsement shall not increase the justments, tests or applicable Limits Of Insurance shown in the servicing as the Declarations. vendor has agreed to make or normally B. EXPECTED OR INTENDED INJURY OR undertakes to make in DAMAGE the usual course of Exclusion 2.a. Expected Or Intended Injury of business, in con- Section I — Coverage A — Bodily Injury And nechon with the Property Damage Liability is deleted and disthe producn or sale of replaced by the following' the products. (b) This insurance does not apply to a. Expected Or Intended Injury Or Damage any insured person or organa- "Bodily injury or"property damage" expected zation, from whom you have or intended from the standpoint of the acquired products, or any insured This exclusion does not apply to ingredient, part or container, "bodily injury" or "property damage" resulting entering into, accompanying or from the use of reasonable force to protect containing such products. persons or property 2. With respect to coverage provided by this C. KNOWLEDGE OF OCCURRENCE Provision A. Miscellaneous Additional Insureds, the following additional provisions Paragraph 2.a. Duties In The Event Of apply Occurrence, Offense, Claim Or Suit of Section IV— Commercial General Liability Conditions a. Any insurance provided to an additional is deleted and replaced by the following insured designated under Paragraphs A.1.c.(1) through A.1.c.(e) above does a. You must see to it that we are notified as not apply. soon as practicable of an "occurrence" or an offense which may result in a claim only (1) To "bodily injury' or "property when the "occurrence" or offense is known damage" included within the to. "products-completed operations (1) You, if you are an individual; hazard", or (2) To "bodily injury", "property damage" (2) A partner, if you are a partnership; or "personal and advertising injury' (3) A manager, if you are a limited liability arising out of the sole negligence of company, or such additional insured (4) An "executive officer" or the "employee" b. The insurance afforded to such additional designated by you to give such notice, if insured only applies to the extent you are an organization other than a permitted by law. partnership or a limited liability company. c. The insurance afforded to such additional To the extent possible, notice should include: insured will not be broader than that which you are required to provide by the (i) How, when and where the "occurrence" written contract or written agreement. or offense took place; CL CG 04 92 09 16 Includes copyrighted material of Insurance Services Office, Inc., Page 4 of 7 with its permission (ii) The names and addresses of any injured you, or in the case of damage by fire, persons and witnesses, and lightning, explosion, "smoke", or leakage from automatic fire protective systems, (iii)The nature and location of any injury or while rented to you or temporarily damage arising out of the "occurrence" occupied by you with permission of the or offense. owner D. LEGAL LIABILITY — DAMAGE TO PREMISES This limit will apply to all damage RENTED TO YOU (Fire, Lightning, Explosion, proximately caused by the same event, Smoke, Or Leakage From Automatic Fire whether such damage results from fire, Protective Systems) lightning, explosion, "smoke", leakage If damage to premises rented to you is not from automatic fire protective systems, or otherwise excluded from this policy or coverage other covered causes of loss or any part,then the following provisions apply. combination thereof. 1. Under Section I — Coverage A — Bodily 4. Subparagraph b.(1)(a)(II) of Paragraph 4. Injury And Property Damage Liability, the Other Insurance of Section IV — last paragraph (after the exclusions) is Commercial General Liability Conditions deleted and replaced by the following: is deleted and replaced by the following. Exclusions c.through n. do not apply to dam- (Ii) That is fire, lightning, explosion, "smoke" age by fire, lightning, explosron, "smoke", or or leakage from automatic fire protective leakage from automatic fire protective systems insurance for premises rented to systems to premises while rented to you or you or temporarily occupied by you with temporarily occupied by you with the permission of the owner; permission of the owner. A separate limit of 5. Subparagraph a. of Definition 9. "Insured insurance appkes to this coverage as contract" of Section V — Definitions is described in Section III — Limits Of deleted and replaced by the following: Insurance. a. A contract for a lease of premises 2. The paragraph immediately after Sub- paragraph j.(6) of Paragraph 2. Exclusions a lease that portion of the indemnifies for of Section I — Coverage A — Bodily Injury a lease of premises that for d m ag any And Property Damage Liability is deleted person or organization for damage by and replaced by the following fire, lightning, explosion, "smoke" or leakage from automatic fire protective Paragraphs (1), (3) and (4) of this exclusion systems to premises while rented to you do not apply to "property damage" (other or temporarily occupied by you with than damage by fire, lightning, explosion, permission of the owner is not an "smoke", or leakage from automatic fire "insured contract". protective systems) to premises, including 6. As used in this Provision D. Legal Liability — the contents of such premises, rented to you Damage To Premises Rented To You for a period of seven or fewer consecutive days. A separate limit of insurance applies to "Smoke" does not include smoke from Damage To Premises Rented To You as agricultural smudging, industrial operations descnbed in Section III — Limits Of or"hostile fire". Insurance. E. MEDICAL PAYMENTS 3. Paragraph 6. of Section III — Limits Of If Coverage C — Medical Payments is not Insurance is deleted and replaced by the otherwise excluded from this policy or coverage follownng part, the Medical Expense Limit is changed, 6. Subject to Paragraph 5. above, the subject to the terms of Section III — Limits Of greater of Insurance,to the greater of: a. $300,000; or a. $10,000, or b. The Damage To Premises Rented b. The Medical Expense Limit shown in the To You Limit shown in the Declarations. Declarations, F. MOBILE EQUIPMENT REDEFINED is the most we will pay under Coverage Subparagraph f.