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19-124.00 Patriot Fire Protection: Fire Sprinkler System & Backflow Device Inspection ATRIOT ww. ��w d RUPfOTECTO ,.D. tal>o9)926-mn F11X(59N994T/M 8/2/2019 Center Place 2426 N Discovery PI Spokane Valley,WA 99216 Atln Brian,Chris,or Facility Manager Re Center Place 5 year inspection of(1)wet fire sprinkler system and annual inspection of(6)backflow devices Patriot Fire Protection, Inc will provide the labor to perform the inspecton(s)for the amount of $621 not including applicable state and local taxes Our price(s)will remain in effect for 30 days,after which time it will be subject to our review All work shall be in accordance with NFPA 25 and the local authorities All customers are responsible for any/all filing fees initiated by your local authority having jurisdiction,unless otherwise stated Your authorization is required prior to scheduling Patriot could require access to all occupied/unoccupied spaces in the building while doing the inspection(s) Patriot will require an escort while entering residential spaces We may also require your assistance in silencing alarms during the inspection Please return a signed copy of this letter,authorizing Patriot la perform the above referenced services and show that you have read /and �aagree to our terns and conditions Accepted By rlyl,2)I,♦.7r ,� PO# Print Name Max t _ CA] KIOUI) lick Email Billing Name (,1 l Yl yy01 Srobci i/ IIPN Phone 509 azo - 5 'ao Billing Email ACCOUm1 tit-In/11B t SPO�LAnt/deti.00l Date 8 James Riddelle 11 Patriot Fire Protection Inc Phone 509 462 6809 Email James Riddelle@Patnotfire.com NOTE. BY SIGNING THIS BID PROPOSAL,THIS ISA BINDING CONTRACT WHERE YOU AUTHORIZED US TO PERFORM THE WORK ABOVE YOU ASSERT THAT YOU HAVE THE AUTHORITY TO SIGN THIS CONTRACT ON BEHALF OF THE OWNER OR ENTITY AND AGREE TO BE PERSONALLY BOUND INTEREST AND LATE FEES SHALL ACCRUE ON UNPAID BALANCES AT THE RATE OF 1% PER MONTH YOU ALSO AGREE TO PAY REASONABLE ATTORNEYS FEES AND COSTS OF COLLECTION IF ACTION IS NECESSARY TO COLLECT THIS BALANCE THE QUOTE PRICE WILL REMAIN IN EFFECT FOR 30 DAYS UNLESS OTHERWISE SPECIFIED. VANCOUVER,WA OFFICE TEL(360)699 4403 TACOMA,WA PORTLAND(503)2228001 www.paWotfIre corn TEL(263)9282290 FAX(300)6994485 PATRIFP089CF FAX(253)922.6150 • 103115 Moy PATRIOT rife spmNiers Sawtis�w Lives! ` m aw . aa FIRE PROTECTION,INC. 1El-i50ei v[saew FAX M0)926-3700 Terms and Conditions for Fire Protection System(s) Inspection, Testing, and Maintenance Agreement 1. All work will be performed during normal working hours, unless otherwise specified herein. 2. Water purveyors may assess a surcharge or penalty for firewater use. These fees, if applicable, are not included in the proposal and are the responsibility of the building owner 3. Unless specifically noted otherwise, and in accordance with NFPA 25, inspection refers to visual examination from the floor of exposed systems or portions thereof to verify that it appears to be in operating condition and is free of physical damage. 4. Unless specifically noted otherwise, 'testing and inspection" does not constitute "winterization" of dry systems. 5. As a minimum,all jurisdictions require a current record of annual inspection and testing for fire protection systems. NFPA 25 (Inspection, Testing, and Maintenance of Water Based Fire Protection Systems) identifies the frequency for inspection and testing required on a more-often-than-annual basis. Patriot Fire Protection, Inc recommends compliance with NFPA 25; however, it is the owner or tenants responsibility to determine if the local authority having jurisdiction will be enforcing these requirements. 6. Payment terms are net ten days for the entire invoice amount unless otherwise specified No retention is to be withheld from payment. 7. Price includes only that work specifically described. Additional labor and/or materials necessary for repairs during the primary inspection must be specifically authorized by the customer in writing, and will be added to the invoice. At the customer's option, a detailed written estimate will be provided for repairs to be done at a later date. 8. Washington State sales tax (if applicable) will be added to the price unless the customer provides a valid resale certificate. 9. A late fee of ten dollars or five percent of the agreement price (whichever is greater) will be assessed for delinquent payments 10 When signed and returned, this agreement constitutes an agreement for the specific work described Any additional paperwork required and/or provided by the customer must reference this agreement. 11 Patriots liability is limited to the actual agreement amount of our inspection services Please indicate any special instructions regarding scheduling (times, days, month, etc ) and/or other pertinent information in the space below. Client#: 112292 PATRFIRE _ _ ACORDT. CERTIFICATE OF LIABILITY INSURANCE OAR IMM VOTYYYJ 6/7212039 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 POLICES BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZE:0 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 endorse:1. 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 any rights to the certificate holder In lieu of such endorsement(s) PRODUCER CONTACT Christine Maden I Propel Insurance PHONE 800499-0933 FAX o 866577-'1316 WC No,Ed) IAc.N ) 6657_ Tacoma Commercial Insurance E-MAIL Christine.maden@pro_p_elinsurance.com ADDRESS _. 1201 Pacific Ave,Suite 1000 INSURERISIAFFORflrIG COVERAGE NAICY Tacoma,WA 98402 INSURER Nautilus Insurance Company _ :'17370 INSURED INSURER B SAIF Corporation !61I93 Patriot Fire Protection Inc. INSURER Alaska National Insurance Company 38733 10005 E Montgomery Or 'INSURER D Spokane,WA 99206 - —- - --- -- INSURER E INSURERF _ COVERAGES CERTIFICATE NUMBER. REV€EION NUMBER. �Y THS IS TO CERT FY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMIFD ABOVE FOR THE FOLIC"PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMEII WITH RESPECT TO VVH'VH THIS CERTIFICATE MAY BE ISSUED CR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL 1 HF TEEMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR ADDL'SUSR POLICY EFF I POLICY EXP ' LIMITS LW TYPE OF INSURANCE INSR WV!) POLICY NUMBER MMIDD/YYYY)'(MMIDD/YYYYI_ _ _ A X COMMERCIAL GENERAL LIABILITY ECP202417911 10/05/2018110/05/2019 EACH OCTCURRENCE ,$1,000,000_ 'CLAIMS-MADE I XI OCCUF ' 'PREMb ES(Ed avIErrenue, I$1'9110 DO I X BI/PD Ded:$50,000 _ _ MED EXF IAny mepe mons s5,I1OC _ I PERSONAL 5 AOM INJURY '11,900,000 CEWL AOGREGME'LIMIT APPLIES PER GENERAL AGGREGATE r t2,009O01) PRO _ POLICY' JECT __ LOC1:1PI PROF)IS COMOP AGG 52,l)OD',000 X OTHER _ __ a AUTOMOBILE LIABILITY COIF NEO5INGLr LIMIT C iB.lAS06688 - 0/OS/201810/05/207• Ea ac,Jemj $1,000,000 X kW AUTO I BODILY INJURY IP,person/ $ - - - OWNED 3CHED'JLE D BODILY IN JURY I Prm am,d-rti O OSONLV AUTOS -- ----- HIRED NONOWNED PRCPLR'V DAMAGE X AUTOS JNY © AUTOS ONLY Perry atl NL_ - X CA0001 I I -_ ALA UMBRELuuaa X ., OCI:UF FFX20241B011 10/05/2018 10/05/201' HOCC.URRENCE s1110010�00Q___ X' EXCESSLIAB CLLIMS-MADE also applies XS ,AGGR:GATE $10,000,000 DEO XI RETENTON$0 ' of Poll&Prof I _ _ WORKERS COMPENSATION _a B 854204(Oregon) 70/07I2018',10/O1/2019X Is'ATUTE -� 0TH- (ANDEMPLOYERB'LIABILITY VtN �- ' --—--- A 'ANY CER/MEETOR EXCLUDED? ECP202417911 10/01/2018110/01/2019 EL EhCH Ae^IOEIeI 1,1,000000 'JFF,6£R/MEMBERS%CWDED' - NIA (Mandatory in NH) I(WA Stop Gap) 'EL Drepse-EAnu•LOVL t_7,f100000 6666 I le: aescnbe undrr I 1— IJEBGRIprION OF OPERATIONS belay/ E L DISEASE-PO Gv'JMJ 's1,000,0110 A Professional Liab ECP202417911 10/05/20181110/05/201• $1,(OC,000 ea Claim A Poll w/Mold I ECP202417911 10/05/2018 10/05/201' $1,(0(,000 Limit DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101 AddItIonal Remarks Schedule,may he attached If man space Is required) RE:Center Place-5 Year Inspections. Additional Insured Status applies per attached form(s). CERTIFICATE HOLDER CANCELLATION Cityof Spokane ValleySHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BE )RE THE EXPIRATION DATE THEREOF NOTICE WILL BE DELIVEREI: IN Parks and Recreation ACCORDANCE WITH THE POLICY PROVISIONS 2426 N Discovery Plce _____________ Spokane, WA 99216 AUTHORIZED REPRESENTATIVE IIrr I -- Q-r )pq#992,,..X, ©1988-2015 ACORD CORPORATION.All right's rasa rved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S3755283/M3387610 KTROO ENDORSEMENT This endorsement forms a part of the policy to which it is attached Please read it ca dully ADDITIONAL INSURED COVERAGE A, B & D-SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following ENVIRONMENTAL COMBINED POLICY In consideration of the premium charged and notwithstanding anything contained in the policy to the ccntray, it iE hereby agreed and understood that this endorsement shall apply only to the Coverage Part(s) corresponding with the bcx or boxes marked below vgii COVERAGES PARTS A AND B-GENERAL LIABILITY COVERAGE D- CONTRACTORS POLLUTION LIABILITY SCHEDULE Any person or organization that you are required by written ccnlract cr agi tiem a nt Name of Person or Organization: to include as an additional insured TAny location Job Description/Location: -- — - - SECTION III - WHO IS AN INSURED is amended to include as an insured, with respect In Coveiage A, E anc D any person(s) or organization(s) shown in the schedule above Such additional insured status applies only 1. Under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY ana COVERAGE B PERSCNAL AND ADVERTISING INJURY LIABILITY for claims or suits resulting from a. Your work performed for such person(s) or organization(s) in the performance c^ your on]oing onera inns fur the additional insured, or b. Your work performed for such person(s) or organization(s) and included in the productscornplided operations hazard. 