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09-233.01 Western Dance Assoc: Western Dance Hall Lease • CONTRACT AMENDMENT TO THE LEASE AGREEMENT BETWEEN THE CITY OF SPOKANE VALLEY AND WESTERN DANCE ASSOCIATION OF SPOKANE Spokane Valley Contract#09-233.01 For good and valuable consideration, the legal sufficiency of which is hereby acknowledged, City and the Lessee mutually agree as follows: I. Purpose: This Amendment is for the Lease with the Western Dance Association of the Dance Hall at Sullivan Park by and between the Parties, executed by the Parties on July 14, 2009, and which terminates on June 1, 2019 Said contract shall be referred to as the "Original Contract" and its terms are hereby incorporated by reference. Total compensation under the Original Contract is a lease fee of$500 per month. 2.Original Contract Provisions:The Parties agree to continue to abide by those terms and conditions of the Original Contract and any amendments thereto which are not specifically modified by this Amendment. 3. Amendment Provisions: This Amendment is subject to the following amended provisions, which are either as follows. All such amended provisions are hereby incorporated by reference herein and shall control over any conflicting provisions of the Original Contract, including any previous amendments thereto. Lease agreement is extended until June 1, 2020. All terms and conditions remain the same. 4. Compensation Amendment History: This is Amendment #1 of the Original Contract. The history of amendments to the compensation on the Original Contract and all amendments is as follows: Date Compensation Original Contract Amount 7/14/2009 $500/month lease fee Amendment 41 6/17/2019 $0.00 Total Amended Compensation $500/month lease fee The parties have executed this Amendment to the Original Contract this V day of June,2019. CITY OF SPOKANE VALLEY. WESTERN DANCE ASSOCIAT N OF Mark Calhoun By: City Manager Its: A K E • APPROVED • FORM: Christine Bainbridge. City Clerk I 0 ice the Ci' •(r ey 1 -----.Th SOUA&F0-01 I SANTHONY ACORD' DATE(JMTDYVYY) ��. CERTIFICATE OF LIABILITY INSURANCE 08/17/2018 THIS CERTIFICATE is ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE O R PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to tlx,ceJtjflca4Elp ItilicJ0 nett of suc�h�eenn�dorsement(s). PRODUCER I Ti ka L-I V C.f.) NAME CT McDonald Zaring Insurance,Inc. PHONE FAX Ne1.(509 525-5705 pp1n WC,No,Ex (509)525-5730 FAX ) 22 E Main St AUb 1 7 LU10 Walla Walla,WA 99362 I 1AODte'unss- Info mctlODaldZaNOg.GOm INSURER(S)AFFORDING COVEPGE NAIC0 (PARKS & RECREATI0i1 DEPT INSURER The Cincinnati Insurance Company 10677 INSURED INSURERS: Square&Folk Dance Federation of Washington,Inc. INSURERC 5612 S Napa St INSURER O. Spokane,WA 99223 INSURER E INSURER F. COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: ITHIS IS TO THAT THE POLICIES OF NDICATED CERTIFY TIMTHSTANDING ANY REQUIREMENT,TERMCE (STED OR CONDITION OF ANY CCNTR CBELOW HAVE BEEN ISSUEDOT OR OTHER DOCUMENT WITH RESP CT TOTHE INSURED NAMED ABOVE FOR THEL WHICH ICY THOIS 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 NSRADDL SUER POLICY NUMBER POLICY EFF POLICY ESP LIMITS TYPE OF INSURANCE INSD ID IMM,UD,IYYYI IMMIIWYYM 1rODDrDDD A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE PREMIES Eg ocaIr 500,000 CWMSMNE n OCCUR EPP 0308268 09(01/2018 09/0112019 PREMISES RENT ne(,Oel 5,000 MED EDT(Any one person) PERSONAL&ADV INJURY 1,000,000 GENERAL AGGREGATE 2,000,000 GEN'POLIYEGATE Lgm[peTAVPUESPER 2,000,000 POLICY nJEOi LOC PRODUCTS-COMP/OP AGG _ OTHER COMBINED SINGLE LIMIT AUTOMOBILE LIABLITT In rider° ANY AUTO BODILY INJJRY(Per person) — OWNED — SCHEDULED BODILY IN.URYIPoretdEmn IHIIRR�OpS ONLY AUTOS BODILY BODILY INJURMAGE _NPOSONLY _Vara 11 GG 11 A X UMBRELLA LIAR X OCCUR EACH OCCURRENCE - 1,000,000 EXCESS OAS QNMSIMDE EPP 0346258 09101/2018 08101/2019 AGGREGATE a 1,000,000 OED X RETENTION PER WA1ER0TH- NREMPLeOMPENT STATUTE AND EMPLOYERs'UARIUA&UTY YIN ANY PROPRIETCRPPRTNER/DECUTIVE EL EACH ACCIDENT OFfl[EPUME ...EXCLUDED? N IA (Mandatory In NH) EL DISEASE-EA EMPLOYEE Il yes des(nbe under EL DISEASE-POLICY LIMITDESCRIPTION OF OPERATIONS balmy DESCRIPTION of OPERATIONS I LOCATORS/VEHICLES ACORD 01,Additional Remarks Schedule,may be attached II mon space Is eq9uine) Square and Round Dancing for the dance season of 2018-2019 at Western Dance Center,1901 N Sullivan,Spokane Valley,WA 99216. Certificate holder is named as additional insured in regard to operations of the named Insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN City of Spokane Valley ACCORDANCE WIT(THE POLICY PROWBIONS. Parks and Recreation Centerpiece 2426 N Discovery Place Spokane Valley,WA 99216 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) @1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD nn 33 SQUA&FO-01 SBARNETT ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) `� 9/8/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: McDonald-Zaring Insurance, a Marsh & McLennan Agency LLC company "HONE (509) 525-5730 FAX No): Marsh McLennan Agency LLC E-MAIL 22 E. Main ADORES • mmanwmziinfo@marshmma.com Walla Walla, WA 99362 _ , , „-, INSURED Square & Folk Dance Federation of Washington, Inc. 5612 S Napa St Spokane, WA 99223 INSURER F : Cincinnati rn%1P 7AnI7Q CERTIFICATE Ml IRARFR• REVISION MHURFR• THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICDY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FXI OCCUR X EPP 0346268 9I1(2025 9/1/2026 EACH OCCURRENCE $ 1,000,000 DpRMMG ESO RENTED n 500,000 MED EXP (Any oneperson) 5,000 PERSONAL & ADV INJURY 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY 0 jECOT LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG 2,000,000 AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY Perperson) $ BODILY INJURY Per accident $ PPe�PEciRdent AMAGE $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE X .EPP 0346268 9/1/2025 9/1/2026 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ DIED I X RETENTION$ 0 1,000,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROP R I ETO RIPARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N f A PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Club: Western Dance Association Event: Rental of the Western Dance Center located @ 1901 N Sullivan Rd, Spokane Valley, WA 99216 from 9/1/2025 to 8/31/2026 City of Spokane Valley Parks and Recreation Centerplace 2426 N Discovery Place Spokane, WA 99216 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016103) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NOTICE TO POLICYHOLDERS ADDITIONAL INSURED ENDORSEMENTS This is a summary of the major changes found in new editions of additional insured endorsements. NO COVERAGE IS PROVIDED BY THIS SUMMARY. Nor can it be construed to replace any provision of your policy. YOU SHOULD READ YOUR POLICY AND REVIEW YOUR DECLARATIONS PAGE CAREFULLY for complete information on the coverages that you are provided. If there is any conflict, between the policy and this summary, THE PROVISIONS OF THE POLICY SHALL PREVAIL. The major areas within the endorsements that broaden or reduce coverage, and other changes, are highlighted below. This notice does not reference every editorial change made in the endorsements. Clarification of Coverage: The following additional insured endorsements are revised to indicate that when these endorsements are attached to a policy, if coverage provided to the additional insured is required by contract or agreement, coverage to the additional insured will be afforded to the extent permitted by law and to the extent the named insured is required by the contract or agreement to provide insurance available under the applicable Limits of Insurance shown in the Declarations, whichever is less: • CG 20 03 0413 ADDITIONAL INSURED - CONCESSIONAIRES TRADING UNDER YOUR NAME • CG 20 05 0413 ADDITIONAL INSURED - CONTROLLING INTEREST • CG 20 07 04 13 ADDITIONAL INSURED - ENGINEERS, ARCHITECTS OR SURVEYORS • CG 20 10 0413 ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION • CG 20 11 0413 ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES • CG 20 12 04 13 ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS • CG 2013 0413 ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS RELATING TO PREMISES • CG 20 15 04 13 ADDITIONAL INSURED -VENDORS • CG 20 18 0413 ADDITIONAL INSURED - MORTGAGEE, ASSIGNEE OR RECEIVER • CG 20 23 04 13 ADDITIONAL INSURED - EXECUTORS, ADMINISTRATORS, TRUSTEES OR BENEFICIARIES • CG 20 24 04 13 ADDITIONAL INSURED - OWNERS OR OTHER INTERESTS FROM WHOM LAND HAS BEEN LEASED • CG 20 26 04 13 ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION • CG 20 27 04 13 ADDITIONAL INSURED - CO-OWNER OF INSURED PREMISES • CG 20 28 0413 ADDITIONAL INSURED - LESSOR OF LEASED EQUIPMENT • CG 20 29 04 13 ADDITIONAL INSURED - GRANTOR OF FRANCHISE • CG 20 30 04 13 OIL OR GAS OPERATIONS - NONOPERATING, WORKING INTERESTS • CG 20 31 04 13 ADDITIONAL INSURED - ENGINEERS, ARCHITECTS OR SURVEYORS • CG 20 32 04 13 ADDITIONAL INSURED - ENGINEERS, ARCHITECTS OR SURVEYORS NOT ENGAGED BY THE NAMED INSURED • CG 20 34 04 13 ADDITIONAL INSURED - LESSOR OF LEASED EQUIPMENT - AUTOMATIC STATUS WHEN REQUIRED IN LEASE AGREEMENT WITH YOU • CG 20 35 04 13 ADDITIONAL INSURED - GRANTOR OF LICENSES - AUTOMATIC STATUS WHEN REQUIRED BY LICENSOR GA 4496 09 18 Pagel of 2 • CG 20 36 0413 ADDITIONAL INSURED - GRANTOR OF LICENSES • CG 20 37 0413 ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS • CG 29 35 04 13 ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS • GA42480917 ADDITIONAL INSURED - PICK UP OR DELIVERY - SCHEDULED PERSON OR ORGANIZATION • GA 4397 09 17 ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION (VICARIOUS LIABILITY) GA 472 09 18 CONTRACTORS ADDITIONAL INSURED - AUTOMATIC STATUS AND AUTOMATIC WAIVER OF SUBROGATION WHEN REQUIRED IN WRITTEN CONTRACT, AGREEMENT, PERMIT OR AUTHORIZATION GA 4255 09 18 CONTRACTORS ADDITIONAL INSURED - AUTOMATIC STATUS AND AUTOMATIC WAIVER OF SUBROGATION WHEN REQUIRED IN WRITTEN CONTRACT OR AGREEMENT The above forms have the following changes: Broadening of Coverage: • Coverage is no longer restricted to entities for whom work is performed by you. Reduction of Coverage: • Coverage has been removed for oral oontracts. Clarification of Coverage: • Expressly address, in part, claims alleging negligence or other wrongdoing in the hiring, employment, training, supervision or monitoring of others by any insured. • Expressly states the exclusion applies only in your capacity as an engineer, architect or surveyor and not within construction means, methods, techniques, sequences and procedures employed by you in connection with your operations in your capacity as a construction contractor. CG 20 08 0413 ADDITIONAL INSURED - USERS OF GOLFMOBILES The above form has the following change: Reduction of Coverage: • Golfmobile was added as a defined term. GA 4496 09 18 Page 2 of 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENDED LIABILITY ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Endorsement -Table of Contents: Coverage: Begins on Page: 1. Employee Benefit Liability Coverage................................................................................................. 