(1) of Definition 12. "Mobile A for damages because of "property equipment" of Section V—Definitions is deleted damage" to premises while rented to and replaced by the following CL CG 04 92 09 16 Includes copyrighted matenal of Insurance Services Office, Inc., Page 5 of 7 with its permission (1) Equipment with a gross vehicle weight of partnership or limited liability company 1,000 pounds or more and designed primarily are the same or similar to the operations for, of insureds already covered under this insurance, (a) Snow removal; Road maintenance, but not construction (v) Coverage only applies for those limited (b) liability companies who have established or resurfacing; or a date of formation as recorded within (c) Street cleaning, the filed state articles of organization, certificates of formation or certificates of G. NEWLY FORMED OR ACQUIRED ORGANIZA- organization; and TION, PARTNERSHIP OR LIMITED LIABILITY COMPANY AND EXTENDED PERIOD OF (vi) Coverage only applies for those part- COVERAGE nerships who have established a date of formation as recorded within a written Paragraph 3. of Section II —Who Is An Insured partnership agreement or partnership is deleted and replaced by the following certificate. 3. Any organization you newly acquire or form, H. WHO IS AN INSURED—AMENDMENT other than a joint venture, and over which you maintain ownership or The last paragraph of Section II — Who Is An a. Majority interest of more than 50% if you Insured is deleted and replaced by the following are a corporation, No person or organization is an insured with b. Majonty interest of more than 50% as a respect to the conduct of any: general partner of a newly acquired or a. Current partnership or limited liability formed partnership, and/or company, unless otherwise provided for c. Majority interest of more than 50% as an under Paragraph 3. of Section II — Who Is 1 YAn Insured, owner of a newly acquired or formed limited liability company, b. Current joint venture, or will qualify as a Named Insured if there is no c. Past partnership, joint venture or limited other similar insurance available to that liability company, organization However, for these organiza- that is not shown as a Named Insured in the tons' Declarations (i) Coverage under this provision is afforded I. NON-OWNED WATERCRAFT only until the next anniversary date of this policy's effective date after you Subparagraph (2) of Exclusion 2.g. Aircraft, acquire or form the organization, Auto Or Watercraft of Section I — Coverage A partnership or limited liability company, —Bodily Injury And Property Damage Liability or the end of the policy period, whichever is deleted and replaced by the following is earlier, (2) A watercraft you do not own that is (ii) Section I— Coverage A— Bodily Injury (a) Less than 51 feet long, and And Property Damage Liability does not apply to "bodily injury" or "property (b) Not being used to carry persons or damage" that occurred before you property for a charge. acquired or formed the organization, J. SUPPLEMENTARY PAYMENTS—INCREASED partnership or limited liability company, LIMITS (Ili)Section I — Coverage B — Personal Section I — Supplementary Payments — And Advertising Injury Liability does Coverages A And B is changed as follows not not apply to "personal and advertising injury' arising out of an offense 1. The limit shown in Paragraph 1.b. for the committed before you acquired or formed cost of bail bonds is changed from $250 to the organization, partnership or limited $3,000, and liability company, 2. The limit shown in Paragraph 1.d. for loss of (iv) Coverage applies only when operations earnings because of time off from work is of the newly acquired organization, changed from $250 a day to$1,000 a day CL CG 04 92 09 16 Includes copyrighted material of Insurance Services Office, Inc., Page 6 of 7 with its permission K. UNINTENTIONAL OMISSION OR UNINTEN- M. LIBERALIZATION CLAUSE TIONAL ERROR IN DISCLOSURE The following is added to Section IV — The following provision is added to Paragraph 6. Commercial General Liability Conditions: Representations of Section IV — Commercial If we adopt a mandatory attachment form change General Liability Conditions: which broadens coverage under this edition of However, the unintentional omission of, or the Commercial General Liability CG0001 for no unintentional error in, any information given or additional charge, and those changes are provided by you shall not prejudice your rights intended to apply to all insureds under this edition under this insurance. of CG0001, that change will automatically apply to your insurance as of the date we implement This provision does not affect our right to collect additional premium or to exercise our right of clausea change in yaoury state. This ed cancellation or non-renewal through does not ion to changes implementedf introduction of a subsequent edition of L. WAIVER OF TRANSFER OF RIGHTS OF the Commercial General Liability form CG0001 RECOVERY AGAINST OTHERS N. INCIDENTAL MEDICAL MALPRACTICE The following is added to Paragraph 8. Transfer 1. Paragraph 2.a.