2. Under COVERAGE D CONTRACTORS POLLUTION LIABILITY for claims or suits arising out of cut pollution conditions that are the results of a. Your work performed for such person(s) or organization(s) in the performance o"your ongoing opera inn; 'or the additional insured, or b. Your work performed for such person(s) or organizatwn(s) and included i9 the product:-completed operations hazard. With respect to damages caused by your work, as described above, the coverage provided hereunder sha I be primary and not contributing with any other insurance available to those person(s) or organization(s) shown in :he scnecUE above ECP 1005 08 16 P3ge 1 of 2 ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED ECP 1005 08 16 Pace 2 of 2 ENDORSEMENT This endorsement forms a part of the policy to which it is attached Please read it carefully WAIVER OF SUBROGATION- SCHEDULED ENTITIES It is agreed that the Company, in the event of any payment under this policy, waives its -ighl of recovery ag2msl the person(s) or organization(s) shown in the schedule below, but only at the specific written request of the Na Tied Inured either before or after loss, wherein such waiver of subrogation has been included before loss as part of a written contractual undertaking by the Named Insued 11$ waiver of subrogation shall apply on y with respect to losses occurring due to operations undertaken as per the specific contract existing between the Named Insured and such person(s) or organization(s) shown in the schedule below and shall not be construed to be a waiver of subrogation with respect to other operations of such persc n(s) or organization(s) shown in the schedule below in which the Named Insured has no contractual mt=_rest No waiver of subrogation shall directly or indirectly apply to any employee, employees or agents of either the Named Insured or of the person(s) or organizationls) shown in the schedule below, and the Company reserves its right Cr li:•n tc he reimbursed from any recovery funds obtained by any injured employee This waiver of subrogation does not apply in any jurisdiction or situation where such waiver is held to be illegal or against public policy or rn any situation wherein the person(s) or organization(s) shown in the schedule below against wrorr subrogation is to be waived is found to be solely negligent SCHEDULE Name of Person(s) or Organization(s): Any person or orgamzatior that you are required by written contractor agreement to provide a waiver of subrogation ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND RENIAIN UNCHANGED ENV 2013 06 18 Page 1 of 1 j.,4 7 Alaska Na M r�Ional III INSURANCE COANY R' BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following' BUSINESS AUTO COVERAGE FORM Various provisions in this endorsement restrict SECTION IV — Business Auto Comfit ons, coverage Read the entire policy carefully to Paragraph A. 5. -- Transfer of Rights off Rocs very determine rights. duties, and what is and is not Against Others To Us is amended to include: covered 5. Transfer of Rights of Recovery Agairst Throughout this policy, the words "you" and "your' Others to Us refer to the Named Insured shown in the Declarations The words"we", 'us", and "our" refer to This condition does not apply to any the company providing this insurance person(s) or organization(s) to the exien that subrogation aga:nst that person or Other words and phrases that appear in quotabon organization is waived pr or to the asp lest' marks have special meaning Refer to SECTION V— or the"loss" under a contract with thai p¢r sn DEFINITIONS in the Business Auto Coverage Form or organization The coverages provided by this endorsement apply SECTION II — COVERED AUTO LI/.BILI IV per "accident" and, unless otherwise specified, are COVERAGE. Paragraph A 2 a. (2)—SupplernenteAry subject to all of the terms, conditions, exclusions and Payments ts replaced by the following deductible provisions of the policy to which it is attached (2) Up to $10,300 fry cost cf ba I bods (including bonds for related trail' Ian SECTION II — COVERED AUTO LIABILITY violations) regLred because ct an COVERAGE, Paragraph A.1. Who Is An Insured is "accident' we cover We do rot .1 ave amended to includa to furnish these bonds d Any "employee" of yours while operating SECTION II — COVERED AUTO LIABILITY an "auto' hired or rented under a COVERAGE, Paragraph A.2 a. (4) —Supplernentff ry contract or agreement in an "employee's" Payments is replaced by the fol owing name. with your permission, whtle performing duties related to the conduct (4) All reascnable expenses tnourred by of your business the"insured" at cur request, incluchnc actual loss of earnings up to $50: a e. Any person or organization for whom you day because of time off from wor^ have agreed in writing to provide insurance such as is afforded by this Coverage Form, but only with respect to liability arising out of the ownership, maintenance or use of"autos"covered by this policy If such person or organization has other insurance then this insurance is primary to and we will not seek contribution from the other insurance. ANIC CA 1150 10 13 Page 1 o 4 ts7 AlaskaNational INSURANCE PANY C. "Loss" caused by falling object; or SECTION II — COVERED AUTO LIABILITY missiles COVERAGE, Paragraph A 2 c —Voluntary Property Damage is added as follows However, you have the option of having class breakage caused by a covered "auto's" c. Voluntary Property Damage collision or overturn considered a "loss" t neer Collision Coverage At your written request, we may make a voluntary payment for Property Damage Glass Repair—Waiver of Deductible caused by an "insured', but without liability to a third party, up to$25,000 We No deductible applies to glass breakage, if will not make a Voluntary Property the glass is repaired rather than replaced Damage payment to anyone who is an "insured" under this policy SECTION III — PHYSICAL DAMAGE COVERAGE, Paragraph A.4 a — Transportation Expenses is SECTION III — PHYSICAL DAMAGE COVERAGE, replaced by the following Paragraph A 2 —Towing is replaced by the following a. Transportation Expenses Towing We will pay up to $200 per day to a We will pay up to $500 for towing and labor maximum of $1,500 for temp Diary costs incurred each time a covered "auto' transportation expense incurred by you that is a because of the total theft of a cot ered "auto"that is a a. Private passenger, (1) Private passenger, b. Truck, (2) Truck, c. Pick-up truck, (3) Picrt-up truck, d. Panel , or (4) Panel, or e. Van (5) Van type vehicle under 20,000 lbs of Gross Vehicle Weight is disabled However, the type vehicle under 20,000 lbs of Gress labor must be performed at place of Vehicle Weight We will pay only 'or d.sablement those covereo 'autos" for witch you :,airy ed SECTION III — PHYSICAL DAMAGE COVERAGE, either Comprehensivera or , wilpay Paragraph A.3 — Glass Breakage — Hitting a Bird Causes poof aLy Coverage \/e wil pay es or Animal —Falling Objects or Missiles is replaced for temporary the period beginning s48 bythe followingincurred during the period 48 hours after the theft and ending Glass Breakagea Bird or Animal regardless of the policy's expiration, 9 Hitting when the covered "auto' is returned to —Falling Objects or Missiles use or we pay for its "loss" If you carry Comprehensive Coverage for the damaged covered "auto', we will pay the following under Comprehensive Coverage a. Glass Breakage. b. "Loss' caused by hitting a bird or animal, and ANIC CA 1150 10 13 Page 2 ct 4 a ;. Alaska NINSURANCE ational ak. OiPANY (2) Specified Causes of Loss only if the SECTION III - PHYSICAL DAMAGE COVERAGE, Declarations indicate that Specified Paragraph A 4 b - Loss of Use Expenses is Causes of Loss Coverage is provided replaced by the following for the "auto" withdrawn from seance, or b. Loss of Use Expenses-Hired, Rented, (3) Collision only if the Declarations or Borrowed Automobiles indicate that Co!ision Coverage is provided for the "auto' withdrawn We will pay expenses for which an from service "insured" becomes legally responsible to pay for loss of use of a vehicle hired, SECTION III - PHYSICAL DAMAGE COVERAGE, rented or borrowed without a dnver under Paragraph A 4 d. - Airbag Coverage Fs added as a written rental contract or agreement follows We will pay for loss of use expenses, if caused by d. Airbag Coverage (1) Other than Collision, only if the We will pay for the cost to repair, replace, Declarations indicate that or reset an airbag that inflates for any Comprehensive Coverage is provided reason other than as a result of a for the vehicle withdrawn from collision, if the Declarations indicate that service the covered 'auto" has Comp•ehe.:srve Coverage or Specified Causes of Loss (2) Specified Causes of Loss only if the Coverage. Declarations indicate that Specified Causes of Loss Coverage is provided SECTION III - PHYSICAL DAMAGE COVERAGE, for the vehicle withdrawn from Paragraph A.4 e. - Rental Reimbursement service Coverage is added as fo lows (3) Collision only if the Declarations e. Rental Reimbursement Coverage indicate that Collision Coverage is provided for the vehicle withdrawn We will pay up to It75 per day for rental from service reimbursement expenses Inc urea by you for the rental of an "auto" because of However the most we will pay for any "loss" to a covered 'auto"that is a expenses*or loss of use is$200 per day, to a maximum of 51,500 (1) Private Passenger, SECTION 111 - PHYSICAL DAMAGE COVERAGE, (2) Truck, Paragraph A 4 c - Non-Transportation Loss of Use Expenses is added as follows (3) Pick-up truck, c. Non-Transportation Loss of Use (4) Panel, of Expenses (5) Van We will pay up to $2.000 for non- transportation expense incurred by you, type vehicle under 2f1,000 lbs of Gross because of "loss" to a covered "auto", if Vehicle Weght. Payment applies in caused by addition to the otherwise applicable amount cf eaoh coeerage you have ori a (1) Other than Collision, only if the covered "auto" No deductibles apply to Declarations indicate that this coverage Comprehensive Coverage is provided for the "auto"withdrawn from service, ANIC CA 1150 10 13 Page 3 of 4 f4 1 Alaska NatiANCE onal ANY (1) We will pay only for those expenses SECTION IV — BUSINESS AUTO CONDITIONS — incurred during the policy period Paragraph 8 5.b — Other Insurance is replaced by beginning 24 hours after the "loss' the following and ending, regardless of the policy's expiration, with the lesser of the b. For Hired Auto Physical Damage following number of days Coverage, th a following are deemea to be covered "autos" you own (a) The number of days reasonably required to repair or replace the (1) Any covered "auto' you lease, hit, covered "auto" rent. or borrow, and (b) 30 days. (2) Any covered "auto"" hired or rented by your 'employee" under a contract (2) This coverage does not apply while in that individual 'employee's' name, there are spare or reserve "autos" with your permission, while available to you for your operations performing duties rela ed to the conduct o, your business. (3) The Rental Reimbursement Coverage described above does not However, any "auto' that is leased, hired, apply to a coverec "auto' that is rented or boi rowed with a driver is nu. a described or designated as a covered coverea"auto' auto' on Rental Reimbursement Coverage Form CA 99 23 SECTION V — DEFINITIONS -. Paragraph C — SECTION IV — BUSINESS AUTO CONDITIONS — "Bodily injury"is replaced by the following Paragraph 8.2 —Concealment, Misrepresentation Or Fraud is amendec by adding Unintentional Failure C. "Bodily injury' means bodily injury, sickness or to Disclose Hazards at the end of Paragraph B 2 as disease sustained by a person including death or follows mental anguish resulting from any of these Mental angush means any type of mental or Unintentional Failure to Disclose Hazards emotional illness or disease If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Farm because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal This endorsement changes the policy to which it is attached and, unless otherwise stated, is efective on the date issued at 1201 P..M standard time at your mailing address shown in the policy The information below is required only when this endorsement is issued subsequent to commencement of the policy. Endorsement Effective Policy No. Insured Endorsement Vo Countersigned By © Insurance Services Office. Inc., 2009 ANIC CA 1150 10 13 Page 4 or 4 FOLLOW FORM EXCESS LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage Read the entire policy carefully to determ ne rights, duties and what is and is not covered Throughout this policy the words "you" and "your" refer to the Named Insured shown in the Declarations, and any other personompany providing this insurance The word "insured" means an policy or organization ei ahf andg 's su' under to tne or organization qualifying as a Named Insured under thisThe words "we". y persong alifyi�g as such tne controlling underlying insurance Other words and phrases that appear in bold in this Coverage Form have special meaorig Refer to Sectcn IV - Definitions Other words and phrases that are not defined under this Coverage Form but defined in the contrclli19 underlying insurance will have the meaning described in the policy of controlling underlying insurance his policy is subject to the same representations and warranties as are contained in the application for any contrclli ig underlying insurance, and the insurance provided under this Coverage Form will follow the same terms, conditions, agreements, exclusions, definitions and limitations that are contained in the applicable controlling uncc'rlying insurance, unless otherwise directed by this insurance To the extent such provisions differ or conflict, the provisons of this Coverage Form will apply However, the coverage provided under this Coverage Form will not be broader thou that provided by the applicable controlling underlying insurance There may be more than one controlling underlying insurance listed in the Declarations and provisions in those policies conflict, and which are not superseded by the provisions of this Coverage Form In such a case, the terns, conditions, agreements, exclusions, definitions and limitations of the controlling underlying insurance applicable to the particular event for which a claim is made or suit is brought will apply SECTION I-COVERAGES 1. Insuring Agreement a. We will pay on behalf of the insured the ultimate net loss in excess of the retained limit because of injiu Ty or damage to which insurance provided under this Coverage Form applies Where the controlling underlying insurance has the duty to defend, we will have the right and duty to defend the insured against any suit seeking damages for such injury or damage under this Coverage Form wher the applicable limits of controlling underlying insurance have been exhausted through the payment o. the underlying limits in full in accordance with the provisions of such controlling underlying insurance When we have no duty to defend, we will have the right to defend, or to participate in the defense of the insured against any other suit seeking damages for injury or damage However, we will have no duty to defend the insured against any suit seeking damages for which insurance under this policy does not apply At our discretion, we may investigate any event that may involve this insurance and settle any resultant :la m or suit, for which we have the duty to defend But (1) The amount we will pay for ultimate net loss is limited as described in Section II - Limits Ot Insurance, a-d (2) Our right and auty to defend ends when we have used up the applicable limit of insurance in the payme it of defense costs,judgments or settlements under this Coverage Form b. This insurance applies to injury or damage that is subject to an applicable retained limit If any other limit, such as a sublimit. is specified in the controlling underlying insurance, this insurance does not apply to injury or damage arising out of that exposure unless that limit is specified in the Declarations under the Schedule of controlling underlying insurance Furthermore, if any controlling underlying insurance shown in the Schedue of Underlying Insurance (SCHEDULE) attached hereto has a limit of liability (1) Greater than the amount shown in such Schedule of Underlying Insurance, then th's policy wil appy in excess of the greater amount, or (2) Less than the amount shown in such Schedule of Underlying Insurance, then this policy will apply in excess of the amount shown in such Schedule of Underlying Insurance r FX 8000 07 18 Pige1 of] c. (1) If the controlling underlying insurance requires, for a particular claim, that the injury or danca•,ge occur during its policy period in order for that coverage to apply, then this insurance will only apply to that injury or damage if it occurs during the policy period of this Coverage Form If the controlling underlying insurance requires that the event causing the particular injury or damage takes place during its policy period in nicer for that coverage to apply, then this insurance will apply to the claim only if the event causing that injury or damage takes place during the policy period of this Coverage Form (2) If any controlling underlying insurance is written on a claims-made or discovery basis, the following applies to the insurance provided by this Coverage Form which is excess over that underlying insurance If the controlling underlying insurance requires, for a particular claim, that the injury or damage occur on or after the Retroactive Date shown in the Declarations of that insurance in order for that coverage to apply, then this insurance will only apply to that injury or damage which occurs on or after the Retroactive Date shown in the controlling underlying insurance but before the end of the policy period of this Coverage Form If the controlling underlying insurance requires, for a particular claim, that tne event causing the particular injury or damage takes place on or after the Retroactive Date shown In the Declarations a that insurance in order for that coverage to apply, then this insurance will apply to the claim only if the event causing that injury or damage takes place on or after the Retroactive Date shown in the controlling underlying insurance but before the end of the policy period of this Coverage Form A