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19-153.00 AM Landshaper: Edgecliff Park Swings Contract No. 19-153.00 CONSTRUCTION AGREEMENT AM Landshaper,Inc. THIS CONSTRUCTION AGREEMENT (the "Agreement") is made by and between the City of Spokane Valley, a code City of the State of Washington("City")and AM Landshaper.Inc.,("Contractor") jointly referred to as the"Parties". IN CONSIDERATION of the terms and conditions contained herein the Parties agree as follows: I. Work to Be Performed Contractor shall do all work and furnish all labor,supervision,tools, materials, supplies, and equipment and other items necessary for the construction and completion of the Edgecliff Park Swings Project(the"Work")in accordance with documents described in Exhibit B and in accordance with this Agreement (which are by this reference incorporated herein and made part hereof and referred to as the "Contract Documents"), and shall perform any changes in the work in accordance with the Contract Documents. The terms and provisions in this Agreement shall control over any inconsistent or incompatible terms in any other Contract Document. Contractor shall, for the amount set forth in paragraph 4, below, assume and be responsible for the cost and expense of all work required for constructing and completing the Work and related activities to the City's satisfaction, provided for in the Contract Documents, within the time limits prescribed in the Contract Documents. The City Manager or designee shall administer and be the primary contact for Contractor. Upon notice from City,Contractor shall promptly commence work,complete the same in a timely manner,and cure any failure in performance under this Agreement. Unless otherwise directed by City,all work shall be performed in conformance with the Contract Documents, and all City,state,and federal standards,codes,ordinances,regulations,and laws as now existing or as may be adopted or amended. 2. Time for Performance. Contractor shall commence the Work within 10 days of receipt of a notice to proceed and shall complete the Work by December 31,2019 with substantial completion being December 15, 2019. 3. Liquidated Damaaes. Time is of the essence for this Agreement. Delays cause inconvenience to the residents of City and cost taxpayers undue sums of money,adding time needed for administration,engineering, inspection, and supervision It is impractical for City to calculate the actual cost of delays. Accordingly, Contractor agrees to pay liquidated damages for failure to achieve Substantial Completion(as defined in the Contract Documents) which shall be in the amount of$150.00 per day. These liquidated damages are not a penalty,but are fixed and agreed upon by and between Contractor and City because of the impracticability and difficulty of fixing and ascertaining the actual damages that City would sustain in the event that the Work is not completed in accordance with the Contract Documents. Liquidated damages may be retained by City and deducted from payments otherwise due to the Contractor. 4. Compensation In consideration of Contractor performing the Work, City agrees to pay Contractor in accordance with the Contract Documents the sum of $33,951.00, plus Washington State Sales Tax of Construction Agreement Page 1 of 9 $3,021.64(if applicable),for a total of$36.972.64.based on the bid submitted by Contractor(Exhibit B),and as may be adjusted in accordance with the Contract Documents. 5.Payment. Contractor may elect to be paid in monthly installments,upon presentation of an application for payment to a form satisfactory to City. Applications for payment shall be sent to the City Finance Department at the address stated in paragraph 6. Pursuant to chapter 60.28 RCW,five percent of the compensation due Contractor shall be retained by City. City reserves the right to withhold payment under this Agreement for that portion of the work(if any)which is determined in the reasonable judgment of the City Manager or designee to be noncompliant with the Contract Documents,City standards, City Code, state standards,or federal standards. 6. Notice. Notice other than applications for payment shall be given in writing as follows: TO THE CITY: TO THE CONTRACTOR: Name: Christine Bainbridge,City Clerk Name: A M Landshaper, Inc Phone:(509) 720-5000 Phone: (509)468-4335 Address: 10210 East Sprague Avenue Address: 8004 N. Market Spokane Valley,WA 99206 Spokane, WA 99217 7.Applicable Laws and Standards. The Parties,in the performance of this Agreement,agree to comply with all applicable federal, state,and local laws,codes,and regulations 8. Certification Regarding Debarment, Suspension, and Other Responsibility Matters — Primary Covered Transactions. A.By executing this Agreement,the Consultant certifies to the best of its knowledge and belief,that it and its principals: 1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal department or agency, 2. Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local)transaction or contract under a public transaction;violation of federal or state antitrust statutes or commission of embezzlement,theft,forgery,bribery,falsification or destruction of records, making false statements, or receiving stolen property; 3. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph(A)(2)of this certification;and 4. Have not within a three-year period preceding this application/proposal had one or more public transactions(federal,state,or local)terminated for cause or default. B. Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this Agreement. 9.Prevailing Wages on Public Works. Contractor,any subcontractor,or other person doing work under this Agreement, shall comply with the requirements of chapter 39.12 RCW, and shall pay each employee an Construction Agreement Page 2 of 9 amount not less than the Prevailing Rate of Wage,as specified by the Industrial Statistician of the Washington State Department of Labor and Industries("L&I"). If employing labor in a class not shown,Contractor shall request a determination of the correct wage rate for the class and locality from the Industrial Statistician. Contractor shall provide a copy of any such determinations to City. Before commencing,during,and upon completion of the work,Contractor shall file all forms and pay all fees required by L&I and shall indemnify and hold City harmless from any claims related to its failure to comply with chapter 39.12 RCW. The following information is provided pursuant to RCW 39.12 030: A. State of Washington prevailing wage rates applicable to this public works project, published by L&I, are located at the L&I website address: https://fortress.wa.govil n i/wagelookup/pryW agelookup.aspx B. This Project is located in Spokane County. C. The effective prevailing wage date is the same date as the bid due date as referenced in the original request for bids and as may be revised by addenda A copy of the applicable prevailing wage rates is also available for viewing at the City Community&Public Works Department located at 10210 East Sprague Avenue,Spokane Valley,WA 99206. Upon request,City will mail a hard copy of the applicable prevailing wages for this project. 10. Relationship of the Parties. It is understood and agreed that Contractor shall be an independent contractor and not the agent or employee of City,that City is interested only in the results to be achieved,and that the right to control the particular manner,method,and means in which the services are performed is solely within the discretion of Contractor. Any and all employees who provide services to City under this Agreement shall be deemed employees solely of Contractor. Contractor shall be solely responsible for the conduct and actions of all its employees under this Agreement and any liability that may attach thereto. 11.Ownership of Documents. All drawings,plans,specifications,and other related documents prepared by Contractor under this Agreement are and shall be the property of City, and may be subject to disclosure pursuant to chapter 42.56 RCW, or other applicable public record laws. 12.Records. The City or State Auditor or any of their representatives shall have full access to and the right to examine during normal business hours all of Contractor's records with respect to all matters covered in this Agreement. Such representatives shall be permitted to audit,examine,make excerpts or transcripts from such records,and to make audits of all contracts,invoices,materials,payrolls,and record of matters covered by this Agreement for a period of three years from the date final payment is made hereunder. 13.Warranty. Unless provided otherwise in the Contract Documents,Contractor warrants that all Work and materials performed or installed under this Agreement are free from defect or failure for a period of one year following final acceptance by City,unless a supplier or manufacturer has a warranty for a greater period,which warranty shall be assigned or transferred to City. In the event a defector failure occurs in work or materials, Contractor shall, within the warranty period, remedy the same at no cost or expense to City. This warranty provision shall not be construed to establish a period of limitation with respect to Contractor's other obligations under this Agreement. Construction Agreement Page 3 of 9 14.Contractor to Be Licensed and Bonded. Contractor shall be duly licensed,registered,and bonded by the State of Washington at all times this Agreement is in effect. 15 Contractor to Provide Performance and Payment Bonds. Contractor shall provide a payment bond and a performance bond in the full amount of the Agreement on the City's bond fortes. Alternatively,Contractor may elect to have the City retain 10%of the Agreement amount in lieu of providing the City with a payment bond and a performance bond,pursuant to RCW 39.08.010(3). 16. Insurance. Contractor shall procure and maintain for the duration of the Agreement insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by Contractor, its agents,representatives, or employees. A.Minimum Scooe of Insurance. Contractor shall obtain insurance of the types described below: 1.Automobile liability insurance covering all owned,non-owned,hired,and leased vehicles. Coverage shall be written on Insurance Services Office(ISO)form CA 00 01 or a substitute form providing equivalent liability coverage. If necessary, the policy shall be endorsed to provide contractual liability coverage. 2 Commercial general liability insurance shall be written on ISO occurrence form CG 00 01 and shall cover liability arising from premises,operations,independent contractors,products- completed operations, stop gap liability, personal injury, advertising injury, and liability assumed under an insured contract. The commercial general liability insurance shall be endorsed to provide a per project aggregate limit using ISO form CG 25 03 05 09 or an equivalent endorsement. There shall be no endorsement or modification of the commercial general liability insurance for liability arising from explosion, collapse, or underground property damage. City shall be named as an additional insured under Contractor's commercial general liability insurance policy with respect to the work performed for City using ISO Additional Insured endorsement CG 20 10 10 01 and Additional Insured-Completed Operations endorsement CG 20 37 10 01 or substitute endorsements providing equivalent coverage. 3. Workers'compensation coverage as required by the industrial insurance laws of the State of Washington. B. Minimum Amounts of Insurance. Contractor shall maintain the following insurance limits: 1.Automobile liability insurance with a minimum combined single limit for bodily injury and property damage of no less than $1,000,000 per accident. 2.Commercial general liability insurance shall be written with limits no less than$1,000,000 each occurrence, $2,000,000 general aggregate, and no less than a $2,000,000 products- completed operations aggregate limit. C.Other Insurance Provisions. The insurance policies are to contain,or be endorsed to contain,the following provisions for automobile liability and commercial general liability insurance: 1. Contractor's insurance coverage shall be primary insurance with respect to City. Any insurance, self-insurance,or insurance pool coverage maintained by City shall be excess of Contractor's insurance and shall not contribute with it. Construction Agreement Page 4 of 9 2 Contractor shall fax or send electronically in .pdf format a copy of insurer's cancellation notice within two business days of receipt by Contractor 3 If Contractor maintains higher insurance limits than the minimums shown above,City shall be insured for the full available limits of commercial general and excess or umbrella liability maintained by Contractor, irrespective of whether such limits maintained by Contractor are greater than those required by this Agreement or whether any certificate of insurance furnished to the City evidences limits of liability lower than those maintained by Contractor. 4. Failure on the part of Contractor to maintain the insurance as required shall constitute a material breach of this Agreement, upon which the City may, after giving at least five business days' notice to Contractor to correct the breach, immediately terminate the Agreement, or at its sole discretion, procure or renew such insurance and pay any and all premiums in connection therewith, with any sums so expended to be repaid to City on demand, or at the sole discretion of the City, offset against funds due Contractor from the City. D.Acceptability of Insurers. Insurance is to be placed with insurers with a current A.M.Best rating of not less than A:VII. E. Evidence of Coverage. As evidence of the insurance coverages required by this Agreement, Contractor shall furnish acceptable insurance certificates to City at the time Contractor returns the signed Agreement,which shall be Exhibit C. The certificate shall specify all of the parties who are additional insureds,and shall include applicable policy endorsements,and the deduction or retention level. Insuring companies or entities are subject to City acceptance. If requested,complete copies of insurance policies shall be provided to City. Contractor shall be financially responsible for all pertinent deductibles,self-insured retentions, and/or self-insurance. F.Subcontractor Insurance. Contractor shall cause each and every subcontractor to provide insurance coverage that complies with all applicable requirements of the Contractor-provided insurance as set forth herein,except Contractor shall have sole responsibility for determining the limits of coverage to be required to be obtained by subcontractors. Contractor shall ensure that the City is an additional insured on each and every subcontractor's commercial general liability insurance policy using an endorsement at least as broad as ISO additional insured endorsement CG 20 38 04 13. 17.Indemnification and Hold Harmless. Contractor shall,at its sole expense,defend,indemnify,and hold harmless City and its officers, agents, and employees, from any and all claims, actions, suits, liability, loss, costs,attorney's fees and costs of litigation,expenses,injuries,and damages of any nature whatsoever relating to or arising out of the wrongful or negligent acts,errors,or omissions in the services provided by Contractor, Contractor's agents, subcontractors, subconsultants, and employees to the fullest extent permitted by law, subject only to the limitations provided below. Contractor's duty to defend,indemnify,and hold City harmless shall not apply to liability for damages arising out of such services caused by or resulting from the sole negligence of City or City's agents or employees. Contractor's duty to defend,indemnify,and hold City harmless against liability for damages arising out of such services caused by the concurrent negligence of(a) City or City's agents or employees, and(b)Contractor, Contractor's agents, subcontractors, subconsultants, and employees shall apply only to the extent of the negligence of Contractor,Contractor's agents,subcontractors,subconsultants, and employees. Construction Agreement Page 5 of 9 Contractor's duty to defend,indemnify,and hold City harmless shall include,as to all claims,demands,losses, and liability to which it applies, City's personnel-related costs,reasonable attorneys'fees,and the reasonable value of any services rendered by the office of the City Attorney,outside consultant costs,court costs,fees for collection,and all other claim-related expenses. Contractor specifically and expressly waives any immunity that may be granted it under the Washington State Industrial Insurance Act,Title 51 RCW. These indemnification obligations shall not be limited in any way by any limitation on the amount or type of damages,compensation,or benefits payable to or for any third party under workers' compensation acts, disability benefit acts, or other employee benefits acts. Provided, that Contractors waiver of immunity by the provisions of this paragraph extends only to claims against Contractor by City,and does not include,or extend to,any claims by Contractor's employees directly against Contractor. Contractor hereby certifies that this indemnification provision was mutually negotiated. 18 Waiver. No officer,employee,agent,or other individual acting on behalf of either party has the power, right,or authority to waive any of the conditions or provisions of this Agreement. No waiver in one instance shall be held to be waiver of any other subsequent breach or nonperformance. All remedies afforded in this Agreement or by law shall be taken and construed as cumulative and in addition to every other remedy provided herein or by law. Failure of either party to enforce at any time any of the provisions of this Agreement or to require at any time performance by the other party of any provision hereof shall in no way be construed to be a waiver of such provisions nor shall it affect the validity of this Agreement or any part thereof. 19. Assignment and Delegation. Neither party shall assign, transfer, or delegate any or all of the responsibilities of this Agreement or the benefits received hereunder without first obtaining the written consent of the other party. 20. Confidentiality. Contractor may,from time-to-time,receive information which is deemed by City to be confidential. Contractor shall not disclose such information without the pnor express written consent of City or upon order of a Court of competent jurisdiction. 21.Disputes. All disputes arising under or related to this Agreement that cannot be resolved through informal discussion and negotiations shall be resolved by litigation filed in the Superior Court of the State of Washington for Spokane County,unless otherwise required by applicable federal or state law. 22. Subcontractor Responsibility. As required by RCW 39.06.020,Contractor shall verify responsibility criteria for each first tier subcontractor and its subcontractors of any tier that hires other subcontractors shall verify responsibility criteria for each of its subcontractors. Verification shall include that each subcontractor,at the time of subcontract execution,meets the responsibility criteria listed in RCW 39.04.3500)and possesses an electrical contractor license,if required by chapter 19.28 RCW,or an elevator contractor license if required by chapter 70.87 RCW. This verification requirement shall be included in every subcontract of every tier. 23.Jurisdiction and Venue. This Agreement is entered into in Spokane County,Washington Venue shall be in Spokane County, State of Washington. 24. Entire Agreement. This Agreement constitutes the entire and complete agreement between the parties and supercedes any prior oral or written agreements. This Agreement may not be changed,modified,or altered except in writing signed by the Parties Construction Agreement Page 6 of 9 25. Anti-kickback. No officer or employee of City,having the power or duty to perform an official act or action related to this Agreement, shall have or acquire any interest in this Agreement, or have solicited, accepted, or granted a present or future gift, favor, service, or other thing of value from any person with an interest in this Agreement. 26.Business Registration. Prior to commencement of Work under this Agreement,Contractor shall register with the City as a business if it has not already done so. 27.Severability. If any section,sentence,clause,or phrase of this Agreement should be held to be invalid for any reason by a court of competent jurisdiction,such invalidity shall not affect the validity of any other section, sentence, clause, or phrase of this Agreement. 28. Exhibits. Exhibits attached and incorporated into this Agreement are: A Assurance of compliance with applicable federal laws B. Bid Response Documents C. Insurance Endorsements D. Performance and Payment Bond The Parties have executed this Agreement this 9th day of October, 2019. CITY OF SPOKANE VALLEY: Contractor: A.M.LANDSHAPER,INC. Mark Calhoun, City Manager By: Tye C. McGee Its. Authorized Representative ATTEST: a it Christine Bainbridge, ity Clerk APPROVED AS TO FORM: Office of e City Attorney Construction Agreement Page 7 of 9 Exhibit A—Assurance of Compliance with Applicable Federal Law During the performance of this Agreement,the Contractor, for itself, its assignees, and successors in interest(hereinafter referred to as the "Contractor")agrees as follows: 1.Compliance with Regulations:The Contractor shall comply with the federal laws set forth in Section 7 of this Exhibit("Acts and the Regulations")relative to non-discrimination in federally-assisted programs of the U.S. Department of Transportation,Washington State Department of Transportation(WSDOT),as they may be amended from time-to-time,which are herein incorporated by reference and made a part of this Agreement. 2.Non-discrimination:The Contractor,with regard to the work performed by it during this Agreement,shall not discriminate on the grounds of race, color, or national origin in the selection and retention of subcontractors, including procurements of materials and leases of equipment. The Contractor shall not participate directly or indirectly in the discrimination prohibited by the Acts and the Regulations, including employment practices when the contract covers any activity,project,or program set forth in Appendix B of 49 CFR Part 21. 3 Solicitations for Subcontracts, Including Procurements of Materials and Equipment: In all solicitations,either by competitive bidding,or negotiation made by the Contractor for work to be performed under a subcontract,including procurements of materials,or leases of equipment,each potential subcontractor or supplier shall be notified by the Contractor of the Contractor's obligations under this Agreement and the Acts and the Regulations relative to non-discrimination on the grounds of race,color, or national origin. 4. Information and Reports The Contractor shall provide all information and reports required by the Acts, the Regulations,and directives issued pursuant thereto,and shall permit access to its books,records,accounts, other sources of information,and its facilities as may be determined by the City or the WSDOT to be pertinent to ascertain compliance with such Acts, Regulations, and instructions. Where any information required of Contractor is in the exclusive possession of another who fails or refuses to furnish the infonnation, the Contractor shall so certify to the City or the WSDOT, as appropriate, and shall set forth what efforts it has made to obtain the information. 5. Sanctions for Noncompliance:In the event of a Contractor's noncompliance with the non-discrimination provisions of this Agreement,the City will impose such contract sanctions as it or the WSDOT may determine to be appropriate, including, but not limited to: a.withholding payments to the Contractor under the Agreement until the Contractor complies; and/or b. cancelling,terminating,or suspending the Agreement, in whole or in part. 6.Incorporation of Provisions:The Contractor shall include the provisions of paragraphs one through six of this Exhibit in every subcontract,including procurements of materials and leases of equipment,unless exempt by the Acts, the Regulations and directives issued pursuant thereto. The Contractor shall take action with respect to any subcontract or procurement as the City or the WSDOT may direct as a means of enforcing such provisions,including sanctions for noncompliance. Provided,that if the Contractor becomes involved in,or is threatened with litigation by a subcontractor or supplier because of such direction,the Contractor may request that the City enter into any litigation to protect the interests of the City. In addition,the Contractor may request the United States to enter into the litigation to protect the interests of the United States. 7. Pertinent Non-Discrimination Authorities: During the performance of this Agreement, the Contractor agrees to comply with the following non-discrimination statutes and authorities;including but not limited to: Construction Agreement Page 8 of 9 Title VI of the Civil Rights Act of 1964(42 U.S.C. §2000d et seq.,78 stat.252).(prohibits discrimination on the basis of race,color,national origin); and 49 CFR Part 21; The Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, (42 U S.C. §4601),(prohibits unfair treatment of persons displaced or whose property has been acquired because of Federal or Federal-aid programs and projects); Federal-Aid Highway Act of 1973,(23 U.S.C. §324 et seq.).(prohibits discnmination on the basis of sex); Section 504 of the Rehabilitation Act of 1973, (29 U.S.C. §794 et seq.), as amended, (prohibits discrimination on the basis of disability):and 49 CFR Part 27; The Age Discrimination Act of 1975,as amended,(42 U.S.C. §6101 et seq.),(prohibits discrimination on the basis of age): Airport and Airway Improvement Act of 1982, (49 USC §471. Section 47123), as amended, (prohibits discrimination based on race,creed, color, national ongin, or sex); The Civil Rights Restoration Act of 1987,(PL 100-209),(Broadened the scope,coverage and applicability of Title VI of the Civil Rights Act of 1964,The Age Discrimination Act of 1975 and Section 504 of the Rehabilitation Act of 1973,by expanding the definition of the terms"programs or activities"to include all of the programs or activities of the Federal-aid recipients, sub-recipients and contractors,whether such programs or activities are Federally funded or not); Titles II and III of the Americans with Disabilities Act, which prohibit discrimination on the basis of disability in the operation of public entities, public and private transportation systems, places of public accommodation,and certain testing entities(42 U.S.C. §§12131-12189)as implemented by Department of Transportation regulations at 49 C.F.R. parts 37 and 38; The Federal Aviation Administration's Non-discrimination statute (49 U.S.C. §47123) (prohibits discrimination on the basis of race, color, national origin, and sex); Executive Order 12898,Federal Actions to Address Environmental Justice in Minority Populations and Low-Income Populations,which ensures Non-discrimination against minority populations by discouraging programs,policies,and activities with disproportionately high and adverse human health or environmental effects on minority and low-income populations, Executive Order 13166,Improving Access to Services for Persons with Limited English Profic iency,and resulting agency guidance, national origin discrimination includes discrimination because of Limited English proficiency(LEP).To ensure compliance with Title VI,you must take reasonable steps to ensure that LEP persons have meaningful access to your programs(70 Fed. Reg. at 74087 to 74100), Title IX of the Education Amendments of 1972, as amended, which prohibits you from discriminating because of sex in education programs or activities(20 U.S C §1681 et seq.). Construction Agreement Page 9 of 9 crrrokan � jMalley PART 3 BID RESPONSE DOCUMENTS EDGECLIFF PARK SWINGS September 4, 2019 City of Spokane Valley, Washington Parks and Recreation Department 2426 N. Discovery Place Spokane Valley, WA 99216 Prepared By: MTBIL A Michael Terrell ■ Landscape Architecture, PLLC 1421 North Meadowwood Lane, Suite 150 Liberty Lake, WA 99019 (509) 922-7449 EDGECLIFF PARK SWINGS CITY OF SPOKANE VALLEY PARKS AND RECREATION DEPARTMENT • Person/Entity Name: AM Landehaper,Inc Signature Of Bidder: /(q. Part 3 - Bid Response Documents Page II EDGECLIFF PARK SWINGS CRY OF SPOKANE VALLEY PARKS AND RECREATION DEPARTMENT PART 3 - BID RESPONSE DOCUMENTS BID PROPOSAL PROJECT TITLE: Edgecliff Park Swings NAME OF FIRM SUBMITTING BID: AM I andchaner Inc Each bid shall constitute an offer to the City of Spokane Valley as outlined herein and no bidder may withdraw his bid after the hour set for the bid dosing except under the conditions explained in the Information to Bidders Section. RECEIPT OF ADDENDA: Bidder acknowledges receipt of the following addenda: Addendum No. Date Addendum No. Date REJECTION: The City reserves the right to reject any or all proposals, portions or parts thereof and to waive all minor Irregularities in bidding. Special attention will be directed to the qualifications of the bidders when considering awarding a contract. TIME TO COMPLETE: The work related to the EDGECLIFF PARK SWINGS will be substantially completed by November 15, 2019. BID IS NOT ELIGIBLE FOR CONTRACTOR'S BOND ELECTION to withhold 50% retainage in lieu of furnishing a Contractor's Bond (Performance and Payment Bond). SUBCONTRACTORS LIST: See Special Conditions SUBMITTAL: The"Bid Response Documents"Section constitutes the Bid Proposal when completed and submitted. Please do not submit the entire Invitation to Bid manual. FREIGHT: Bid price(s) to include all freight costs to the job site. Person/Entity Name: AM I andchapar, Inn Signature Of Bidder: 12 (7 1,*?