(1)(d) of Section II — Who Is Of Rights Of Recovery Against Others To Us An Insured does not apply to a physician, of Section IV — Commercial General Liability nurse practitioner, physician assistant, nurse, Conditions' emergency medical technician or paramedic We waive any right of recovery we may have employed by you if you are not in the against any person or organization because of business or occupation of providing medical, payments we make for injury or damage arising paramedical, surgical, dental, x-ray or out of your ongoing operations or"your work"and nursing services. included in the "products-completed operations 2. This provision is excess over any other valid hazard" when you have agreed in a written and collectible insurance whether such contract or written agreement that any right of insurance is primary, excess, contingent or recovery is waived for such person or on any other basis. Any payments by us will organization. This waiver applies only to the follow Paragraph 4.b. of Section IV — person(s) or organization(s) agreed to in the Commercial General Liability Conditions written contract or written agreement and is subject to those provisions. This waiver does not apply unless the written contract or written agreement has been executed prior to the"bodily injury" or"property damage". However, if any person or organization is separately scheduled on a separate waiver of transfer of rights of recovery which is attached to this policy, then this waiver does not apply. CL CG 04 92 09 16 Includes copyrighted material of Insurance Services Office, Inc., Page 7 of 7 with its permission COMMERCIAL GENERAL LIABILITY CL CG 05 29 09 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY ULTRA PLATINUM ENHANCEMENT COVERAGES This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM A. The following coverage is added: paragraph 2.a. above,the words caused in ADDITIONAL INSURED - OWNERS, LESSEES whole in part are replaced by the OR CONTRACTORS - AUTOMATIC STATUS words arrising out off.. INCLUDING PRIMARY NON-CONTRIBUTORY c. The insurance afforded to such additional 1. Section II -Who is An Insured is amended to insured only applies to the extent include as an additional insured any person(s) permitted by law; and or organization(s) for whom you are required d. If coverage provided to the additional by virtue of a written contract or agreement insured is required by a contract or that such person(s) or organization(s) be agreement, the insurance afforded to such added as an additional insured on your policy. additional insured will not be broader than to the additional that which you are required by the contract 2. The insurance providedor agreement to provide for such insured is limited as follows. additional insured a. Such person or organization is an e. This insurance ends at the earliest of the additional insured only with respect to following times: liability for "bodily injury', "property damage" or "personal and advertising (1) When any Named Insured(s) work injury"caused in whole or in part by called for in the wntten contract has (1) Acts or omissions of the Named been completed Insured; or (2) When all of any Named Insured(s) (2) The acts or omissions of those actingwork done at a job site has been completed if the written contract calls on behalf of the Named Insured, for work at more than one job site in the performance of the Named Insureds (3) When that part of any Named work for the additional insured(s) specified Insured(s) work done at a job site has in the written contract provided the been put to its intended use by any contract or agreement requires you to person or organization other than the provide the additional insured such Named Insured or those acting on the coverage and is: Named Insured(s) behalf i. Currently in effect or becomes Work that may need service, maintenance, effective during the term of this correction, repair or replacement, but is policy, and otherwise complete, will be treated as ii. Was executed prior to the "bodily completed injury', "property damage" or f. This insurance does not apply to any "personal and advertising injury" additional insured scheduled on your b. If the written contract specifically requires policy by separate endorsement. you to provide additional insured coverage g. For purposes of paragraph A. of this via the 10/01 edition of CG2010 (aka CG endorsement, the terms "you" and "your" 20 10 10 01) or via the 11/85 edition of refer to the Named Insured shown in the CG2010 (aka CG 20 10 11 85), then in Declarations CL CG 05 29 0916 Includes copyrighted material of Insurance Services Page 1 of 3 Office, Inc., with its permission 3. Exclusions b. Available under the applicable Limits of With respect to the insurance afforded to these Insurance shown in the Declarations, additional insureds, the following additional whichever is less. exclusions apply to 'bodily injury", "property This endorsement shall not increase the damage' or "personal and advertising injury' applicable Limits of Insurance shown in the arising out of Declarations a. The rendering of or failure to render any 5. Other Insurance professional services by you or on your behalf, but only with respect to either or For purposes of this endorsement, the both of the following operations following is added to the Section IV - (1) Providing engineering, architectural or Commercial General Liability Conditions, 4. surveying services to others in your Other capacityInouranct condition and supersedes any as an engineer, architect or provision to the contrary. surveyor, and (2) This insurance is excess of all other Providing, or hiring independent professionals to provide, engineering, insurance available to ma , ess, architectural or surveying services in insuredonwhether on t primary, excess,t, i connection with construction work you contingent or any other basis. But, if perform. required by a written contract or written agreement to be primary and b. Subject to Paragraph c. below, noncontributory, this insurance will be professional services include primary to and will not seek contribution from any insurance on which the additional (1) Preparing, approving, or failing to insured is a Named Insured. prepare or approve, maps, shop drawings, opinions, reports, surveys, No other coverage or limit in the policy field orders, change orders, or applies to loss or damage insured by this drawings and specifications, and coverage. (2) Supervisory or inspection activities B. The following coverage is added: performed as part of any related CONTRACTUAL LIABILITY-RAILROADS architectural or engineering activities. c. Professional