2 2. Unintentional Failure to Disclose Hazards......................................................................................... 8 3. Damage to Premises Rented to You................................................................................................. 8 4. Supplementary Payments..................................................................................................................9 5. 180 Day Coverage for Newly Formed or Acquired Organizations..................................................... 9 6. Waiver of Subrogation....................................................................................................................... 9 7. Automatic Additional Insured - Specified Relationships: ................................................................. 10 • Managers or Lessors of Premises; • Lessor of Leased Equipment; • Vendors; and • State or Political Subdivisions - Permits Relating to Premises 8. Property Damage to Borrowed Equipment........................................................................................12 9. Employees as Insureds - Specified Health Care Services: .............................................................13 • Nurses; - Emergency Medical Technicians; and • Paramedics 10. Broadened Notice of Occurrence...................................................................................................... 13 B. Limits of Insurance: The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorse- ment, except as provided below: 1. Employee Benefit Liability Coverage Each Employee Limit: $ 1,000,000 Aggregate Limit: $ 3,000,000 Deductible: $ 1,000 3. Damage to Premises Rented to You The lesser of: a. The Each Occurrence Limit shown in the Declarations; or b. $500,000 unless otherwise stated $ 4. Supplementary Payments a. Bail bonds: $ 1,000 b. Loss of earnings: $ 350 8. Property Damage to Borrowed Equipment Each Occurrence Limit $ 10,000 Deductible $ 250 Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 1 of 13 C. Coverages 2) Occurred prior to the ef- fective date of this en- 1. Employee Benefit Liability Coverage dorsement provided: a. The following is added to SECTION I a) You did not have - COVERAGES: Employee Benefit knowledge of a Liability Coverage. claim or "suit" on or (1) Insuring Agreement before the effective date of this en - (a) We will pay those sums that dorsement. the insured becomes legally obligated to pay as dam- You will be ages caused by any act, er- ror or omission of the in- knowledge of a claim or "suit' sured, or of any other per- when any "author- son for whose acts the in- sured is legally liable, to ized representa- which this insurance applies. tive"; We will have the right and i) Reports all, or duty to defend the insured any part, of the against any "suit" seeking act, error or those damages. However, omission to us we will have no duty to de- or any other fend against any "suit" seek- insurer; ing damages to which this insurance does not apply. ii) Receives a We may, at our discretion, written or ver- investigate any report of an bal demand or act, error or omission and claim for dam - settle any claim or "suit" that ages because may result. But: of the act, er- 1) The amount we will pay ror or omis- sion; and for damages is limited as described in SEC- b) There is no other TION III - LIMITS OF applicable insur- INSURANCE; and ance. 2) Our right and duty to (2) Exclusions defend ends when we have used up the appli- This insurance does not apply to: cable limit of insurance (a) Bodily Injury, Property in the payment of judg- Damage or Personal and ments or settlements. Advertising Injury No other obligation or liabil- "Bodily injury", "property ity to pay sums or perform damage" or "personal and acts or services is covered advertising injury". unless explicitly provided for under Supplementary Pay- (b) Dishonest, Fraudulent, ments. Criminal or Malicious Act (b) This insurance applies to Damages arising out of any damages only if the act, er- intentional, dishonest, ror or omission, is negli- fraudulent, criminal or mali- gently committed in the cious act, error or omission, "administration" of your "em- committed by any insured, ployee benefit program"; including the willful or reck- and less violation of any statute. 1) Occurs during the policy period; or Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 2 of 13 (c) Failure to Perform a Con- effort and cooperation of the tract insured, from the applicable funds accrued or other col - Damages arising out of fail- lectible insurance. ure of performance of con- tract by any insurer. (i) Taxes, Fines or Penalties (d) Insufficiency of Funds Taxes, fines or penalties, in - cluding those imposed un- Damages arising out of an der the Internal Revenue insufficiency of funds to Code or any similar state or meet any obligations under local law. any plan included in the "employee benefit program". (j) Employment -Related Prac- tices (e) Inadequacy of Perform- ance of Investment / Ad- Any liability arising out of vice Given with Respect to any: Participation (1) Refusal to employ; Any claim based upon: (2) Termination of employ- 1) Failure of any invest- ment; ment to perform; (3) Coercion, demotion, 2) Errors in providing in- evaluation, reassign - formation on past per- ment, discipline, defa- formance of investment mation, harassment, vehicles; or humiliation, discrimina- tion or other employ- 3) g y ment - related practices, person