claim for damages for such injury or damage must be first made against tne insured during this polcy period or any extended reporting period provided under this Coverage Form A claim will be considered first made under this Coverage Form (1) When notice of such claim is received and recorded by any insured or by us, whichever comes 'first, if the controlling underlying insurance is written on a claims-made and recorded basis, or (2) When notice of such claim, after being received by any insured, is reported to us In writing, if the controlling underlying insurance is written on any other claims-made basis d. Any additional insured under any policy of controlling underlying insurance will automatically be ar additional insured under this insurance If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance required by the contract, less any amounts payable by any controlling underlying insurance Additional insured coverage provided by this insurance will not be broader than coverage provided by the controlling underlying insurance 2. Exclusions The following exclusions, and any other exclusions added by endorsement, apply to this Coverage Form Ir addition, the exclusions applicable to any controlling underlying insurance apply to this insurance unless superseded by the following exclusions, or superseded by any other exclusions added by endorsement to this Coverage Form Insurance provided under this Coverage Form does not apply to a. Medical Payments Medical payments coverage or expenses that are provided without regard to fault, whether or not provided by the applicable controlling underlying insurance b. Auto Any loss, cost or expense payable under or resulting from any of the following auto coverages (1) First-party physical damage coverage, (2) No-fault coverage, (3) Personal injury protection or auto medical payments coverage, or (4) Uninsured or underinsured motorists' coverage c. Workers' Compensation And Similar Laws Any obligation of the insured under a workers' compensation, disability benefits or unemployment compensation law or any similar law SECTION II - LIMITS OF INSURANCE 1. The Limits of Insurance shown in the Declarations, and the rules below fix the most we will pay regardless of the number of FFX 8000 07 18 Page 2 cit 7 a. Insu•eds b. Claims made or suits brought, or number of vehicles involved, c. Persons or organizations making claims or bringing suits, or d. Limits available under any controlling underlying insurance 2. The Limits of Insurance of this Coverage Form will apply as follows a. This insurance only applies in excess of the retained limit b. The Aggregate Limit is the most we will pay for all ultimate net loss, for all injury or damage including defailse costs covered under this Coverage Form Defense costs are part of, and not n addition to, the imils of insurance, and toe payment of defense costs reduces the limits of insurance However, this Aggregate Limit only applies to injury or damage that is subject to an aggregate limit of insnranra c. Subject to Paragraph Lb. above, the Each Occurrence Limit is the most we will pay for all ultimate ret mss inc'uding defense costs under this insurance because of all injury or damage arising out of any one evert Defense costs are part of, and not in addition to, the limits of insurance, and the payment of deigns? cosis reduces the limits of insurance 3. If any controlling underlying insurance has a policy penod that is different from the policy period of this Cove rige Form then, for the purposes of this insurance, the retained limit will only be reduced or exhausted by ac uai payments made in full by the controlling underlying insurer for injury or damage covered under this insurance 4, The Limits of Insurance shown in the Declarations will not ever be reinstated SECTION 111 -CONDITIONS "he following conditions apply In addition, the conditions applicable to any controlling underlying insurance ,ire also applicable to the coverage provided under this insurance unless superseded by the following conditions Appeals If the controlling underlying insurer or insured elects not to appeal a judgment in excess of the amount el the retained limit, we may do so at our own expense We will also pay for taxable court costs, pre-and poslJLdg Tent interest and disbursements associated with such appeal In no event will this provision ncrease our lowly beyond the applicable Limits of Insurance described in Section 11- Limits Of Insurance 2. Bankruptcy a. Bankruptcy Of Insured Bankruptcy or insolvency of the insured or of the insured's estate will not relieve us of our obligations urger This Coverage Form b. Bankruptcy Of Controlling Underlying Insurer Bankruptcy or insolvency of the controlling underlying insurer will not relieve us of our obligatiors under this Coverage Form However, insurance provided under this Coverage Form will not replace any controlling underlying ins orange in the event of bankruptcy or insolvency of the controlling underlying insurer The insurance provide❑ cn:ter this Coverage Form will apply as if the controlling underlying insurance were in full effect and recoverable 3, Duties In The Event Of An Event, Claim Or Suit a. You must see to it that we are notified as soon as practicable of an event, regardless of the amount, whic:h may result in a claim under this insurance To the extent possible, notice should include (1) How, when and where the event took place, (2) The names and addresses of any injured persons and witnesses, and (3) The nature and location of any injury or damage arising out of the event b. If a claim is made or suit is brought against any insured, you must (1) Immediately record the specifics of the claim or suit and the date received, and (2) Notify us as soon as practicable You must see to it that we receive written notice of the claim or suit as soon as practicable FFx 8000 07 18 P 3 je 3 o17 c. You and any other insured involved must (1) Immediately send us copies of any demands, notices, summonses or legal papers received in conneclior vnth the claim or suit (2) Authorize us to obtain records and other information, (3) Cooperate with us in the investigation or settlement of the claim or defense against the suit, and (4) Assist us, upon our request, in the enforcement of any right against any person or organization which may be liable to the insured because of injury or damage to which this insurance may also apply d. No insured will do or omit to do anything to prejudice our rights under this Coverage Form, and no insurec will, except at that insured's own cost, voluntarily make a payment, assume any obligator, or incur any expense, of^er than for first aid, without our consent 4. First Named Insured Duties The first Named Insured is the person or organization first named in the Declarations and is responsible 'or the payment of all premiums The first Named Insured will act on behalf of all other Named Insureds for giving anc receiving of notice of cancellation or the receipt of any return premium that may become payable At our newest, the first Named Insured will furnish us, as soon as practicable, with a complete copy of any controlling underlying insurance and any subsequently issued endorsements or policies which may in any way affect the nsurance provided under this Coverage Form 5. Cancellation a. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation b. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least (1) 10 days before the effective date of cancellation if we cancel for nonpayment of premium, or (2) 30 days before the effective date of cancellation if we cancel for any other reason c. We will mail or deliver our notice to the first Named Insured's last mailing address known to us d. Notice of cancelat:on will state the effective date of cancellation The policy period will end on that date e. If this policy is cancelled, we will send the first Named Insured any premium refund due If we cancel, the refund will be pro rata If the first Named Insured cancels, the refund may be less than pro rata The cancellation a ill be effective even if we have not made or offered a refund f. If notice is mailed, proof of mailing will be sufficient proof of notice • 6. Changes This Coverage Form contains all the agreements between you and us concerning the insurance afforded The first Named Insured is authorized by all other insureds to make changes in the terms of his Coverage Form with our consent No change in, modification of, or assignment of interest under this Coverage Form shall be effective except when made by written endorsement to this Coverage Form which is signed by our authorized representative This Coverage Form shall become subject to any changes upon the effective date of the changes In the controlling underlying insurance, but only upon the condition that we agree to follow such charges by written endorsement attached hereto and the Insured pays when due any additional premium required by us relating to such changes Ind i or agrees to any amendment of the provisions of this Coverage Form required by us relating to such changes 7. Maintenance Of 1 Changes To Controlling Underlying Insurance The insured warrants that the retained limit, where applicable, as shown in the Schedule of Underlying Insurance, shall be unimpaired as of the effective date of this policy Any controlling underlying insurance must be maintained in full effect