/ '-` Part 3 - Bid Response Documents Page III EDC.LCT.IFF PARK SWINGS CITY OF SPOKANE VALLEY PARKS AND RECREATION DEPARTMENT Edgediff Park Swings— Base Bld As identified in the Construction Documents plans and details. 1. This project consists of the construction of a swing set in the existing Edgecliff Park. Base Bid Work includes excavation,grading, swing equipment installation,safety surfacing Installation, play area curb Installation, concrete walk Installation, and sod placement and repair of all disturbed areas and construction access, and irrigation repair. BASE BID = $ 33,951.00 8.9% SALES TAX = $ 3,021.64 TOTAL BASE BID = $ 36,972.64 Alternate #1 1. Not Applicable ALTERNATE#1 = $ 8.9%SALES TAX = $ TOTAL Al TFRNATE #1 = $ BID SUMMARY TOTAL BASE BID= $ 36,972.64 GRAND TOTAL = $ 36,972.64 Person/Entity Name: AM I anrichnpar, Inr Signature Of Bidder: 2 {- 'Y"'� Part 3 - Bid Response Documents Page IV EDGECLIFF PARK SWINGS CITY OF SPOKANE VALLEY PARKS AND RECREATION DEPARTMENT REPRESENTATIONS AND CERTIFICATIONS Part 3 - Bid Response Documents Page V EDGECLIFF PARK SWINGS CITY OF SPOKANE VALLEY PARKS AND RECREATION DEPARTMENT ANTI-KICKBACK No officer or employee of the City of Spokane Valley, having the power or duty to perform an official act or action related to this submittal, shall have or acquire any Interest In this submittal, or have solicited, accepted or granted a present or future gift, favor, service, or other thing of value from or to any person involved in this submittal. REPRESENTATION: In submitting this bid we represent that the bid documents have been read and understood, that the site has been visited and or that we have familiarized ourselves with the local conditions under which the work is to be performed, that by signature of this proposal we acknowledge all requirements and that we have signed all certificates contained herein. REPRESENTATION: In submitting this bid we acknowledge the requirements and conditions applicable to bid deposits in the form of a cash bid deposit or surety bond bid deposit. I CERTIFY that no final determination of violation of RCW 50.12.070(1)(b), 50.16.070(1)(b), or 82.32.070(1)(b) has been made by the Washington State Departments of Employment Security, Labor And Industries or Revenue respectively dated within two years of the date of the opening of this bid. I understand further that no bid may be submitted, considered or contract awarded for a public work to any person or entity that has a determination of violation of the above referenced statutes within two years from the date that a violation Is finally determined and the date of this bid opening. I CERTIFY that to the best of my knowledge the information contained in this proposal is accurate and complete and that I have the legal authority to commit this Firm to a contractual agreement. I realize the final funding for any service is based upon budget levels and the approval of the City of Spokane Valley. Name: AM andchaper,Inc. Person/Entity submitting bid (print) y� i Signature: / �- C- /.92 Title: Secretary/Treasurer Date: 9/20/19 Part 3 - Bld Response Documents Page VI This document contains confidential tax information and Lias been redacted pursuant to RCW 82.32.330. You may petition for a review of our findings pertaining to any redacted or withheld documents pursuant to Spokane Valley Municipal Code (SVMC) 2.75.080; and obtain judicial review EDGECLIFF PARK SWINGS pursuant to RCW 42 56 550 CITY OF SPOKANE VALLEY PARKS AND RECREATION DEPARTMENT BIDDER'S ADMINISTRATIVE INFORMATION 1. PERSON/ENTITY a. Name as registered with the State of Washington: AM Landshaper, Inc., b. Physical Address:8004 N. Market Spokane, WA 99217 c. Mailing Address including zip code: same as physical address d. Remit To Address including zip code: same as physical address e. Telephone number including area code: (509)468-4335 f. Fax number including area code: (509)468-4225 g. E-mail address for business correspondence:amlandshaper@msn.com h. Washington State Contractors License Number: AMLANI*971D0 i. Federal Tax Identification Number REDACTED j. Washington State UBI Number: 601 701 273 k. State Industrial Account Identification Number: 816,368 01 2. INSURANCE COMPANY: a. Name of company: Cincinnati Insurance Co. b. Mailing Address including zip code: PO Box 145620 Cincinnatti, Oh 45250-5620 c. Insurance Agent Name: Clint Morton d. Insurance Agent Telephone number including area code: (509)838-3501 e. Insurance Agent Fax number Including area code: (509)838-3511 3. BONDING COMPANY: a. Surety Name: North American Specialty Insurance Co. b. Surety Mailing Address including zip code: 1420 5th Ave STE 2200 Seattle, WA 98101 c. Bonding Agent Name: George Schroeder d. Bonding Agent Mailing Address including zip code:Alliant Insurance 818 W. Riverside Ste 800 Spokane, WA 99201 e. Bonding Agent Telephone number including area code: (509)325-1863 f. Bonding Agent Fax number including area code: (509)325-1803 Part 3 - Bid Response Documents Page VII EDGECLIFF PARK SWINGS CITU OF SPOKANE VALLEY PARKS AND RECREATION DEPARTMENT Bidder to orovide the following information for ALL of the following trades/sub- contractors. y General Contractor g, Certified Plavaround Eauiament Installer BIDDER QUALIFICATION STATEMENT - GENERAL CONTRACTOR The following statements of experience, personnel, equipment, and general qualifications of the Bidder are submitted with the assurance that the Owner can rely on Its accuracy and truthfulness. If more space Is required for your answers please attach a continuation sheet(s) to the corresponding bid response page referencng the Item number. 1. The company has been in business continuously from (month and year) 7/1992 2. Provide the following information on three similar public works projects, for a city or county park, the company has completed that was on an order of magnitude equal to or greater in scope and complexity to that required under the proposed contract. Failure to provide adequate information on past work and projects will result in a non-responsive bid. Project Name Owner Phone No. Location #1 Terrace View Park City of Spokane Valley 927-1000 Spokane Valley #2: Sullivan Park City of Spokane Valley 927-1000 Spokane Valley #3: Centerpiece West Lawn City of Spokane Valley 927-1000 Spokane Valley Provide responses to the following items regarding each project listed above: A. Short description of project focused particularly on the grading, paving of asphalt trails, and park irrigation systems in a public park. #1 Picnic shelter construction/landscape restoration #2 Picnic shelter/drinking fountain/landscape,initiation #3 Install Irrigation,topsoil and turf on rough grade.Fence and lighting. B. Identify elements of project focused particularly on excavation, setting critical grades and layout. Each of these projects required the creation of grades using heavy equipment in preparation for newly constructed picnic shelters,an/or arbors,concrete slabs,and accessible walkways in public places. Each project included the installation of piping for potable water,irrigation and/or storm drainage work. C. Name of Designer. #i Michael Terrell Landscape Ardikecture #2 Linda M.Cyra-Korsggard LA. #3 Michael Terrell Landscape Archkecture Part 3 - Bid Response Documents Page VIII EDGECLIFF PARK SWINGS CITY OF SPOKANE VALLEY PARKS MID RECREATION DEPARTMENT D. Construction contract value, both at the time of award and upon completion. #1 578,000-$76,619 #2$151,842-6149,561 #3$135,163-$135,163 E. Identify if you were the general contractor or a subcontractor on the project. General contractor on all three projects F. The date each project was started and completed. #1 7(2011 to 11/2011 #2 10/2013-42014 #342018-102018 4. List supervisory personnel currently employed by the Bidder and available for work on the project (Construction Manager, principal foreman, superintendents and engineers) is as follows: Years of Name Title EXoerience Tye C.McGee Sec/Treasurer 33 Ryan Woke Foreman 23 Justin Can Project Manager 9 Part 3 - Bid Response Documents Page IX EDGECLIFF PARK SWINGS CITY OF SPOKANE VALLEY PARKS MD RECREATION DEPARTMENT Bidder to provide the following information for ALL of the followino trades/sub- contractors: k Certified Playground Eauioment Installer BIDDER QUALIFICATION STATEMENT- Certified Playground Equipment Installer The following statements of experience, personnel, equipment, and general qualifications of the Bidder are submitted with the assurance that the Owner can rely on its accuracy and truthfulness. If more space is required for your answers please attach a continuation sheet(s) to the corresponding bid response page referencing the item number 1. The company has been in business continuously from (month and year) 612019 2. Provide the following information on three similar public works projects, for a city or county park, the company has completed that was on an order of magnitude equal to or greater in scope and complexity to that required under the proposed contract. Failure to provide adequate information on past work and projects will result In a non-responsive bid. Please note'Same as General Contractor'if self-performing. Project Name Owner Phone No. Location *1 Airway Heights Glen Price City of Airway 509-679-8391 Airway Heights,WA #2: Quincy JR High Tom Hams 509-398-0835 Quincy,WA #3: Blossom ESD Mike 509-571-5003 Yakima,WA Provide responses to the following items regarding each project listed above: A. Short description of project focused particularly on playground equipment installation. 1. Remove&reinstall play ground 2.Layout install playground&EWF 3.Layout,prep,dirtwork,install playground&tile. B. Identify elements of project focused particularly on layout and installation of equipment within manufacturer's required fall zones. Verify and layout all 3 per plans and manufacturer requirements C. Name of Designer. 1.Play Craft 2.Gametme 3.Gametme Part 3 - Bid Response Documents Page X EDGECLIFF PARK SWINGS CITY OF SPOKANE VALLEY PARKS AND RECREATION DEPARTMENT D. Construction contract value, both at the time of award and upon completion. 1.6700.00 2. 17000.00 3. 12,500.00 E. Identify if you were the general contractor or a subcontractor on the project. sub on all three F. The date each project was started and completed. 1.5/1/19 5/12/19 2.5/14/19 6/1/19 3.2/14/19 2/25/19 4. List supervisory personnel currently employed by the Bidder and available for work on the project (Construction Manager, principal foreman, superintendents and engineers) is as follows: Years of Name Thla Experience Steve Burgener owner 1.5 CPSI Certified Certified Game Time installer Part 3 - Bid Response Documents Page xI EDGECLUFF PARK SWINGS CITY OF SPOKANE VALLEY PARKS MID RECREATION DEPARTMENT BIDDER COMPLIANCE CERTIFICATION PROJECT COMPLIANCE In compliance with the request for quotation, bidder hereby proposes to perform all work for this project in strict accordance with the contract documents, within the time set forth therein, and at the prices bid. SPECIFICATION COMPLIANCE The bidder certifies below that his/her bid complies in all respects with the attached specification documents, including the minimum specifications and any addenda. YES X NO Part 3 - Bid Response Documents Page XII EDGECLIFF PARK SWINGS CITY OF SPOKANE VALLEY PARKS AND RECREATION DEPARTMENT SUBCONTRACTOR LIST Project: Edgecliff Park Swings Subcontractor list to be enclosed with the bid documents. Please refer to "SUBCONTRACTORS" in the Information For Bidders Section for specific information regarding the listing requirements. Attach additional sheets if required. Use copies of these pages as masters for attachment. Type of work -Certified Playground Equipment Installer. If this work is required and the bidder will be doing the work the bidder must list Its name as the contractor below. Steve's Installs LLC NAME (please print) BID DEPOSIT CHECKLIST Part 3- Bid Response Documents Page %III EDGECLIFF PARK SWINGS CITY OF SPOKANE VALLEY PARKS MD RECREATION DEPARTMENT FORM OF BID DEPOSIT- CHECK ONE: Please submit this sheet with the bid deposit. CASH. Attach the deposit behind this sheet. X SURETY BOND - Attach bid bond behind this sheet. STIS STRONGLY RECOMMENDED THAT YOU USE THE ATTACHED FORM. Part 3 - Bid Response Documents Page XIV EDGECOFF PARK SWINGS Cm'OF SPOKANE VALLEY PARKS AND RECREATION DEPARTMENT _;,0 BOND NO: Bid Bond CONTRACTOR'S BID DEPOSIT SURETYDOND to City of Spokane Valleq,Washington We,A.M. Landshaper, Inc. as Principal,existing wider and byvhlue of the laws of the Sore of Washington and authorized to do business in the State of Washington,ands mm.m"b3an sPe=eIiY insurance as Surety,organized and existing kmder the laws of the State of NH , are held and firmly bound unto the Crty of Spokane Valley, a Washington nmsicipality,as Obligee,In the pool=not 5%of the total=outbid,not to exceed S 5% for the payment of,ttIi we jointly and sever4'bkd oiuseves,and oar legal representatives and successors. WHEREAS,the Principal has submitted abid for Edgecliff Park Swing NOW THEREFORE,the condition of the obligation is such that if the Obligee shall accept bebid ofPrincipal and make timely award to the Principal according to the tams ofthe bid documents;anti the Principal shall,within ten days after notice of the award,exclusive of the dayof notice,enter into the contact with the Obligee and Banish the contractor's bonds @r&ntano Md payment bonds)with Surety satisfactory to the Obligee in an amount equal to 100%of the mnoimt of the bid proposed including additives,alternatives and Washington State sales tat,then this obligation shall be null and void;otherwise if the Principal ails to enter into the contact and fails to furnish the contactor's bonds withintea days ofnotice of/ward,exclusive oldie day ofnotice, the amount of the bid deposit shall be forfeited to tie Obligee,payable by the Surety;but mm event will the Surety's liability exceed the Ree amount of this bid bond. This bond maybe executed in two original counterparts,and shall be signed by Separate'duly audlarized officers.ibis bond will oalybeaccepted ifit is accompanied by aRilyexewtedandoriginalpowerofatmmeyfortheomcerexewdngonbebslfof the surety. PRINCIPAL(CONTRACTOR) SURETY A.M. Landshaper, Inc. �t North American Specialty Insurance Company By: 712— C �i^^-- By: _241 14 \ 2 PrincipalSignn a September 20,2019 Date SuretySigmmne °ptember 20.2019 Date Tye C. McGee Shelly Donovan PrintedName Printed Name Secretary/Treasurer Attorney-in-Fact Tills Title Name,address,and telephone of localofficeragent of Surety Company is: Alliant Insurance Services, Inc. 818 West Riverside Avenue,Suite 800, Spokane,WA 99201 509-325-3024 SWISS RE CORPORATE SOLUTIONS NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY GENERAL POWER OF ATTORNEY 1240W ALL MEN BY THESE PRESENTS,THAT North American Specialty Insurance Company,a corporation duly organized and existing under laws of the State of New Hampshire,and having its principal office in the City of Overland Park,Kansa,and Washington International Insurance Company,a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Overland Park,Kansas,each does hereby make,constitute and appoint: GEORGE C.SCHROEDER,NICHOLAS W.PAGET, SHAWN M.WILSON,LAUREN E.RICHARDSON and SHELLY DONOVAN JOINTLY OR SEVERALLY Its tore and lawful Attomey(s)-in-Fact,to make,execute,seal and deliver,for and on its behalf and as its act and deed,bonds or other writings obligatory in the nature of a bond on behalf of each of said Companies,as surety,on contracts of suretyship as are or may be required or permitted by law,regulation,contract or otherwise,provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the amount of: FIFTY MILLION($50,000,000.00)DOLLARS This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both North Amencan Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held on the 9a of May,2012: "RESOLVED,that any two of the Presidents,any Managing Director,any Senior Vice President,any Vice President,any Assistant Vice President, the Secretary or any Assistant Secretary be,and each or any of them hereby is authorized to execute a Power of Attorney qualfymg the attorney named in die given Power of Attorney to execute on behalf of the Company bonds,undertakings and all contracts of surety,and that each or any of them hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and itis FURTHER RESOLVED,that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be binding upon the Company when so affixed and in the future with regard to any bond,undertaking or contract of surety to which it is attached" 5:17410‘ uas rr � -.f€g By /usfirb'q`l}e SEAL _ LnnP.A.an.aj.Sn bPr.ebu rw.,uyu.r.wmwr.ursae C.a try r SEAL Ktx„1V3 sSaler v1u Mildest of Nerds Moab=.ssPctecaltyin.n. Camper g tear" By Mi _/GM1+Ls�r�m.m MichaelA.A.ENS:War Vice Perm Nal Juana.rbmpay &Lour eke Pedant anon!.inseam apedoky lawman Company IN WITNESS WHEREOF,North American Specialty Insurance Company and Washington International Insurance Company have caused their official seals to be hereunto affixed,and these presents to be signed by their authorized officers this 20th day of July ,2017. North American Specialty Insurance Company Washington International Insurance Company State of Illinois County of Cook ss' On this 201h day of July 2017,before me,a Notary Public personally appeared Steven P.Anderson ,Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Michael A Ito Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company,personally known to me,who being by me duly sworn,acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the voluntary act and deed of their respective companies. OFFxxaL SEAL M KENNY1 _ NOTARY PU014SUJE OFIWN01S M.Kenny,Nob.ry Public N MY COMPASSION SOWS 10/0411017 I. Jeffrey Goldberg . the duly elected Assistant Secretary of North American Specialty Insurance Company and Washington International Insurance Company,do hereby certify that the above and foregoing is atrue and correct copy of a Power of Attorney given by said North American Specialty Insurance Company and Washington International Insurance Company, whichicis still in full force and effect. IN WITNESS WHEREOF,I have set my hand and affixed the seals of the Companies this -X:hday of 52&In be e ,2019 . - Jamey Golan ,VicohmM&Anti i ay.ey er WehYlm Wmntime .n .Cagnys Met eeeeee sweet>Seemecoeemy i—w.1 AMLANDS-01 BPATTERSON ,4R o CERTIFICATE OF LIABILITY INSURANCE RA1On2019 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).}s XAME PRODUCER .CT Spokane Office Paynewest Insurance Inc. INC,Ho,ENO:(609)8383501 W.Nol:(509)838-3511 501 N.Rive oint Blvd.,Ste 403 yA ANiss. Spokane,WA 99202 INSURERIS)AFFORDING COVERAGE NAICY INSURER A.Cincinnati Insurance Company 10677 INSURED INSURER B. A.M.Landshaper,Inc. INSURER c: Mark Albin 8004 North Market INSURER D: Spokane,WA 99217 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR 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 INS0. TYPE OF INSURANCE ADOL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LIR [NSD WVO IMM'DOIYYYYI IMMIDONTYYI A X COMMERCIAL GENERAL LIAWIRY EACH OCCURRENCE 1'00%000 CLAIMS MADE X OCCUR X X EPP0128051 2/24/2019 2/24/2020 PREEMMISEe Ee RENTED e) 500,000 MED EXP(Any one perms) 10,000 PERSONAL SADV INJURY 1,000,000 GENL AGGREGATE LIMIITAPPUES PER GENERAL AGGREGATE 2,000,000 POLICY[1—X7 JECr n LOC PRODUCTS-COMP/OP AGG 2,000,000 OTHER WA STOP GAP 1,00%000 A AUTOMOBILE LIABILITY EHMBBCWer0i01NGLE LIMIT 1,000,000 X ANY AUTO EBA0128051 2/24/2019 2/24/2020 BODILY INJURY(Per Person) OWNED —SCHEDULED AUTOS ONLY _AUTTOS BODILY INJURY(Per mldent) ZIT&ONLY _;SWAN 174711YGE A X UMBRELLA LIAR X OCCUR EACH OCCURRENCE 1.000,000 EXCESS LIAR CLAIMS-MADE EPP0128051 2/24/2019 2/24/2020 AGGREGATE 1.000'000 DED X RETENTIONS 0 WORKERS COMPENSATION PER OTH- ANO EMPLOYERS'LIABILITY YIN STATUTE ER ANY�F PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT CFFICCEER.MryFMABER EXCLUDED? N I A IAIe NH) EL DISEASE-EA EMPLOYEE If ydescribe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT A Equipment Floater EPP0128051 2/24/2019 2/24/2020 Leased and Rented 850,000 A Equipment Floater EPP0128051 2/24/2019 2/24/2020 Deductible 1,000 DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES (ACORD101.Additional Remarks Schedule.maybe attached II mon spina Is NI:Dad) RE:Edgecllff Park Swings/Project No.19-153.00 City of Spokane Valley is additional Insured as per the attached forms.Coverage is primary and non contributory.Waiver of subrogation and per project aggregate applies per attached forms CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CityofS ukase ValleyTHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P ACCORDANCE WITH THE POLICY PROVISIONS. Attn:Christine Bainbridge,City Clerk 10210 East Sprague Ave Spokane,WA 99206 AUTHORIZED REPRESENTATIVE A ACORD 25(2016/03) @ 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS' COMMERCIAL GENERAL LIABILITY BROADENED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Endorsement-Table of Contents: Coverage: Begins on Page: 1. Employee Benefit Liability Coverage. 2 2. Unintentional Failure to Disclose Hazards 7 3. Damage to Premises Rented to You 8 4. Supplementary Payments 9 5. Medical Payments 9 6. Voluntary Property Damage(Coverage a.)and Care, Custody or Control Liability Coverage(Coverage b.) 9 7. 180 Day Coverage for Newly Formed or Acquired Organizations 10 8. Waiver of Subrogation 10 9. Automatic Additional Insured-Specified Relationships: 10 Managers or Lessors of Premises; Lessor of Leased Equipment; Vendors; State or Political Subdivisions-Permits Relating to Premises; State or Political Subdivisions-Permits;and Contractors'Operations 10. Broadened Contractual Liability-Work Within 50'of Railroad Property . 14 11. Property Damage to Borrowed Equipment 14 12. Employees as Insureds-Specified Health Care Services: 14 • Nurses; • Emergency Medical Technicians;and • Paramedics 13. Broadened Notice of Occurrence 14 B. Limits of Insurance: The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorse- ment,except as provided below: 1. Employee Benefit Liability Coverage Each Employee Limit: $ 1,000,000 Aggregate Limit: $ 3,000,000 Deductible: $ 1,000 3. Damage to Premises Rented to You The lesser of: a. The Each Occurrence Limit shown in the Declarations;or b. $500,000 unless otherwise stated$ 4. Supplementary Payments a. Bail bonds: $ 1,000 b. Loss of earnings: $ 350 5. Medical Payments Medical Expense Limit: $ 10,000 Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc,with its permission. Page 1 of 15 6. Voluntary Property Damage(Coverage a.)and Care,Custody or Control Liability Coverage (Coverage b.) Limits of Insurance (Each Occurrence) Coverage a.$1,000 Coverage b.$5,000 unless otherwise stated $ Deductibles(Each Occurrence) Coverage a.$250 Coverage b.$250 unless otherwise stated $ COVERAGE PREMIUM BASIS RATE ADVANCE PREMIUM (a) Area (For Limits in Excess of (For Limits in Excess of (b) Payroll $5,000) $5,000) ) Gross Sales (d) Units (e) Other b. Care, Custody $ or Control TOTAL ANNUAL PREMIUM $ 11. Property Damage to Borrowed Equipment Each Occurrence Limit: $ 10,000 Deductible. $ 250 C. Coverages: have used up the ap- t. Employee Benefit Liability Coverage aln ebt in the ofle 1. a. The following is added to SECTION I judgments or settle- - COVERAGES: Employee Benefit ments. Liability Coverage. No other obligation or liabil- (1) Insuring Agreement ity to pay sums or perform acts or services is covered (a) We will pay those sums that unless explicitly provided for the insured becomes legally under Supplementary Pay- obligated to pay as dam- ments. ages caused by any act, er- ror (b) This insurance applies to sured,or omission of the in- damages only if the act, er- nor of any other in-son for whose acts the ror or omission, is negli- sured is legally liable, to gently committed in the which this insurance ap- administration' of your plies. We will have the right "employee benefit pro- and duty to defend the in- gram":and sured against any "suit" 1) Occurs during the pol- seeking those damages. icy period;or However, we will have no duty to defend against any 2) Occurred prior to the "suit" seeking damages to effective date of this which this insurance does endorsement provided: not apply. We may, at our discretion, investigate any a) You did not have report of an act, error or knowledge of a omission and settle any claim or "suit" on claim or "suit" that may re- or before the ef- sult. But: fective date of this endorsement. 1) The amount we will pay for damages is limited You will be as described in SEC- deemed to have TION III - LIMITS OF knowledge of a INSURANCE;and claim or "suit" when any 2) Our right and duty to "authorized repre- defend ends when we sentative"; Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 2 of 15 i) Reports all, or formance of investment any part, of the vehicles; or act, error or omission to us 3) Advice given to any or any other person with respect to insurer; that person's decision to participate or not to ii) Receives a participate in any plan written or ver- included in the "em- bal demand or ployee benefit pro- claim for dam- gramTM. ages secse er- offthe act, r- (f) WorkersCompensation Censation ror or omis- and Similar Laws sion;and Any claim arising out of b) There is no other your failure to comply with applicable insur- the mandatory provisions of ance. any workers'compensation, unemployment compensa- (2) Exclusions lion insurance, social secu- rityThis insurance does nota I or disability benefits law apply or any similar law. to: (a) Bodily Injury, Property (g) ERISA Damage or Personal and Damages for which any in- Advertising Injury sured is liable because of "Bodily injury", "property liability imposed on a fiduci- "Bodily ary by the Employee Re- damage" or "personal and tirement Income Security advertising injury". Act of 1974, as now or (b) Dishonest, Fraudulent, hereafter amended, or by Criminal or Malicious Act any similar federal, state or local laws Damages arising out of any (h) Available Benefits intentional, dishonest, fraudulent, criminal or mall- Any claim for benefits to the cious act, error or omission, extent that such benefits committed by any insured, are available, with reason- including the willful or reek- able effort and cooperation less violation of any statute. of the insured, from the ap- (c) Failure to Perform a Con- plicable funds accrued or tract other collectible insurance. Damages arising out of fail- (i) Taxes, Fines or Penalties ure of performance of con- Taxes, fines or penalties, tract by any insurer. including those imposed (d) under the Internal Revenue Insufficiency of Funds Code or any similar state or Damages arising out of an local law. insufficiency of funds to (j) Employment-Related meet any obligations under Practices any plan included in the "employee benefit pro- My liability arising out of gram". any: (e) Inadequacy of Perform- (1) Refusal to employ; ance of Investment / Ad- vice Given With Respect (2) Termination of em- to Participation ployment; Any claim based upon: (3) Coercion, demotion, reassign- 1) Failure of anyinvest- evaluation,ment, discipline, defa- ment to perforin; nation, harassment, 2) Errors in providing in- humiliation, discrimina- formation on past per- tion or other employ- Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 3 of 15 ment-related practices, (e) A trust, you are an insured. acts or omissions;or Your trustees are also in- sureds, but only with re- (4) Consequential liability spect to their duties as as a result of(1), (2) or trustees. (3)above. (2) Each of the following is also an This exclusion applies insured: whether the insured may be held liable as an employer (a) Each of your "employees" or in any other capacity and who is or was authorized to to any obligation to share administer your "employee damages with or repay benefit program". someone else who must (b) Any persons, organizations pay damages because of or "employees" having the injury. proper temporary authori- (3) Supplementary Payments zation to administer your "employee benefit program" SECTION I - COVERAGES, if you die, but only until your SUPPLEMENTARY PAY- legal representative is ap- MENTS - COVERAGES A AND pointed B also apply to this Coverage. (c) legal b. Who is an Insured you Your representative die, but only i - re- As repects Employee Benefit Liabil- spect to duties as such. ity Coverage, SECTION II - WHO IS That representative will AN INSURED is deleted in its en- have all your rights and du- tirety and replaced by the following: ties under this Coverage Part. (1) If you are designated in the (3) Any organization you newly ac- Declarations as: quire or form, other than a part- (a) An individual, you and your nership, joint venture or limited spouse are insureds, but liability company, and over only with respect to the which you maintain ownership conduct of a business of or majority interest, will qualify which you are the sole as a Named Insured if no other owner. similar insurance applies to that organization. However, cover- (b) A partnership or joint yen- age under this provision: ture, you are an insured. Your members, your part- (a) Is afforded only until the ners, and their spouses are 180th day after you acquire also insureds but only with or form the organization or respect to the conduct of the end of the policy period, your business, whichever is earlier;and (c) A limited liability company, (b) Does not apply to any act, you are an insured Your error or omission that was members are also insureds, committed before you ac- but only with respect to the quired or formed the or- conduct of your business. ganization. Your managers are in- c. Limits of Insurance sureds, but only with re- spect to their duties as your As respects Employee Benefit Liabil- managers. ity Coverage, SECTION III - LIMITS (d) An organization other than OF INSURANCE is deleted in Its en- a partnership, joint venture tirety and replaced by the following: or limited liability company, (1) The Limits of Insurance shown you are an insured. Your in Section B. Limits of Insur- "executive officers" and di- ance, 1. Employee Benefit Li- rectors are insureds, but ability Coverage and the rules only with respect to their below fix the most we will pay duties as your officers or di- regardless of the number of: rectors. Your stockholders are also insureds, but only (a) Insureds; with respect to their liability as stockholders. Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 4 of 15 (b) Claims made or "suits" (b) The deductible amount brought; stated in the Declarations (c) Persons or organizations applies to all damages 9 sustained by any one "em- making claims or bringing ployee", including such "suits"; "employee's" dependents (d) Acts,errors or omissions;or and beneficiaries, because of all acts, errors or omis- (e) Benefits included in your sions to which this insur- "employee benefit pro- ance applies. gram". (c) The terms of this insurance, (2) The Aggregate Limit shown in including those with respect Section B. Limits of Insurance, to: 1. Employee Benefit Liability 1) Our right and duty to Coverage of this endorsement defend the insured is the most we will pay for all against any "suits" damages because of acts, er- seeking those dam- rors or omissions negligently ages;and committed in the "administra- tion" of your "employee benefit 2) Your duties, and the program'. duties of any other in- (3) Subject to the limit described in volved insured, in the (2) above, the Each Employee event ,or claim, Limit shown in Section B. Limits omission,an error or o of Insurance, 1. Employee apply irrespective of the Benefit Liability Coverage of application of the deductible this endorsement is the most we amount. will pay for all damages sus- tained by any one "employee", (d) We may pay any part or all including damages sustained by of the deductible amount to such "employee's" dependents effect settlement of any and beneficiaries,as a result of: claim or "suit" and, upon notification of the action (a) An act, error or omission;or taken, you shall promptly (b) A series of related acts, er- reimburse us for such part rors or omissions, regard- of the deductible amount as less of the amount of time we have paid. that lapses between such d. Additional Conditions acts,errors or omissions, ne li enll committed in the As respects Employee Benefit Li- negligently i- g 9 Y ability Coverage, SECTION IV - "administration" of your "em- COMMERCIAL GENERAL LIABIL- ployee benefit program". ITY CONDITIONS is amended as However, the amount paid un- follows: der this endorsement shall not (1) Item 2. Duties in the Event of exceed, and will be subject to Occurrence, Offense, Claim or the limits and restrictions that Sult is deleted in its entirety and apply to the payment of benefits replaced by the following: in any plan included in the "em- ployee benefit program". 2. Duties in the Event of an Act, Error or (4) Deductible Amount Omission, or Claim or Suit Our obligation to paydam- a. You must see to it that we are noti- (a) 9 tied as soon as practicable of an act, ages on behalf of the in- error or omission which may result in sured applies only to the a claim. To the extent possible, no- amount of damages in ex- tice should include: cess of the deductible amount stated in the Decla- (1) What the act, error or omission rations as applicable to was and when it occurred;and Each Employee. The limits of insurance shall not be (2) The names and addresses of reduced by the amount of anyone who may suffer dam- this deductible. ages as a result of the act, error or omission. Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 5 of 15 b. If a claim is made or"suit" is brought b. Method of Sharing against any insured,you must: If all of the other insur- (1) Immediately record the specifics ance permits contribu- of the claim or "suit" and the tion by equal shares, date received;and we will follow this method also. Under (2) Notify us as soon as practicable. this approach each in- You must see to it that we receive surer contributes equal written notice of the claim or"suit"as amounts until it has soon as practicable. paid its applicable limit of insurance or none of c. You and any other involved insured the loss remains, must: whichever comes first. (1) Immediately send us copies of If any of the other in- any demands, notices, sum- surance does not per- manses or legal papers re- mit contribution by ceived in connection with the equal shares, we will claim or"suit"; contribute by limits. Under this method, (2) Authorize us to obtain records each insurer's share is and other information; based on the ratio of its Cooperate with us in the investi- applicable limit of in- (3) Coo P surance to the total ap- gation or settlement of the claim plicable limits of insur- or defense against the "suit'; ance of all insurers. and (4) Assist us, upon our request, in c. No Coverage the enforcement of any right This insurance shall not against any person or organize- cover any loss for tion which may be liable to the which the insured is insured because of an act, error entitled to recovery un- or omission to which this insur- der any other insur- ance may also apply. ance in force previous to the effective d. No insured will, except at that in- this Coverage Part. of sured's own cost, voluntarily make a payment, assume any obligation, or e. Additional Definitions incur any expense without our con- sent. As respects Employee Benefit Li- ability Coverage, SECTION V - (2) Item 5. Other Insurance is de- DEFINITIONS is amended as fol- leted in its entirety and replaced lows: by the following: (1) The following definitions are 5. Other Insurance added: If other valid and collectible 1. "Administration"means: insurance is available to the insured for a loss we cover a. Providing information to under this Coverage Part, "employees", including our obligations are limited their dependents and as follows: beneficiaries, with re- spect to eligibility for or a. Primary Insurance scope of "employee This insurance is pri- benefit programs"; mary except when c. b. Interpreting the "em- below applies. If this ployee benefit pro- insurance is primary, grams"; our obligations are not affected unless any of c. Handling records in the other insurance is connection with the also primary. Then,we "employee benefit pro- will share with all that grams";or other insurance by the d. Effecting, continuing or method described in b. terminating any below, "em- ployee's" participation Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 6 of 15 in any benefit included benefits, workers' corr- in the"employee bene- pensation and disability fit program". benefits;and However, "administration" d. Vacation plans, includ- does not include: Mg buy and sell pro- grams; leave of on- a. Handlingpayroll de- sence programs, in- ductions;or eluding military, mater- b. The failure to effect or nity, family, and civil assis- maintain any insurance leave; tuition adequate limits of tante plans; transpor- ortation and healthalthclub coverage of insurance, subsidies, including but not limited to unemployment in- (2) The following definitions are surance, social security deleted in their entirety and re- benefits, workers' corn- placed by the following: pensation and disability benefits. 21. "Suit" means a civil pro- ceeding2. "Cafeteria plans" means in which money plan authorizedia bya tica-ans damages because of an la law to ol "employ-pact, error or omission to which this insurance applies ees" to elect to pay for cer- are alleged "Suit"includes: tame benefits with pre-tax dollars. a. An arbitration pro- benefit pro- pro- ceeding in which such 3. "Employee damages are claimed grams" means a program and to which the in- providing some or all of the sured must submit or following benefits to "em- does submit with our ployees", whether provided consent; through a"cafeteria plan" or otherwise: b. Any other alternative pro- a. Grouplife insurance; dispute resolution ceeding in which such group accident or damages are claimed health insurance; den- and to which the In- tal, vision and hearing sured submits with our plans; and flexible consent;or spending accounts; provided that no one c. An appeal of a civil other than an "em- proceeding. ployee" may subscribe to such benefits and 8. "Employee" means a per- such benefits are made son actively employed, for- generally available to merly employed, on leave those "employees"who of absence or disabled, or satisfy the plan's eligi- retired. "Employee" in- bility requirements; eludes a "leased worker". "Employee" does not m- b. Profit sharing plans, elude a"temporary worker". employee savings plans, employee stock 2. Unintentional Failure to Disclose Haz- ownership plans, pen- ards sion plans and stock SECTION IV-COMMERCIAL GENERAL subscription plans, LIABILITY CONDITIONS, 7. Represen- provided that no one tations is hereby amended by the addi- other than an "em- tion of the following: ployee" may subscribe to such benefits and Based on our dependence upon your such benefits are made representations as to existing hazards, if generally available to unintentionally you should fail to disclose all "employees" who all such hazards at the inception date of are eligible under the your policy, we will not reject coverage plan for such benefits; under this Coverage Part based solely on c. Unemployment insur- such failure. ance, social security Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc,with its permission. Page 7 of 15 3. Damage to Premises Rented to You e) Settling, cracking, a. The last Subparagraph of Paragraph pension;g or ex- a. pension; or 2. SECTION I - COVERAGES, COVERAGE A. - BODILY INJURY t) Nesting or infesta- AND PROPERTY DAMAGE, 2. LI- tion, or discharge ABILITY Exclusions is hereby de- or release of leted and replaced by the following: waste products or secretions, by in- Exclusions c.through q.do not apply sects, birds, ro- to damage by fire, explosion, light- dents or other ning, smoke or soot to premises animals. while rented to you or temporarily occupied by you with permission of (b) Loss caused directly or indi- the owner. rectly by any of the follow- b. The insurance provided under SEC- mg. TION I- COVERAGES, COVERAGE 1) Earthquake, volcanic A. BODILY INJURY AND PROP- eruption, landslide or ERTY DAMAGE LIABILITY applies any other earth move- to "property damage" arising out of ment; water damage to premises that are 2) Water that backs up or both rented to and occupied by you. overflows from a (1) As respects Water Damage Le- sewer,drain or sump; gal Liability, as provided in 3) Water under the Paragraph 3.b.above: ground surface press- The exclusions under SECTION ing on, or flowing or I - COVERAGES, COVERAGE seeping through: A. BODILY INJURY AND o Fundations, PROPERTY DAMAGE LIABIL- a) walls, floors or ITY, 2. Exclusions, other than i. War and the Nuclear Energy paved surfaces; Liability Exclusion, are deleted b) Basements, and the following are added: whether paved or This insurance does not apply not;or to: c) Doors,windows or (a) "Property damage": other openings. 1) Assumed in any con- (c) Loss caused by or resulting tract;or from water that leaks or flows from plumbing, heat- 2) Loss caused by or re- ing, air conditioning, or fire suiting from any of the protection systems caused following: by or resulting from freez- a) Wear and tear; ing, unless: b) Rust, corrosion, 1) You did your best to maintain heat in the fungus, decay, building or structure;or deterioration, hid- den or latent de- 2) You drained the fect or any quality equipment and shut off in property that the water supply if the causes it to dam- heat was not main- age or destroy it- tained. self; (d) Loss to or damage to: c) Smog; 1) Plumbing, heating, air d) Mechanical conditioning, fire pro- breakdown in- tection systems, or cluding rupture or other equipment or ap- bursting caused pliances;or by centrifugal force; 2) The interior of any building or structure, or to personal property in the building or structure Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 8 of 15 caused by or resulting 5. Medical Payments fromradriven, snow, sleet ice, The Medical Expense Limit of Any One or whetherPerson as stated in the Declarations is by wind or not. amended to the limit shown in Section B. c. Limit of Insurance Limits of Insurance, 5. Medical Pay- ments of this endorsement. The Damage to Premises Rented to You Limit as shown in the Declare- 6. Voluntary Property Damage and Care, tions is amended as follows: Custody or Control Liability Coverage (2) Paragraph O6 If SECTION IIIis- a. erage Voluntary Property Damage Coy- LIMITS hereby deleted and replaced by We will pay for"property damage"to the following: property of others arising out of op- 6. Subject to 5. above, the erations incidental to the insured's Damage to Premises business when: Rented to You Limit is the most we will pay under (1) Damage is caused by the in- COVERAGE A. BODILY cured;or INJURY AND PROPERTY (2) Damage occurs while in the in- DAMAGE LIABILITY, for sured's possession. damages because of "property damage" to With your consent, we will make premises while rented to these payments regardless of fault. you or temporarily occupied by you with permission of b. Care, Custody or Control Liability the owner, arising out of Coverage any one "occurrence" to SECTION I - COVERAGES, COV- which this insurance ap- ERAGE A. BODILY INJURY AND plies. PROPERTY DAMAGE LIABILITY,2. (3) The amount we will pay is urn- Exclusions,j. Damage to Property, ited as described in Section B. Subparagraphs (3), (4) and (5) do Limits of Insurance, 3. Dam- not apply to "property damage" to age to Premises Rented to the property of others described You of this endorsement. therein. 4. Supplementary Payments With respect to the insurance provided by this section of the endorsement, the fol- Under SECTION I - COVERAGE, SUP- lowing additional provisions apply: PLEMENTARY PAYMENTS - COVER- AGES A AND B: a. The Limits of Insurance shown in the Declarations are replaced by the lim- a. Paragraph 2. is replaced by the fol- its designated in Section B.Limits of lowing: Insurance, 6. Voluntary Property Damae and Care, or Up to the limit shown in Section B. Control Liability Cove ageoof this Limits of Insurance,4.a. Bail Bonds endorsement with respect to cover- of this endorsement for cost of bail age provided by this endorsement. bonds required because of accidents These limits are inclusive of and not or traffic law violations arising out of in addition to the limits being re- the use of any vehicle to which the placed. The Limits of Insurance Bodily Injury Liability Coverage ap- shown in Section B. Limits of Insur- plies. We do not have to furnish ance, 6. Voluntary Property Dam- these bonds. age and Care, Custody or Control b. Paragraph 4. is replaced by the fol- Liability Coverage of this endorse- lowing• ment fix the most we will pay in any one "occurrence" regardless of the All reasonable expenses incurred by number of: the insured at our request to assist us in the investigation or defense of (1) Insureds; the claim or "suit", including actual (2) Claims made or "suits" brought; loss of earnings up to the limit shown or in Section B. Limits of Insurance, 4.b. Loss of Earnings of this en- (3) Persons or organizations mak- dorsement per day because of time ing claims or bringing"suits". off from work. Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 9 of 15 b. Deductible Clause 9, Automatic Additional Insured - Speci- fied Relationships (1) Our obligation to pay damages on your behalf applies only to a. The following is hereby added to the amount of damages for each SECTION II-WHO IS AN INSURED. "occurrence" which are in ex- nperson or organization cess of the deductible amount (1) Any g de- stated in Section B. Limits of scribed in Paragraph 9.a.(2) Insurance, 6. Voluntary Prop- below(hereinafter referred to as erty Damage and Care, Cus- additional insured) whom you tody or Control Liability Cov- are required to add as an addi- erage of this endorsement. The tional insured under this Cover- limits of insurance will not be re- age Part by reason of: duced by the application of such (a) A written contract or deductible amount. agreement;or (2) Condition 2.Duties in the Event (b) An oral agreement or con- of Occurrence, Offense, Claim tract where a certificate of or Suit, applies to each claim or insurance showing that per- "suit"irrespective of the amount. son or organization as an (3) We may pay any part or all of additional insured has been the deductible amount to effect issued, settlement of any claim or "suit" is an insured,provided: and, upon notification of the ac- tion taken, you shall promptly (a) The written or oral contract reimburse us for such part of the or agreement is: deductible amount as has been paid by us. 1) Currently in effect or becomes effective 7. 180 Day Coverage for Newly Formed or during the policy pe- Acquired Organizations Hod;and SECTION II - WHO IS AN INSURED is 2) Executed prior to an amended as follows: "occurrence"or offense a. of Paragraph 4. is to which this insurance Subparagraph would apply;and hereby deleted and replaced by the fol- lowing: (b) They are not specifically Is af- named as an additional in- a. Insurance under this provisionsured under any other pro- forded only until the 180th day after vision of, or endorsement you acquire or form the organization added to, this Coverage or the end of the policy period, Part. whichever is earlier; 8. Waiver of Subrogation (2) Only the following persons or 9 organizations are additional in- SECTION IV- COMMERCIAL GENERAL sureds under this endorsement, LIABILITY CONDITIONS, 9. Transfer of and insurance coverage pro- Rights of Recovery Against Others to vided to such additional in- Us is hereby amended by the addition of - sureds is limited as provided the following: herein: We waive any right of recovery we may (a) The manager or lessor of a have because of payments we make for premises leased to you with injury or damage arising out of your on- whom you have agreed per going operations or"your work" done un- Paragraph 9.a.(1) above to der a written contract requiring such provide insurance, but only waiver with that person or organization with respect to liability ads- and included in the "products-completed ing out of the ownership, operations hazard". However, our rights maintenance or use of that may only be waived prior to the "occur- part of a premises leased to rence" giving rise to the injury or damage you, subject to the following for which we make payment under this additional exclusions: Coverage Part. The insured must do This insurance does not nothing after a loss to impair our rights. apply to: At our request,the insured will bring"suit" or transfer those rights to us and help us 1) Any "occurrence" enforce those rights. which takes place after Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 10 of 15 you cease to be a ten- c) Any physical or ant in that premises. chemical change in the product 2) Structural alterations, made intentionally new construction or by the vendor; demolition operations performed by or on be- d) Repackaging, un- half of such additional less unpacked insured. solely for the pur- pose(b) Anyperson or organization m of inspection, on, 9 t demonstration, or gui which you lease testing, n the equipment with whom you substitution of have agreed per Paragraph parts under in- 9.a.(1) above to provide in- structions from the surance. Such person(s)or manufacturer, and organization(s)are insureds then repackaged solely with respect to their in the original liability arising out of the container; maintenance, operation or use by you of equipment e) Any failure to leased to you by such per- make such in- son(s) or organizations(s). spections, adjust- However, this insurance ments, tests or does not apply to any "oc- servicing as the currence"which takes place vendor has after the equipment lease agreed to make or expires- normally under- takes to make in (c) Any person or organization the usual course (referred to below as ven- of business, in dor) with whom you have connection with agreed per Paragraph the distribution or 9.a.(1) above to provide in- sale of the prod- surance, but only with re- ucts; spect to "bodily injury" or "property damage" arising f) Demonstration, in- out of"your products"which stallation, servic- are distributed or sold in the ing or repair op- regular course of the ven- erations, except dors business, subject to such operations the following additional ex- performed at the clusions: vendor's premises in connection with 1) The insurance afforded the sale of the the vendor does not product; apply to: g) Products which, a) "Bodily injury" or after distribution or "property damage" sale by you, have for which the ven- been labeled or dor is obligated to relabeled or used pay damages by as a container, reason of the as- part or ingredient sumption of habil- of any other thing ity in a contract or or substance by or agreement. This for the vendor. exclusion does not apply to liability for 2) This Insurance does damages that the not apply to any in- vendor would sured person or or- have in the ab- ganizationr sence of the con- tract or agree- a) From whom you merit; have acquired such products, or b) Any express war- any ingredient, ranty unauthorized part or container, by you; entering into, ac- Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 11 of 15 companying or 2) This insurance does containing such not apply to "bodily in- products;or jury", "property dam- age" or "personal and h When liabilityin- Whendvertising injury" ails- cluded "products-diaw ilithe ing out of operations performed for the state completed opera- or political subdivision. tions hazard" has been excluded (f) Any person or organization under this Cover- with which you have agreed age Part with re- per Paragraph 9.a.(1) spect to such above to provide insurance, products. but only with respect to li- ability(d) Anystate orpolitical subdi- arising out of "your work" performed for that vision with which you have additional insured by you or agreed per Paragraph on your behalf. A person or 9.a.(1) above to provide in- organization's status as an surance, subject to the fol- insured under this provision lowing additional provision: of this endorsement contin- This insurance applies only ues for only the period of time required by the written with respect to the following hazards for which the state contract or agreement, but or political subdivision has in no event beyond the ex- issued a permit in connec- piration date of this Cover- age Part. If there is no rion with premises you own, written contract or agree- rent or control and to which ment, or if no period of time this insurance applies. is required by the written 1) The existence, mainte- contract or agreement, a nance, repair, con- person or organization's struction, erection, or status as an insured under removal of advertising this endorsement ends signs, awnings, cano- when your operations for pies, cellar entrances, that insured are completed. coal holes, driveways, (3) Any insurance provided to an manholes, marquees, additional insured designated hoist away openings, under Paragraph 9.a.(2): sidewalk vaults, street banners, or decora- (a) Subparagraphs (e) and (f) tions and similar expo- does not apply to "bodily sures;or injury"or"property damage" 2) The construction, erec- included within the "prod- tion, or removal of ale- ucts-completed operations vators;or hazard"; 3) The ownership, main- (b) Subparagraphs (a), (b), (d), tenance, or use of any (e)and (f)does not apply to elevators covered by "bodily injury", "property this insurance. damage' or "personal and advertising injury" arising (e) Any state or political subdi- out of the sole negligence vision with which you have or willful misconduct of the agreed per Paragraph additional insured or their 9.a.(1) above to provide in- agents, "employees" or any surance, subject to the fol- other representative of the lowing provisions: additional insured;or 1) This insurance applies (c) Subparagraph (f) does not only with respect to op- apply to "bodily injury", erations performed by "property damage" or "per- you or on your behalf sonal and advertising injury" for which the state or arising out of: political subdivision has 1) Defects in design fur- issued a permit. nished by or on behalf Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission Page 12 of 15 of the additional in- spects any other insurance sured;or policy issued to the addi- tional2 The renderingof, insured, and such or other insurance policy shall failure to render, any be excess and/or noncon- professional architec- tributing, whichever applies, tura!, engineering or with this insurance. surveying services, in- cluding: (b) Any insurance provided by this endorsement shall be a) The preparing, primary to other insurance approving or fail- available to the additional ing to prepare or insured except: approve maps, shop drawings, 1) As otherwise provided opinions, reports, in SECTION IV - surveys, field or- COMMERCIAL GEN- ders, change or- ERAL LIABILITY ders or drawings CONDITIONS,5. Other and specifications; Insurance, b. Excess and Insurance;or b) Supervisory, in- 2) For any other valid and spection, archi- collectible insurance tectural or engi- available to the addi- neering activities. tional insured as an 3) by "Your work"for which a additionalminsured en- consolidated (wrap-up) attachment tooann ( P- P) insurance( another insurance program hthe insurancertten policy that is been provided by the basis. onIexcess primecontmctor-project basis. In such case, manager or owner of the coverage provided the construction project under this endorse- in which you are in- ment shall also be ex- volved. cess. b. Only with regard to Insurance pro- (2) Condition 11. Conformance to vided to an additional insured desig- Specific Written Contract or nated under Paragraph 9.a.(2) Sub- Agreement is hereby added. paragraph (f) above, SECTION III - LIMITS OF INSURANCE is amended 11. Conformance to Specific to include: Written Contract or The limits applicable to the additional Agreement insured are those specified in the With respect to additional written contract or agreement or in insureds described in Para- the Declarations of this Coverage graph 9.a.(2)(f)above only: Part,whichever are less If no limits are specified in the written contract If a written contract or or agreement, or if there is no written agreement between you contract or agreement, the limits ap- and the additional insured plicable to the additional insured are specifies that coverage for those specified in the Declarations of the additional insured: this Coverage Part The limits of in- a. Be provided by the In- surance are inclusive of and not in surance Services Of- addition to the limits of insurance fice additional insured shown in the Declarations, form number CG 20 10 c. SECTION IV - COMMERCIAL GEN- or CG 20 37 (where ERAL LIABILITY CONDITIONS is edition specified);or hereby amended as follows: b. Include coverage for (1) Condition 5. Other Insurance is completed operations; amended to include: or (a) Where required by a written c. Include coverage for contract or agreement, this your work'; insurance is primary and / and where the limits or cov- or noncontributory as re- erage provided to the addi- Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 13 of 15 tional insured is more re- 11. of this endorsement fix the strictive than was specifi- most we will pay in any one "oc- cally required in that written currence" regardless of the contract or agreement, the number of: terms of Paragraphs 9.a.(3)(a), 9.a.