with respect to acts or omissions; or that person's decision to participate or not to par- (4) Consequential liability ticipate in any plan in- as a result of (1), (2) or cluded in the "employee (3) above. benefit program". This exclusion applies (f) Workers' Compensation whether the insured may be and Similar Laws held liable as an employer or in any other capacity and An claim arising out of our y g y to any obligation to share failure to comply with the damages with or repay mandatory provisions of any someone else who must pay workers' compensation, un- damages because of the in - employment compensation jury insurance, sodal security or disability benefits law or any (3) Supplementary Payments similar law. SECTION I - COVERAGES, (g) ERISA SUPPLEMENTARY PAYMENTS - COVERAGES A AND B also Damages for which any in- apply to this Coverage. sured is liable because of li- ability imposed on a fiduci- b. Who is an Insured ary by the Employee Re- tirement Income Security As respects Employee Benefit Liabil- Act of 1974, as now or ity Coverage, SECTION II - WHO IS hereafter amended, or by AN INSURED is deleted in its entirety any similar federal, state or and replaced by the following: local laws. (1) If you are designated in the Dec- (h) Available Benefits larations as: Any claim for benefits to the (a) An individual, you and your extent that such benefits are spouse are insureds, but available, with reasonable only with respect to the con - Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 3 of 13 duct of a business of which liability company, and over which you are the sole owner. you maintain ownership or major- ity interest, will qualify as a (b) A partnership or joint ven- Named Insured if no other similar ture, you are an insured. insurance applies to that organi- Your members, your part- zation. However, coverage un- ners, and their spouses are der this provision: also insureds but only with respect to the conduct of (a) Is afforded only until the your business. 180th day after you acquire or form the organization or (C) A limited liability company, the end of the policy period, you are an insured. Your y whichever is earlier; and members are also insureds, but only with respect to the (b) Does not apply to any ad, conduct of your business. error or omission that was Your managers are insur- committed before you ac- eds, but only with respect to quired or formed the organi- their duties as your manag- zation. ers. c. Limits of Insurance (d) An organization other than a partnership, joint venture or As respects Employee Benefit Liabil- limited liability company, you ity Coverage, SECTION III - LIMITS are an insured. Your "ex_ OF INSURANCE is deleted in its en- ecutive officers" and direc- tirety and replaced by the following: tors are insureds, but only (1) The Limits of Insurance shown in with respect to their duties Section B. Limits of Insurance, as your officers or directors. 1. Employee Benefit Liability Your stockholders are also Coverage and the rules below fix insureds, but only with re- the most we will pay regardless spect to their liability as of the number of: stockholders. (a) Insureds; (e) A trust, you are an insured. Your trustees are also in- (b) Claims made or "suits" sureds, but only with respect brought; to their duties as trustees. (c) Persons or organizations (2) Each of the following is also an making claims or bringing insured: "suits"; (a) Each of your "employees" (d) Acts, errors or omissions; or who is or was authorized to "employee (e) Benefits included in your administer your benefit program". "employee benefit program". (b) Any persons, organizations (2) The Aggregate Limit shown in or "employees" having Section B. Limits of Insurance, proper temporary authoriza- 1. Employee Benefit Liability tion to administer your "em- Coverage of this endorsement is ployee benefit program" if the most we will pay for all dam - you die, but only until your ages because of acts, errors or legal representative is ap- omissions negligently committed pointed. in the "administration" of your "employee benefit program". (c) Your legal representative if die, but only with re- (3) Subject to the limit described in you sped to duties as such. (2) above, the Each Employee That representative will have Limit shown in Section B. Limits all your rights and duties of Insurance, 1. Employee under this Coverage Part. Benefit Liability Coverage of this endorsement is the most we (3) Any organization you newly ac- will pay for all damages sus - quire or form, other than a part- tained by any one "employee", nership, joint venture or limited including damages sustained by Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 4 of 13 such "employee's" dependents (d) We may pay any part or all and beneficiaries, as a result of. of the deductible amount to effect settlement of any a An act, error or omission; or () claim or "suit" and, upon no- (b) A series of related acts, er- tification of the action taken, rors or omissions, regard- you shall promptly reim- less of the amount of time burse us for such part of the that lapses between such deductible amount as we acts, errors or omissions. have paid. negligently committed in the d. Additional Conditions "administration" of your "em- As respects Employee Benefit Li- ployee benefit program". ability Coverage, SECTION IV - However, the amount paid under COMMERCIAL GENERAL LIABIL- this endorsement shall not ex- ITY CONDITIONS is amended as fol- ceed, and will be subject to the lows: limits and restrictions that apply (1) Item 2. Duties in the Event of to the payment of benefits in any Occurrence, Offense, Claim or plan included in the "employee Suit is deleted in its entirety and benefit program." replaced by the following: (4) Deductible Amount 2. Duties in the Event of an (a) Our obligation to pay dam- Act, Error or Omission, or ages on behalf of the in- Claim or Suit sured applies only to the a. You must see to it that amount of damages in ex- we are notified as soon cess of the deductible as practicable of an act, amount stated in the Decla- error or omission which rations as applicable to may result in a claim. Each Employee. The limits To the extent possible, of insurance shall not be re- notice should include: duced by the amount of this deductible. (1) What the act, error (b) The deductible amount or omission was and when it oc- stated in the Declarations curred; and applies to all damages sus- tained by any one "em- (2) The names and ployee", including such "em- addresses of any- ployee's" dependents and one who may suf- beneficiaries, because of all fer damages as a acts, errors or omissions to result of the act, which this insurance applies. error or omission. (c) The terms of this insurance, b. If a claim is made or including those with respect "suit" is brought against to: any insured, you must: 1) Our right and duty to (1) Immediately record defend the insured the specifics of the against any "suits" claim or "suit" and seeking those dam- the date received; ages; and and 2) Your duties, and the du- ties of any other in- volved insured, in the event of an act, error or omission, or claim, apply irrespective of the ap- plication of the deductible amount. (2) Notify us as soon as practicable. You must see to it that we receive written no- tice of the claim or "suit" as soon as practicable. c. You and any other in- volved insured must: Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 5 of 13 (1) Immediately send method described in b. us copies of any below. demands, notices, b. Method of Sharing summonses or le- gal papers re- If all of the other insur- ceived in connec- ance permits contribu- tion with the claim tion by equal shares, or "suit"; we will follow this (2) Authorize us to ob- method also. Under tain records and this approach each in - other information; surer contributes equal amounts until it has (3) Cooperate with us paid its applicable limit in the investigation of insurance or none of or settlement of the the loss remains, claim or defense whichever comes first. against the "suit"; and If any of the other in- surance does not permit (4) Assist us, upon our contribution by equal request, in the en- shares, we will contrib- forcement of any ute by limits. Under this right against any method, each insurer's person or organi- share is based on the zation which may ratio of its applicable be liable to the in- limit of insurance to the sured because of total applicable limits of an act, error or insurance of all insur- omission to which ers. this insurance may c. No Coverage also apply. d. No insured will, except This insurance shall not at that insured's own cover any loss for which cost, voluntarily make a the insured is entitled to payment, assume any recovery under any obligation, or incur any other insurance in force expense without our previous to the effective consent. date of this Coverage Part. (2) Item 5. Other Insurance is de- leted in its entirety and replaced by the following: 5. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is pri- mary except when c. below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the e. Additional Definitions As respects Employee Benefit Li- ability Coverage, SECTION V - DEFINITIONS is amended as follows: (1) The following definitions are added: 1. "Administration" means: a. Providing information to "employees", including their dependents and beneficiaries, with re- spect to eligibility for or scope of "employee benefit programs"; b. Interpreting the "em- ployee benefit pro- grams", c. Handling records in connection with the Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 6 of 13 "employee benefit pro- benefits and such bene- grams"; or fits are made generally available to all "employ- d. Effecting, continuing or ees" who are eligible terminating any "em- under the plan for such ployee's" participation in benefits; any benefit included in the "employee benefit c. Unemployment insur- program". ance, social security benefits, workers' com- However, "administration" pensation and disability does not include: benefits; and a. Handling payroll deduc- d. Vacation plans, indud- tions; or ing buy and sell pro- b. The failure to effect or grams; leave of ab- maintain any insurance sence programs, indud- or adequate limits of ing military, maternity, coverage of insurance, family, and civil leave; including but not limited tuition assistance plans; to unemployment insur- transportation and ance, social security health club subsidies. benefits, workers' com- (2) The following definitions are de- pensation and disability leted in their entirety and re - benefits. placed by the following: 2. "Cafeteria plans" means 21. "Suit' means a civil proceed - plans authorized by applica- ing in which money dam- ble law to allow "employees" ages because of an act, er- to elect to pay for certain ror or omission to which this benefits with pre-tax dollars. insurance applies are al- 3. "Employee benefit pro- leged. "Suit" includes: grams" means a program a. An arbitration proceed - providing some of all of the ing in which such dam - following benefits to "em- ages are claimed and to ployees", whether provided which the insured must through a "cafeteria plan" or submit or does submit otherwise: with our consent; a. Group life insurance; b. Any other alternative group accident or health dispute resolution pro - insurance; dental, vision ceeding in which such and hearing plans; and damages are claimed flexible spending ac- and to which the in - counts; provided that no sured submits with our one other than an "em- consent; or ployee" may subscribe to such benefits and c. An appeal of a civil pro - such benefits are made ceeding. generally available to those "employees" who 8. "Employee" means a person satisfy the plan's eligibil- actively employed, formerly ity requirements; employed, on leave of ab- sence or disabled, or retired. b. Profit sharing plans, "Employee" includes a employee savings "leased worker". "Em- plans, employee stock ployee" does not include a ownership plans, pen- "temporary worker". sion plans and stock subscription plans, pro- 2. Unintentional Failure to Disclose Haz- vided that no one other ands than an "employee" SECTION IV - COMMERCIAL GENERAL may subscribe to such LIABILITY CONDITIONS, 7. Representa- Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 7 of 13 tions is hereby amended by the addition to damage or de - of the following: stroy itself; Based on our dependence upon your rep- c) Smog; resentations as to existing hazards, if un- d) Mechanical break - intentionally you should fail to disclose all such hazards at the inception date of your down including policy, we will not reject coverage under rupture or bursting this Coverage Part based solely on such caused by cen- failure. trifugal force; 3. Damage to Premises Rented to You e) Settling, cracking, shrinking or ex - a. The last Subparagraph of Paragraph pansion; or SECTION I - COVERAGES, COV- ERAGE A BODILY INJURY AND f) Nesting or char PROPERTY DAMAGE LIABILITY 2., tion, or discharge Exclusions is hereby deleted and or release of waste replaced by the following: products or secre- tions, by insects, Exclusions c. through q. do not apply birds, rodents or to damage by fire, explosion, light- other animals. ning, smoke or soot to premises while rented to you or temporarily occupied (b) Loss caused directly or lo - by you with permission of the owner. rectly by any of the follow- ing: b. The insurance provided under SEC- TION I - COVERAGES, COVERAGE 1) Earthquake, volcanic A. BODILY INJURY AND PROP- eruption, landslide or ERTY DAMAGE LIABILITY applies any other earth move - to "property damage" arising out of ment; water damage to premises that are 2) Water that backs up or both rented to and occupied by you. overflows from a sewer, (1) As respects Water Damage Le- drain or sump; gal Liability, as provided in Para- 3) Water under the ground graph 3.b. above: surface pressing on, or The exclusions under SECTION I flowing or seeping - COVERAGES, COVERAGE A. through: BODILY INJURY AND PROP- a) Foundations, walls, ERTY DAMAGE LIABILITY, 2. floors or paved Exclusions, other than L War surfaces; and the Nuclear Energy Liabil- ity Exclusion, are deleted and b) Basements, the following are added: whether paved or not; or This insurance does not apply to: c) Doors, windows or damage": (a) "Property " g other openings. 1) Assumed in any con- (c) Loss caused by or resulting tract; or from water that leaks or 2) Loss caused by or re- flows from plumbing, heat- sulting from any of the ing, air conditioning, or fire following: protection systems caused by or resulting from freezing, a) Wear and tear; unless: b) Rust, corrosion, 1) You did your best to fungus, decay, de- maintain heat in the terioration, hidden building or structure; or or latent defect or any quality in prop- 2) You drained the equip- erty that causes it ment and shut off the Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 8 of 13 water supply if the heat was not maintained. (d) Loss to or damage to: 1) Plumbing, heating, air conditioning, fire protec- tion systems, or other equipment or appli- ances; or 2) The interior of any building or structure, or to personal property in the building or structure caused by or resulting from rain, snow, sleet or ice, whether driven by wind or not. c. Limit of Insurance The Damage to Premises Rented to You Limit as shown in the Declara- tions is amended as follows: (2) Paragraph 6. of SECTION III - LIMITS OF INSURANCE is hereby deleted and replaced by the following: 6. Subject to 5. above, the Damage to Premises Rented to You Limit is the most we will pay under COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY for damages because of "prop- erty damage" to premises while rented to you or tem- porarily occupied by you with permission of the owner, arising out of any one "occurrence" to which this insurance applies. (3) The most we will pay is limited as described in Section B. Limits of Insurance, 3. Damage to Prem- ises Rented to You of this en- dorsement. 4. Supplementary Payments Under SECTION I - COVERAGE, SUP- PLEMENTARY PAYMENTS - COVER- AGES A AND B: a. Paragraph 2. is replaced by the fol- lowing: the use of any vehicle to which the Bodily Injury Liability Coverage ap- plies. We do not have to furnish these bonds. b. Paragraph 4, is replaced by the fol- lowing: All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to the limit shown in Sec- tion B. Limits of Insurance, 4.b. Loss of Earnings of this endorsement per day because of time off from work. 5. 