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21-064.00 NA Degerstrom: Sullivan Overcrossing Deck Repair Contract This agreement is entered into this day of , 2021, between the City of Spokane Valley ("City")and N.A. Degerstrom ("Contractor"),pursuant to Title 35 RCW, as adopted or amended. In consideration of the terms and conditions contained herein and attached and made a part of this agreement,the parties agree as follows: I. The Contractor shall do all work and furnish all tools,materials, and equipment for: Sullivan Rd Overcrossing Deck Repair Project#0310 Contract 21-064 in accordance with and as described in the project plans and specification,and the standard specification of the Washington State of Department of Transportation which are by this reference incorporated herein and made part hereof and, shall perform any changes in the work in accord with the Contract Documents. The Contractor shall provide and bear the expense of all equipment, work, and labor, of any sort whatsoever that may be required for the transfer of materials and for constructing and completing the work provided for in these Contract Documents except those items mentioned therein to be furnished by the City. II. The City hereby promises and agrees with the Contractor to employ, and does employ the Contractor to provide the materials and to do and cause to be done the above described work and to complete and finish the same in accord with the project plans and specification and the terms and conditions herein contained and hereby contracts to pay for the same according to the referenced specifications and the schedule of unit or itemized prices at the time and in the manner and upon the conditions provided for in this contract. III. The Contractor for himself/herself, and for his/hers heirs, executors, administrators, successors,and assigns,does hereby agree to full performance of all covenants required of the Contractor in the contract. IV. It is further provided that no liability shall attach to the City by reason of entering onto this contract,except as provided herein. V. The project was awarded for the bid amount of$206,260.00 including applicable sales tax.. IN WITNESS WHEREOF,the Contractor has executed this instrument,on the date below, and the City has caused this instrument to be executed on the date stated above. City of Spokane Valley Sullivan Rd Overcrossing Deck Repair Project Executed by Contractor April, 28`h ,2021. Date Judi Tallman Printed Name Executive Vice President Title Signature City of Spokane Valley pie.Mark Calhoun Printed Name City Manager Title Sig Lure Revised 1-8-16 City of Spokane Valley Sullivan Rd Overcrossing Deck Repair Project Spokane . Valley 023214829 BOND NO: CONTRACTOR'S PERFORMANCE BOND to City of Spokane Valley,Washington The City of Spokane Valley, Washington, in Spokane County, has awarded to NA.Degerstrom,Inc. (Contractor), as Principal,a contract for the construction of the project designated as Sullivan Rd Overcrossine Deck Repair Project No. 0310 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 Liberty Mutual Insurance Company (Surety), a corporation, organized under the laws of Massachusetts 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$206.260.00 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 terms of the Contract, the specifications accompanying the Contract,or to the work to be performed under the Contract shall in any way affect its obligation on this bond,and waives notice of any change, extension of time,alteration or addition to the terms of the Contract or the work performed.The Surety agrees that modifications and changes to the terms and conditions of the Contract that increase the total amount to be paid the Principal shall automatically increase the obligation of the Surety on this bond and notice to Surety is not required for such increased obligation. This bond may be executed in two original counterparts, and shall be signed by the 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) N.A.Degerstrom,Inc. TY Liberty su Company if-,14-( — 4/28/2021 4 021 Principal)Signature Date Surety Signature Date f / / /illQ Diana R.Williams Printed Name Printed Name 'G Xe L✓ i ✓e- VP Attorney-in-Fact Title Title Name,address,and telephone of local office/agent of Surety Company is: HUB International Northwest LLC 835 N.Post Street,Suite 203,Spokane,WA 99201 509-319-2901 0; ; I4 City of Spokane Valley Sullivan Rd Overcrossing Deck Repair Project BOND NO: 023214829 