(3)(b) or 9.b. (a) Insureds; above, or any combination (b) Claims made or "suits" thereof, shall be interpreted brought; or as providing the limits or coverage required by the (c) Persons or organizations terms of the written contract making claims or bring or agreement, but only to "suits". the extent that such limits or coverage is included within (2) Deductible Clause the terms of the Coverage (a) Our obligation to pay dam- Part to which this endorse- ages on your behalf applies ment is attached. If, how- only to the amount of dam- ever, the written contract or ages for each "occurrence" agreement specifies the In- which are in excess of the surance Services Office Deductible amount stated in additional insured form Section B. Limits of Insur- number CG 20 10 but does ance, 11. of this endorse- not specify which edition,or ment. The limits of insur- specifies an edition that ance will not be reduced by does not exist, Paragraphs the application of such De- )(a) and 9.a.(3)(b) of ductible amount. this endorsement endorsement shall not apply and Paragraph 9.b.of (b) Condition 2. Duties in the this endorsement shall ap- Event of Occurrence, Of- Ply. fense, Claim or Suit, ap- 10. Broadened Contractual Liability-Work plies to each claim or "suit" Within 50'of Railroad Property irrespective of the amount. It is hereby agreed that Paragraph f.(1) of (c) We may pay any part or all Definition 12. "Insured contract" (SEC- of the deductible amount to TION V-DEFINITIONS)is deleted. effect settlement of any claim or suit' and, upon 11. Property Damage to Borrowed Equip- notification of the action ment taken, you shall promptly reimburse us for such part a. The following is hereby added to Ex- of the deductible amount as clusion j. Damage to Property of has been paid by us. Paragraph 2., Exclusions of SEC- TION I • COVERAGES, COVERAGE 12. Employees as Insureds - Specified A. BODILY INJURY AND PROP- Health Care Services ERN DAMAGE LIABILITY It is hereby agreed that Paragraph Paragraphs (3) and (4) of this exclu- 2.a.(1)(d) of SECTION II - WHO IS AN sion do not apply to tools or equip- INSURED, does not apply to your "em- ment loaned to you, provided they ployees" who provide professional health are not being used to perform opera- care services on your behalf as duly li- tions at the time of loss. censed: b. With respect to the insurance pro- a. Nurses; vided by this section of the en- b. Emergency Medical Technicians;or dorsement, the following additional provisions apply: c. Paramedics, (1) The Limits of insurance shown in the jurisdiction where an "occurrence" in the Declarations are replaced or offense to which this insurance applies by the limits designated in Sec- takes place tion B. Limits of Insurance, 11. of this endorsement with respect 13. Broadened Notice of Occurrence to coverage provided by this Paragraph a. of Condition 2. Duties in endorsement. These limits are the Event of Occurrence, Offense, inclusive of and not in addition to Claim or Suit (SECTION IV- COMMER- CIAL GENERAL LIABILITY CONDI- Limits of Insurance shown in Section B. Limits of Insurance, Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 14 of 15 TIONS) is hereby deleted and replaced (2) The names and addresses of by the following: any injured persons and wit- nesses;and a. You must see to it that we are noti- fied as soon as practicable of an (3) The nature and location of any "occurrence" or an offense which injury or damage arising out of may result in a claim. To the extent the"occurrence"or offense. possible,notice should include: This requirement applies only when (1) How, when and where the "oc- the "occurrence" or offense is known currence"or offense took place; to an"authorized representative". Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 15 of 15 you or while performing duties related to d. Your legal representative if you die, but the conduct of your business. However, only with respect to duties as such That none of these "employees" or "volunteer representative will have all your rights workers"are insureds for: and duties under this Coverage Part, (1) "Bodily injury" or "personal and ad 3. Any organization you newly acquire or form, vertising injury": other than a partnership, joint venture or lim partners or ited liability company, and over which you (a) To you, to your maintain ownership or majority interest, will members (if you are a partner- qualify as a Named Insured if there is no other ship or joint venture), to your similar insurance available to that organiza- members (if you are a limited li tion. However: ability company), to a co- "employee" while in the course a Insurance under this provision is afforded of his or her employment or only until the 90th day after you acquire performing duties related to the or form the organization or the end of the conduct of your business, or to policy period,whichever is earlier; your other "volunteer workers" b. COVERAGE A. BODILY INJURY AND while performing duties related to the conduct of your business; PROPERTY DAMAGE LIABILITY does not apply to "bodily injury' or "property (b) To the spouse, child, parent, damage" that occurred before you ac- brother or sister of that co quired or formed the organization;and "employee" consequenceor "volunteer c COVERAGE B. PERSONAL AND AD- ParagraphParagr" aa above; of VERTISI NG INJURY LIABILITY does not (1)(a)above; apply to "personal and advertising injury" (c) For which there is any obligation arising out of an offense committed be to share damages with or repay fore you acquired or formed the organi- someone else who must pay zation. damages because of the injury described in Paragraphs (1)(a) No person or organization is an insured with re or(b)above;or spect to the conduct of any current or past part- nership, joint venture or limited liability company (d) Arising out of his or her provid- that is not shown as a Named Insured in the Dec- ing or failing to provide profes- larations. sional health care services. SECTION III-LIMITS OF INSURANCE (2) "Property damage"to property' 1. The Limits of Insurance shown in the Declare- (a) Owned,occupied or used by;or tions and the rules below fix the most we will (b) Rented to, in the care, custody pay regardless of the number of: or control of, or over which a Insureds; physical control Is being exer cised for any purpose by, b. Claims made or"suits"brought; or you, any of your "employees", "vol- c. Persons or organizations making claims unteer workers", any partner or or bringing"suits". member (if you are a partnership or 2 a. The General Aggregate Limit is the most joint venture), or any member (if you we will pay for the sum of: are a limited liability company). "employee" (1) Medical expenses under COVER- b. Any person (other than yourAGE C.MEDICAL PAYMENTS; or "volunteer worker"), or any organiza tion while acting as your real estate man- (2) Damages under COVERAGE A. ager. BODILY INJURY AND PROPERTY person or organization havingproper DAMAGE LIABILITY, except dam c, Any 9 P P ages because of bodily injury" or temporary custody of your property if you "property damage" included in the die,but only: "products-completed operations (1) With respect to liability arising out of hazard";and the maintenance or use of that prop- (3) Damages under COVERAGE B. erty;and PERSONAL AND ADVERTISING (2) Until your legal representative has INJURY LIABILITY. been appointed. This General Aggregate Limit will not ap ply if either the Location General Aggre- Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc,with its permission. Page 12 of 22 gate Limit of Insurance, Paragraph 2 b, your behalf at the same location for or the Construction Project General Ag- the same persons or organizations, gregate Limit of Insurance, Paragraph no matter how often or under how 2 c applies, many different contracts, will be Location General Aggregate deemed to be a single construction b. separateA project. Limit of Insurance, equal to the amount of the General Aggregate Limit shown in the 3. The Products Completed Operations Aggre Declarations,shall apply to each location gate Limit is the most we will pay under COV- owned by, or rented or leased to you and ERAGE A. BODILY INJURY AND PROP- is the most we will pay for the sum of: ERTY DAMAGE LIABILITY for damages be under COVERAGE A. cause of "bodily injury" and "property darn (1) BODIDamagesLINJURY AND PROPERTY age" included in the "products-completed op- DAMAGE LIABILITY, except dam erahons hazard". ages because of "bodily injury" or 4 Subject to 2 a, above, the Personal and Ad- "property damage" included in the vertising Injury Limit is the most we will pay "products completed operations under COVERAGE B, PERSONAL AND AD- hazard", and VERTISING INJURY LIABILITY for the sum of Medical expenses under COVER- all damages because of all "personal and ad- (2) P vertising injury" sustained by any one person AGE C.MEDICAL PAYMENTS, or organization, which can be attributed to operations at 5 Subject to 2 or 3 above, whichever applies, only a single location owned by, or rented the Each Occurrence Limit is the most we will or leased to you. pay for the sum of: c. A separate Construction Project General a Damages under COVERAGE A. BODILY Aggregate Limit of Insurance, equal to INJURY AND PROPERTY DAMAGE LI. the amount of the General Aggregate ABILITY;and Limit shown in the Declarations, shall ap- plyto each construction project and is the b Medical expenses under COVERAGE C most we will pay for the sum of: MEDICAL PAYMENTS; (1) Damages under COVERAGE A. because of all "bodily injury" and "property BODILY INJURY AND PROPERTY damage"arising out of any one "occurrence". DAMAGE LIABILITY, except dam 6 Subject to 5 above, the Damage to Premises ages because of "bodily injury" or 1 0 "property damage" included in the Rented to You Limit is the most we will pay "products completed operations under COVERAGE A. BODILY INJURY AND hazard";and PROPERTY DAMAGE LIABILITY for dam- ages because of "property damage" to any (2) Medical expenses under COVER- one premises, while rented to you, or in the AGE C.MEDICAL PAYMENTS; case of damage by fire or explosion, white which can be attributed onlyto ongoing rented to you or temporarily occupied by you 9 g with permission of the owner. operations and only at a single construc- tion project. 7 Subject to 5 above, the Medical Expense COVER- d. Onlyfor the purpose of determiningwhich Limit is the most we will pay under P P AGE C.MEDICAL PAYMENTS for all medical General Aggregate Limit of Insurance, expenses because of"bodily injury"sustained 2 a,2 b,or 2 c ,applies: by any one person. (1) Location means premises involving The Limits of Insurance of this Coverage Part ap- the same or connecting lots, or ply separately to each"coverage term". premises,whose connection is inter rupted only by a street, roadway, SECTION IV COMMERCIAL GENERAL LI waterway or right of way of a rail ABILITY CONDITIONS road. 1. Bankruptcy (2) Construction project means a loca Bankruptcy or insolvency of the insured or of where ongoing improvements,tion you do not own, rentall leasethe insured's estate will not relieve us of our terations, installation, demolition or obligations under this Coverage Part, maintenance work is performed by 2, Duties in the Event of Occurrence, Offense, you or on your behalf. All connected Claim or Suit ongoing improvements, alterations, installation, demolition or mainte- a You must see to it that we are notified as nance work performed by you or on soon as practicable of an "occurrence" or Includes copyrighted material of Insurance GA 101 12 04 Services Office,Inc,with its permission Page 13 of 22 ' Search LSI 1 SEARCH CioWashington State Department of Labor & Industries A M LANDSHAPER INC Owner or tradesperson 8004 N.MARKET PrincipalsSPOKANE,WA 99217 ALBIN,MARK C.PRESIDENT 509-488-4335 SPOKANE County MCGEE,TYE CYRIL,SECRETARY Doing business as A M LANDSHAPER INC WA UBI No. Business type 801 701 273 Corporation Governing persons MARK C ALBIN WE C MC GEE, License Venfy the contractor's active registration/license/cem0cation(depending on trade)and any past violations. Construction Contractor Active Meets current requirements. License specialties GENERAL License no AM LANI.971DO Effective—expiration 03/20/2003-04/12/2020 Bond North American Spec Ins Co $12,000.00 Bond account no 2181927 Received by LSI Effective date 07/16/2014 09/24/2014 Expiration date Until Canceled RLI INS CO $12,000.00 Bond account no S513397618 Received by L&I Effective date 10/02/2009 09/24/2009 Expiration date Until Canceled Insurance Cincinnati Ins Co $1,000,00000 Policy no " i f EPP225013 Received by L&I Effective date 02/21/2019 02/2412012 Expiration date 02/24/2020 Savings No savings accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period L81 Tax debts No 1.81 tax debts are recorded for this contractor license during the previous 6 year period,but some debts may be recorded by other agencies. License Violations No license violations during the previous 6 year period. Certifications & Endorsements OMWBE Certifications No active certifications exist for this business. Apprentice Training Agent Registered training agent Check their eligible programs and occupations. Workers' comp Do you know if the business has employees?If so,verify the business is up-to-date on workers'comp premiums LEI Account ID Account Is current. 816,368-01 Doing business as A M LANDSHAPER INC Estimated workers reported Quarter 2 of Year 2019"21 to 30 Workers" LEI account contact TO I KRISTI LINN(360)0244620-Email LINB235@ini wa.gov Public Works Requirements Verity the contractor is eligible to perform work on public works projects. Required Training—Effective July 1,2019 Exempt from this requirement. Contractor Strikes No strikes have been Issued against this contractor. Contractors not allowed to bid No debarments have been issued against this contractor Workplace safety and health No inspections dunng the previous 8 year period. Wadrrngtnn State Dept of Laboi A Indusluss Use el this site is sub1 .t to the lass of the stale of Weshingmn Va li'lt`'401000* �� BOND NO: 2290110 CONTRACTOR'S PERFORMANCE BOND to City of Spokane Valley,Washington The City of Spokane Valley,Washington,in Spokane County,has awarded to A.M.LANDSHAPER,INC. (Contractor),as Principal,a contract for the construction of the project designated as EDGECLIFF PARK SWINGS PROJECT Project No. 19-153.00, in Spokane Valley, Washington, and said Principal is required under the terms of the Contract to furnish a performance bond in accordance with chapter 39.08 Revised Code of Washington(RCW). The Principal, and North American Specialty Insurance Company (Surety), a corporation, organized under the laws of New Marna and licensed to do business in the State of Washington as surety and named in the current list of"Surety Companies Acceptable in Federal Bonds"as published in the Federal Register by the Audit Staff Bureau of Accounts,U.S.Treasury Dept.,are jointly and severally held and firmly bound to the City of Spokane Valley,as Obligee,in the sum of$36,972.64 total Contract amount (including Washington State sales tax), subject to the provisions herein. This performance bond shall become null and void, if and when the Principal,its heirs,executors,administrators,successors, or assigns shall well and faithfully perform all of the Principal's obligations under the Contract and fulfill all the terms and conditions of all duly authorized modifications,additions,and changes to said Contract that may hereafter be made,at the time and in the manner therein specified;shall warranty the work as provided in the Contract and shall indemnify and hold harmless the Obligee from any defects in the workmanship and materials incorporated into the work for the period identified in the Contract;and if such performance obligations have not been fulfilled,this bond shall remain in full force and effect. The Surety for value received agrees that no change,extension of time,alteration or addition to the terns of the Contract,the specifications accompanying the Contract, or to the work to be performed under the Contract shall in any way affect its obligation on this bond,and waives notice of any change,extension of time,alteration or addition to the terms of the Contract or the work performed. The Surety agrees that modifications and changes to the terms and conditions of the Contract that increase the total amount to be paid the Principal shall automatically increase the obligation of the Surety on this bond and notice to Surety is not required for such increased obligation. This bond may be executed in two original counterparts,and shall be signed by the parties'duly authorized officers.This bond will only be accepted if it is accompanied by a fully executed and original power of attorney for the officer executing on behalf of the surety. PRINCIPAL(CONTRACTOR) SURETY A.M. ndsha er Inc. North AmericanSpecialty Insurance Company y r 4J < 10-04-19 4if J tdexl .t)Yfl�lf4+.-" Principal Signature Date !!!Sur"ety Sig::tlire Date Tye C. McGee Shelly Donovan Printed Name Printed Name Secretary/Treasurer Attorney In Fart Title Tule Name,address,and telephone of local office/agent of Surety Company is. Alliant Insurance Services, Inc. 818 W. Riverside Ave.,Ste. 800,Spokane,WA 99201. (509) 375-3024 Updated 1.14.2013 ma� s ��Val lel BOND NO: 2290110 CONTRACTOR'S PAYMENT BOND(NON-FEDERALLY FUNDED PROJECT) to City of Spokane Valley,Washington The City of Spokane Valley,Washington,in Spokane County,has awarded to A.M.LANDSHAPER.INC.(Contractor),as Principal,acontract for the construction of the project designated as EDGECLIFF PARK SWINGS PROJECT Project No. 19-153.00.in Spokane Valley,Washington,and said Principal is required under the terms of the Contract to furnish a payment bond in accordance with chapter 39.08 Revised Code of Washington(RCW) The Principal, and North American Specialty Insurance Company (Surety), a corporation organized under the laws New Harnnshire and licensed to do business in the State ofWashmgton as surety and named in the current list of"Surety Companies Acceptable in Federal Bonds"as published in the Federal Register by the Audit Staff Bureau of Accounts,U.S.Treasury Dept,are jointly and severally held and firmly bound to the City of Spokane Valley,as Obligee,in the sum of S 36,972,64 total Contract amount (including Washington State sales tax), subject to the provisions herein. This payment bond shall become null and void,if and when the Principal,its heirs,executors,administrators, successors,or assigns shall pay all persons in accordance with chapters 39.08 and 39.12 RCW, including all workers,laborers,mechanics, subcontractors,and materialmen,and all persons who shall supply such contractor or subcontractor with provisions and supplies for the carrying on of such work; and shall indemnify and hold harmless the Obligee from all.loss, cost or damage which Obligee may suffer by reason of the failure of Principal to make such required payments;and if such payment obligations have not been fulfilled,this bond shall remain in full force and effect. The Surety for value received agrees that no change,extension of time,alteration or addition to the terms of the Contract,the specifications accompanying the Contract, or to the work to be performed under the Contract shall in any way affect its obligation on this bond,except as provided herein,and waives notice of any change,extension of time,alteration or addition to the terms of the Contract or the work performed The Surety agrees that modifications and changes to the terms and conditions of the Contract that increase the total amount to be paid the Principal shall automatically increase the obligation of the Surety on this bond and notice to Surety is not required for such increased obligation. This bond may be executed in two original counterparts,and shall be signed by the parties'duly authorized officers.This bond will only be accepted ff it is accompanied by a fully executed and original power of attorney for the officer executing on behalf of the surety PRINCIPAL(CONTRACTOR) SURETY A.M. L Sp dshapper, Inc. N h A eric ecialty Insurance Company C° r 10-04-19 /}(/y4.--..10-04-19 Principal ignature Date Surety Sig e Date Tye C. McGee Shelly Donovan Printed Name Printed Name Secretary/Treasurer Attorney In Fart Title Title Name,address,and telephone of local office/agent of Surety Company is. Alliant Insurance Services, Inc. 818 W. Riverside Ave.,Ste.800,Spokane.WA 99201. (509) 325-3024 Updated 1.14.2013 SWISS RE CORPORATE SOLUTIONS NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY GENERAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS,THAT North American Specialty Insurance Company,a corporation duly organized and existing under laws of the State of New Hampshire,and having its principal office in the City of Overland Park,Kansas,and Washington International Insurance Company,a corporation organized and existmg under the laws of the State of New Hampshire and having its principal office in the City of Overland Park,Kansas,each does hereby make,constitute and appoint: GEORGE C.SCHROEDER,NICHOLAS W.PAGET, SHAWN M.WILSON,LAUREN E.RICHARDSON and SHELLY DONOVAN JOINTLY OR SEVERALLY Its true and lawful Attamey(s)-in-Fact,to make,execute,seal and deliver,for and on its behalf and as its act and deed,bonds or other writings obligatory m the nature of a bond on behalf of each of said Companies,as surety,on contracts of suretyship as are or may be required or permitted by law,regulation,contract or otherwise,provided that no bond or undertaking or contract or suretyship executed under this authonty shall exceed the amount of FIFTY MILLION($50,000,000 00)DOLLARS This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held on the 9th of May,2012: "RESOLVED,that any two of the Presidents,any Managing Director,any Senior Vice President,any Vice President,any Assistant Vice President, the Secretary or any Assistant Secretary be,and each or any of them hereby is authonzed to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds,undertakings and all contracts of surety,and that each or any of them hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is FURTHER RESOLVED,that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be binding upon the Company when so affixed and in the future with regard to any bond,undertaking or contract of surety to which it is attached" $‘00-)T Y/41‘. "o`'`3 B - ` a SEAL .m_ Steven P Anteroom.Smorvi:Pament ofW. agmnmkrmmnYrm.r..m Company 3,, SEA ye. ty�.S ee:na &Sesta Vkx Prenatal of north American Specialtyr.wne.Company $i 7(4. .-: skA4 xnmlaoM Fth Michael A.BIty& kPremien wY w vr Vice enaen of os inarn.hi.evee tomy'p. tr &Senior Vke Proficient M North AmeAemspetlaay Immmee Company IN WITNESS WHEREOF,North American Specialty Insurance Company and Washington International Insurance Company have caused their official seals to be hereunto affixed,and these presents to be signed by their authorized officers this 20th day of July ,2017 North American Specialty Insurance Company Washington International Insurance Company State of Illinois ss County of Cook On this 20th day of July 2017 ,before me,a Notary Public personally appeared Steven P.Anderson ,Senior Vice President of I Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Michael A Ito Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company,personally known to me,who being by me duly sworn,acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the voluntary act and deed of their respective companies OFFICML SEAL M KENNY NOTPAY P090C,STATE OF SBNq$ M Kenny.Notary['uWn=llT` MY COMMISSION EXPIRES 12104/2017 _ I, Jeffrey Goldberg , the duly elected Assistant Secretary of North American Specialty Insurance Company mid Washndginn International Insurance Company,do hereby certify that the above and foregoing is a true and correct copy of a Power of Attt may iivez by said Mirth Amen can Specialty Insurance Company and Washington International Insurance Company,which is still in full force and effect _ IN WITNESS WHEREOF,I have set my hand and affixed the seals of the Companies this 4 'da ,2o-totof QC4 >hey ,2o1 . /afro: /afGoldberg,Via Pronhvt&Assistant Sectary of Wmhmgtm lmemanwil Laurance Company&Nat American SianWiyIoamw'e Company • 4 �...•..4) AMLANDS-01 MNEIGHBORS A Rt® CERTIFICATE OF LIABILITY INSURANCE DA2/21/2020 TE ) 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). IITACT PRODUCER urea Spokane Office PHONE PayneWest Insurance,Inc. (A/C,No,Ext):(509)838-3501 FAic,No):(509)838-3511 501 N.Riverpoint Blvd.,Ste 403 ADDRESS: Spokane,WA 99202 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Cincinnati Insurance Company 10677 INSURED INSURER B:Continental Casualty Company 20443 A.M.Landshaper,Inc. INSURER C: Mark Albin 8004 North Market INSURER D: Spokane,WA 99217 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR 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 POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MM/DDIYYYYI IMM/DDIYYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR X x EPP0128051 2/24/2020 2/24/2021 EMISES C a ocwrrDence) $ 500,000 MED EXP(Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X fief LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: WA STOP GAP $ 1,000,000 A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ X ANY AUTO EBA0128051 2/24/2020 2/24/2021 BODILY INJURY(Per person) $ AUTOOS ONLY SCHEDULEDD USyy pBODILY INJURYp (Per accident) $ AUTOS ONLY AUTOS ONLY (Per acEcident)AMAGE $ $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE EPP0128051 2/24/2020 2/24/2021 AGGREGATE $ 1,000,000 DED X RETENTION$ 0 $ WORKERS COMPENSATION PER H AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY IPRO ry inEPRIE NR PPAEXCLUDED?T /EECUTIVE N/A E.L.EACH ACCIDENT $ MandatoH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ B Leased/Rented EQ 6076287866 2/24/2020 2/24/2021 $1,000 Deductible 500,000 B Installation Floater 6076287866 2/24/2020 2/24/2021 $1,000 Deductible 100,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) RE:Edgecliff Park Swings/Project No.19-153. 0 City of Spokane Valley is additional insured as per the attached forms.Coverage is primary and non contributory.Waiver of subrogation and per project aggregate applies per attached forms. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Spokane Valle THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y P y ACCORDANCE WITH THE POLICY PROVISIONS. Attn:Christine Bainbridge,City Clerk 10210 East Sprague Ave Spokane,WA 99206 AUTHORIZED REPRESENTATIVE 1 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS' COMMERCIAL GENERAL LIABILITY BROADENED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Endorsement-Table of Contents: Coverage: Begins on Page: 1. Employee Benefit Liability Coverage 2 2. Unintentional Failure to Disclose Hazards 7 3. Damage to Premises Rented to You 8 4. Supplementary Payments 9 5. Medical Payments 9 6. Voluntary Property Damage (Coverage a.)and Care,Custody or Control Liability Coverage (Coverage b.) 9 7. 180 Day Coverage for Newly Formed or Acquired Organizations 10 8. Waiver of Subrogation 10 9. Automatic Additional Insured -Specified Relationships: 10 • Managers or Lessors of Premises; • Lessor of Leased Equipment; • Vendors; • State or Political Subdivisions-Permits Relating to Premises; • State or Political Subdivisions-Permits;and • Contractors'Operations 10. Broadened Contractual Liability-Work Within 50'of Railroad Property 14 11. Property Damage to Borrowed Equipment 14 12. Employees as Insureds-Specified Health Care Services: 14 • Nurses; • Emergency Medical Technicians;and • Paramedics 13. Broadened Notice of Occurrence 14 B. Limits of Insurance: The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorse- ment,except as provided below: 1. Employee Benefit Liability Coverage Each Employee Limit: $ 1,000,000 Aggregate Limit: $ 3,000,000 Deductible: $ 1,000 3. Damage to Premises Rented to You The lesser of: a. The Each Occurrence Limit shown in the Declarations;or b. $500,000 unless otherwise stated$ 4. Supplementary Payments a. Bail bonds: $ 1,000 b. Loss of earnings: $ 350 5. Medical Payments Medical Expense Limit: $ 10,000 Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 1 of 15 6. Voluntary Property Damage (Coverage a.)and Care, Custody or Control Liability Coverage (Coverage b.) Limits of Insurance (Each Occurrence) Coverage a.$1,000 Coverage b.$5,000 unless otherwise stated $ Deductibles(Each Occurrence) Coverage a.$250 Coverage b.$250 unless otherwise stated $ COVERAGE PREMIUM BASIS RATE ADVANCE PREMIUM (a) Area (For Limits in Excess of (For Limits in Excess of (b) Payroll $5,000) $5,000) (c) Gross Sales (d) Units (e) Other b. Care, Custody $ or Control TOTAL ANNUAL PREMIUM $ 11. Property Damage to Borrowed Equipment Each Occurrence Limit: $ 10,000 Deductible: $ 250 C. Coverages: have used up the ap- plicable limit in f 1. Employee Benefit LiabilityCoverage ance in the ayment of a. The following is added to SECTION I judgments or settle- - COVERAGES: Employee Benefit ments. Liability Coverage. No other obligation or liabil- (1) Insuring Agreement ity to pay sums or perform acts or services is covered (a) We will pay those sums that unless explicitly provided for the insured becomes legally under Supplementary Pay- obligated to pay as dam- ments. ages caused by any act, er- ror (b) This insurance applies to or omission of the in- damages only if the act, er- sured, or of any other per- ror or omission, is negli- son for whose acts the in- gently committed in the negli- sured h islegally liable,ap-to "administration" of your which this insurance plies. We will have the right "employee benefit pro- and and duty to defend the in- gram";and sured against any "suit" 1) Occurs during the pol- seeking those damages. icy period; or However, we will have no duty to defend against any 2) Occurred prior to the "suit" seeking damages to effective date of this which this insurance does endorsement provided: not apply. We may, at our discretion, investigate any a) You did not have report of an act, error or knowledge of a omission and settle any claim or "suit" on claim or "suit" that may re- or before the ef- sult. But: fective date of this endorsement. 