services do not include 1. With respect to operations performed for a construction means, Railroad within 50 feet of railroad property, the services within methods, techniques, sequences and definition of "insured contract" in Section V - procedures employed by you or performed Definitions is replaced by the following. by or for the construction manager, its 9. "Insured Contract"means. employees or its subcontractors in ' a. A contract for a lease of premises. connection with your ongoing operations. However, that portion of the contract This exclusion applies even if the claims for a lease of premises that against any insured allege negligence or other indemnifies any person or wrongdoing in the supervision, hiring, organization for damage by fire to employment, training or monitoring of others premises while rented to you or by that insured, if the "occurrence" which temporarily occupied by you with caused the "bodily injury' or "property permission of the owner is not an damage", or the offense which caused the "insured contract", "personal and advertising injury", involved the b. A sidetrack agreement, rendering of, or the failure to render, any professional architectural, engineering or c. Any easement or license agreement; surveying services. • d. An obligation, as required by 4. Limits of Insurance ordinance, to indemnify a municipality, With respect to the insurance afforded to these except in connection with work for a additional insureds, the following is added to municipality; Section III -Limits Of Insurance. e. An elevator maintenance agreement; If coverage provided to the additional insured f. That part of any other contract or is required by a contract or agreement, the agreement pertaining to your business most we will pay on behalf of the additional (including an indemnification of a insured is the amount of insurance: municipality in connection with work a. Required by the contract or agreement, or performed for a municipality) under Page 2 of 3 Includes copyrighted material of Insurance Services CL CG 05 29 09 16 Office, Inc., with its permission • which you assume the tort liability of pay settlements or judgments will be reduced, and another party to pay for "bodily injury' may be exhausted, by defense expenses. or property damage" to a third person The following is added to paragraph 14. "Personal or organization. Tort liability means a and advertising injury" SECTION V- liability that would be imposed by law DEFINITIONS OF COMMERCIAL GENERAL in the absence of any contract or LIABILITY COVERAGE FORM: agreement. Paragraph f. does not include that part h. "Non-employment discrimination" means of any contract or agreement: violation of a person's civil rights with That indemnifies an architect, respect to such person's race, color, (1) national origin, religion, gender, marital engineer or surveyor for injury or status, age, sexual orientation or damage arising out of• preference, physical or mental condition, (a) Preparing, approving or failing or any other protected class or to prepare or approve maps, characteristic established by any federal, shop drawings, opinions, state or local statutes, rules or regulations. reports, surveys, field orders, "Non-employment discrimination" does not change orders or drawings include violation of civil rights arising out of and specifications, or past, present or prospective employment. (b) Giving directions or Any obligation to the insured to pay "non- instructions, or failing to give employment discrimination" liability damages them, if that is the primary on your behalf applies only to the amount of cause of the injury or damage; damages in excess of $5,000 deductible as Under which the insured, if an the result of any one offense regardless of the (2) number of persons or organizations who architect, engineer or surveyor, sustain damages because of the offense assumes liability for an injury or damage arising out of the The most we will pay for all damages for"non- insured's rendering or failure to employment discrimination" is 515,000 annual render professional services, aggregate. No other liability to pay sums or including those listed in Paragraph perform acts or services is covered. (1) above and supervisory, Supplementary Payments -Coverage A and inspection, architectural or B do not apply to non-employment engineering activities discrimination. 2. Other Insurance D. AGGREGATE LIMITS OF INSURANCE For purposes of this endorsement, the The General Aggregate Limit under SECTION III - following is added to the Section IV- LIMITS OF INSURANCE applies separately to Commercial General Liability each of your: Conditions, 4. Other Insurance condition and supersedes any provision to the 1. Projects away from premises owned by or contrary rented to you This insurance is excess of all other 2. "Locations" owned by or rented to you. insurance that is Railroad Protective "Location" means premises involving the same Liability or similar coverage for"your work" or connecting lots, or premises whose performed for a Railroad. But, if required connection is interrupted only by a street, by a written contract or written agreement roadway, waterway or right-of-way of a to be primary and noncontributory, this railroad. insurance will be primary to and will not seek contribution from any insurance on When paragraph B.Construction Project which the Railroad is a Named Insured. General Aggregate Limit on form CL CG 00 20 is No other coverage or limit in the policy a part of this policy,then this endorsement applies to loss or damage insured by this CL CG 05 29 paragraph D. Aggregate Limits Of Insurance does not apply. coverage. C. The following coverage is added: NON-EMPLOYMENT DISCRIMINATION LIABILITY This coverage contains a DEFENSE WITHIN LIMIT provision The limit of liability for "Non- employment discrimination" coverage available to CL CG 05 29 0916 Includes copyrighted material of Insurance Services Page 3 of 3 Office, Inc.,with its permission COMMERCIAL GENERAL LIABILITY