CONTRACTOR'S PAYMENT BOND(FEDERALLY FUNDED PROJECT) to City of Spokane Valley,Washington The City of Spokane Valley,Washington,in Spokane County,has awarded to N.A.Degerstrom,Inc. (Contractor), as Principal, a contract for the construction of the project designated as Sullivan Rd Overcrossine Deck Repair, Project No. 0310 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)and chapter 60.28 RCW. The Principal, and Liberty Mutual Insurance Company (Surety), a corporation organized under the laws of Massachusetts 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$206,260.00 total Contract amount, subject to the provisions herein. This payment bond shall cover any and all taxes incurred pursuant to Titles 50 and 51 RCW,taxes imposed on the Principal pursuant to Title 82 RCW,and any additional sales taxes. 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, 39.12, and 60.28 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;shall pay all taxes due pursuant to Titles 50,51,and 82 RCW;and shall indemnify and hold harmless the Obligee from all loss, cost or damage which Obligee may suffer by reason of the failure of Principal to make such required payments; and if such payment obligations have not been fulfilled,this bond shall remain in full force and effect. The Surety for value received agrees that no change, extension of time, alteration or addition to the terms of the Contract, the specifications accompanying the Contract,or to the work to be performed under the Contract shall in any way affect its obligation on this bond,except as provided herein,and waives notice of any change,extension of time,alteration or addition to the terms of the Contract or the work performed.The Surety agrees that modifications and changes to the terms and conditions of the Contract that increase the total amount to be paid the Principal shall automatically increase the obligation of the Surety on this bond and notice to Surety is not required for such increased obligation. This bond may be executed in two original counterparts, and shall be signed by the parties' duly authorized officers.This bond will only be accepted if it is accompanied by a fully executed and original power of attorney for the officer executing on behalf of the surety. PRINCIPAL(CONTRACTOR)71....AYbov"--- N.A.Degerstrom,Inc. TY Liberty Ins ce Company 4/28/2021 , /28/202,1 Principal Signature Date Surety Signature Date (Ike(/ /aliwt 4 /L Diana R.Williams Printed Name Printed Name (VC (/� Attorney-in-Fact Title Title Name,address,and telephone of local office/agent of Surety Company is: HUB International Northwest LLC 835 N.Post Street,Suite 203,Spokane,WA 99201 509-319-2901 City of Spokane Valley Sullivan Rd Overcrossing Deck Repair Project • • This Power of Attorney limits the acts of those named herein,and they have no authority to - ` bind the Company except in the manner and to the extent herein stated. % oxf Liberty Liberty Mutual Insurance Company r*t Mutual. The Ohio Casualty Insurance Company Certificate No: 8204945-985770 West American Insurance Company SURETY POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS:That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire,that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts,and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana(herein collectively called the"Companies"),pursuant to and by authority herein set forth,does hereby name,constitute and appoint, Alan M. Wolfson,Amy F.Cathey,Chris Larson,Craig Jones,Diana R.Williams,Erin L.Repp,H.Keith McNally,Laurie A.Stewart,Meggan Davenport,Natasha Geiser,Ryan J.Pugh,Scott Jones,Susan B.Green,Travis Long,Wm Dinneen all of the city of Spokane state of WA each individually if there be more than one named,its true and lawful attorney-in-fact to make, execute,seal,acknowledge and deliver,for and on its behalf as surety and as its act and deed,any and all undertakings,bonds,recognizances and other surety obligations,in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF,this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 2nd day of March , 2021 . Liberty Mutual Insurance Company P�tNSUitt P�SV IN$" , tNSUiq, The Ohio Casualty Insurance Company tiJ „ceO14).y0 yJ 001" bA. .4PooaP°4r+0 West American Insurance Company J3 ebrn Q3 Foe+ a = t0 (' 1912 0 0 :!