1) The amount we will pay You will be for damages is limited as described in SEC- deemed to have TION III - LIMITS OF knowledge of a INSURANCE;and claim or "suit" when any 2) Our right and duty to "authorized repre- defend ends when we sentative"; Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 2 of 15 i) Reports all, or formance of investment any part, of the vehicles;or act, error or omission to us 3) Advice given to any or any other person with respect to insurer; that person's decision to participate or not to ii) Receives a participate in any plan written or ver- included in the "em- bal demand or ployee benefit pro- claim for dam- gram". ages because of the act, er- (f) Workers' Compensation ror or omis- and Similar Laws sion;and Any claim arising out of b) There is no other your failure to comply with applicable insur- the mandatory provisions of ance. any workers'compensation, • unemployment compensa- (2) Exclusions tion insurance, social secu- rity or disability benefits law This insurance does not apply or any similar law. to: (a) Bodily Injury, Property (g) ERISA Damage or Personal and Damages for which any in- Advertising Injury sured is liable because of injury", "property liability imposed on a fiduci- "BodilyP p y ary by the Employee Re- damage" or "personal and tirement Income Security advertising injury". Act of 1974, as now or (b) Dishonest, Fraudulent, hereafter amended, or by Criminal or Malicious Act any similar federal, state or local laws. Damages arising out of any intentional, dishonest, (h) Available Benefits fraudulent, criminal or mali- Any claim for benefits to the cious act, error or omission, extent that such benefits committed by any insured, are available, with reason- including the willful or reck- able effort and cooperation less violation of any statute, of the insured, from the ap- (c) Failure to Perform a Con- plicable funds accrued or tract other collectible insurance. Damages arising out of fail- (i) Taxes, Fines or Penalties ure of performance of con- Taxes, fines or penalties, tract by any insurer, including those imposed (d) Insufficiency of Funds under the Internal Revenue Code or any similar state or Damages arising out of an local law. insufficiency of funds to meet any obligations under (j) Employment-Related any plan included in the Practices "employee benefit pro- Any liability arising out of gram". any: (e) Inadequacy of Perform- (1) Refusal to employ; ance of Investment / Ad- vice Given With Respect (2) Termination of em- to Participation ployment; Any claim based upon: (3) Coercion, demotion, reassign- 1) Failure of anyinvest- evaluation,ment, discipline, defa- ment to perform; mation, harassment, 2) Errors in providing in- humiliation, discrimina- formation on past per- tion or other employ- Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 3 of 15 ment-related practices, (e) A trust, you are an insured. acts or omissions;or Your trustees are also in- sureds, re- (4) Consequential liability but only with q spect to their duties as as a result of(1), (2) or trustees. (3) above. (2) Each of the following is also an This exclusion applies insured: whether the insured may be held liable as an employer (a) Each of your "employees" or in any other capacity and who is or was authorized to to any obligation to share administer your "employee damages with or repay benefit program". someone else who must pay damages because of (b) Any persons, organizations the injury, or "employees" having proper temporary authori- (3) Supplementary Payments zation to administer your SECTION I - COVERAGES, "employee benefit program" SUPPLEMENTARY PAY- if you die, only until your MENTS - COVERAGES A AND legal representative is ap- B also apply to this Coverage. pointed. b. Who is an Insured (c) Your legal representative if you die, but only with re- As respects Employee Benefit Liabil- spect to duties as such. ity Coverage, SECTION II - WHO IS That representative will AN INSURED is deleted in its en- have all your rights and du- tirety and replaced by the following: ties under this Coverage Part. (1) If you are designated in the (3) Any organization you newly ac- Declarations as: quire or form, other than a part- (a) An individual, you and your nership, joint venture or limited spouse are insureds, but liability company, and over only with respect to the which you maintain ownership conduct of a business of or majority interest, will qualify which you are the sole as a Named Insured if no other owner, similar insurance applies to that organization. However, cover- (b) A partnership or joint yen- age under this provision: ture, you are an insured. Your members, your part- (a) Is afforded only until the ners, and their spouses are 180th day after you acquire also insureds but only with or form the organization or respect to the conduct of the end of the policy period, your business. whichever is earlier;and (c) A limited liability company, (b) Does not apply to any act, you are an insured. Your error or omission that was members are also insureds, committed before you ac- but only with respect to the quired or formed the or- conduct of your business. ganization. Your managers are in- sureds, but only with re- c. Limits of Insurance spect to their duties as your As respects Employee Benefit Liabil- managers. ity Coverage, SECTION III - LIMITS (d) An organization other than OF INSURANCE is deleted in its en- a partnership, joint venture tirety and replaced by the following: or limited liability company, (1) The Limits of Insurance shown you are an insured. Your in Section B. Limits of Insur- "executive officers" and di- ance, 1. Employee Benefit Li- rectors are insureds, but ability Coverage and the rules only with respect to their below fix the most we will pay duties as your officers or di- regardless of the number of: rectors. Your stockholders are also insureds, but only (a) Insureds; with respect to their liability as stockholders. Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 4 of 15 z (b) Claims made or "suits" (b) The deductible amount brought; stated in the Declarations (c) Persons or organizations applies to all damages g sustained by any one "em- making claims or bringing ployee", including such "suits";; "employee's" dependents (d) Acts,errors or omissions;or and beneficiaries, because of all acts, errors or omis- (e) Benefits included in your sions to which this insur- "employee benefit pro- ance applies. gram". (c) The terms of this insurance, (2) The Aggregate Limit shown in including those with respect Section B. Limits of Insurance, to: 1. Employee Benefit Liability 1) Our right and duty to Coverage of this endorsement insured the reo is the most we will pay for all de defendagainst any "sured damages because of acts, er- its" seeking those dam- rors or omissions negligently • committed in the "administra- ages; and tion" of your "employee benefit 2) Your duties, and the program". duties of any other in- (3) Subject to the limit described in volved insured, in the (2) above, the Each Employee event of an act, error or Limit shown in Section B. Limits omission,or claim, of Insurance, 1. Employee apply irrespective of the Benefit Liability Coverage of application of the deductible this endorsement is the most we amount. will pay for all damages sus- tained by any one "employee", (d) We may pay any part or all including damages sustained by of the deductible amount to such "employee's" dependents effect settlement of any and beneficiaries,as a result of: claim or "suit" and, upon notification of the action (a) An act,error or omission;or taken, you shall promptly (b) A series of related acts, er- reimburse us for such part rors or omissions, regard- of the deductible amount as w less of the amount of time we have paid. that lapses between such d. Additional Conditions acts,errors or omissions, committed in the As respects Employee Benefit Li- negligently ability Coverage, SECTION IV - "administration" of your "em- COMMERCIAL GENERAL LIABIL- ployee benefit program". ITY CONDITIONS is amended as However, the amount paid un- follows: der this endorsement shall not (1) Item 2. Duties in the Event of exceed, and will be subject to Occurrence, Offense, Claim or the limits and restrictions that Suit is deleted in its entirety and apply to the payment of benefits replaced by the following: in any plan included in the "em- ployee benefit program". 2. Duties in the Event of an Act, Error or (4) Deductible Amount Omission, or Claim or Suit a. You must see to it that we are noti- (a) Our obligation to pay dam- fled as soon as practicable of an act, ages on behalf of the in- error or omission which may result in sured applies only to the a claim. To the extent possible, no- amount of damages in ex- tice should include: cess of the deductible amount stated in the Decla- (1) What the act, error or omission rations as applicable to was and when it occurred; and Each Employee. The limits of insurance shall not be (2) The names and addresses of reduced by the amount of anyone who may suffer dam- this deductible. ages as a result of the act, error or omission. Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 5 of 15 3 b. If a claim is made or"suit" is brought b. Method of Sharing against any insured,you must: If all of the other insur- (1) Immediately record the specifics ance permits contribu- of the claim or "suit" and the tion by equal shares, date received; and we will follow this method also. Under (2) Notify us as soon as practicable. this approach each in- You must see to it that we receive surer contributes equal written notice of the claim or"suit" as amountsaiditsuntilc it has soon as practicable. paid its applicable limit of insurance or none of c. You and any other involved insured the loss remains, must: whichever comes first. (1) Immediately send us copies of If any of the other in- any demands, notices, sum- surance does not per- monses or legal papers re- mit contribution by ceived in connection with the equal shares, we will claim or"suit"; contribute by limits. Under this method, (2) Authorize us to obtain records each insurer's share is and other information; based on the ratio of its (3) Cooperate with us in the investi- applicable limit of in- surance the total limits ap- gation insur- or defense against the "suit"; ancecable of all insurers. ns of and (4) Assist us, upon our request, in c. No Coverage the enforcement of any right This insurance shall not against any person or organiza- cover any loss for tion which may be liable to the which the insured is insured because of an act, error entitled to recovery un- or omission to which this insur- der any other insur- ance may also apply. ance in force previous d. No insured will, except at that in- to the effective date of this Coverage Part. sured's own cost, voluntarily make a payment, assume any obligation, or e. Additional Definitions incur any expense without our con- sent. As respects Employee Benefit Li- ability Coverage, SECTION V - (2) Item 5. Other Insurance is de- DEFINITIONS is amended as fol- leted in its entirety and replaced lows: by the following: (1) The following definitions are 5. Other Insurance added: If other valid and collectible 1. "Administration"means: insurance is available to the insured for a loss we cover a. Providing information to under this Coverage Part, "employees", including our obligations are limited their dependents and as follows: beneficiaries, with re- spect to eligibility for or a. Primary Insurance scope of "employee This insurance is pri- benefit programs"; mary except when c. b. Interpreting the "em- below applies. If this ployee benefit pro- insurance is primary, grams"; our obligations are not affected unless any of c. Handling records in the other insurance is connection with the also primary. Then, we "employee benefit pro- will share with all that grams"; or other insurance by the method described in b. d. Effecting, continuing or below, terminating any "em- ployee's" participation Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 6 of 15 in any benefit included benefits, workers' corn- in the "employee bene- pensation and disability fit program". benefits;and However, "administration" d. Vacation plans, includ- does not include: ing buy and sell pro- grams; leave of ab- a. Handling payroll de- sence programs, in- ductions; or cluding military, mater- b. The failure to effect or nity, family, and civil maintain any insurance leave; tuition assis- or adequate limits of tance plans; transpor- coverage of insurance, tation and health club including but not limited subsidies. to unemployment in- (2) The following definitions are surance, social security deleted in their entirety and re- benefits, workers' com- placed by the following: pensation and disability benefits. 21. "Suit" means a civil means pro- ceeding in which money 2. "Cafeteria plans" damages because of an plan authorized by applica- act error or omission to ble law to allow "employ- which this insurance applies ees" to elect to pay for cer- are alleged. "Suit"includes: tain benefits with pre-tax dollars. a. An arbitration pro- ceeding3. "Employee benefitpro- in which such damages are claimed grams" means a program and to which the in- providing some or all of the sured must submit or following benefits to "em- does submit with our ployees", whether provided consent; through a"cafeteria plan"or otherwise: b. Any other alternative dispute resolution pro- a. Group life insurance; ceeding in which such group accident or damages are claimed health insurance; den- and to which the in- tal, vision and hearing sured submits with our plans; and flexible consent; or spending accounts; provided that no one c. An appeal of a civil other than an "em- proceeding. ployee" may subscribe to such benefits and 8. "Employee" means a per- such benefits are made son actively employed, for- generally available to merly employed, on leave those "employees"who of absence or disabled, or satisfy the plan's eligi- retired. "Employee" in- bilitycludes a "leased worker". requirements; "Employee" does not in- b. Profit sharing plans, dude a"temporary worker". employee savings plans, employee stock 2. Unintentional Failure to Disclose Haz- ownership plans, pen- ards sion plans and stock SECTION IV-COMMERCIAL GENERAL subscription plans, LIABILITY CONDITIONS, 7. Represen- provided that no one tations is hereby amended by the addi- other than an "em- tion of the following: ployee" may subscribe to such benefits and Based on our dependence upon your such benefits are made representations as to existing hazards, if generally available to unintentionally you should fail to disclose all "employees" who all such hazards at the inception date of are eligible under the your policy, we will not reject coverage plan for such benefits; under this Coverage Part based solely on c. Unemployment insur- such failure. ance, social security Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 7 of 15 3. Damage to Premises Rented to You e) Settling, cracking, of Paragraph shrinking or ex- a. The last Subparagraph pan"sion; or 2. SECTION I - COVERAGES, COVERAGE A. - BODILY INJURY f) Nesting or infesta- AND PROPERTY DAMAGE, 2. LI- tion, or discharge ABILITY Exclusions is hereby de- or release of leted and replaced by the following: waste products or in- Exclusions c.throughdo not apply secretions, ,9 q. pP Y sects, birds, ro- to damage by fire, explosion, light- dents or other ning, smoke or soot to premises animals. while rented to you or temporarily occupied by you with permission of (b) Loss caused directly or indi- the owner. rectly by any of the follow- b. The insurance provided under SEC- mg. 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 both rented to and occupied by you. 2) Water that backs up or overflows from a (1) As respects Water Damage Le- sewer,drain or sump; gal Liability, as provided in Paragraph 3.b.above: 3) Water under the ground surface press- The exclusions under SECTION ing on, or flowing or I - COVERAGES, COVERAGE seeping through: A. BODILY INJURY AND PROPERTY DAMAGE LIABIL- a) Foundations, ITY, 2. Exclusions, other than i. walls, floors or War and the Nuclear Energy paved surfaces; Liability Exclusion, are deleted b) Basements, and the following are added: whether paved or This insurance does not apply not;or to: c) Doors, windows or (a) "Property damage": other openings. 1) Assumed in any con- (c) Loss caused by or resulting tract;or from water that leaks or flows from plumbing, heat- 2) Loss caused by or re- ing, air conditioning, or fire suiting from any of the protection systems caused following: by or resulting from freez- ing, unless: a) Wear and tear; b) Rust, corrosion, 1) You did your best to maintain heat in the fungus, decay, building or structure;or deterioration, hid- den or latent de- 2) You drained the fect or any quality equipment and shut off in property that the water supply if the causes it to dam- heat was not main- age or destroy it- tained. self; (d) Loss to or damage to: c) Smog; 1) Plumbing, heating, air d) Mechanical conditioning, fire pro- breakdown in- tection systems, or cluding rupture or other equipment or ap- bursting caused pliances;or by centrifugal force; 2) The interior of any building or structure, or to personal property in the building or structure Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 8 of 15 caused by or resulting 5. Medical Payments from rain, snow, sleet or ice, whether driven The Medical Expense Limit of Any One by wind or not. Person as stated in the Declarations is amended to the limit shown in Section B. c. Limit of Insurance Limits of Insurance, 5. Medical Pay- The Damage to Premises Rented to ments of this endorsement. You Limit as shown in the Declare- 6. Voluntary Property Damage and Care, tions is amended as follows: Custody or Control Liability Coverage (2) Paragraph 6. of SECTION III - a. Voluntary Property Damage Coy- LIMITS OF INSURANCE is erage hereby deleted and replaced by the following: We will pay for"property damage" to property of others arising out of op- 6. Subject to 5. above, the erations incidental to the insured's Damage to Premises business when: Rented to You Limit is the most we will pay under (1) Damage is caused by the in- COVERAGE A. BODILY sured;or INJURY AND PROPERTY (2) Damage occurs while in the in- DAMAGE LIABILITY, for sured's possession. damages because of "property damage" to With your consent, we will make premises while rented to these payments regardless of fault. you or temporarily occupied by you with permission of b. Care, Custody or Control Liability the owner, arising out of Coverage any one "occurrence" to SECTION I - COVERAGES, COV- which this insurance ap- ERAGE A. BODILY INJURY AND plies. PROPERTY DAMAGE LIABILITY, 2. (3) The amount we will pay is Iim- Exclusions,j. Damage to Property, ited as described in Section B. Subparagraphs (3), (4) and (5) do Limits of Insurance, 3. Dam- not apply to "property damage" to age to Premises Rented to the property of others described You of this endorsement. therein. 4. Supplementary Payments With respect to the insurance provided by this section of the endorsement, the fol- Under SECTION I - COVERAGE, SUP- lowing additional provisions apply: PLEMENTARY PAYMENTS - COVER- AGES A AND B: a. The Limits of Insurance shown in the Declarations are replaced by the lim- a. Paragraph 2. is replaced by the fol- its designated in Section B.Limits of lowing: Insurance, 6. Voluntary Property Up to the limit shown in Section B. Damage and Care, Custody or Limits of Insurance, 4.a. Bail Bonds Control Liability Coverage of this cover- of this endorsement for cost of bail agendorsement with respect to bonds required because of accidents Thesee provided by this endorsement.ofandno or traffic law violations arising out of limits are inclusivelimits beingand re- thee- use of any vehicle to which the in addition to the Bodily Injury Liability Coverage ap- placed. The LimitsBL of Insurance plies. We do not have to furnish shown in Section B. Limits of Insur- bonds.W ance, 6. Voluntary Property Dam- theseage and Care, Custody or Control b. Paragraph 4. is replaced by the fol- Liability Coverage of this endorse- lowing: ment fix the most we will pay in any one "occurrence" regardless of the All reasonable expenses incurred by number of: the insured at our request to assist us in the investigation or defense of (1) Insureds; the claim or "suit", including actual (2) Claims made or "suits" brought; loss of earnings up to the limit shown or in Section B. Limits of Insurance, 4.b. Loss of Earnings of this en- (3) Persons or organizations mak- dorsement per day because of time ing claims or bringing"suits". off from work. Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 9 of 15 b. Deductible Clause 9. Automatic Additional Insured - Speci- (1) Our obligation to pay damages fled Relationships on your behalf applies only to a. The following is hereby added to the amount of damages for each SECTION li-WHO IS AN INSURED: "occurrence" which are in ex- cess of the deductible amount (1) Any person or organization de- stated in Section B. Limits of scribed in Paragraph 9.a.(2) Insurance, 6. Voluntary Prop- below (hereinafter referred to as erty Damage and Care, Cus- additional insured) whom you tody or Control Liability Coy- are required to add as an addi- erage of this endorsement. The tional insured under this Cover- limits of insurance will not be re- age Part by reason of: duced by the application of such (a) A written contract or deductible amount. agreement;or (2) Condition 2.Duties in the Event (b) An oral agreement or con- of Occurrence, Offense, Claim tract where a certificate of or Suit, applies to each claim or insurance showing that per- "suit"irrespective of the amount. son or organization as an (3) We may pay any part or all of additional insured has been the deductible amount to effect issued, settlement of any claim or "suit" is an insured, provided: and, upon notification of the ac- tion taken, you shall promptly (a) The written or oral contract reimburse us for such part of the or agreement is: deductible amount as has been paid by us. 1) Currently in effect or becomes effective 7. 180 Day Coverage for Newly Formed or during the policy pe- Acquired Organizations riod; and SECTION II - WHO IS AN INSURED is 2) Executed prior to an amended as follows: "occurrence" or offense Subparagraph a. of Paragraph 4. is to which this insurance hereby deleted and replaced by the fol- lowing: (b) They are not specifically a. Insurance under this provision is af- named as an additional in- forded only until the 180th day after cured under any other pro- you acquire or form the organization vision of, or endorsement or the end of the policy period, added to, this Coverage Part. whichever is earlier; 8. Waiver of Subrogation (2) Only the following persons or organizations are additional in- SECTION IV- COMMERCIAL GENERAL sureds under this endorsement, LIABILITY CONDITIONS, 9. Transfer of and insurance coverage pro- Rights of Recovery Against Others to vided to such additional in- Us is hereby amended by the addition of sureds is limited as provided the following: herein: We waive any right of recovery we may (a) The manager or lessor of a have because of payments we make for premises leased to you with injury or damage arising out of your on- whom you have agreed per going operations or"your work" done un- Paragraph 9.a.(1) above to der a written contract requiring such provide insurance, but only waiver with that person or organization with respect to liability aris- and included in the "products-completed ing out of the ownership, operations hazard". However, our rights maintenance or use of that may only be waived prior to the "occur- part of a premises leased to rence" giving rise to the injury or damage you, subject to the following for which we make payment under this additional exclusions: Coverage Part. The insured must do This insurance does not nothing after a loss to impair our rights. apply to: At our request,the insured will bring "suit" or transfer those rights to us and help us 1) Any "occurrence" enforce those rights, which takes place after Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 10 of 15 you cease to be a ten- c) Any physical or ant in that premises. chemical change in 2) Structural alterations, the pro made intentionallyuct new construction or by the vendor; demolition operations performed by or on be- d) Repackaging, un- half of such additional less unpacked insured. solely for the pur- pose or organization of inspection, (b) Any persong demonstration, from which you lease testing, or the equipment with whom you substitution of have agreed per Paragraph parts under in- 9.a.(1) above to provide in- structions from the surance. Such person(s)or manufacturer, and organization(s)are insureds then repackaged solely with respect to their in the original liability arising out of the container; maintenance, operation or use by you of equipment e) Any failure to leased to you by such per- make such in- son(s) or organizations(s). spections, adjust- However, this insurance ments, tests or does not apply to any "oc- servicing as the currence"which takes place vendor has after the equipment lease agreed to make or expires. normally under- takes to make in (c) Any person or organization the usual course (referred to below as ven- of business, in dor) with whom you have connection with agreed per Paragraph the distribution or 9.a.(1) above to provide in- sale of the prod- surance, but only with re- ucts; spect to "bodily injury" or "property damage" arising f) Demonstration, in- out of"your products"which stallation, servic- are distributed or sold in the ing or repair op- regular course of the ven- erations, except dor's business, subject to such operations the following additional ex- performed at the clusions: vendor's premises in connection with 1) The insurance afforded the sale of the the vendor does not product; apply to: g) Products which, a) "Bodily injury" or after distribution or "property damage" sale by you, have for which the ven- been labeled or dor is obligated to relabeled or used pay damages by as a container, reason of the as- part or ingredient sumption of liabil- of any other thing ity in a contract or or substance by or agreement. This for the vendor. exclusion does not apply to liability for 2) This insurance does damages that the not apply to any in- vendor would sured person or or- have in the ab- ganization: sence of the con- tract or agree- a) From whom you ment; have acquired such products, or b) Any express war- any ingredient, ranty unauthorized part or container, by you; entering into, ac- Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 11 of 15 companying or 2) This insurance does containing such not apply to "bodily in- products; or jury", "property dam- age" or "personal and b) When liability in- advertising injury" aris- cluded within the ing out of operations "products- performed for the state completed opera- or political subdivision. tions hazard" has been excluded (f) Any person or organization under this Cover- with which you have agreed age Part with re- per Paragraph 9.a.(1) spect to such above to provide insurance, products. but only with respect to li- ability(d) Anystate orpolitical subdi- arising out of "your work" performed for that vision with which you have additional insured by you or agreed per Paragraph on your behalf. A person or 9.a.(1) above to provide in- organization's status as an surance, subject to the fol- insured under this provision lowing additional provision: of this endorsement contin- This insurance applies only ues for only the period of time required by the written with respect to the following hazards for which the state contract or agreement, but or political subdivision has in no event beyond the ex- piration date of this Cover- issued a permit in connec- age Part. If there is no tion with premises you own, written contract or agree- rent or control and to which this insurance applies: ment, or if no period of time is required by the written 1) The existence, mainte- contract or agreement, a nance, repair, con- person or organization's struction, erection, or status as an insured under removal of advertising this endorsement ends signs, awnings, cano- when your operations for pies, cellar entrances, that insured are completed. coal holes, driveways, (3) Any insurance provided to an manholes, marquees, additional insured designated hoist away openings, under Paragraph 9.a.