CL CG 20 71 09 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES, CONTRACTORS OR OTHERS - COMPLETED OPERATIONS - AUTOMATIC STATUS, INCLUDING PRIMARY NONCONTRIBUTORY This endorsement modifies insurance provided under the following. COMMERCIAL GENERAL LIABILITY COVERAGE PART A. SECTION II -WHO IS AN INSURED is amended For purposes of this endorsement,throughout to include as an additional insured any person(s) the policy, the terms"you" and "your refer to or organization(s) when you are obligated by the Named Insured shown in the Declarations. virtue of a written contract or agreement that B. Exclusions such person or organization(s) be added as an additional insured to your policy. With respect to the insurance afforded to these Such person(s) or organization(s) is an additional additional insureds, the following additional insured only with respect to liability for "bodily exclusions apply to "bodily Injury' and "property injury' or "property damage" or "personal and damage" arising out of: advertising injury"caused, in whole or in part by: 1. The rendering of or failure to render any (1) Acts or omissions of the Named Insured; professional services by you or on your behalf, but only with respect to either or both of the of following operation s- (2) The acts or omissions of those acting on a. Providing engineering, architectural or behalf of the Named Insured, surveying services to others in your and included in the "products-completed capacity as an engineer, architect or operations hazard" surveyor; and This insurance applies only when you are required b. Providing, or hiring Independent to add the additional insured by virtue of a written professionals to provide, engineering, contract or agreement, provided the contract or architectural or surveying services in agreement is connection with construction work you 1. Currently in effect or becomes effective during perform. the term of this policy, and This exclusion applies even if the claims against any insured allege negligence or other 2. Was executed prior to the "bodily injury" or wrongd"property damage" or "personal and oing in the supervision, hiring, advertisingu employment, training or monitoring of others by injury".ry , that insured, if the"occurrence"which caused the However "bodily injury'or"property damage",or the offense a. The insurance afforded to such additional which caused the "personal and advertising Insured only applies to the extent permitted by injury", involved the rendering of, or the failure to law, and render,any professional architectural,engineering or surveying services. b. If coverage provided to the additional insured 2, Subject to Paragraph 3. below, professional is required by a contract or agreement, the services include' insurance afforded to such additional insured will not be broader than that which you are a. Preparing, approving, or failing to prepare required by the contract or agreement to or approve, maps, shop drawings, provide for such additional insured. opinions, reports, surveys, field orders, change orders, or drawings and specifications; and CL CG 20 71 09 16 Includes copyrighted material of Insurance Services Page 1 of 2 Office, Inc., with its permission b. Supervisory or inspection activities D. Other Insurance performed as part of any related For purposes of this endorsement,the following is architectural or engineering activities. added to the Section IV - Commercial General 3. Professional services do not include services Liability Conditions, 4. Other Insurance within construction means, methods, condition and supersedes any provision to the techniques, sequences and procedures contrary- employed ontraryemployed by you or performed by or for the This insurance is excess of all other insurance construction manager, its employees or its available to an additional insured whether on a subcontractors in connection with your primary, excess, contingent or any other basis. ongoing operations. But, if required by a written contract or written C. Limits of Insurance agreement to be primary and noncontributory,this insurance will be primary to and will not seek With respect to the insurance afforded to these contribution from any insurance on which the additional insureds, the following is added to additional insured is a Named Insured. Section 111-Limits Of Insurance No other coverage or limit in the policy applies to If coverage provided to the additional insured is required by a contract or agreement, the most we loss or damage insured by this coverage. will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement, or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 Includes copyrighted material of Insurance Services CL CG 20 71 09 16 Office, Inc,with its permission • COMMERCIAL AUTO CL CA 01 49 06 17 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTOMOBILE EXPANSION ENDORSEMENT - PLATINUM This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to the coverages provided by this endorsement, the provisions of the Business Auto Coverage Form apply unless modified by this endorsement. A. NEWLY ACQUIRED OR FORMED "property damage": because of the conduct of ORGANIZATIONS an"insured" under Paragraphs a. or b. under Paragraph A.1.Who Is An Insured of Section The following is added to Paragraph A.1.Who Is II -Covered Autos Liability Coverage, caused An Insured of Section II - Covered Autos Liability by an "accident" and resulting from the Coverage' ownership, maintenance or use of a covered Any organization you newly acquire or form,other "auto"; than a partnership, joint venture or limited liability 2. The written contract or agreement described company or any organization excluded either by above must have been executed prior to the this Coverage Part or by endorsement, and over "accident" that caused the "bodily injury" or which you maintain ownership or majority interest "property damage" and be in effect at the time of more than 50 percent will qualify as a Named of such"accident"; Insured