+) 1' 1991 0Y` b; i= s 0fl BY / Ta co David M.Carey,Assistant Secretary �� a 6 State of PENNSYLVANIA ss — = m rn County of MONTGOMERY g ...... w 3 On this 2nd day of March , 2021 before me personally appeared David M.Carey,who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance 3 o co Company,The Ohio Casualty Company,and West American Insurance Company,and that he,as such,being authorized so to do,execute the foregoing instrument for the purposes_-= m > therein contained by signing on behalf of the corporations by himself as a duly authorized officer. c a a IN WITNESS WHEREOF,I have hereunto subscribed my name and affixed my notarial seal at King of Prussia,Pennsylvania,on the day and year first above written. o'iCO n S a0 O /Q4i��pH Eqr�! CommonwealM of PennsyHania-Notary Seal _ a) O `° (- 9 Teresa Pastella,Notary Public 'kp Montgomery CountyE o OF My commission expires March 28,2025 By: o E c P Commission number 1126044 P�` eresa Pastella,Notary Public Q o N�, t.V ,�j Member,Pennsylvania Association of No4ries ,� c0 41) OL,Na, ? This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual 3 co, E•E Insurance Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows: a CO ARTICLE IV—OFFICERS:Section 12.Power of Attorney. CO i 12Any officer or other offidal of the Corporation authorized for that purpose in writing by the Chairman or the President,and subject to such limitation as the Chairman or the a . President may prescribe,shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Corporation to make,execute,seal,acknowledge and deliver as surety (co CO m any and all undertakings,bonds,recognizances and other surety obligations.Such attorneys-in-fact,subject to the limitations set forth in their respective powers of attorney,shall a 3 have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation.When so executed,such o a) zc0i instruments shall be as binding as if signed by the President and attested to by the Secretary.Any power or authority granted to any representative or attorney-in-fact under the-3 iti provisions of this article may be revoked at any time by the Board,the Chairman,the President or by the officer or officers granting such power or authority. ti a ARTICLE XIII—Execution of Contracts:Section 5.Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president,and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings, bonds,recognizances and other surety obligations.Such attorneys-in-fact subject to the limitations set forth in their respective powers of attorney,shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company.When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation—The President of the Company,acting pursuant to the Bylaws of the Company,authorizes David M.Carey,Assistant Secretary to appoint such attorneys-in- fact as may be necessary to act on behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Authorization—By unanimous consent of the Company's Board of Directors,the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company,wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds,shall be valid and binding upon the Company with the same force and effect as though manually affixed. I,Renee C.Llewellyn,the undersigned,Assistant Secretary,The Ohio Casualty Insurance Company,Liberty Mutual Insurance Company,and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full,true and correct copy of the Power of Attorney executed by said Companies,is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this 28th day of April . 2021 . 0,itau - for INS" d%NSUg4 J 3 Fob -) `o c+ i, Fo k� 1912 0 1919 0 1991 0 !i .44-.... : 0 G y. ci0 4t icHug�.da y0 HA,,,,s, as v:s, %tot da A. B Renee C.Llewellyn,Assistant 9i7 * 0 ''yl * 0 d,N * 1-14 Secretary LMS-12873 LMIC OCIC WAIC Multi Co 02/21 NADEGER-03 KBREMER ACOR D DATE(MMIDDIYYYY) `,� CERTIFICATE OF LIABILITY INSURANCE 4/27/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Kristy Bremer Hub International Northwest LLC PO Box 3144 (A//cC,NNo,Ext):(509)319-2909 FAX No): Spokane,WA 99220 RDI REss:Kristy.Bremer@hubinternational.com INSURER(S)AFFORDING COVERAGE NAIC II INSURER A:Alaska National Insurance Company 38733 INSURED INSURER B: N.A.Degerstrom,Inc. INSURER C: 3303 N.Sullivan Road INSURER D: Spokane Valley,WA 99216 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 UMITS LTR INSD WVD (MMIDD/YYYYI (MM/DD/YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 20FPS09101 6/30/2020 6/30/2021 DAMAGES(RENTED 100,000 X X PREMISES(Ea occurrence) $ X Aggregate Limits Per MED EXP(Any one person) $ 5,000 X Emp Liab/Stop Gap PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JEC: LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER WA