(2): sidewalk vaults, street banners, or decora- (a) Subparagraphs (e) and (f) tions and similar expo- does not apply to "bodily sures; or injury"or"property damage" 2) The construction, erec- included within the "prod- tion, or removal of ele- ucts-completed operations vators;or hazard , 3) The ownership, main- (b) Subparagraphs (a), (b), (d), tena (e)and (f) does not apply to elevators covered ce, or use any "bodily injury", "property by damage" or "personal and this insurance. advertising injury" arising (e) Any state or political subdi- out of the sole negligence vision with which you have or willful misconduct of the agreed per Paragraph additional insured or their 9.a.(1) above to provide in- agents, "employees" or any surance, subject to the fol- other representative of the lowing provisions: additional insured;or 1) This insurance applies (c) Subparagraph (f) does not only with respect to op- apply to "bodily injury", erations performed by "property damage" or "per- you or on your behalf sonal and advertising injury" for which the state or arising out of: political subdivision has 1) Defects in design fur- issued apermit, nished by or on behalf Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 12 of 15 of the additional in- spects any other insurance sured; or policy issued to the addi- tional insured, and such 2) The rendering of, or other insurance policy shall failure to render, any be excess and /or noncon- professional architec- tributing,whichever applies, tural, engineering or with this insurance. surveying services, in- cluding: (b) Any insurance provided by a) The preparing, this endorsement shall be approving or fail-g, primary to other insurance pp gavailable to the additional ing to prepare or insured except: approve maps, shop drawings, 1) As otherwise provided opinions, reports, in SECTION IV - surveys, field or- COMMERCIAL GEN- ders, change or- ERAL LIABILITY ders or drawings CONDITIONS, 5. Other and specifications; Insurance, b. Excess and Insurance;or b) Supervisory, in- 2) For any other valid and spection, archi- collectible insurance tectural or engi- available to the addi- neering activities. tional insured as an • 3 "Your work"for which a additional insured by attachment of an en- consolidated (wrap-up) dorsement to another insurance program has insurance policy that is been provided by the written on an excess primecontractor-project basis. In such case, manager or owner of the coverage provided the construction project under this endorse- in which you are in- ment shall also be ex- volved. cess. b. Only with regard to insurance pro- (2) Condition 11. Conformance to vided to an additional insured desig- Specific Written Contract or nated under Paragraph 9.a.(2) Sub- Agreement is hereby added: paragraph (f) above, SECTION III - LIMITS OF INSURANCE is amended 11. Conformance to Specific to include: Written Contract or The limits applicable to the additional Agreement insured are those specified in the With respect to additional written contract or agreement or in insureds described in Para- the Declarations of this Coverage graph 9.a.(2)(f)above only: Part,whichever are less. If no limits are specified in the written contract If a written contract or or agreement, or if there is no written agreement between you contract or agreement, the limits ap- and the additional insured plicable to the additional insured are specifies that coverage for those specified in the Declarations of the additional insured: this Coverage Part. The limits of in- a. Be provided by the In- surance are inclusive of and not in surance Services Of- addition to the limits of insurance fice additional insured shown in the Declarations, form number CG 20 10 c. SECTION IV - COMMERCIAL GEN- or CG 20 37 (where ERAL LIABILITY CONDITIONS is edition specified);or hereby amended as follows: b. Include coverage for (1) Condition 5. Other Insurance is completed operations; amended to include: or (a) Where required by a written c. Include coverage for contract or agreement, this "your work"; insurance is primary and / and where the limits or cov- or noncontributory as re- erage provided to the addi- Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 13 of 15 tional insured is more re- 11. of this endorsement fix the strictive than was specifi- most we will pay in any one "oc- cally required in that written currence" regardless of the contract or agreement, the number of: terms of Paragraphs (a) Insureds; 9.a.(3)(a), 9.a.(3)(b) or 9.b. above, or any combination (b) Claims made or "suits" thereof, shall be interpreted brought; or as providing the limits or coverage required by the (c) Persons or organizations terms of the written contract making claims or bring or agreement, but only to "suits". the extent that such limits or coverage is included within (2) Deductible Clause the terms of the Coverage (a) Our obligation to pay dam- Part to which this endorse- ages on your behalf applies ment is attached. If, how- only to the amount of dam- ever, the written contract or ages for each "occurrence" agreement specifies the In- which are in excess of the surance Services Office Deductible amount stated in additional insured form Section B. Limits of Insur- number CG 20 10 but does ance, 11. of this endorse- not specify which edition, or ment. The limits of insur- specifies an edition that ance will not be reduced by does not exist, Paragraphs the application of such De- 9.a.(3)(a) and 9.a.(3)(b) of ductible amount. this endorsement shall not apply and Paragraph 9.b.of (b) Condition 2. Duties in the this endorsement shall ap- Event of Occurrence, Of- Ply. Tense, Claim or Suit, ap- 10. Broadened Contractual Liability-Work plies to each claim or "suit" Within 50'of Railroad Property irrespective of the amount. It is hereby agreed that Paragraph f.(1) of (c) We`may pay any part or all Definition 12. "Insured contract" (SEC- of the deductible amount to TION V-DEFINITIONS)is deleted. effect settlement of any claim or "suit" and, upon 11. Property Damage to Borrowed Equip- notification of the action ment taken, you shall promptly reimburse us for such part a. The following is hereby added to Ex- of the deductible amount as clusion j. Damage to Property of has been paid by us. Paragraph 2., Exclusions of SEC- TION I - COVERAGES, COVERAGE 12. Employees as Insureds - Specified A. BODILY INJURY AND PROP- Health Care Services ERTY DAMAGE LIABILITY: It is hereby agreed that Paragraph Paragraphs (3) and (4) of this exclu- 2.a.(1)(d) of SECTION II - WHO IS AN sion do not apply to tools or equip- INSURED, does not apply to your "em- ment loaned to you, provided they ployees" who provide professional health are not being used to perform opera- care services on your behalf as duly li- tions at the time of loss. censed: b. With respect to the insurance pro- a. Nurses; vided by this section of the en- b. Emergency Medical Technicians;or dorsement, the following additional provisions apply: c. Paramedics, (1) The Limits of insurance shown in the jurisdiction where an "occurrence" in the Declarations are replaced or offense to which this insurance applies by the limits designated in Sec- takes place. tion B. Limits of Insurance, 11. of this endorsement with respect 13. Broadened Notice of Occurrence to coverage provided by this endorsement. These limits are Paragraph a. of Condition 2. Duties in inclusive of and not in addition to the Event of Occurrence, Offense, the limits being replaced. The Claim or Suit (SECTION IV- COMMER- Limits of Insurance shown in CIAL GENERAL LIABILITY CONDI- Section B. Limits of Insurance, Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 14 of 15 TIONS) is hereby deleted and replaced (2) The names and addresses of by the following: any injured persons and wit- a. You must see to it that we are noti- nesses; and fied as soon as practicable of an (3) The nature and location of any "occurrence" or an offense which injury or damage arising out of may result in a claim. To the extent the"occurrence"or offense. possible, notice should include: This requirement applies only when (1) How, when and where the "oc- the "occurrence" or offense is known currence"or offense took place; to an "authorized representative". Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 15 of 15 COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this Coverage Part restrict SUPPLEMENTARY PAYMENTS - COV- this insurance. Read the entire Coverage Part ERAGES A AND B. carefully to determine rights, duties and what is and is not covered. b. This insurance applies to "bodily injury" and "property damage"only if: Throughout this Coverage Part the words "you" and "your" refer to the Named Insured shown in (1) The "bodily injury" or "property dam- the Declarations, and any other person or organi- age" is caused by an "occurrence" zation qualifying as a Named Insured under this that takes place in the"coverage ter- Coverage Part. The words "we", "us" and "our" ritory ; refer to the Company providing this insurance. (2) The "bodily injury" or "property dam- The word "insured" means any person or organi- age" occurs during the policy period; zation qualifying as such under SECTION II-WHO and IS AN INSURED. (3) Prior to the "coverage term" in which Other words and phrases that appear in quotation "bodily injury" or "property damage" marks have special meaning. Refer to SECTION occurs, you did not know, per Para- V-DEFINITIONS, graph 1.d. below, that the "bodily in- jury" or "property damage" had oc- SECTION I-COVERAGES curred or had begun to occur, in whole or in part. COVERAGE A. BODILY INJURY AND PROP- ERTY DAMAGE LIABILITY c. "Bodily injury" or "property damage" which: 1. Insuring Agreement (1) Occurs during the "coverage term"; a. We will pay those sums that the insured and becomes legally obligated to pay as damages because of "bodily injury" or (2) Was not, prior to the "coverage "property damage" to which this insur- term", known by you, per Paragraph ance applies. We will have the right and 1.d. below,to have occurred; duty to defend the insured against any includes any continuation, change or re- we will have no duty to defend the in- "suit" seeking those damages. However, sumption of that "bodily injury" or "prop- surederty damage" after the end of the "cover- ages for"bodily injury" or "property dam- against any "suit" seeking dam- age term" in which it first became known age" to which this insurance does not by you. apply. We may, at our discretion, investi- d. You will be deemed to know that "bodily gate any "occurrence" and settle any injury" or "property damage" has oc- claim or"suit"that may result. But: curred at the earliest time when any (1) The amount we will pay for damages "authorized representative": is limited as described in SECTION (1) Reports all,or any part, of the "bodily III-LIMITS OF INSURANCE;and injury" or"property damage" to us or (2) Our right and duty to defend ends any other insurer; when we have used up the applica- (2) Receives a written or verbal demand ble limit of insurance in the payment or claim for damages'because of the of judgments or settlements under "bodily injury"or"property damage"; SECTION I - COVERAGES, COV- ERAGE A. BODILY INJURY AND (3) First observes, or reasonably should PROPERTY DAMAGE LIABILITY; have first observed, the "bodily in- SECTION I - COVERAGES, COV- jury"or"property damage"; ERAGE B. PERSONAL AND AD- VERTISING INJURY LIABILITY; or (4) Becomes aware, or reasonably medical expenses under SECTION I should have become aware, by any - COVERAGES, COVERAGE C. means other than as described in (3) MEDICAL PAYMENTS, above, that "bodily injury" or "prop- erty damage" had occurred or had No other obligation or liability to pay sums begun to occur; or • or perform acts or services is covered unless expressly provided for under (5) Becomes aware, or reasonably should have become aware, of a Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc.,with its permission. Page 1 of 22 condition from which "bodily injury" (3) Any statute, ordinance or regulation or"property damage" is substantially relating to the sale, gift, distribution certain to occur. or use of alcoholic beverages. e. Damages because of "bodily injury" in- This exclusion applies only if you are in dude damages claimed by any person or the business of manufacturing, distribut- organization for care, loss of services or ing, selling,serving or furnishing alcoholic death resulting at any time from the "bod- beverages. ily injury". d. Workers' Compensation and Similar 2. Exclusions Laws This insurance does not apply to: Any obligation of the insured under a a. Expected or Intended Injury workers'compensation, disability benefits or unemployment compensation law or "Bodily injury" or "property damage" any similar law. which may reasonably be expected to re- e. Employer's Liability suit from the intentional or criminal acts of the insured or which is in fact expected or "Bodily injury"to: ihtended by the insured, even if the injury or damage is of a different degree or type (1) An "employee" of the insured sus- than actually expected or intended. This tained in the"workplace"; exclusion does not apply to "bodily injury" (2) An "employee" of the insured arising resulting from the use of reasonable force out of the performance of duties re- to protect persons or property. lated to the conduct of the insured's b. Contractual Liability, business; or "Bodily injury" or "property damage" for (3) The spouse, child, parent, brother or which the insured is obligated to pay sister of that"employee" as a conse- damages by reason of the assumption of quence of Paragraphs (1) or (2) liability in a contract or agreement. This above. exclusion does not apply to liability for This exclusion applies: damages: (1) That the insured would have in the (1) Whether the insured may be liable as an employer or in any other ca- absence of the contract or agree- pacity; and ment;or Assumed in a contract or agreement (2) To any obligation to share damages (2) g with or repay someone else who that is an "insured contract", pro- must paydamages because of the vided the "bodilyinjury" or "property g damage" occur subsequent to the injury. execution of the contract or agree- This exclusion does not apply to liability ment. When a claim for such "bodily assumed by the insured under an "in- injury" or "property damage" is sured contract". made, we will defend that claim pro- vided the insured has assumed the f. Pollutant obligation to defend such claim in the (1) "Bodily injury" or "property damage" "insured contract". Such defense arising out of the actual, alleged or payments will not reduce the limits of threatened discharge, dispersal, insurance, seepage, migration, release, escape c. Liquor Liability or emission of"pollutants": "Bodily injury" or "property damage" for (a) At or from any premises, site or which any insured may be held liable by location which is or was at any reason of: time owned or occupied by, or rented or loaned to, any insured. (1) Causing or contributing to the intoxi- However, Paragraph (a) does cation of any person; not apply to: (2) The furnishing of alcoholic bever- 1) "Bodily injury"to any person ages to a person under the legal injured while on any prem- drinking age or under the influence ises, site or location owned of alcohol;or or occupied by, or rented or loaned to,you provided: Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc.,with its permission. Page 2 of 22 a) The injury is caused by airborne irritants or con- the inadequate ventila- taminants used in a manu- tion of vapors; facturing process or which b) Theperson is is the product or by-product injuredof any manufacturing proc- first exposed to such ess; vapors during the pol- icy period; and 2) "Bodily injury" or "property Within 30 days of such damage" for which you may c) Y be held liable, if you are a first exposure, the per- contractor, and the owner son injured is clinically or lessee of such premises,. diagnosed or treated site or location has been by a physician for the added to this Coverage Part medical condition as an additional insured caused by the expo- with respect to your ongo- ,ure to such vapors. ing operations or "your However, Paragraph c) work" performed for that does not apply if the additional insured at that "bodily injury"is caused premises, site or location by vapors produced by and such premises, site or or originating from location is not and never equipment that is used was owned or occupied by, to heat, cool or dehu- or rented or loaned to, any midify the building, or insured, other than that ad- equipment that is used ditional insured; or to heat water for per- sonal use, by the 3) "Bodily injury" or "property building's occupants or damage"arising out of heat, their guests. smoke or fumes from a "hostile fire"; This exception 1) shall ap- ply only to Named Insureds; (b) At or from any premises, site or we shall have no duty to location which is or was at any defend or pay damages for time used by or for any insured any person or organization or others for the handling, stor- that is not a Named In- age, disposal, processing or sured. However, this para- treatment of waste; graph does not apply if the "bodily injury" is caused by (c) Which are or were at any time vapors produced by or transported, handled, stored, originating from equipment treated, disposed of, or proc- that is used to heat, cool or essed as waste by or for: dehumidify the building, or 1) Any insured; or equipment that is used to heat water for personal use, 2) Any person or organization by the building's occupants for whom you may be le- or their guests. gaily responsible; For the purpose of the ex- (d) At or from any premises, site or ception granted in Para- location on which any insured or graph 1) only, vapors any contractors or subcontrac- means any gaseous or air- tors working directly or indirectly borne irritant or airborne on any insured's behalf are contaminant, including performing operations if the smoke, fumes, vapor or "pollutants"'are brought on or to soot, but excluding asbes- the premises, site or location in tos, which is discharged, connection with such operations dispersed, emitted, re- by such insured, contractor or leased or escapes from subcontractor. However, Para- materials, machinery or graph (d)does not apply to: equipment used in the service or maintenance of 1) "Bodily injury" or "property the premises. Vapors does damage" arising out of the not mean any gaseous or discharge, dispersal, seep- age, migration, release, es- Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc.,with its permission. Page 3 of 22 cape or emission of fuels, erations are to test for, monitor, lubricants or other operating clean up, remove, contain, treat, fluids, or exhaust gases, detoxify or neutralize, or in any which are needed to per- way respond to, or assess the form, or are the result of, effects of,"pollutants". the normal electrical, hy- draulic (2) Anyloss, cost or expense arisingout or mechanical func- p tions necessary for the op- of any: eration of "mobile equip- (a) Request, demand, order or ment" or its parts, if such statutory or regulatory require- fuels, lubricants or other ment that any insured or others operating fluids, or exhaust test for, monitor, clean up, re- gases, escape, seep or mi- move, contain, treat, detoxify or grate, or are discharged, neutralize, or in any way re- dispersed, released or spond to, or assess the effects emitted from a vehicle part of, "pollutants";or designed to hold, store or receive them. This excep- (b) Claim or suit by or on behalf of a tion does not apply if the fu- governmental authority for dam- els, lubricants or other op- ages because of testing for, erating fluids, or exhaust monitoring, cleaning up, remov- gases, escape, seep or mi- ing, containing, treating, detoxi- grate, or are discharged, fying or neutralizing, or in any dispersed, released or way responding to, or assessing emitted with the intent to the effects of, "pollutants". cause "bodily injury" or "property damage" or with However, Paragraphs (2)(a) and (b) the knowledge that "bodily do not apply to liability for damages injury"or"property damage" because of "property damage" that is substantially certain to the insured would have in the ab- occur, or if such fuels, lubri- sence of such request, demand, or- cants or other operating der or statutory or regulatory re- fluids, or exhaust gases, quirement, or such claim or "suit" by are brought on or to the or on behalf of a governmental premises, site or location authority. with such intent to escape, g. Aircraft,Auto or Watercraft seep or migrate, or be dis- charged, dispersed, re- "Bodily injury" or "property damage" aris- leased or emitted as part of ing out of the ownership, maintenance, the operations being per- use or entrustment to others of any air- formed by such insured, craft, "auto" or watercraft owned or oper- contractor or subcontractor; ated by or rented or loaned to any g "Bodilyinjury" or "property in- sured. Use includes operation and p p y "loading or unloading". damage" sustained within a building and caused by the This exclusion applies even if the claims release of gases, fumes or against any insured allege negligence or vapors from materials other wrongdoing in the supervision, hir- brought into that building in ing, employment,training or monitoring of connection with operations others by that insured, if the "occurrence" being performed by you or which caused the "bodily injury" or"prop- on your behalf by a con- erty damage" involved the ownership, tractor or subcontractor; or maintenance, use or entrustment to oth- ers of any aircraft, "auto" or watercraft 3) "Bodily injury" or "property that is owned or operated by or rented or damage"arising out of heat, loaned to any insured. smoke or fumes from a "hostile fire";or This exclusion does not apply to: (e) At or from any premises, site or (1) A watercraft while ashore on prem- location on which any insured or ises you own or rent; any contractors or subcontrac- tors working directly or indirectly (2) A watercraft you do not own that is: on any insured's behalf are (a) Less than 51 feet long; and performing operations if the op- Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc.,with its permission. Page 4 of 22 (b) Not being used to carry persons governmental authority in hindering or property for a charge; or defending against any of these. (3) Parking an "auto" on, or on the ways j. Damage to Property next to, premises you own or rent, "Property damage"to: provided the "auto" is not owned by or rented or loaned to you or the in- (1) Property you own, rent or occupy, sured; including any costs or expenses in- (4) Liability assumed under any"insured curred by you, or any other person, contract" for the ownership, mainte- organization or entity, for repair, re- nance or use of aircraft or watercraft; placement, enhancement, restora- or tion or maintenance of such property for any reason, including prevention (5) "Bodily injury" or "property damage" of injury to a person or damage to arising out of: another's property; (a) The operation of machinery or (2) Premises you sell, give away or equipment that is on, attached abandon, if the "property damage" to, or part of, a land vehicle that arises out of any part of those prem- would qualify under the defini- ises; tion of "mobile equipment" if it were not subject to a compul- (3) Property loaned to you; sory or financial responsibility (4) Personal property in the care, cus- law or other motor vehicle insur- tody or control of an insured; ance law in the state where it is licensed or principally garaged; ,(5) That particular part of real property or on which you or any contractors or subcontractors working directly or (b) The operation of any of the ma- indirectly on your behalf are per- chinery or equipment listed in forming operations, if the "property Paragraph f.(2) or f.(3) of the damage" arises out of those opera- definition of"mobile equipment". tions;or h. Mobile Equipment (6) That particular part of any property "Bodily injury" or "property damage" aris- that must be restored, repaired or ing out of: replaced because "your work" was incorrectly performed on it. (1) The transportation of "mobile equip- ment" by an "auto" owned or oper- Paragraphs (1), (3) and (4) of this exclu- ated by or rented or loaned to any sion do not apply to "property damage" insured; or (other than damage by fire or explosion) to premises, including the contents of (2) The use of"mobile equipment" in, or such premises, rented to you for a period while in practice for, or while being of 7 or fewer consecutive days, for which prepared for, any prearranged rac- the amount we will pay is limited to the ing, speed, demolition, or stunting Damage To Premises Rented To You activity. Limit as described in SECTION III - LIM- ITS OF INSURANCE. i. War Paragraph (2) of this exclusion does not "Bodily injury" or "property damage", apply if the premises are "your work" and however caused, arising, directly or indi- were never occupied, rented or held for rectly,out of: rental by you. (1) War, including undeclared or civil Paragraphs (3), (4), (5) and (6) of this ex- war; clusion do not apply to liability assumed (2) Warlike action by a military force, in- under a sidetrack agreement. cluding action in hindering or de- Paragraph (6) of this exclusion does not fending against an actual or ex- apply to "property damage" included in pected attack, by any government, the "products-completed operations haz- sovereign or other authority using ard". military personnel or other agents; or (3) Insurrection, rebellion, revolution, k. Damage to Your Product usurped power, or action taken by "Property damage" to "your product" arising out of it or any part of it. Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc.,with its permission. Page 5 of 22 I. Damage to Your Work q. Employment-Related Practices "Property damage" to "your work" arising "Bodily injury"to: out of it or any part of it and included in the "products-completed operations haz- (1) A person arising out of any: ard". (a) Refusal to employ that person; This exclusion does not apply if the dam- (b) Termination of that person's aged work or the work out of which the employment;or damage arises was performed on your behalf by a subcontractor. (c) Other employment-related prac- or m. Damage to Impaired Property or Prop- tic , policies, of lit omissions erty Not Physically Injured includingu but not limited to coer- cion, criticism, demotion, "Property damage" to "impaired property" evaluation, a lua ion, failureopr defa- injured, promote, or property that has not been physically g disci pin injured,arising out of: mation, harassment, humiliation or discrimination directed at that (1) A defect, deficiency, inadequacy or person; or dangerous condition in "your prod • - uct"or"your work"; or (2) The spouse, child, parent, brother or sister of that person as a conse- (2) A delay or failure by you or anyone quence of "bodily injury" to that per- acting on your behalf to perform a son at whom any of the employment- contract or agreement in accordance related practices described in Para- with its terms, graphs (a), (b) or (c) above is di- This exclusion does not apply to the loss rected. of use of other property arising out of This exclusion applies: sudden and accidental physical injury to "your product" or "your work" after it has (1) Whether the insured may be liable been put to its intended use, as an employer or in any other ca- pacity;and n. Recall of Products, Work or Impaired Property (2) To any obligation to share damages with or repay someone else who Any liability or damages claimed for any must pay damages because of the loss, cost or expense incurred by you or injury. others for the loss of use, withdrawal, re- call, inspection, repair, replacement, ad- r. Additional Insured Prior Knowledge justment, removal or disposal of: An additional insured added by attach- (1) "Your product"; ment of an endorsement to this verage Part that is s ek ng coverage foroa claim (2) "Your work";or or "suit", if that additional insured knew, per the following paragraph, that "bodily (3) "Impaired property"; injury" or "property damage" had oc- if such product, work or property is with- curred or had begun to occur, in whole or drawn or recalled from the market or from in part, prior to the "coverage term" in use by any person or organization be- which such "bodily injury" or "property cause of a known or suspected defect, damage" occurs or begins to occur. deficiency, inadequacy or dangerous An additional insured added by attach- condition in it. ment of an endorsement to this Coverage o. Personal and Advertising Injury Part will be deemed to have known that "bodily injury" or "property damage" has "Bodily injury"arising out of"personal and occurred or has begun to occur at the advertising injury", earliest time when that additional insured, or any one of its owners, members, part- p. Asbestos ners, managers, executive officers, "em- "Bodily injury" or "property damage" aris- ployees" assigned to manage that addi- ing out of, attributable to, or any way re- tional insured's insurance program, or lated to asbestos in any form or trans- "employees" assigned to give or receive miffed in any manner. notice of an "occurrence", "personal and advertising injury"offense,claim or"suit": Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc.,with its permission. Page 6 of 22 (1) Reports all,or any part, of the"bodily a. We will pay those sums that the insured injury" or"property damage" to us or becomes legally obligated to pay as any other insurer; damages because of "personal and ad- vertising injury" to which this insurance (2) Receives a written or verbal demand applies. We will have the right and duty or claim for damages because of the to defend the insured against any "suit" "bodily injury"or"property damage"; seeking those damages. However, we (3) First observes, or reasonably should will have no duty to defend the insured have first observed, the "bodily in- against any "suit" seeking damages for jury"or"property damage"; thisrinsurance does onal and notadvertisingapply.injury" may to , Y (4) Becomes aware, or reasonably at our discretion, investigate any offense should have become aware, by any and settle any claim or"suit"that may re- means other than as described in (3) suit. But: above, that "bodily injury" or "prop- erty damage" had occurred or had (1) The amount we will pay for damages begun to occur; or is limited as described in SECTION III-LIMITS OF INSURANCE; and (5) Becomes aware, or reasonably should have become aware, of a (2) Our right and duty to defend ends condition from which "bodily injury" when we have used up the applica- or "property damage" is substantially ble limit of insurance in the payment certain to occur. of judgments or settlements under SECTION I - COVERAGES, COV s. Electronic Data ERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY; Damages arising out of the loss of, loss SECTION I - COVERAGES, COV- of use of, damage to, corruption of, in- ERAGE B. PERSONAL AND AD- ability to access, or inability to manipulate VERTISING INJURY LIABILITY; or "electronic data". medical expenses under SECTION I t. Distribution of Material in Violation of - COVERAGES, COVERAGE C. Statutes MEDICAL PAYMENTS. "Bodily injury" or "property damage" aris- No other obligation or liability to pay sums ing directly or indirectly out of any action or perform acts or services is covered or omission that violates or is alleged to unless expressly provided for under violate: SUPPLEMENTARY PAYMENTS - COV- ERAGES A AND B. a. The Telephone Consumer Protection Act (TCPA), including any amend- b. This insurance applies to "personal and ment of or addition to such law;or advertising injury"only if: b. The CAN-SPAM Act of 2003, includ- (1) The"personal and advertising injury" ing any amendment of or addition to is caused by an offense arising out such law;or of your business; and c. Any statute, ordinance or regulation, (2) The "personal and advertising injury" other than the TCPA or CAN-SPAM offense was committed in the "cov- Act of 2003, that prohibits or limits the erage territory" during the policy pe- sending, transmitting, communicating hod; and or distribution of material or informa- (3) Prior to the "coverage term" in which tion. the "personal and advertising injury" Exclusions c. through q. do not apply to offense is committed, you did not "property damage" by fire or explosion to know, per Paragraph 1.d. below,that premises while rented to you or temporarily the offense had been committed or occupied by you with permission of the owner, had begun to be committed,in whole for which the amount we will pay is limited to or in part. the Damage to Premises Rented To You Limit c. "Personal and advertising injury" caused as described in SECTION III - LIMITS OF IN- by an offense which: SURANCE. COVERAGE B. PERSONAL AND ADVERTISING (1) Was committed during the"coverage INJURY LIABILITY term';and 1. Insuring Agreement Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc.,with its permission. Page 7 of 22 (2) Was not, prior to the "coverage (1) The inception of this Coverage Part; term", known by you, per Paragraph or 1.d. below,to have been committed; (2) The "coverage term" in which insur- includes any continuation, change or re- ance coverage is sought. sumption of that offense after the end of the "coverage term" in which it first be- d. Criminal Acts came known by you. "Personal and advertising injury" arising d. You will be deemed to know that a "per- out of a criminal act committed by or at sonal and advertising injury" offense has the direction of the insured. been committed at the earliest time when e. Contractual Liability any"authorized representative": Reports all, or anypart, "per-of the "Personal and advertising injury" for (1) Re p which the insured is obligated to pay sonal and advertising injury"to us or damages by reason of the assumption of any other insurer; liability in a contract or agreement. This (2) Receives a written or verbal demand exclusion does not apply to liability for or claim for damages-because of the damages: "personal and advertising injury"; (1) That the insured would have in the (3) First observes, or reasonably should absence of the contract or agree- have first observed, the offense that ment;or caused the "personal and advertis- (2) Assumed in a contract or agreement ing injury"; that is an "insured contract", pro- (4) Becomes aware, or reasonably vided the "personal and advertising should have become aware, by any injury" is caused by or arises out of means, other than as described in an offense committed subsequent to (3) above, that the offense had been the execution of the contract or committed or had begun to be corn- agreement. When a claim for such miffed;or "personal and advertising injury" is made, we will defend that claim, pro- (5) Becomes aware, or reasonably vided the insured has assumed the should have become aware, of a obligation to defend such claim in the condition from which "personal and "insured contract". Such defense advertising injury" is substantially payments will not reduce the limits of certain to occur. insurance. 2. Exclusions f, Breach of Contract This insurance does not apply to: "Personal and advertising injury" arising a. KnowingViolation of Rights of Another out of a breach of contract, except an im- g plied contract to use another's advertising "Personal and advertising injury" caused idea in your"advertisement". by or at the direction of the insured with g. Quality or Performance of Goods - the knowledge that the act would violate Failure to Conform to Statements the rights of another and would inflict "personal and advertising injury". "Personal and advertising injury" arising out of the failure of goods, products or b. Material Published With Knowledge of services to conform with any statement of Falsity quality or performance made in your"ad- "Personal and advertising injury" arising vertisement". out of oral or written publication of mate- h. Wrong Description of Prices rial,if done by or at the direction of the in- sured with knowledge of its falsity. "Personal and advertising injury" arising c. Material Published Prior to Coverage out of the wrong description of the price g of goods, products or services stated in Term your"advertisement". "Personal and advertising injury" arising i. Infringement of Copyright, Patent, out of oral or written publication of mate- Trademark or Trade Secret rial whose first publication took place be- fore the later of the following: "Personal and advertising injury" arising out of the infringement of copyright, pat- Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc.,with its permission. Page 8 of 22 ent, trademark, trade secret or other in- or discrimination directed at that tellectual property rights. person; or However,this exclusion does not apply to (2) The spouse, child, parent, brother or infringement, in your "advertisement", of sister of that person as a conse- copyright,trade dress or slogan. quence of "personal and advertising Insureds in Media and Internet Type injury"to that person at whom any of j. yp the employment-related practices Businesses described in Paragraphs (a), (b) or "Personal and advertising injury" com- (c)above is directed. mitted by an insured whose business is: This exclusion applies: (1) Advertising, broadcasting, publishing (1) Whether the insured may be liable or telecasting; as an employer or in any other ca- (2) Designing or determining content of parity; and web-sites for others; or (2) To any obligation to share damages (3) An Internet search, access, content with or repay someone else who or service provider. must pay damages because of the injury. However,this exclusion does not apply to Paragraphs 17. a., b. and c. of"personal n. Pollutant and advertising injury" under SECTION V "Personal and advertising injury" arising - DEFINITIONS. out of the actual, alleged or threatened For the purposes of this exclusion, the discharge, dispersal, seepage, migration, placing of frames, borders or links, or ad- release, escape or emission of "pollut- vertising, for you or others anywhere on ants"at any time. the Internet is nof, by itself, considered o. Pollutant-Related the business of advertising, broadcasting, publishing or telecasting. Any loss, cost or expense arising out of k. Electronic Chatrooms or Bulletin any: Boards (1) Request, demand, order or statutory or regulatory requirement that any "Personal and advertising injury" arising insured or others test for, monitor, out of an electronic chatroom or bulletin clean up, remove, contain, treat, board any insured hosts, owns, or over detoxify or neutralize, or in any way which any insured exercises control. respond to, or assess the effects of, I. Unauthorized Use of Another's Name "pollutants',or or Product (2) Claim or suit by. or on behalf of a "Personal and advertising injury" arising governmental authority for damages out of the unauthorized use of another's because of testing for, monitoring, name or product in your e-mail address, cleaning up, removing, containing, domain name or metatag, or any other treating, detoxifying or neutralizing, similar tactics to mislead another's poten- or in any way responding to, or as- tial customers. sessing the effects of, "pollutants". m. Employment Related Practices p. Asbestos "Personal and advertising injury"to: "Personal and advertising injury" arising out of, attributable to, or any way related (1) A person arising out of any: to asbestos in any form or transmitted in (a) Refusal to employ that person; any manner. (b) Termination of that person's q. Additional Insured Prior Knowledge employment;or An additional insured added by attach- (c) Other employment-related prac- attach- ment of an endorsement to this Coverage Part that is seeking coverage for a claim tices, policies, acts or omissions or "suit", if that additional insured knew, including but not limited to coer- per the following paragraph, that a "per- cion, criticism, demotion, sonal and advertising injury" offense had evaluation, failure to promote, been committed or had begun to be reassignment, discipline, defa- committed,in whole or in part, prior to the mation, harassment, humiliation "coverage term" in which such offense Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc.,with its permission. Page 9 of 22 was committed or began to be commit- "Personal and advertising injury" arising ted, directly or indirectly out of any action or omission that violates or is alleged to An additional insured added by attach- violate: ment of an endorsement to this Coverage Part will be deemed to have known that a a. The Telephone Consumer Protection "personal and advertising injury" offense Act (TCPA), including any amend- has been committed or has begun to be ment of or addition to such law;or committed at the earliest time when that additional insured, or any one of its own- b. The CAN-SPAM Act of 2003, includ- ers, members, partners, managers, ex- ing any amendment of or addition to ecutive officers, "employees" assigned to such law;or manage that additional insured's insur- c. Any statute, ordinance or regulation, ance program, or "employees" assigned other than the TCPA or CAN-SPAM to give or receive notice of an "occur- Act of 2003, that prohibits or limits the rence", "personal and advertising injury" sending, transmitting, communicating offense,claim or"suit": or distribution of material or informa- (1) Reports all, or any part, of the "per- tion. sonal and advertising injury" to us or COVERAGE C. MEDICAL PAYMENTS any other insurer; (2) Receives a written or verbal demand 1. Insuring Agreement or claim for damages because of the a. We will pay medical expenses as de- "personal and advertising injury"; scribed below for "bodily injury" caused (3) First observes, or reasonably should by an accident: have first observed, the offense that (1) On premises you own or rent; caused the "personal and advertis- 2 On ways next topremises you own ing injury"; ( ) Y or rent;or (4) Becomes aware, or reasonably should have become aware, by any (3) Because of your operations; means other than as described in (3) provided that: above, that the "personal and adver- tising injury" offense had been corn- (1) The accident takes place in the miffed or had begun to be commit- "coverage territory" and during the ted; or policy period; (5) Becomes aware, or reasonably (2) The expenses are incurred and re- should have become aware, of a ported to us within three years of the condition from which "personal and date of the accident; and advertising injury" is substantially certain to occur. (3) The injured person submits to ex- amination, at our expense, by physi- r. War cians of our choice as often as we "Personal and advertising injury", how- everreasonably require. caused, arising, directly or indirectly, b. We will make these payments regardless out of: of fault These payments will not exceed (1) War, including undeclared or civil the applicable limit of insurance. We will pay reasonable expenses for: war; (1) First aid administered at the time of (2) Warlike action by a military force, in- an accident; cluding action in hindering or de- fending against an actual or ex- (2) Necessary medical, surgical, x-ray pected attack, by any government, and dental services, including pros- sovereign or other authority using thetic devices; and military personnel or other agents; or (3) Necessary ambulance, hospital, (3) Insurrection, rebellion, revolution, professional nursing and funeral usurped power, or action taken by services. governmental authority in hindering or defending against any of these. 2. Exclusions s. Distribution of Material in Violation of We will not pay expenses for"bodily injury": Statutes Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc.,with its permission. Page 10 of 22 a. Any Insured cluding actual loss of earnings up to $250 a To any insured, except "volunteer work- day because of time off from work. ers". 5. All costs taxed against the insured in the "suit". b. Hired Person To aperson hired to do work for or on 6. Prejudgment interest awarded against the insured on that part of the judgment we be- behalf of any insured or a tenant of any come obligated to pay and which falls within insured, the applicable limit of insurance. If we make c. Injury on Normally Occupied Premises an offer to pay the applicable limit of insur- ance,we will not pay any prejudgment interest To a person injured on that part of prem- based on that period of time after the offer. ises you own or rent that the person nor- 7. All interest on the full amount of any judgment mally occupies. that accrues after entry of the judgment and d. Workers' Compensation and Similar before we have paid, offered to pay, or de- Laws posited in court the part of the judgment that To a person, whether or not an "em- is within the applicable limit of insurance. ployee" of any insured, if benefits for the These payments will not reduce the limits of insur- "bodily injury" are payable or must be ance. provided under a workers' compensation SECTION II-WHO IS AN INSURED or disability benefits law or a similar law. e. Athletic Activities 1. If you are designated in the Declarations as: To any person injured while officiating, a. An individual, you and your spouse are coaching, practicing for, instructing or insureds, but only with respect to the participating in any physical exercises or conduct of a business of which you are games, sports, or athletic contests or ex- the sole owner. hibitions of an athletic or sports nature. b. A partnership or joint venture, you are an f. Products-Completed Operations Haz- insured. Your members, your partners, and and their spouses are also insureds, but only with respect to the conduct of your Included within the "products-completed business. operations hazard". c. A limited liability company, you are an in- g. Coverage A Exclusions sured. Your members are also insureds, Excluded under COVERAGE A. BODILY but only with respect to the conduct of AND PROPERTY DAMAGE LI- your business. Your managers are in- INJURY INJURY sureds, but only with respect to'their du- . ties as your managers. SUPPLEMENTARY PAYMENTS - COVERAGES d. An organization other than a partnership, A AND B joint venture or limited liability company, We will pay, with respect to any claim we investi- you are an insured. Your"executive offi- gate or settle, or any "suit" against an insured we cers"and directors are insureds, but only defend: with respect to their duties as your offi- cers or directors. Your stockholders are 1. All expenses we incur. also insureds, but only with respect to 2. Up to$250 for cost of bail bonds required be- their liability as stockholders, cause of accidents or traffic law violations e. A trust,you are an insured. Your trustees arising out of the use of any vehicle to which are also insureds, but only with respect to the Bodily Injury Liability Coverage applies, their duties as trustees. We do not have to furnish these bonds. 2. Each of the following is also an insured: 3. The cost of bonds to release attachments, but only for bond amounts within the applicable a. Your "volunteer workers" only while per- limit of insurance. We do not have to furnish forming duties related to the conduct of your business, or your "employees", these bonds. other than either your"executive officers" 4. All reasonable expenses incurred by the in- (if you are an organization other than a sured at our request to assist us in the inves- partnership,joint venture or limited liability tigation or defense of the claim or "suit", in- company)or your managers (if you are a limited liability company), but only for acts within the scope of their employment by Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc.,with its permission. Page 11 of 22 you or while performing duties related to d. Your legal representative if you die, but the conduct of your business. However, only with respect to duties as such. That none of these "employees" or "volunteer representative will have all your rights workers"are insureds for: and duties under this Coverage Part. (1) "Bodily injury" or "personal and ad- 3. Any organization you newly acquire or form, vertising injury": other than a partnership, joint venture or lim- ited liability company, and over which you (a) To you, to your partners or maintain ownership or majority interest, will members (if you are a partner- qualify as a Named Insured if there is no other ship or joint venture), to your similar insurance available to that organiza- members (if you are a limited Ii- tion. However: ability company), to a co- "employee" while in the course a. Insurance under this provision is afforded of his or her employment or only until the 90th day after you acquire performing duties related to the or form the organization or the end of the conduct of your business, or to policy period,whichever is earlier; your otherrf "volunteeringworkers" b. COVERAGE A. BODILY INJURY AND while formiog duties related PROPERTY DAMAGE LIABILITY does to the conduct of your business; not apply to "bodily injury" or "property (b) To the spouse, child, parent, damage" that occurred before you ac- brother or sister of that co- quired or formed the organization;and "employee" or "volunteer worker" as a consequence of c. COVERAGE B. PERSONAL AND AD- Paragraph (1)(a)above; VERTISING INJURY LIABILITY does not apply to "personal and advertising injury" (c) For which there is any obligation arising out of an offense committed be- to share damages with or repay fore you acquired or formed the organi- someone else who must pay zation. damages because of the injury described in Paragraphs (1)(a) No person or organization is an insured with re- or(b)above; or spect to the conduct of any current or past part- nership, joint venture or limited liability company (d) Arising out of his or her provid- that is not shown as a Named Insured in the Dec- ing or failing to provide profes- larations. sional health care services. SECTION III-LIMITS OF INSURANCE (2) "Property damage"to property: 1. The Limits of Insurance shown in the Declara- (a) Owned, occupied or used by; or tions and the rules below fix the most we will (b) Rented to, in the care, custody pay regardless of the number of: or control of, or over which a. Insureds; physical control is being exer- b. Claims made or"suits"brought;or cised for any purpose by, you, any of your "employees", "vol- c. Persons or organizations making claims unteer workers", any partner or or bringing"suits". member (if you are a partnership or 2. a. The General Aggregate Limit is the most joint venture), or any member (if you we will pay for the sum of: are a limited liability company). b. Any person (other than your "employee" (1) Medical expenses under COVER- or "volunteer worker"), or any organiza- tion AGE C. MEDICAL PAYMENTS; while acting as your real estate man- (2) Damages under COVERAGE A. ager. BODILY INJURY AND PROPERTY c. Any person or organization having proper DAMAGE LIABILITY, except dam- ages because of "bodily injury" or temporary custody of your property if you "property damage" included in the die, but only: "products-completed operations (1) With respect to liability arising out of hazard"; and' the maintenance or use of that prop- (3) Damages under COVERAGE B. erty;and PERSONAL AND ADVERTISING (2) Until your legal representative has INJURY LIABILITY. been appointed. This General Aggregate Limit will not ap- ply if either the Location General Aggre- Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc.,with its permission. Page 12 of 22 gate Limit of Insurance, Paragraph 2.b., your behalf at the same location for or the Construction Project General Ag- the same persons or organizations, gregate Limit of Insurance, Paragraph no matter how often or under how 2.c,applies. many different contracts, will be b. A separate Location General Aggregate projecttd to be a single construction p Limit of Insurance, equal to the amount of the General Aggregate Limit shown in the 3. The Products-Completed Operations Aggre- Declarations, shall apply to each location gate Limit is the most we will pay under COV- owned by, or rented or leased to you and ERAGE A. BODILY INJURY AND PROP- is the most we will pay for the sum of: ERTY DAMAGE LIABILITY for damages be- cause of "bodily injury" and "property dam- (1) Damages under COVERAGE A. age" included in the "products-completed op- BODILY INJURY AND PROPERTY erations hazard". DAMAGE LIABILITY, except dam- ages because of "bodily injury" or 4. Subject to 2.a. above, the Personal and Ad- "property damage" included in the vertising Injury Limit is the most we will pay "products-completed operations under COVERAGE B. PERSONAL AND AD- hazard"; and VERTISING INJURY LIABILITY for the sum of Medical expenses under COVER- all damages because of all "personal and ad- (2) P vertising injury" sustained by any one person AGE C. MEDICAL PAYMENTS, or organization. which can be attributed to operations at 5. Subject to 2. or 3. above, whichever applies, only a single location owned by, or rented the Each Occurrence Limit is the most we will or leased to you. pay for the sum of: c. A separate Construction Project General a. Damages under COVERAGE A. BODILY Aggregate Limit of Insurance, equal to INJURY AND PROPERTY DAMAGE Li- the amount of the General Aggregate ABILITY; and Limit shown in the Declarations, shall ap- ply to each construction project and is the b. Medical expenses under COVERAGE C. most we will pay for the sum of: MEDICAL PAYMENTS; (1) Damages under COVERAGE A. because of all "bodily injury" and "property BODILY INJURY AND PROPERTY damage"arising out of any one"occurrence". DAMAGE LIABILITY, except dam- ages because of "bodily injury" or 6. Subject to 5. above, the Damage to Premises "property damage" included in the Rented to You Limit is the most we will pay "products-completed operations under COVERAGE A. BODILY INJURY AND hazard"; and PROPERTY DAMAGE' LIABILITY for dam- ages because of "property damage" to any (2) Medical expenses under COVER- one premises, while rented to you, or in the AGE C. MEDICAL PAYMENTS; case of damage by fire or explosion, while rented to you or temporarily occupied by you which can be attributed only to ongoing with permission of the owner. operations and only at a single construc- tion project. 7. Subject to 5. above, the Medical Expense Limit is the most we will pay under COVER- d. Only for the purpose of determining which AGE C. MEDICAL PAYMENTS for all medical General Aggregate Limit of Insurance, expenses because of"bodily injury"sustained 2.a.,2.b.,or 2.c.,applies: by any one person. (1) Location means premises involving The Limits of Insurance of this Coverage Part ap- the same or connecting lots, or ply separately to each "coverage term". premises, whose connection is inter- rupted only by a street, roadway, SECTION IV - COMMERCIAL GENERAL LI- waterway or right-of-way of a rail- ABILITY CONDITIONS road. 1. Bankruptcy (2) Construction project means a loca- tion you do not own, rent or lease Bankruptcy or insolvency of the insured or of where ongoing improvements, al- the insured's estate will not relieve us of our terations, installation, demolition or obligations under this Coverage Part. maintenance work is performed by 2. Duties in the Event of Occurrence, Offense, you or on your behalf. All connected Claim or Suit ongoing improvements, alterations, installation, demolition or mainte- a. You must see to it that we are notified as nance work performed by you or on soon as practicable of an "occurrence" or Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc.,with its permission. Page 13 of 22 a "personal and advertising injury" of- under the terms of this Coverage Part or that fense which may result in a claim. To the are in excess of the applicable limit of insur- extent possible, notice should include: ance. An agreed settlement means a settle- (1) How, when and where the "occur- settle- ment and release of liability signed by us, the insured and the claimant or the claimant's le- rence"or offense took place; gal representative. (2) The names and addresses of any 4. Liberalization injured persons and witnesses;and If,within 60 days prior to the beginning of this (3) The nature and location of any injury Coverage Part or duringthe policy or damage arising out of the "occur- g P Y period,endorse- rence" make any changes to any forms or or offense, ments of this Coverage Part for which there is b. If a claim is made or "suit" is brought currently no separate premium charge, and against any insured,you must: that change provides more coverage than this Coverage Part, the change will automatically (1) Immediately record the specifics of apply to this Coverage Part as of the latter of: the claim or "suit" and the date re- a. The date we implemented the change in ceived; and P g your state; or (2) Notify us as soon as practicable. b. The date this Coverage Part became ef- You must see to it that we receive written fective;and notice of the claim or "suit" as soon as will be considered as included until the end of practicable. the current policy period. We will make no c. You and any other involved insured must: additional premium charge for this additional coverage during the interim. (1) Immediately send us copies of any demands, notices, summonses or 5. Other Insurance legal papers received in connection If other valid and collectible insurance is with the claim or"suit"; available to the insured for a loss we cover (2) Authorize us to obtain records and under COVERAGE A. BODILY INJURY AND other information; PROPERTY DAMAGE LIABILITY or COV- ERAGE B. PERSONAL AND ADVERTISING (3) Cooperate with us in the investiga- INJURY LIABILITY of this Coverage Part, our tion or settlement of the claim or de- obligations are limited as follows: fense against the"suit";and a. Primary Insurance (4) Assist us, upon our request, in the enforcement of any right against any This insurance is primary except when b. person or organization which may be below applies. If this insurance is pri- liable to the insured because of in- mary, our obligations are not affected jury or damage to which this insur- unless any of the other insurance is also ance may also apply. primary. Then, we will share with all that other insurance by the method described d. No insured will, except at that insured's in c,below. own cost, voluntarily make a payment, assume any obligation, or incur any ex- b. Excess Insurance pense, other than for first aid, without our consent. This insurance is excess over: 3. Legal Action Against Us (1) Any of the other insurance, whether primary, excess, contingent or on No person or organization has a right under any other basis: this Coverage Part: (a) That is Fire, Extended Cover- a. To join us as a party or otherwise bring age, Builder's Risk, Installation us into a "suit" asking for damages from Risk or similar insurance for an insured;or "your work"; b. To sue us on this Coverage Part unless (b) That is Fire or Explosion insur- all of its terms have been fully complied ance for premises rented to you with. or temporarily occupied by you with permission of the owner; A person or organization may sue us to re- cover on an agreed settlement or on a final (c) That is insurance purchased by judgment against an insured; but we will not you to cover your liability as a be liable for damages that are not payable tenant for "property damage" to Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc.,with its permission. Page 14 of 22 premises rented to you or tern- shown in the Declarations of this Cover- porarily occupied by you with age Part. permission of the owner;or c. Method of Sharing (d) If the loss arises out of the maintenance or use of aircraft, If all of the other insurance permits con- "autos" or watercraft to the ex- tribution by equal shares, we will follow tent not subject to SECTION I - this method also. Under this approach COVERAGES, COVERAGE A. each insurer contributes equal amounts BODILY INJURY AND PROP- until it'has paid its applicable limit of in- ERTY DAMAGE LIABILITY, 2. surance or none of the loss remains, Exclusions,g.Aircraft,Auto or whichever comes first. Watercraft. If any of the other insurance does not (2) Any other primary insurance avail- permit contribution by equal shares, we able to the insured covering liability will contribute by limits. Under this for damages arising out of the method, each insurer's share is based on premises or operations, or the prod- the ratio of its applicable limit of insurance ucts and completed operations, for to the total applicable limits of insurance which the insured has been added of all insurers. as an additional insured by attach- 6. Premium Audit ment of an endorsement. Anyother insurance: a. We will compute all premiums for this (3) Coverage Part in accordance with our (a) Whether primary, excess, con- rules and rates. tingent or on any other basis, b. Premium shown in this Coverage Part as except when such insurance is advance premium is a deposit premium written specifically to be excess only. At the close of each audit period we over this insurance; and will compute the earned premium for that (b) That is a consolidated (wrap-up) period and send notice to the first Named insurance program which has Insured. The due date for audit and ret- been provided by the prime rospective premiums is the date shown contractor/project manager or as the due date on the bill. If: owner of the consolidated proj- (1) The earned premium is less than the ect in which you are involved. deposit premium, we will return the When this insurance is excess, we will excess to the first Named Insured; or have no duty under COVERAGE A. (2) The earned premium is greater than BODILY INJURY AND PROPERTY the deposit premium, the difference DAMAGE LIABILITY or COVERAGE B. will be due and payable to us by the PERSONAL AND ADVERTISING IN- first Named Insured upon notice from JURY LIABILITY to defend the insured us. against any "suit" if any other insurer has a duty to defend the insured against that c. The first Named Insured must keep rec- "suit". If no other insurer defends, we will ords of the information we need for pre- undertake to do so, but we will be entitled mium computation,and send us copies at to the insured's rights against all those such times as we may request. other insurers. 