without reduction of coverage cr limits except for the reduction of aggregate limits in accordance with the provisions of such controlling underlying insurance that results from injury or damage to which this insurance applies Such exhaustion or reduction is not a failure to maintain controlling underlying insurance The Insured, not the Insurer, will bear the risk that any controlling underlying insurance is or may be uncollectible This Coverage Form will not drop down for any reason, including, but not limited to, the uncollectibility (in whole or in part) of the controlling underlying insurance, even if such uncollectibility is due to the financial impairment or insolvency of the issuer of any controlling underlying insurance Coverage under th's policy will not be ava fable FFX 8000 07 18 P a_e J of 7 unless and until all controlling underlying insurance has been exhausted by the actua' payment by the contrctling underlying insurer of the applicable retained limit as shown in the Schedule of Underlying Insurance Tre first Named Insured must notify us in writing with full particulars as soon as practicable in the event a. Any controlling underlying insurance is cancelled, not renewed, replaced or other se terminated, b. The limits or scope of coverage of any controlling underlying insurance is changeo c. The aggregate limits of liability of any controlling underlying insurance become exhausted, d. Any controlling underlying insurance is not maintained in full effect during the policy period, or e. Any insurer issuing any controlling underlying insurance becomes subject to receivership, fquidation, tlssd�nori, rehabilitation, or similar proceeding or being taken over by any regulatory authority 8. Other Insurance a. This insurance is excess over, and shalt not contribute with any of the other insurance, whether primary, excess, contingent or on any other basis This condition will not apply to insurance specifical y written as excess over tins Coverage Form When this insurance is excess, if no other insurer defends, we may undertake to do so, but we will be entitled to the insureds rights against all those other insurers b. When this insurance is excess over other insurance, we will pay only our share of the ultimate net loss that exceeds (1) The total amount that all such other insurance would pay for the loss in the absence of the insurance provided under this Coverage Form, plus (2) The total of all deductible and self-insured amounts under all that other insurance 9. Premium Audit a. We will compute all premiums for this Coverage Form in accordance with our rules arid rates b. If this policy is auditable, the premium shown in this Coverage Form as advance premium is a deposit premium only At the close of each audit period, we will compute the earned premium for that cenod and send no.ice to the first Named Insured The due date for audit premium is the date shown as the due d ate on the bill if the sum of the advance and audit premiums paid for the policy period is greater than the earned premium, we wil 'etur I the excess to the first Named Insured c. The first Named Insured must keep records of the information we need for premium computation, arid send us copies at such times as we may request ^0. Loss Payable Liability under this Coverage Form does not apply to a given claim unless and until a. The insured or insured's controlling underlying insurer has become obligated to pay the retained limit ano b. The obligation of the insured to pay the ultimate net loss in excess of the retained limit has been determined by a final settlement or judgment or written agreement among the insured, claimant, controlling underlying insurer (or a representative of one or mcre of these) and us, and first-party claim amount that we, at our sole discretion, agree in writing to be necessary anc reasonable 11. Legal Action Against Us No person or organization has a right under this Coverage Form a. To join us as a party or otherwise bring us into a suit asking for damages from an insured, or b. To sue us on this Coverage Form unless all of its terms have been fully complied with A person or organization may sue us to recover on an agreed settlement or on a final judgment against an ,nsFred, but we will not be liable for damages that are not payable under the terms of this Coverage Form or that are in excess of the applicable limit of insurance An agreed settlement means a settlement and release of liability signet isy us, the insured, controlling underlying insurer and the claimant or the claimant's legal representative 12. Transfer Of Defense a. Defense Transferred To Us When the limits of controlling underlying insurance have been exhausted, in accordance with the orovisions of controlling underlying insurance, we may elect to have the defense transferred to us We will cooperate in the FFX 8000 07 18 Page 5 of 7 transfer of control to us of any outstanding claims or suits seeking damages to will( li this insurance apples ano which would have been covered by the controlling underlying insurance had the applicable emit nct been exhausted b. Defense Transferred By Us When our limits of insurance have been exhausted our duty to provide a defense will cease We will cooperate in the transfer of control of defense to any insurer specifically written as excess over this Coverage Form of any outstanding claims or suits seeking damages to which this nsurance applies and which would have been covered by the controlling underlying insurance had the applicable limit not been exhausted In the event that there is no insurance written as excess over this Coverage Form, we will cooperate in the transfer of control to the insured and its designated representative 13. When We Do Not Renew If we decide not to renew this Coverage Form, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expiration date If notice is mailed, proof of mailing will be sufficient proof of notice 14. Claims-Made Extended Reporting Period a. Any provisions under the controlling underlying insurance relating to an Extended Reporting Period for wh ich a separate premium charge is made do not apply to this insurance, unless an Extendec Reporting Pericd Is purchased under this insurance b. An Extended Reporting Period, consistent with the terms, conditions and duration of any Extended Reporting Period available in accordance with the terms of any controlling underlying insurance, will be available for this Coverage Form by endorsement, for an additional charge, if (1) This policy is cancelled or not renewed, or (2) This policy is renewed or replaced with insurance that i. Has a Retroactive Date later than the date shown in the controlling underlying insurance, or ii. Does not apply to injury or damage on a claims-made basis c. If this policy and the controlling underlying insurance are cancelled or not renewed and an Extended Reim Ing Period has been provided under the controlling underlying insurance, then an Extended Reporting Penoa will be available for this Coverage Form The Extended Reporting Period available under this Coverage Form w ill be consistent with the terms, conditions and duration of any Extended Reporting Period provided in accordance with the terms of the controlling underlying insurance d. You must give us a written request for the Extended Reporting Period endorsement under this Coverage For n nc later than the time allowed to purchase such endorsement under the controlling underlying insurance The Extended Reporting Period will not go into effect unless you pay the additional prem urn promptly when due ono any premium you owe us for coverage provided under this policy e. We will determine the additional premium in accordance with our rules and rates In doing so, we may take isle account the following (1) The exposures insured, (2) Previous types and amounts of insurance, (3) Limits of Insurance available under this policy for future payment of damages, and (4) Other related factors 15. Notices All notices under this policy shall be given as provided for in the controlling underlying insurance In addition all notices to us under this policy shall be sent to the address below or any substitute address as provided by us Berkley Environmental Attention Claims Department 101 Hudson Street, Suite 2500 Jersey City. New Jersey 07302 SECTION IV-DEFINITIONS FFX 8000 07 18 Pare G of 7 The definitions applicable to any controlling underlying insurance also apply to this insure ce In addition, he talk wing definitions apply I. Controlling underlying insurance means any policy of insurance or self-insurance listed in the Declarations under the Schedule of contrciliug underlying insurance 2. Controlling underlying insurer means any insurer who provides any policy of insurance listed in the Declarations under the Schedule of contrclli ig underlying insurance 3. Defense Costs means any reasonable and necessary fees charged by an attorney and designated by the company, and where the insured has the right to select independent counsel, the rates we would actually pay to counsel that we retain n the ordinary course of business in the defense of a similar claim or suit in the community where the claim or suit aro=se or is being defended, as well as other reasonable and necessary costs, including expert witness and coat reporters, in connection with the investigation, adjustment. settlement, defense or appeal