WY STOP GAP $ 1,000,000 A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ X ANY AUTO X X 20FAS09101 6/30/2020 6/30/2021 BODILY INJURY(Per person) $ OWNED SCHEDULED _ AUTOSRE� ONLY AUTOS BODILY O� INJURY7yp (Per accident) $ X AUTOS ONLY X AUTOS ONLY (Per acoid t)AMAGE $ A X UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 10,000,000✓ EXCESS UAB CLAIMS-MADE X x 20FLU09101 6/30/2020 6/30/2021 AGGREGATE $ 10,000,000 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER OFFICEE ELUE ?PROPRIETOR/PARTNER/EXECUTIVE N I A E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required RE:SULLIVAN RD OVERCROSSING DECK REPAIR PROJECT-CIP NO 0310-CONTRACT 21-064-FEDERAL AID NO.BHM-4103(014) PRIMARY NON-CONTRIBUTORY ADDITIONAL INSURED AND WAIVER OF SUBROGATION TO THE CITY OF SPOKANE VALLEY IF REQUIRED BY WRITTEN CONTRACT AND AS GRANTED BY THE ACTUAL INSURANCE POLICY FORMS THAT ARE ATTACHED TO THE CERTIFICATE IN ACCORDANCE WITH THE TERMS AND CONDITIONS OF THE POLICIES. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Spokane ValleyTHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P ACCORDANCE WITH THE POLICY PROVISIONS. 10210 E.Sprague Avenue Spokane Valley,WA 99206 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AP Alaska National INSURANCE COMPANY CONTRACTORS' GENERAL LIABILITY ENHANCEMENT ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Coverage afforded under this extension of coverage endorsement does not apply to any person or organization covered as an additional insured on any other endorsement now or hereafter attached to this Coverage Part. SCHEDULE OF COVERAGES ARE SUMMARIZED BELOW 1. Miscellaneous Additional Insureds 14. In Rem Actions 8 additional insured extensions. 1. MISCELLANEOUS ADDITIONAL INSUREDS Primary and Noncontributory Insurance Section li Who Is An Insured is amended to 2. Damage To Premises Rented to You include as an additional Insured any person or Limit increased to $500,000. organization described in Paragraphs 2.a. through 2.h. below whom you are required to add 3. Medical Payments as an additional insured on this policy under a Limits increased to$15,000. written contract or written agreement. However, Reporting period increased to three years from the written contract or written agreement must be: the date of accident. 1. Currently in effect or becoming effective 4. Non-owned Watercraft during the term of this policy; and Increased to 50 feet. 2. Executed prior to the "bodily injury", 5. Supplementary Payments "property damage" or"personal injury and Cost of bail bonds increased to$10,000. advertising injury", but Daily loss of earnings increased to$500. Only the following persons or organizations 6. Newly Formed Or Acquired Organizations are additional insureds under this Coverage extended to the end of the policy period endorsement and coverage provided to such or the next anniversary of this policy's effective additional insureds is limited as provided date. herein: 7. Liberalization Clause a. State or Governmental Agency or Subdivision or Political Subdivi- 8. Unintentional Failure To Disclose Hazards sions 9. Notice of Occurrence Any state or governmental agency or subdivision or political subdivision 10. Broad Knowledge of Occurrence that has issued a permit in connection with operations performed 11. Bodily Injury- Extension of Coverage by you or on your behalf and that you 12. Expected Or Intended Injuryare required by any ordinance, law or p building code to include as an Reasonable force - bodily injury or property additional insured on this coverage damage. part is an additional insured, but only with respect to liability for "bodily 13. Blanket Waiver of Subrogation injury", "property damage", "personal Waiver of subrogation where required by written and advertising injury" arising out of contract or written agreement. such operations. ANIC GL 1187 07 16 Page 1 of 6 Alaska National INSURANCE COMPANY The insurance provided to such state e. Owners or Other Interests From or political subdivision does not apply Whom Land Has Been Leased to any "bodily injury", "property damage" or"personal and advertising An owner or other interest from whom injury" arising out of operations land has been leased by you but only performed for that state or political with respect to liability arising out of subdivision. the ownership, maintenance or use of that specific part of the land leased to b. Controlling Interest you and subject to the following additional exclusions: Any persons