However 3. The insurance afforded to any such additional 1. This insurance does not apply to any newly acquired or formed organization that is an eyodoespnotof apply to any "accident" the q 9 beyond the period time required the "insured"be un er"incur otd"er under such policye or written contract or agreement described would be an "insured" under such policy but above, for its termination or the exhaustion of its Limit of Insurance 4. The most we will pay on behalf of such 2. Coverage does not apply to "bodily injury" or additional "insured(s)"is the lesser of: "property damage" that occurred before you a. The Limits of Insurance specified in the acquired or formed the organization written contract or agreement described 3. Coverage under this provision is afforded only above; or until the 180th day after you acquire or form b. The Limits of Insurance shown in the the organization or the end of the policy Declarations. period, whichever is earlier This provision shall not increase the Limit of B. ADDITIONAL INSURED BY CONTRACT OR Insurance shown in the Declarations in this AGREEMENT policy or coverage part; and The following is added to Paragraph A.1.,Who Is 5. The following changes are made to Paragraph An Insured of Section II - Covered Autos Liability 5. Other Insurance of B. General Conditions Coverage: under Section IV- Business Auto Conditions- When you have agreed in a written contract or a. The following is added to Paragraph 5.a.- agreement to include a person or organization as If required by the written contract or an additional "insured", such person or agreement described above, the organization is included as an"insured"subject to insurance afforded to the additional the following insured under this provision will be 1. Such person or organization is an additional primary to, and will not seek contribution "insured" only to the extent such person or from, the additional insured's own organization is liable for "bodily injury" or insurance. CL CA 01 49 06 17 Includes copyrighted material of Insurance Services Page 1 of 5 Office, Inc ,with its permission b. Paragraph 5.c. is deleted in its entirety. 2. We will also pay reasonable and necessary 6. Paragraph Ate. under Section II - Covered expenses to facilitate the return of the stolen "auto" to you. Autos Liability Coverage is deleted in its entirety. 3. It is agreed and understood and it is our stated intent that expenses incurred by you under the 7. The definition of "insured contract" under Section V- Definitions is amended to add the Transportation Expenses Coverage Extension will not also be covered or paid following: under the Rental Reimbursement Coverage An "insured contract" does not include that provided by this endorsement or any rental part of any contractor agreement: reimbursement coverage added by separate endorsement to this policy. That pertains to the ownership, maintenance or use of an "auto" and which indemnifies a H. EXTENDED COVERAGE-AIRBAGS person or organization for other than the The following is added to Exclusion B.3.a. of vicarious liability of such person or Section III -Physical Damage Coverage. organization for "bodily injury" or "property damage" caused by your operation or use of However, this exclusion does not apply to the a covered"auto". unintended discharge of an airbag. However, a person or organization is an This coverage is excess over any other collectible additional "insured" under this provision only insurance or warranty providing such airbag to the extent such person or organization is coverage not named as an "insured" by separate I. AUTO LOAN/LEASE GAP COVERAGE endorsement to this policy. C. EMPLOYEES AS INSUREDS The following is added to Section III - Physical Damage Coverage, Paragraph C. Limits of The following is added to Paragraph A.1. Who Is Insurance. An Insured Section II - Covered Autos Liability 4. In the event of a total "loss" to a covered Coverage: "auto",we will pay the lesser of: Any "employee" of yours is an "insured" while a. Any unpaid amount due on the lease or using a covered "auto" you don't own, hire or loan for a covered"auto", less: borrow in your business or your personal affairs. D. INCREASED COVERAGE-BAIL BONDS (1) The amount under the Physical Damage Coverage section of the The Supplementary Payments Coverage policy, and Extension of Section II - Covered Autos Liability (2) Any Coverage is amended as follows: The Limit of Insurance in paragraph A.2.a.(2) is (a) Overdue lease/loan payments at the time of the"loss"; increased to$5,000. E. (b) Financial penalties imposed INCREASED COVERAGE - LOSS OF under a lease for excessive use, EARNINGS abnormal wear and tear or high The Supplementary Payments Coverage mileage, Extension of Section II - Covered Autos Liability (c) Security deposits not returned by Coverage is amended as follows the lessor; The Limit of Insurance in paragraph A.2.a.(4) is (d) Costs for extended warranties, increased to$1,000 Credit Life Insurance, Health, F. FELLOW EMPLOYEE COVERAGE Accident or Disability Insurance The Fellow Employee Exclusion contained in purchased with the loan or lease, and Section 11-Covered Autos Liability Coverage does not apply. This coverage is excess over any other (e) Carry-over balances from collectable insurance. previous loans or leases, or G. COVERAGE EXTENSION -TRANSPORTATION b. $5,000. EXPENSES However, this provision does not apply to the Paragraph A.4.a. Transportation Expenses of extent loan/lease gap coverage has been Section III- Physical Damage Coverage is provided by separate endorsement to this amended as follows: policy. 1. The Limits of Insurance are increased to$75 per day to a maximum of$2,500. Page 2 of 5 Includes copyrighted material of Insurance Services CL CA 01 49 06 17 Office, Inc ,with its permission J. GLASS REPAIR-NO DEDUCTIBLE When fire extinguishers are kept in your covered "auto" and any are discharged in an attempt to The following is added to Paragraph D. Deductible of Section I- Paddical Damage Coverage: extinguish a fire, we will pay the lesser of the actual cost of recharging or replacing such fire Any Comprehensive Coverage deductible shown extinguisher(s). in the Declarations does not apply to "loss" to No deductible applies to this coverage. glass when you elect to patch or repair rather than replace the glass. 