of a claim o-suit It does nct ircude the salaries of our regular employees or supervisory counsel retained by us, or any cost or expense incurred br the insured in assisting in the investigation or defense of the claim or suit S. Event means an occurrence, offense, accident, act, discovery, claim or suit or other event, to which the applicable controlling underlying insurance applies 5. Injury or damage means any injury or damage, covered in the applicable controlling underlying insurance arising from at event 6. Retained limit means the available limits of controlling underlying insurance applicable to the claim 7. Ultimate net loss means the amount covered by this Coverage Form, after reduction for recoveries, or salvages collectible, that the insured becomes legally obligated to pay as damages by reason of a. Defense costs, settlements,judgments, binding arbitration. plus b. Other binding alternate dispute resolution proceeding entered into with our consent, plus c. Any first-party claim amount that we, at our sole discretion, agree in writing to be necessary and reasonable 1Fx80000718 Paye rhil 1 his page has been left blanl. intentionally. I9— Izy Client#:112292 PATRFIRE ACORDre MTE(MMNWYYYIT CERTIFICATE OF LIABILITY INSURANCE 10/0412019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder Is an ADDITIONAL INSURED,the pollcy(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 any dghtgto the certificate holder in lieu of such endorsement(s). PRODUCER I P L.. i....WED NW" Christine Maden C.1`. l �dJ PHONE FAX Propel Insurance i IAA No,Fyn 800499-0933 (AIC.No): 866577-1326 Tacoma Commercial Insurance EMAIL christIne.maden@propellnsurance.com OCT U 2019 ADORERq' P 1201 Pacific Ave,Suite 1000 INSURENS)AFFORDING COVERAGE NAM It Tacoma,WA 98402 - . , - - -- INSURER A:Everest Indemnity Insurance 10851 INSURED - imam a:Alaska National Insurance Company 38733 Patriot Fire Protection Inc. INSURER c. 10005 E Montgomery Dr INSURER D Spokane,WA 99206 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS (NSRADMSUBR POLICY EFF POIICYE% LBWS TYPE OF INSURANCE MAR MVO POLICY NUMBER IMMI00.MYYYf (MWD A X cOMMERCLAL GENEJALLmBIUTY 51GL014669191 10/051201910/05/2020 EACH OCCURRENCE 51,000,000 �" pkgtandaE TEL�I 5100,000 X BI/PDD Ded:d: C $10,000 (OCCUR PR 1 $10,000 PERONALa mperson) E5,000 PERsoNAla ATV INJURY $1,000,000 GENL AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,000 pa - POLICY X JECT ri LCC PRODUCTS.CCMPOPAGG s2,000,000 OTHER $ g AUTOMOBILE LIABILITY I 9JAS06688 10105/201910/051202010E°,09¢mOMSINGLE LIMIT 51,000,000 X ANY AUTO BODILY INJURY(Per person) E OWNED —SCHEDULED BODILY INJURY(Per ac dere s AUTNRED ONLY NON-OW ED PROPERTY DAMAGE s X AUTOS ONLY X AUTOS ONLY (Per emden° X CA0001 10/13 X CA116010/13 $ A X UMBRELLA WB X OCCUR 51CC005362191 10/051201910105/202' EACH OCCURRENCE El0,000,000 EXCESS LAB CLAIMS-MACE Applies to GL, AGGREGATE E10,000,000 DEO X RETENTION 31O,000 AL,Poll&Profs WORKERS COMPENSATION WA Stop Gap only: [STATUTE 0TH- PR AND EMPLOYERS'UABIL111' A ANYPRROPRIIMBEftPARTNEEMXECUTIVEf NIA 51GL0146691$1 10/05/20181010512020 EL EACH ACCIDENT 51,000,000 OFFICERME(Mandatary In NN) I EL DISEASE-EA EMPLOYEE 51,0001100 Ifya deco under EL DISEASE-POLICY LIMIT 51,000,000 C roCRIPTIONOFl Liao OPERATIONS 09pry A Professional Liab 51GL014669191 10/05/2019 10105/2020 $1,000,000 A Poll w/Mold 51GL014669191 10105120191010512020 $1,000,000 DESCRIPTION OF OPERATNINSI LOCATIONS VEHICLES(ACORD 101.Addleonal Remits Schedule,may be attached x more apace brequlred) RE:Center Place-5 Year Inspections. Additional Insured Status applies per attached form(s). CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Spokane Valley THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Parks and Recreation ACCORDANCE WITH THE POLICY PROVISIONS. 2426 N Discovery Pine Spokane,WA 99216 AUTHORIZED REPRESENTATIVE lT (01988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) 1 of 1 The ACORD name and logo are registered marks of ACORD MS3852775/M3852755 SXHOO POLICY NUMBER: 51GL014669-191 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locatlon(s)Of Covered Operations Blanket where required by written contract. Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for"bodily injury", "property This insurance does not apply to "bodily injury" or damage" or "personal and advertising injury" "property damage"occurring after: caused, in whole or in part, by; 1. All work, including materials, parts or 1. Your acts or omissions, or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf, maintenance or repairs) to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been designated above. completed;or However: 2. That portion of "your work" out of which the injury or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organization insured only applies to the extent permitted by other than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured is principal as a part of the same project. required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 2010 0413 O Insurance Services Office, Inc.,2012 Page 1 of 2 C. With respect to the insurance afforded to these 2. Available under the applicable Limits of additional insureds, the following is added to Insurance shown in the Declarations; Section III—Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most we applicable Limits of Insurance shown in the will pay on behalf of the additional insured is the Declarations. amount of insurance: 1. Required by the contract or agreement;or Page 2 of 2 ®Insurance Services Office, Inc.,2012 CG 2010 0413 POLICY NUMBER: 51GL014669-191 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Blanket where required by written contract. Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section II —Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III—Limits Of Insurance: with respect to liability for "bodily injury" or If coverage provided to the additional insured is "property damage"caused, in whole or in part, by required by a contract or agreement, the most we "your work" at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and 1. Required by the contract or agreement; or included in the "products-completed operations hazard". 2. Available under the applicable Limits of However: Insurance shown in the Declarations; 1. The insurance afforded to such additional whichever is less. insured only applies to the extent permitted This endorsement shall not increase the applicable by law; and Limits of Insurance shown in the Declarations. 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 37 0413 Cr Insurance Services Office, Inc.,2012 Page 1 of 1 COMMERCIAL GENERAL LIABILITY ECG 24 520 08 05 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT - OTHER INSURANCE (PRIMARY NONCONTRIBUTORY) This endorsement modifies insurance provided under the following. COMMERCIAL GENERAL LIABILITY COVERAGE PART Condition 4. Other Insurance of SECTION IV (2) Any other primary insurance available to COMMERCIAL GENERAL LIABILITY CONDITIONS you covering liability for damages arising is replaced by the following: out of the premises or operations, or the a. Primary Insurance products and completed operations, for which you have been added as an addition- This insurance is primary except when b.below al insured by attachment of an endorse- applies. If this insurance is primary, our obliga- ment. tions are not affected unless any of the other When this insurance is excess, we will have no insurance is also primary. Then, we will share duty under Coverages A or B to defend the in- with all that other insurance by the method de- sured against any"suit""if any other insurer has scribed in c. below, except that we will not seek a duty to defend the insured against that"suit". contribution from any party with whom you have If no other insurer defends,we will undertake to agreed in a written contract or agreement that do so, but we will be entitled to the insured's this insurance will be primary and noncontribu- rights against all those other insurers. tory, if the written contract or agreement was made prior to the subject "occurrence" or of- When this insurance is excess over other in- tense. surance, we will pay only our share of the b. Excess Insurance amount of the loss, if any, that exceeds the sum of: This insurance is excess over: (1) The total amount that all such other insur- (1) Any of the other insurance, whether prima- ance would pay for the loss in the absence ry, excess,contingent or on any other basis: of this insurance; and (a) That is Fire, Extended Coverage, Build- (2) The total of all deductible and self-insured er's Risk, Installation Risk or similar amounts under all that other insurance. coverage for"your work"; We will share the remaining loss, if any, with (b) That is Fire insurance for premises any other insurance that is not described in this rented to you or temporarily occupied by Excess Insurance provision and was not you with permission of the owner; bought specifically to apply in excess of the (c) That is insurance purchased by you to Limits of Insurance shown in the Declarations cover your liability as a tenant for"prop- of this Coverage Part. erty damage"to premises rented to you c. Method Of Sharing or temporarily occupied by you with If all of the other insurance permits contribution permission of the owner;or by equal shares, we will follow this method al- (d) If the loss arises out of the maintenance so. Under this approach each insurer contrib- or use of aircraft, "autos"or watercraft to utes equal amounts until it has paid its applica- the extent not subject to Exclusion g. of ble limit of insurance or none of the loss Section I — Coverage A — Bodily Injury remains, whichever comes first And Property Damage Liability. ECG 24 520 08 05 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 2 ❑ with its permission. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this meth- od, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. ECG 24 520 01305 Includes copyrighted material of Insurance Services Office, Inc. Page 2 of 2 0 Used with its permission. COMMERCIAL GENERAL LIABILITY ECG 24 522 04 02 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following. COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Blanket Where Required By Written Contract, (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV — COMMERCIAL GENERAL LIABILITY CONDITIONS)is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your operations or"your work"done under a written agreement that requires you to waive your rights of recovery. The written agreement must be made prior to the date of the "occurrence". This waiver applies only to the person or organization shown in the Schedule above. ECG 24 522 04 02 Includes copyrighted material of Insurance Services Office, Page 1 of 1 ❑ Inc.,with its permission. EUM 24 565 10 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OTHER INSURANCE - PRIMARY AND NONCONTRIBUTORY FOR ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL CATASTROPHE LIABILITY COVERAGE PART A. Paragraph 5.Other Insurance, SECTION IV—COMMERCIAL CATASTROPHE LIABILITY CONDITIONS is replaced by the following. 5. Other Insurance a. This insurance is excess over, and will not contribute with any"other insurance", whether such "other insurance" is stated to be primary, excess, catastrophe, umbrella, contingent or on any other basis. However, "other insurance"does not include: (1) Insurance specifically written as excess over this Coverage Part;or (2) Insurance held by an additional insured described in paragraph 3. of SECTION II — WHO IS AN INSURED for which they are listed as a named insured, but only under a written contract between you and the additional insured: (a) Requiring a specific limit of insurance that is in excess of the"retained limit"; (b) Requiring that your insurance be primary insurance and not contribute with that of the additional insured; and (c) Executed prior to the loss. In such case as described in sub-paragraph (2)above,we shall not seek contribution from the additional insured's primary or excess insurance for which they are a named insured for amounts payable under this insurance. b. When this insurance is excess over"other insurance",we will pay only our share of the amount of loss, if any,that exceeds the sum of: (1) The total amount that all such other insurance would pay for loss in the absence of this insurance; and (2)The total of all deductible and self-insured amounts under all that other insurance. B. As respects this endorsement,the following definition is added: 1 "Other insurance" means insurance, or any type of self-insurance or other mechanism by which an insured arranges for the funding of legal liabilities,which is available to any insured and covers injury or damage to which this insurance applies, other than: a. "Underlying insurance"; or b. Insurance which is specifically purchased by you to be excess of the insurance afforded by this insurance. EUM 24 565 10 10 Copyright, Everest Reinsurance Co.,2010 Page 1 of 1 0 Includes copyrighted material of ISO Properties, Inc., used with its permission. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following. COMMERCIAL CATASTROPHE LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Blanket where required by written contract. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) Paragraph 13.Transfer Of Rights of Recovery Against Others To Us of Section IV—Commercial Catastro- phe Liability Conditions is amended by the addition of the following' If we waive in"underlying insurance"our right of recovery against the person or organization shown in the Sched- ule above because of payments we make for"injury' arising out of your operations or"your work"done under a written agreement that requires you to waive your rights of recovery,we will also waive those rights with respect to that"injury" under this insurance. However, this waiver only applies if the written agreement is made prior to the date of the "occurrence".This waiver applies only to the person or organization shown in the Schedule above. EUM 24 502 08 02 Copyright, Everest Reinsurance Company,2002 Page 1 of 1 ❑ Includes copyrighted material of Insurance Services Office, Inc.,with its permission For any claim or'suit"for damages wholly or 2. Except with respect to the ownership, partially within the "retained limit', you will maintenance. operation. use, loading or promptly reimburse us for any amount of"net unloading"or entrustment to others of any"auto" loss"we pay or aircraft. if you are designated In the d. We have no obligation to defend any claim Declarations as: or "suit" once the applicable Limit of a. An individual,your spouse is an insured, but Insurance for this Coverage Part has been only with respect to the conduct of a exhausted by the payment of"net loss" business of which you are the sole owner. 2. Supplementary Payments b. A partnership or joint venture, your We will pay. with respect to any claim or "suir members, your partners and their spouses we defend,or for such investigation and defense are insureds, but only with respect to the that we require the insured to make or cause to conduct of your business; be made: c. A limited liability company: a. All expenses we incur or the insured incurs (1) Your members are insureds, but only at our request. with respect to the conduct of your h. Up to $1,000 for the cost of bail bonds business;and required because of accidents or traffic law (2) Your managers are insureds, but only violations arising out of the use of any with respect to their duties as your vehicle to which liability for -bodily Injury' managers; under this Coverage Part applies.We do not d. An organization other than a partnership, have to furnish these bonds. joint venture or limited liability company; c. The cost of,bonds to release attachments, (1) Your 'executive officers" and your but only for bond amounts within the directors are insureds, but only with applicable limit of insurance. We do not have respect to their duties as your officers or to furnish these bonds. directors;and d. All reasonable expenses incurred by the (2) Your stockholders are insureds, but only Insured al our request to assist us In the with respect to their liability as investigation or defense of the claim or"suit", stockholders;or including actual loss of earnings up to$250 a day because of time off from work. e A trust, your trustees are also insureds, but only with respect to their duties as trustees. e. All costs taxed against the insured in the "suir. 3. Any other person or organization is an insured, who is included as an insured in "underlying f. Prejudgment interest awarded against the insurance", but only to the extent of the insured on that part of the judgment we pay. insurance provided the insured under'underlying If we make an offer to pay the applicable limit insurance", and not otherwise excluded by this of insurance, we will not pay any Coverage Part. prejudgmentinterest based on that period of time after thh offer. However, if coverage is required to be provided such an insured under a contract or agreement, g. All interest on the full amount of any the most we will pay for net loss' that such an judgment that accrues after entry of the insured becomes legally obligated to pay is the judgment and before we have paid, offered lesser of: to pay, or deposited in court the part of the The Limits Of Insurance for this Coverage judgment that is within the applicable limit of (a) pad;or insurance. The above payMents will not reduce the limits of (h) The amount of insurance required by the insurance for Coverage A, except for any fee or contract or agreement. expense deemed damages in "underlying less the fug amounts payable by "underlying insurance and assumed in a contract or insurance". agreement covered by this insurance. However, no person or organization is an insured SECTION II-WHOIIS AN INSURED with respect to the conduct of any current or past 1. If you are designated in the Declarations as a partnership,joint venture, limited liability company or Named insured,you are an insured. trust that is not shown as a Named Insured in the Declarations of this policy. EUM 00 502 08 02 Copyright,Everest Reinsurance Company, 1997 Page 5 of 12 Includes copyrighted material of Insurance Services Office,Inc. used With its permission. Copyright,Insurance Service Office,Inc., 1997 atAlaska National INSURANCE COMPANY BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following' BUSINESS AUTO COVERAGE FORM Various provisions in this endorsement restrict SECTION IV — Business Auto Conditions, coverage. Read the entire policy carefully to Paragraph A. 5. —Transfer of Rights of Recovery determine nghts, duties, and what is and is not Against Others To Us is amended to include: covered. 