or organizations with a controlling interest in you but only This insurance does not apply to: with respect to their liability arising out of: (1) Any "occurrence" which takes place after you cease to lease (1) Their financial control of you, or that land; or (2) Premises they own, maintain or (2) Structural alterations, new con- control while you lease or occupy struction or demolition operations these premises. performed by or on behalf of such additional insured. This insurance does not apply to structural alterations, new construc- f. Co-owner of Insured Premises tion and demolition operations performed by or for such additional A co-owner of a premises co-owned insured. by you and covered under this insurance but only with respect to the c. Managers or Lessors of Premises co-owners liability as co-owner of such premises. A manager or lessor of premises but only with respect to liability arising out g. Lessor of Equipment of the ownership, maintenance or use of that specific part of the premises Any person or organization from leased to you and subject to the whom you lease equipment. Such following additional exclusions: person or organization is an additional insured only with respect to This insurance does not apply to: their liability for "bodily injury", "property damage" or "personal and (1) Any "occurrence" which takes Advertising injury" caused, in whole place after you cease to be a or in part, by your maintenance, oper- tenant in that premises; or ation or use of equipment leased to you by such person or organization. (2) Structural alterations, new con- A person's or organization's status as struction or demolition operations an additional insured under this performed by or on behalf of endorsement ends when their written such additional insured. contract or written agreement with you for such leased equipment ends. d. Mortgagee, Assignee or Receiver With respect to the insurance A mortgagee, assignee or receiver afforded these additional insureds, but only with respect to their liability the following additional exclusions as mortgagee, assignee, or receiver apply: and arising out of the ownership, maintenance, or use of a premises by This insurance does not apply: you. (1) To any "occurrence" which takes This insurance does not apply to place after the equipment lease structural alterations, new construc- expires; or tion or demolition operations performed by or for such additional insured. ANIC GL 1187 07 16 Page 2 of 6 Alaska National is INSURANCE COMPANY (2) To "bodily injury", "property additional insured. However, damage", or "personal and even if coverage within the advertising injury" arising out of "products-completed operations the sole negligence of such hazard" is required by the written additional insured. contract, such coverage is available to the additional insured h. Owners, Lessees or Contractors only if the "bodily injury" or "property damage" occurs prior to (1) Such person or organization is an the end of the time period during additional insured for "bodily which you are required by the injury", "property damage" and written contract to provide such "personal and advertising injury" coverage or the expiration date of if, and only to the extent that, the the policy, whichever comes first. injury or damage is caused by negligent acts or omissions of Any insurance provided to an additional you or your subcontractor in the insured designated under Paragraphs 2.a. performance of "your work" to through 2.g. above does not apply to "bodily which the written contract injury" or "property damage" included within applies. This person or organi- the products-completed operations hazard." zation does not qualify as an additional insured with respect to Primary And Noncontributory Insurance injury or damage caused in whole or in part by independent The following is added to the Other Insurance negligent acts or omissions of Condition and supersedes any provision to the such person or organization. contrary: (2) However, this insurance does not apply to "bodily injury", "property This insurance is primary to and will not seek damage" or "personal and contribution from any other insurance available to advertising injury" arising out of an additional insured under your policy provided an architect's, engineer's, or that: surveyor's rendering of or failure to render any professional (1) The additional insured is a services including: Named Insured under such other insurance; and I. the preparing, approving, or