180 Day Coverage for Newly Formed or Acquired Organizations SECTION II - WHO IS AN INSURED is amended as follows: Subparagraph a. of Paragraph 4. is hereby deleted and replaced by the fol- lowing: a. Insurance under this provision is af- forded only until the 180th day after you acquire or form the organization or the end of the policy period, which- ever is earlier; 6. Waiver of Subrogation SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 9. Transfer of Rights of Recovery Against Others to Us is hereby amended by the addition of the following: We waive any right of recovery we may have because of payments we make for injury or damage arising out of your ongo- ing operations or "your work" done under a written contract requiring such waiver with that person or organization and in- cluded in the "products -completed opera- tions hazard". However, our rights may only be waived prior to the "occurrence" giving rise to the injury or damage for which we make payment under this Cov- erage Part. The insured must do nothing after a loss to impair our rights. At our re- quest, the insured will bring "suit" or trans- fer those rights to us and help us enforce those rights. 7. Automatic Additional Insured - Speci- fied Relationships Up to the limit shown in Section B. a. The following is hereby added to Limits of Insurance, 4.a. Bail Bonds SECTION II -WHO IS AN INSURED: of this endorsement for cost of bail bonds required because of accidents (1) Any person or organization de - or traffic law violations arising out of scribed in Paragraph 7.a.(2) be - Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 9 of 13 low (hereinafter referred to as demolition operations additional insured) whom you are performed by or on be - required to add as an additional half of such additional insured under this Coverage Part insured. by reason ot: (b) Any person or organization (a) A written contract or agree- from which you lease ment; or equipment with whom you have agreed per Paragraph (b) An oral agreement or con- 7.a.(1) above to provide in- tract where a certificate of surance. Such person(s) or insurance showing that per- organization(s) are insureds son or organization as an solely with respect to their a additional insured has been liability arising out of the issued, maintenance, operation or is an insured, provided: use by you of equipment leased to you by such per - (a) The written or oral contract son(s) or organization(s). or agreement is: However, this insurance does not apply to any "oc- 1 Current in effect or currence' which takes place becomes effective dur- after the equipment lease ing the policy period; expires. and (c) Any person or organization 2) Executed prior to an (referred to below as ven- "occurrence" or offense dor) with whom you have to which this insurance agreed per Paragraph would apply; and 7.a.(1) above to provide in- (b) They are not specifically surance, but only with re- named as an additional in- spect to "bodily injury" or sured under any other provi- "property damage" arising sion of, or endorsement out of "your products" which added to, this Coverage are distributed or sold in the Part. regular course of the ven- dor's business, subject to (2) Only the following persons or or- the following additional ex- ganizations are additional insur- clusions: eds under this endorsement, and insurance coverage provided to 1) The insurance afforded such additional insureds is lim- the vendor does not ited as provided herein: apply to: (a) The manager or lessor of a a) "Bodily injury" or premises leased to you with "property damage" whom you have agreed per for which the ven- Paragraph 7.a.(1) above to dor is obligated to provide insurance, but only pay damages by with respect to liability aris- reason of the as- ing out of the ownership, sumption of liability maintenance or use of that in a contract or part of a premises leased to agreement. This you, subject to the following exclusion does not additional exclusions: apply to liability for damages that the This insurance does not ap- vendor would have ply to: in the absence of ) y �� 1 An occurrence" which the contract or agreement; takes place after you cease to be a tenant in b) Any express war - that premises. ranty unauthorized by you; 2) Structural alterations, new construction or Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 10 of 13 c) Any physical or nying or containing chemical change in such products; or the product made intentionally by the b) When liability in - vendor; cluded within the "products- d) Repackaging, completed opera - unless unpacked tions hazard" has solely for the pur- been excluded un- pose of inspection, der this Coverage demonstration, Part with respect to testing, or the sub- such products. stitution of parts under instructions (d) Any state or political subdi- from the manufac- vision with which you have turer, and then re- agreed per Paragraph packaged in the 7.a.