5. Transfer of Rights of Recovery Against Throughout this policy, the words "you" and "your Others to Us refer to the Named Insured shown in the Declarations. The words"we", "us", and"our" refer to This condition does not apply to any the company providing this insurance. person(s) or organization(s) to the extent that subrogation against that person or Other words and phrases that appear in quotation organization is waived prior to the "accident" marks have special meaning. Refer to SECTION V— or the"loss" under a contract with that person DEFINITIONS in the Business Auto Coverage Form. or organization. The coverages provided by this endorsement apply SECTION II — COVERED AUTO LIABILITY per "accident" and, unless otherwise specified, are COVERAGE, Paragraph A.2.a. (2)—Supplementary subject to all of the terms, conditions, exclusions and Payments is replaced by the following. deductible provisions of the policy, to which it is attached. (2) Up to $10,000 for cost of bail bonds (including bonds for related traffic law SECTION II — COVERED AUTO LIABILITY violations) required because of an COVERAGE, Paragraph A.1. Who Is An Insured is "accident"we cover. We do not have amended to include: to furnish these bonds. d. Any "employee" of yours while operating SECTION II — COVERED AUTO LIABILITY an "auto" hired or rented under a COVERAGE, Paragraph A.2.a. (4)—Supplementary contract or agreement in an "employee's" Payments is replaced by the following name, with your permission, while performing duties related to the conduct (4) All reasonable expenses incurred by of your business. the"insured"at our request, including actual loss of earnings up to $500 a e. Any person or organization for whom you day because of time off from work. have agreed in writing to provide insurance such as is afforded by this Coverage Form, but only with respect to liability arising out of the ownership, maintenance or use of"autos"covered by this policy. If such person or organization has other insurance then this insurance is primary to and we will not seek contribution from the other insurance. ANIC CA 1150 10 13 Page 1 of 4 MrAlaska National INSURANCE COMPANY c. "Loss" caused by falling objects or SECTION II — COVERED AUTO LIABILITY missiles. COVERAGE, Paragraph A.2.c.—Voluntary Property Damage is added as follows However,you have the option of having glass breakage caused by a covered "auto's" c. Voluntary Property Damage collision or overturn considered a"loss" under Collision Coverage. At your written request, we may make a voluntary payment for Property Damage Glass Repair—Waiver of Deductible caused by an "insured", but without liability to a third party, up to$25,000.We No deductible applies to glass breakage, if will not make a Voluntary Property the glass is repaired rather than replaced. Damage payment to anyone who is an "insured" under this policy. SECTION Ill — PHYSICAL DAMAGE COVERAGE, Paragraph A.4.a. — Transportation Expenses is SECTION III — PHYSICAL DAMAGE COVERAGE, replaced by the following: Paragraph A.2.—Towing is replaced by the following: a. Transportation Expenses Towing We will pay up to $200 per day to a We will pay up to $500 for towing and labor maximum of $1,500 for temporary costs incurred each time a covered "auto" transportation expense incurred by you that is a: because of the total theft of a covered "auto"that is a: a. Private passenger; (1) Private passenger; b. Truck, (2) Truck, c. Pick-up truck, (3) Pick-up truck; d. Panel ,or (4) Panel; or e. Van (5) Van type vehicle under 20,000 lbs. of Gross Vehicle Weight is disabled. However, the type vehicle under 20,000 lbs. of Gross labor must be performed at place of Vehicle Weight. We will pay only for disablement. those covered"autos"for which you carry eitheSECTION III — PHYSICAL DAMAGE COVERAGE, Causes ofCLoss Coverage.a or Specifiedwill of Loss We will pay Paragraph A.3. — Glass Breakage — Hitting a Bird for temporary transportation expenses or Animal—Falling Objects or Missiles is replaced incurred during the period beginning 48 by the following: hours after the theft and ending, regarGlass Breakage—Hittinga Bird or Animal when thes of the"auto"policists expiration, 9 covered returned to —Falling Objects or Missiles use or we pay for its"loss" If you carry Comprehensive Coverage for the damaged covered "auto", we will pay the following under Comprehensive Coverage. a. Glass Breakage; b. "Loss" caused by hitting a bird or animal; and ANIC CA 1150 10 13 Page 2 of 4 ate Alaska National INSURANCE COMPANY (2) Specified Causes of Loss only if the SECTION III — PHYSICAL DAMAGE COVERAGE, Declarations indicate that Specified Paragraph A.4.b. — Loss of Use Expenses is Causes of Loss Coverage is provided replaced by the following: for the"auto"withdrawn from service; or b. Loss of Use Expenses—Hired, Rented, (3) Collision only if the Declarations or Borrowed Automobiles indicate that Collision Coverage is provided for the "auto" withdrawn We will pay expenses for which an from service. "insured" becomes legally responsible to pay for loss of use of a vehicle hired, SECTION 10 — PHYSICAL DAMAGE COVERAGE, rented or borrowed without a driver under Paragraph A.4.d. — Airbag Coverage is added as a written rental contract or agreement. follows: We will pay for loss of use expenses, if caused by. d. Airbag Coverage (1) Other than Collision, only if the We will pay for the cost to repair, replace, Declarations indicate that or reset an airbag that inflates for any Comprehensive Coverage is provided reason other than as a result of a for the vehicle withdrawn from collision, if the Declarations indicate that service. the covered "auto" has Comprehensive Coverage or Specified Causes of Loss (2) Specified Causes of Loss only if the Coverage. Declarations indicate that Specified Causes of Loss Coverage is provided SECTION III — PHYSICAL DAMAGE COVERAGE, for the vehicle withdrawn from Paragraph A.4.e. — Rental Reimbursement service. Coverage is added as follows: (3) Collision only if the Declarations e. Rental Reimbursement Coverage indicate that Collision Coverage is provided for the vehicle withdrawn We will pay up to $75 per day for rental from service. reimbursement expenses incurred by you for the rental of an "auto" because of However, the most we will pay for any "loss"to a covered"auto"that is a: expenses for loss of use is$200 per day,to a maximum of$1,500. (1) Private Passenger; SECTION III — PHYSICAL DAMAGE COVERAGE, (2) Truck; Paragraph A.4.c.—Non-Transportation Loss of Use Expenses is added as follows: (3) Pick-up truck; c. Non-Transportation Loss of Use (4) Panel; or Expenses (5) Van We will pay up to $2,000 for non- transportation expense incurred by you, type vehicle under 20,000 lbs. of Gross because of "loss" to a covered "auto", if Vehicle Weight. Payment applies in caused by. addition to the otherwise applicable amount of each coverage you have on a (1) Other than Collision, only if the covered "auto". No deductibles apply to Declarations indicate that this coverage. Comprehensive Coverage is provided for the"auto"withdrawn from service; ANIC CA 1150 10 13 Page 3 of 4 arAlaska National INSURANCE PANY (1) We will pay only for those expenses SECTION IV — BUSINESS AUTO CONDITIONS — incurred during the policy period Paragraph B.5.b. — Other Insurance is replaced by beginning 24 hours after the "loss" the following. and ending, regardless of the policy's expiration, with the lesser of the b. For Hired Auto Physical Damage following number of days: Coverage, the following are deemed to be covered"autos"you own: (a) The number of days reasonably required to repair or replace the (1) Any covered "auto" you lease, hire, covered"auto". rent, or borrow, and (b) 30 days. (2) Any covered "auto"" hired or rented by your "employee" under a contract (2) This coverage does not apply while in that individual "employee's" name, there are spare or reserve "autos" with your permission, while available to you for your operations. performing duties related to the conduct of your business. (3) The Rental Reimbursement Coverage described above does not However, any"auto"that is leased, hired, apply to a covered "auto" that is rented or borrowed with a driver is not a described or designated as a covered covered"auto" "auto" on Rental Reimbursement Coverage Form CA 99 23. SECTION V — DEFINITIONS — Paragraph C. — SECTION IV — BUSINESS AUTO CONDITIONS — "Bodily injury" is replaced by the following: Paragraph B.2. —Concealment, Misrepresentation Or Fraud is amended by adding Unintentional Failure C. "Bodily injury" means bodily injury, sickness or to Disclose Hazards at the end of Paragraph B.2. as disease sustained by a person including death or follows. mental anguish resulting from any of these. Mental anguish means any type of mental or Unintentional Failure to Disclose Hazards emotional illness or disease If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal. This endorsement changes the policy to which it is attached and, unless otherwise stated, is effective on the date issued at 12:01 A.M. standard time at your mailing address shown in the policy. The information below is required only when this endorsement is issued subsequent to commencement of the policy. Endorsement Effective Policy No. Insured Endorsement No Countersigned By ©Insurance Services Office, Inc.,2009 ANIC CA 1150 10 13 Page 4 of 4