failing to prepare or approve (2) You have agreed in writing in a maps, drawings, opinions, contract or agreement that this reports, surveys, change insurance would be primary and orders, design or would not seek contribution from specifications; and any other insurance available to the additional insured. ii. supervisory, inspection, or Section III - Limits of Insurance, the following is engineering services. added: (3) The insurance provided to this With respect to the insurance afforded to the additional insured, does not additional insureds described in Paragraphs a. cover "bodily injury" or "property through h. above, the most we will pay on behalf damage" caused by your of such additional insured is the amount of negligent acts and omissions in the performance of "your work" insurance: that occurs within the "products- (1) Required by the contract or completed operations hazard", unless the written contract agreement; or contains a specific requirement that you procure completed (2) Available under the applicable operations coverage or coverage Limits of Insurance shown in the within the "products-completed Declarations; operations hazard" for the whichever is less. ANIC GL 1187 07 16 Page 3 of 6 Alaska National INSURANCE COMPANY This provision shall not increase the applicable 4. NON-OWNED WATERCRAFT Limits of Insurance shown in the Declaration. A. If endorsement CG 21 09, CG 21 10, CG 24 2. Damage To Premises Rented to You 50, or CG 24 51 is attached to the policy, Paragraph A. 2. g. (2) (b) is replaced by the SECTION III — LIMITS OF INSURANCE, following: Paragraph 6. is replaced by the following: (b) A watercraft that you do not 6. Subject to Paragraph 5. above, the own that is: Damage to Premises Rented to You Limit is the most we will pay under Coverage A (i) Less than 50 feet long: for damages because of "property and damage" to any one premises, while rented to you, or in the case of damage (ii) Not being used to carry by fire, while rented to you or temporarily persons or property for a occupied by you with permission of the charge. owner. B. If Paragraph A. does not apply, Paragraph g. If a limit is shown for Damage to Premises (2) of 2. EXCLUSION under SECTION I — Rented to You the most we will pay under COVERAGES, COVERAGE A — BODILY Coverage A for damages because or "property INJURY AND PROPERTY DAMAGE damage" to any one premises is the Limit shown LIABILITY is replaced by the following: in the Declarations or $500,000, whichever is greater. (2) A watercraft that you do not own that is: 3. MEDICAL PAYMENTS (a) Less than 50 feet long; and A. Section III—Limits of Insurance, Paragraph 7. is replaced by the following: (b) Not being used to carry persons or property for a 7. Subject to Paragraph 5. above the charge. Medical Expense Limit is the most we will pay under Coverage C for all medical 5. SUPPLEMENTARY PAYMENTS expenses because of "bodily injury" sustained by any one person. A. Under Section I - Supplementary Payments - Coverage A and B, Paragraph 1.b., the If a limit is shown for Medical Expense in limit of$250 shown for the cost of bail bonds the Declarations the most we will pay is replaced by$10,000; under Coverage C for all medical expenses because of "bodily injury" B. In Paragraph 1.d., the limit of$250 shown for sustained by any one person is the Limit daily loss of earnings is replaced by$500. shown in the Declarations or $15,000, whichever is greater. 6. NEWLY FORMED OR ACQUIRED ORGANIZATIONS B. This provision 5. (Medical Payments) does not apply if Section I - Coverage C Medical Paragraph 3.a. of Section II -Who Is An Insured Payments is excluded either by the is deleted and replaced by the following: provisions of the Coverage Part or by endorsement. Coverage under this provision is afforded only until the end of the policy period or the next C. Paragraph 1.a.