7. Representations When this insurance is excess over other insurance, we will pay only our share of By accepting this Coverage Part,you agree: the amount of the loss, if any, that ex- a. The statements in the Declarations are ceeds the sum of: accurate and complete; (1) The total amount that all such other b. Those statements are based upon repre- insurance would pay for the loss in sentations you made to us;and the absence of this insurance;and (2) The total of all deductible and self- c. We have issued this Coverage Part in re- insured amounts under all that other liance upon your representations. insurance. 8. Separation of Insureds We will share the remaining loss, if any, Except with respect to the Limits of Insurance, with any other insurance that is not de- and any rights or duties specifically assigned scribed in this Excess Insurance provi- in this Coverage Part to the first Named In- sion and was not bought specifically to sured,this insurance applies: apply in excess of the Limits of Insurance Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc.,with its permission. Page 15 of 22 a. As if each Named Insured were the only (1) An individual, you and your spouse Named Insured; and are"authorized representatives". b. Separately to each insured against whom (2) A partnership or joint venture, your claim is made or"suit" is brought. members, your partners, and their spouses are "authorized representa- 9. Transfer of Rights of Recovery Against tives". Others to Us (3) A limited liability company, your If the insured has rights to recover all or part members and your managers are of any payment we have made under this "authorized representatives". Coverage Part,those rights are transferred to us. The insured must do nothing after loss to (4) An organization other than a part- impair them. At our request, the insured will nership,joint venture or limited liabil- bring "suit" or transfer those rights to us and ity company, your "executive offi- help us enforce them. cers" and directors are "authorized a Forms or Policies representatives". Provided you are 10. Two or More Coverage not a publicly traded organization, Issued by Us your stockholders are also "author- If this Coverage Part and any other Coverage ized representatives". Form, Coverage Part or policy issued to you (5) A trust,your trustees are "authorized by us or any company affiliated with us apply representatives". to the same "occurrence" or "personal and p advertising injury" offense, the aggregate b. Your"employees": maximum limit of insurance under all the Cov- erage Forms, Coverage Parts or policies shall (1) Assigned to manage your insurance not exceed the highest applicable limit of in- program; or surance under any one Coverage Form, Coy- (2) Responsible for giving or receiving erage Part or policy. This condition does not notice of an "occurrence", "personal apply to any Coverage Form, Coverage Part and advertising injury" offense, claim or policy issued by us or an affiliated company specifically to apply as excess insurance over or"suit"; this Coverage Part. are also"authorized representatives". 11. When We Do Not Renew 3. "Auto"means: If we decide not to renew this Coverage Part, a. A land motor vehicle, trailer or semitrailer we will mail or deliver to the first Named In- designed for travel on public roads, in- sured shown in the Declarations written notice cluding any attached machinery or of the nonrenewal not less than 30 days be- equipment; or fore the expiration date. b. Any other land vehicle that is subject to a If notice is mailed, proof of mailing will be suf- compulsory or financial responsibility law ficient proof of notice. or other motor vehicle insurance law in SECTION V-DEFINITIONS the state where it is licensed or principally garaged. 1. "Advertisement"means a notice that is broad- However, "auto" does not include "mobile cast,telecast or published to the general pub- equipment". lic or specific market segments about your goods, products or services for the purpose of 4. "Bodily injury"means bodily injury,sickness or attracting customers or supporters. "Adver- disease sustained by a person, including tisement" includes a publicity article. For pur- death resulting from any of these at any time. poses of this definition: 5. "Coverage term" means the following individ- a. Notices that are published include mate- ual increment, or if a multi-year policy period, rial placed on the Internet or on similar increments,of time,which comprise the policy electronic means of communication;and period of this Coverage Part: b. Regarding web-sites, only that part of a a. The year commencing on the Effective web-site that is about your goods, prod- Date of this Coverage Part at 12:01 AM ucts or services for the purposes of at- standard time at your mailing address tracting customers or supporters is con- shown in the Declarations, and if a multi- sidered an "advertisement". year policy period, each consecutive t. "Authorized representative"means: an- nual period thereafter,or portion thereof if p any period is for a period of less than 12 a. If you are designated in the Declarations months, constitute individual "coverage as: terms". The last"coverage term" ends at Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc.,with its permission. Page 16 of 22 12:00 AM standard time at your mailing 10. "Hostile fire" means one which becomes un- address shown in the Declarations on the controllable or breaks out from where it was earlier of: intended to be. (1) The day the policy period shown in 11. "Impaired property" means tangible property, the Declarations ends; or other than "your product" or "your work", that (2) The day the policy to which this cannot be used or is less useful because: Cov- erage Part is attached is terminated a. It incorporates "your product" or "your or cancelled, work"that is known or thought to be de- fective, deficient, inadequate or danger- b. However, if after the issuance of this ous; or Coverage Part, any "coverage term" is extended for an additional period of less b. You have failed to fulfill the terms of a than 12 months, that additional period of contract or agreement; time will be deemed to be part of the last preceding"coverage term", if such property can be restored to use by: a. The repair, replacement, adjustment or "Coverage Coverage territory"means: removal of"your product" or "your work"; a. The United States of America (including or its territories and possessions), Puerto b. Your fulfilling the terms of the contract or Rico and Canada; agreement. b. International waters or airspace, but only if the injury or damage occurs in the 12. "Insured contract"means: course of travel or transportation between a. A contract for a lease of premises. How- any places included in a.above; or ever, that portion of the contract for a c. All other parts of the world if the injury or lease of premises that indemnifies any damage arises out of: person or organization for "property damage" by fire or explosion to premises (1) Goods or products made or sold by while rented to you or temporarily occu- you in the territory described in a. pied by you with permission of the owner above; is not an "insured contract"; (2) The activities of a person whose b. A sidetrack agreement; home is in the territory described in a.above, but is away for a short time c. Any easement or license agreement, ex- on your business; or cept in connection with construction or demolition operations on or within 50 feet (3) "Personal and advertising injury" of- of a railroad; fenses that take place through the Internet or similar electronic means d. An obligation, as required by ordinance, of communication, to indemnify a municipality, except in connection with work for a municipality; provided the insured's responsibility to pay damages is determined in a "suit" on e. An elevator maintenance agreement; the merits, in the territory described in a. f. That part of any other contract or agree- above or in a settlement to which we ment pertaining to your business (includ- agree. ing an indemnification of a municipality in 7. "Electronic data" means information, facts or connection with work performed for a programs stored as or on, created or used on, municipality) under which you assume or transmitted to or from computer software, the tort liability of another party to pay for including systems and applications software, "bodily injury", "property damage" or hard or floppy disks, CD-ROMs,tapes, drives, "personal and advertising injury"to a third cells, data processing devices or any other person or organization. Tort liability media which are used with electronically con- means a liability that would be imposed trolled equipment. by law in the absence of any contract or agreement. 8. "Employee" includes a "leased worker". "Em- ployee" Paragraph f, does not include that part of wdoes not include a "temporary anycontract or agreement: worker". g 9. "Executive officer" means a person holding (1) That indemnifies a railroad for"bodily any of the officer positions created by your injury", "property damage" or "per- charter, constitution, by-laws or any other sonal and advertising injury" arising similar governing document. out of construction or demolition op- erations, within 50 feet of any rail- Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc.,with its permission. Page 17 of 22 road property and affecting any rail- engines; marketing analysis; and road bridge or trestle, tracks, road- providing access to the Internet or beds,tunnel, underpass or crossing; other similar networks;or (2) That indemnifies an architect, engi- (7) Under which the insured, if a web- neer or surveyor for injury or damage site designer or content provider, or arising out of: Internet search, access, content or (a) Preparing, approving, or failing service provider, assumes liability for injury or damage arising out of the to prepare or approve, maps, insured's rendering or failure to ren- shop drawings, opinions, re- der Internet services, including those ports, surveys, field orders, listed in Paragraph (6),above. change orders or drawings and specifications;or 13. "Leased worker" means a person leased to Giving directions or instructions, you by a labor leasing firm under an agree- (b) ment between you and the labor leasing firm, or failing to give them, if that is to perform duties related to the conduct of the primary cause of the injury your business. "Leased worker" includes su- or damage; pervisors furnished to you by the labor leasing (3) Under which the insured, if an archi- firm. "Leased worker" does not include a tect, engineer or surveyor, assumes "temporary worker". liability for an injury or damage aris- 14. "Loading or unloading" means the handling of ing out of the insured's rendering or property: failure to render professional serv- ices, including those listed in Para- a. After it is moved from the place where it is graph (2) above and supervisory, in- accepted for movement into or onto an spection, architectural or engineering aircraft,watercraft or"auto"; activities; b. While it is in or on an aircraft, watercraft (4) That indemnifies an advertising, pub- or"auto"; or lic relations or media consulting firm for "personal and advertising injury" c. While it is being moved from an aircraft, arising out of the planning, execution watercraft or "auto" to the place where it or failure to execute marketing corn- is finally delivered; munications programs. Marketing but "loading or unloading" does not include communications programs include the movement of property by means of a me- but are not limited to comprehensive chanical device, other than a hand truck, that marketing campaigns; consumer, is not attached to the aircraft, watercraft or trade and corporate advertising for "auto". all media; media planning, buying, monitoring and analysis; direct mail; 15. "Mobile equipment" means any of the follow- promotion; sales materials; design; ing types of land vehicles, including any at- presentations; point-of-sale materi- tached machinery or equipment: als; market research; public relations a. Bulldozers, farm machinery, forklifts and and new product development; other vehicles designed for use princi- (5) Under which the insured, if an adver- pally off public roads; tising, public relations or media con- sulting firm, assumes liability for b. Vehicles maintained for use solely on or "personal and advertising injury" next to premises you own or rent; arising out of the insured's rendering c. Vehicles that travel on crawler treads; or failure to render professional services, including those services d. Vehicles, whether self-propelled or not, listed in Paragraph (4),above; maintained primarily to provide mobility to (6) That indemnifies a web-site designer permanently mounted: or content provider, or Internet (1) Power cranes, shovels, loaders, dig- search, access, content or service gers or drills;or provider for injury or damage arising out of the planning, execution or fail- (2) Road construction or resurfacing ure to execute Internet services. equipment such as graders, scrap- Internet services include but are not ers or rollers; limited to design, production, distri- e. Vehicles not described in a., b., c. or d. bution, maintenance and administra- above that are not self-propelled and are tion of web-sites and web-banners; maintained primarily to provide mobility to hosting web-sites; registering do- main names; registering with search Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc.,with its permission. Page 18 of 22 permanently attached equipment of the d. Oral or written publication, in any manner, following types: of material that slanders or libels a per- sonAir compressors, pumps andgen- or organization or disparages a per- (1) P P P son's or organization's goods, products or erators, including spraying, welding, services; building cleaning, geophysical explo- ration, lighting and well servicing e. Oral or written publication, in any manner, equipment; or of material that violates a person's right of (2) Cherry pickers and similar devices privacy, used to raise or lower workers; f. The use of another's advertising idea in your"advertisement";or f. Vehicles not described in a., b., c. or d. above maintained primarily for purposes g. Infringing upon another's copyright, trade other than the transportation of persons dress or slogan in your"advertisement". or cargo. 18. "Pollutant"means any solid,liquid,gaseous or However, self-propelled vehicles with the thermal irritant or contaminant, including following types of permanently attached smoke, vapor, soot, fumes, acids, alkalis, equipment are not "mobile equipment" chemicals, petroleum, petroleum products but will be considered "autos": and petroleum by-products, and waste. Waste includes materials to be recycled, re- (1) Equipment designed primarily for: conditioned or reclaimed. "Pollutants"include (a) Snow removal; but are not limited to substances which are generally recognized in industry or govern- (b) Road maintenance, but not con- ment to be harmful or toxic to persons, prop- struction or resurfacing;or erty or the environment regardless of whether c Street cleaning; the injury or damage is caused directly or indi- ( ) rectly by the"pollutants"and whether: (2) Cherry pickers and similar devices a. The insured is regularly or otherwise en- mounted on automobile or truck gaged in activities which taint or degrade chassis and used to raise or lower the environment;or workers;and b. The insured uses, generates or produces (3) Air compressors, pumps and gen- the"pollutant". erators, including spraying, welding, building cleaning, geophysical explo- 19. "Products-completed operations hazard": ration, lighting and well servicing a. Includes all "bodily injury" and "property equipment, damage" occurring away from premises However, "mobile equipment" does not in- you own or rent and arising out of "your dude any land vehicles that are subject to a product"or"your work"except: compulsory or financial responsibility law or (1) Products that are still in your physical other motor vehicle insurance law in the state where it is licensed or principally garaged. possession; or Land vehicles subject to a compulsory or fi- (2) Work that has not yet been com- nancial responsibility law or other motor vehi- pleted or abandoned. However, cle insurance law are considered "autos". "your work" will be deemed com- 16. "Occurrence" means an accident, including pleted at the earliest of the following continuous or repeated exposure to substan- times: tially the same general harmful conditions. (a) When all of the work called for in 17. "Personal and advertising injury" means in- your contract has been com- jury, including consequential "bodily injury", pleted; or arising out of one or more of the following of- (b) When all of the work to be done fenses: at the job site has been com- a. False arrest,detention or imprisonment; pleted if your contract calls for work at more than one job site; b. Malicious prosecution; or c. The wrongful eviction from,wrongful entry (c) When that part of the work done into, or invasion of the right of private oc- at a job site has been put to its cupancy of a room, dwelling or premises intended use by any person or that a person occupies, committed by or organization other than another on behalf of its owner, landlord or lessor; contractor or subcontractor working on the same project. Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc.,with its permission. Page 19 of 22 Work that may need service, main- her work and acts at the direction of and tenance, correction, repair or re- within the scope of duties determined by you, placement, but which is otherwise and is not paid a fee, salary or other compen- complete, will be treated as corn- sation by you or anyone else for their work pleted. performed for you. b. Does not include "bodily injury" or "prop- 24. "Workplace" means that place and during erty damage"arising out of: such hours to which the "employee" sustain- ing "bodily injury" was assigned by you, or (1) The transportation of property, un- any other person or entity acting on your be- less the injury or damage arises out half,to work on the date of"occurrence". of a condition in or on a vehicle not owned or operated by you, and that 25. "Your product": condition was created by the "load- ing or unloading" of that vehicle by a. Means: any insured; (1) Any goods or products, other than (2) The existence of tools, uninstalled real property, manufactured, sold, equipment or abandoned or unused handled, distributed or disposed of materials;or by: (3) Products or operations for which the (a) You; classification, listed in the Declara- (b) Others trading under your name; tions or in a schedule, states that or products-completed operations are included. (c) A person or organization whose 20. "Property damage"means: business or assets you have acquired; and a. Physical injury to tangible property, in- (2) Containers (other than vehicles), cluding all resulting loss of use of that materials, parts or equipment fur- property. All such loss of use shall be nished in connection with such deemed to occur at the time of the physi- goods or products. cal injury that caused it;or b. Loss of use of tangible property that is b. Includes: not physically injured. All such loss of (1) Warranties or representations made use shall be deemed to occur at the time at any time with respect to the fit- of the"occurrence"that caused it. ness, quality, durability, performance For the purposes of this insurance, "electronic or use of"your product"; and data"is not tangible property. (2) The providing of or failure to provide warnings or instructions. "Suit"Suit means a civil proceeding in which money damages because of "bodily injury", c. Does not include vending machines or "property damage" or "personal and advertis- other property rented to or located for the ing injury" to which this insurance applies are use of others but not sold. alleged. "Suit"includes: 26. "Your work": a. An arbitration proceeding in which such damages are claimed and to which the a. Means: insured must submit or does submit with (1) Work or operations performed by our consent; you or on your behalf;and b. Any other alternative dispute resolution (2) Materials, parts or equipment fur- proceeding in which such damages are nished in connection with such work claimed and to which the insured submits or operations. with our consent; or c. An appeal of a civil proceeding. b. Includes: 22. "Temporary worker" means a person who is (1) Warranties or representations made fit- furnished to you to substitute for a permanent ness,any time with respect to mthe ce "employee" on leave or to meet seasonal or r use of y, durability, performance short-term workload conditions. or of"your work"; and 23. "Volunteer worker" means a person who is (2) The providing of or failure to provide not your "employee", and who donates his or warnings or•instructions. Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc.,with its permission. Page 20 of 22 d s 4 NUCLEAR ENERGY LIABILITY EXCLUSION (Broad Form) 1. The insurance does not apply: an insured of services, materials, A. Under anyLiabilityCoverage, to "bodilyparts or equipment in connection 9 with the planning, construction, injury"or"property damage": maintenance, operation or use of (1) With respect to which an insured un- any "nuclear facility", but if such fa- der this Coverage Part is also an in- cility is located within the United sured under a nuclear energy liability States of America, its territories or policy issued by Nuclear Energy Li- possessions or Canada, this Exclu- ability Insurance Association, Mutual sion (3) applies only to "property Atomic Energy Liability Underwriters, damage" to such "nuclear facility" Nuclear Insurance Association of and any property thereat. Canada, or any of their successors, 2. As used in this exclusion: or would be an insured under any such policy but for its termination "Hazardous properties" includes radioactive, upon exhaustion of its limit of liability; toxic or explosive properties. or "Nuclear material" means "source material", (2) Resulting from the "hazardous prop- "special nuclear material" or "by-product ma- erties" of "nuclear material" and with terial". respect to which (a) any person or organization is required to maintain "Source material", "special nuclear material", financial protection pursuant to the and "by-product material" have the meanings Atomic Energy Act of 1954, or any given them in the Atomic Energy Act of 1954 law amendatory thereof, or (b) the or in any law amendatory thereof. insured is, or had this Coverage Part "Spent fuel" means any fuel element or fuel not been issued would be, entitled to component, solid or liquid, which has been indemnity from the United States of used or exposed to radiation in a "nuclear re- America, or any agency thereof, un- actor". der any agreement entered into by the United States of America, or any "Waste" means any waste material (a) con- agency thereof, with any person or taining "by-product material" other than the organization, tailings or wastes produced by the extraction B. Under anyMedical Payments coverage, or concentration of uranium or thorium from Y 9 any ore processed primarily for its "source to expenses incurred with respect to material" content, and (b) resulting from the "bodily injury" resulting from the "hazard- operation by any person or organization of ous properties" of"nuclear material" and any "nuclear facility" included under the first arising out of the operation of a "nuclear two paragraphs of the definition of "nuclear facility"by any person or organization. facility". C. Under any Liability Coverage, to "bodily "Nuclear facility"means: injury" or "property damage" resulting from the "hazardous properties" of "nu- A. Any"nuclear reactor"; clear material",if: B. Any equipment or device designed or (1) The "nuclear material" (a) is at any used for (1) separating the isotopes of "nuclear facility" owned by, or oper- uranium or plutonium, (2) processing or ated by or on behalf of, an insured, utilizing "spent fuel", or (3) handling, or (b) has been discharged or dis- processing or packaging "waste"; persed therefrom; C. Any equipment or device used for the (2) The"nuclear material"is contained in processing, fabricating or alloying of "spent fuel" or "waste" at any time "special nuclear material" if at any time possessed, handled, used, proc- the total amount of such material in the essed, stored, transported or dis- custody of the insured at the premises posed of, by or on behalf of an in- where such equipment or device is lo- sured; or cated consists of or contains more than 25 grams of plutonium or uranium 233 or (3) The "bodily injury" or "property dam- any combination thereof, or more than age" arises out of the furnishing by 250 grams of uranium 235; Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc.,with its permission. Page 21 of 22 D. Any structure, basin, excavation, prem- "Nuclear reactor" means any apparatus de- ises or place prepared or used for the signed or used to sustain nuclear fission in a storage or disposal of"waste"; self-supporting chain reaction or to contain a and includes the site on which any of the critical mass of fissionable material. foregoing is located, all operations conducted "Property damage" includes all forms of ra- on such site and all premises used for such dioactive contamination of property. operations. Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc.,with its permission. Page 22 of 22