0. HIRED AUTO PHYSICAL DAMAGE K. INCREASED COVERAGE - ELECTRONIC COVERAGE EQUIPMENT The following is added to Paragraph A.4. The $1,000 limit indicated in Paragraph C.1.b. Coverage Extensions of Section III - Physical under Section III - Physical Damage Coverage is Damage Coverage increased to $2,500. If hired "autos" are covered "autos" for Covered L. EXTENDED COVERAGE - PERSONAL Autos Liability Coverage and if Physical Damage PROPERTY Coverage is provided for any"auto"you own,then the Physical Damage coverages provided are The following is added to Paragraph A.4. extended to"autos"you lease, rent, hire or borrow Coverage Extensions of Section III - Physical from someone other than your "employees", Damage Coverage: partners or members of their households subject to the following: Physical Damage Coverage on a covered "auto" may be extended to "loss" to your personal 1. The most we will pay in any one "loss" is the property or, if you are an individual, the personal lesser of: property of a family member,that is in the covered a. The actual cash value of the"auto", "auto" at the time of "loss" and caused by an "accident" and resulting from the ownership, b. The cost to repair or replace the"auto"; or maintenance or use of a covered"auto". c. $100,000 The insurance provided by this coverage 2. Paragraph 1.above is subject to a deductible. extension is excess over any other collectible The deductible shall be equal to the amount of insurance. The most we will pay for any one"loss" the highest deductible shown for any owned under this coverage extension is$500. However, "auto" of the same classification for that our payment for "loss" to personal property will coverage In the event there is no owned only be for the account of the owner of the "auto" of the same classification, the highest property deductible for any owned "auto" will apply for Under this provision, personal property does not that coverage include and we will not pay for"loss" of currency, No deductible will apply to "loss" caused by coins, securities or contraband. fire or lightning. No deductible applies to this coverage extension. 3. Hired Auto Physical Damage Coverage is NI. TOWING subject to the following Paragraph A.2. Towing of Section III - Physical a. If symbol 8 is shown in the Covered Auto Damage Coverage, is replaced by the following: section of the Declarations page for any of If a private passenger type "auto" or light truck the Physical Damage coverages,then the "auto"fa te0,0ss Lbs. G isor provided k Hired Auto Physical Damage coverage described in this endorsement does not Comprehensive and Collision Coverage, we will apply pay up to$150 for towing and labor costs incurred each time such "auto" is disabled. If a medium, b. Other than indicated in Paragraphs a. heavy or extra-heavy truck or extra-heavy Truck- directly above, coverage provided under tractor "auto" (greater than 10,000 Lbs. GVW) is this provision will be excess over any provided both Comprehensive and Collision other collectible insurance or coverage. Coverage, we will pay up to $250 for towing and 4. In addition to the limit set forth in Paragraph 1. labor costs incurred each time such "auto" is above we will pay up to $500 per day, to a disabled. However, the labor must be performed maximum of$3,500 per"loss"for at the place of disablement. N. FIRE EXTINGUISHER RECHARGE a. Any costs or fees associated with the "loss"to a hired"auto'; and The following is added to Paragraph A.4. b. Loss of use of the hired"auto", provided it Coverage Extensions of Section IV - Physical is the consequence of an "accident" for Damage Coverage' which you are legally liable, and as a CL CA 01 49 06 17 Includes copyrighted material of Insurance Services Page 3 of 5 Office, Inc,with its permission • result of which a monetary loss is (1) You, if you are designated in the sustained by the leasing or rental Declarations as an individual; concern (2) Your partners or members, if you are However, Paragraph A.4.b. Loss of Use designated in the Declarations as a Expenses under Section III - Physical Damage partnership or Joint venture, Coverage of the Business Auto Coverage Form (3) Your members or managers, if you does not apply. are designated in the Declarations as P. RENTAL REIMBURSEMENT COVERAGE a limited liability company, We will pay for rental reimbursement expenses (4) Your executive officers if you are incurred by you for the rental of an "auto"because designated in the Declarations as an of"loss"to a covered"auto". organization other than an individual, partnership, Joint venture or limited 1. Payment applies in addition to the otherwise liability company; and applicable amount of each coverage you have on the covered "auto" (5) The spouse of any person named in Paragraphs 1.a.(1). through 1.a.(4) 2. No deductible applies to this coverage while a resident of the same 3. We will pay only for those expenses incurred household; during the policy period beginning 24 hours Except: after the "loss" and ending, regardless of the expiration date of the policy,with the lesser of (a) Any "auto" owned by that the following number of days: individual or by any member of his a. The number of days when the covered or her household "auto" has been repaired or replaced, or (b) Any"auto" used by that individual or his or her spouse while working b. 45 days in a business of selling, servicing, 4. Our payment is limited to the lesser of the repairing or parking"autos" following amounts. 