(1) above to provide in - original oontainer; surance, subject to the fol- lowing additional provision: e) Any failure to make such inspections, This insurance applies only adjustments, tests with respect to the following or servicing as the hazards for which the state vendor has agreed or political subdivision has to make or nor- issued a permit in connec- mally undertakes tion with premises you own, to make in the rent or control and to which usual course of this insurance applies: business, in con- 1) The existence, mainte- nection with the nance, repair, oonstruc- distribution or sale tion, erection, or re - of the products; moval of advertising f) Demonstration, in- signs, awnings, cano- stallation, servicing pies, cellar entrances, or repair opera- coal holes, driveways, tions, except such manholes, marquees, operations per- hoist away openings, formed at the ven- sidewalk vaults, street dor's premises in banners, or decorations connection with the and similar exposures; sale of the product; or g) Products which, af- 2) The construction, erec- ter distribution or tion, or removal of ele- sale by you, have vators; or been labeled or re- 3) The ownership, mainte- labeled or used as nance, or use of any a container, part or elevators covered by ingredient of any this insurance. other thing or sub- stance by or for the (3) Any insurance provided to vendor. an additional insured desig- nated under Paragraph 2 This insurance does not 7.a.(2) Subparagraphs (a), apply to any insured (b) and (d) does not apply to person or organization: "bodily injury", "property a) From whom you damage" or, "personal and have aoquired advertising injury" arising out such products, or of the sole negligence or any ingredient, part willful misconduct of the ad - or container, enter- ditional insured or their ing into, accompa- agents, "employees" or any Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 11 of 13 other representative of the (1) The Limits of Insurance shown in additional insured. the Declarations are replaced by the limits designated in Property b. SECTION IV - COMMERCIAL GEN- Damage to Borrowed Equip- ERAL LIABILITY CONDITIONS is ment Section B. Limits of In - hereby amended as follows: surance, 8. Property Damage Condition 5. Other Insurance is to Borrowed Equipment of this amended to include: endorsement with respect to coverage provided by this en- (1) Where required by a written con- dorsement. These limits are in - tract or agreement, this insur- clusive of and not in addition to ance is primary and / or noncon- the limits being replaced. The tributory as respects any other Limits of Insurance shown in insurance policy issued to the Section B. Limits of Insurance, additional insured, and such 8. Property Damage to Bor- other insurance policy shall be rowed Equipment of this en - excess and / or noncontributing, dorsement fix the most we will whichever applies, with this in- pay in any one 'occurrence" re- surance. gardless of the number of: (2) Any insurance provided by this (a) Insureds; endorsement shall be primary to other insurance available to the (b) Claims made or "suits" additional insured except: brought; or (a) As otherwise provided in (c) Persons or organizations SECTION IV - COMMER- making daims or bring CIAL GENERAL LIABILITY "suits". CONDITIONS, 5. Other In- (2) Deductible Clause surance, b. Excess Insur- ance; or (a) Our obligation to pay Jam- ages on your behalf applies b For an other valid and col- () y only to the amount of dam- lectible insurance available ages for each 'occurrence" to the additional insured as which are in excess of the an additional insured by at- deductible amount stated in tachment of an endorsement Section B. Limits of Insur- to another insurance policy ance, 8. Property Damage that is written on an excess to Borrowed Equipment of basis. In such case, the this endorsement. The lim- coverage provided under its of insurance will not be this endorsement shall also reduced by the application be excess. of such deductible amount. 8. Property Damage to Borrowed Equip- (b) SECTION I -COMMERCIAL ment LIABILITY CONDITIONS 2. a. The following is hereby added to Ex- Duties in the Event of Oc- clusion j. Damage to Property of currence, Offense, Claim Paragraph 2., Exclusions SECTION or Suit, applies to each - COVERAGES, COVERAGE A. - claim or "suit" irrespective of BODILY INJURY AND PROPERTY the amount. DAMAGE LIABILITY: (c) We may pay any part or all Paragraphs (3) and (4) of this exclu- of the deductible amount to sion do not apply to tools or equip- effect settlement of any ment loaned to you, provided they are claim or "suit' and, upon no - not being used to perform operations tification of the action taken, at the time of loss. you shall promptly reim- burse us for such part of the b. With respect to the insurance pro- deductible amount as has vided by this section of the endorse- been paid by us. ment, the following additional provi- 9. Employees as Insureds - Specified sions apply: Health Care Services Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 12 of 13 It is hereby agreed that Paragraph 2.a.(1) a. You must see to it that we are notified (d) of SECTION II - WHO IS AN IN- as soon as practicable of an "occur- SURED, does not apply to your "employ- rence" or an offense which may result ees" who provide professional health care in a claim. To the extent possible, services on your behalf as duly licensed: notice should include: a. Nurses; (1) How, when and where the "oc- b. Emergency Medical Technicians; or currence" or offense took place; C. Paramedics, (2) The names and addresses of any injured persons and wit - in the jurisdiction where an "occurrence" nesses; and or offense to which this insurance applies (3) The nature and location of any takes place. iryury or damage arising out of 10. Broadened Notice of Occurrence the "occurrence" or offense. Paragraph a. of Condition 2. Duties in the This requirement applies only when Event of Occurrence, Offense, Claim or the "occurrence" or offense is known Suit (SECTION IV - COMMERCIAL to an "authorized representative". GENERAL LIABILITY CONDITIONS) is hereby deleted and replaced by the fol- lowing: Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 13 of 13