2. Changes In Auto Medical Payments And a. Necessary and actual expenses incurred; Uninsured And Underinsured Motorists or Coverages b. Not more than $75 for any one day; The following is added to Who Is An Insured 5. We will pay up to an additional $300 for the Any individual named in 1.a above and his or reasonable and necessary expenses you her "family members" are "insured" while incur to remove your materials and equipment "occupying" or while a pedestrian when being from the covered "auto" and replace such struck by any"auto"you don't own except. materials and equipment on the rental "auto" Any"auto" owned by that individual or by any 6. This coverage does not apply while there are "family member". spare or reserve "autos" available to you for 3. Changes In Physical Damage Coverage your operations total then of a covered Any private passenger type "auto" you don't 7. If"loss"results from the er type", we will own, hire or borrow is a covered "auto"while "auto" of the"private total P 9 yP " in the care,custody or control of any individual pay under this coverage only that amount of named in Q 1.a. above or his or her spouse your rental reimbursement expenses which is while a resident of the same house-hold not already provided for under the Physical except Damage Coverage Extension of the Business Auto Coverage Form or any endorsements a. Any"auto" owned by that individual or by thereto any member of his or her household; or However, this provision does not apply to the b. Any"auto"used by that individual or his or extent that rental reimbursement is provided her spouse while working in a business of by separate endorsement to this policy selling, servicing, repairing or parking Q. DRIVE OTHER CAR COVERAGE "autos" 1. The followingis added to Section II- Covered 4. The most we will pay for the total of all damages under Covered Autos Liability Autos Liability Coverage: Uninsured Motorists Coverage and a. Any "auto" you don't own, hire or borrow Underinsured Motorists Coverage is the Limit is a covered "auto"for Liability Coverage Of Insurance shown in the Declarations as while being used by: applicable to owned"autos" Page 4 of 5 Includes copyrighted material of Insurance Services CL CA 01 49 06 17 Office, Inc , with its permission 5. Our obligation to pay for, repair, return or T. UNINTENTIONAL OMISSIONS replace damaged or stolen property under The following is added Paragraph B.2. of Section Physical Damage Coverage, will be reduced IV- Business Auto Conditions: by a deductible equal to the amount of the highest deductible shown for any owned If you fail to disclose any hazards existing at the private passenger type "auto" applicable to inception date of this policy, such failure will not that coverage. If there are no owned private prejudice the coverage provided to you. However, passenger type "autos", the deductible shall this provision does not affect our right to collect be $250 for Comprehensive Coverage and additional premium or exercise our right of $500 for Collision Coverage. No deductible cancellation or nonrenewal will apply to"loss"caused by fire or lightning U. LIBERALIZATION 6. Additional Definition If we revise this endorsement to provide greater As used in this DRIVE OTHER CAR coverage without additional premium charge, we Provision' will automatically provide the additional coverage "Familymember" means a person related to to all endorsement holders as of the day the revision is effective in your state. the individual named in 1 a. by blood, marriage or adoption who is a resident of the individual's household, including a ward or foster child. R. KNOWLEDGE OF AN ACCIDENT, CLAIM,SUIT OR LOSS The following is added to Paragraph A.2. of Section IV- Business Auto Conditions Your obligation to provide prompt notice of an "accident", claim, "suit" or"loss" is satisfied if you or a person designated by you to be responsible for insurance matters is notified of, or in any manner made aware of an"accident", claim, "suit" or"loss" and provides us such notice as soon as practicable S. WAIVER OF SUBROGATION BY CONTRACT OR AGREEMENT The following is added to Paragraph A.5 of Section JV- Business Auto Conditions: We waive any right of recovery we may have against a person or organization because of payments we make for"bodily injury"or"property damage" when you and such person or organization have agreed in writing in a contract or agreement to waive such right of recovery, provided 1. Such written contract or agreement was: a. Made prior to the "accident" or "loss" resulting in the covered "bodily injury' or "property damage"; and b. Was in effect at the time of the covered "bodily injury"or"property damage" 2. The covered "bodily injury" or "property damage" must arise out of the operations specified in such written contract or agreement 3. At our request you must provide us with a copy of the aforementioned written contract or agreement CL CA 01 49 0617 Includes copyrighted material of Insurance Services Page 6 of 5 Office, Inc ,with its permission • WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 0313 (Ed. 4-64) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We well not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule Schedule ALL PERSONS AND/OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS POLICY FOR WORK PERFORMED BY YOU FOR THAT PERSON AND/OR ORGANIZATION OR SCHEDULED — AND PREMIUM CHARGE This endorsement changes the policy to which it Is attached and is effective on the date issued unless otherwise stated (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 7/1/18 Policy No. WC874S020 Endorsement No Insured Big Sky ID,Corp. Premium$ Insurance company Countersigned By WC 00 03 13 (Ed 4-84) Copyright 1983 National Council on Compensation Insurance SAM Search Results List of records matching your search for : Search Term : Big Sky ID Corp* Record Status: Active alt: 4 3Y Big Sky ID Corp Status: Active DUNS: 081031757 +4: CAGE Code: 5NEGO DoDAAC: Expiration Date: 11/19/2019 Has Active Exclusion?: No Debt Subject to Offset?: No Address: 10063 Navion Dr City: Hayden State/Province: IDAHO ZIP Code: 83835-5040 Country: UNITED STATES May 13.2019 1:10 PM https//www sam.gov Page 1 of I