(3)(b) of Section I -Coverage anniversary of this policy's effective date after you C - Medical Payments, is replaced by the acquire or form the organization, whichever is following: earlier. (b) The expenses are incurred and reported to us within three years of the date of the accident; and ANIC GL 1187 07 16 Page 4 of 6 Alaska National k A INSURANCE COMPANY 7. LIBERALIZATION CLAUSE 10. BROAD KNOWLEDGE OF OCCURRENCE If we adopt a change in our forms or rules which The following is added to Paragraph 2. of Section would broaden coverage for contractors under IV - Commercial General Liability Conditions - this endorsement without an additional premium Duties in The Event of Occurrence, Offense, charge, your policy will automatically provide the Claim or Suit: additional coverages as of the date the revision is effective in your state. You must give us or our authorized representative notice of an "occurrence", offense, claim, or "suit" 8. UNINTENTIONAL FAILURE TO DISCLOSE only when the "occurrence", offense, claim or HAZARDS "suit' is known to: SECTION IV — COMMERCIAL GENERAL (1) You, if you are an individual; LIABILITY CONDITIONS — Paragraph 6. — Representations is replaced by the following: (2) A partner, if you are a partnership; 6. Representations (3) An executive officer or the By accepting this policy, you agree: employee designated by you to give such notice, if you are a a. The statements in the Declarations are corporation; or accurate and complete; (4) A manager, if you are a limited b. Those statements are based upon liability company. representations you made to us; and 11. EXPANDED BODILY INJURY c. We have issued this policy in reliance Section V - Definitions, the definition of "bodily upon your representations. injury" is changed to read: The unintentional omission of, or "Bodily injury" means bodily injury, sickness or unintentional error in, any information you disease sustained by a person, including death, provided to us which we relied upon in humiliation, shock, mental anguish or mental issuing this policy will not prejudice your injury by that person at any time which results as rights under this insurance. However, this a consequence of the bodily injury, sickness or provision does not affect our right to collect disease. additional premium or to exercise our rights of cancellation or nonrenewal in accordance 12. EXPECTED OR INTENDED INJURY with applicable laws and regulations. Exclusion a. of Section I - Coverage A - Bodily 9. NOTICE OF OCCURRENCE Injury and Property Damage Liability is replaced by the following: The following is added to Paragraph 2. of Section IV - Commercial General Liability Conditions - a. "Bodily injury" or "property damage" Duties In The Event of Occurrence, Offense, expected or intended from the Claim or Suit: standpoint of the insured. This exclusion does not apply to "bodily Your rights under this Coverage Part will not be injury" or "property damage" resulting prejudiced if you fail to give us notice of an from the use of reasonable force to "occurrence", offense, claim or "suit" and that protect persons or property. failure is solely due to your reasonable belief that the "bodily injury" or "property damage" is not covered under this Coverage Part. However, you shall give written notice of this "occurrence", offense, claim or "suit" to us as soon as you are aware that this insurance may apply to such "occurrence", offense, claim or"suit." ANIC GL 1187 07 16 Page 5 of 6 Alaska National L INSURANCE COMPANY 13. BLANKET WAIVER OF SUBROGATION However, this waiver applies only when you have agreed in writing to waive such rights of recovery The Transfer Of Rights Of Recovery Against in a contract or agreement, and only if the Others To Us Condition (Section IV - contract or agreement: Commercial General Liability Conditions) is amended by the addition of the following: 1. Is in effect or becomes effective during the term of this policy; and We waive any right of recovery we may have against any person or organization because of 2. Was executed prior to loss. payments we make for injury or damage arising out of: 14. IN REM ACTIONS 1. Your ongoing operations; or Any action in rem against any vessel owned, operated by or for, or chartered by or for you will 2. "Your work" included in the "products- be treated in the same manner as though the completed operations hazard." action were in personam against you. This endorsement changes the policy to which it is attached and, unless otherwise stated, is effective on the date issued at 12:01 A.M. standard time at your mailing address shown in the policy. The information below is required only when this endorsement is issued subsequent to commencement of the policy. Endorsement Effective Policy No. Insured Endorsement No. Countersigned By Includes copyrighted material of Insurance Services Office, Inc., with its permission ANIC GL 1187 07 16 Page 6 of 6 Alaska National INSURANCAlir DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): All Projects Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. For all sums which the insured becomes legally 3. Any payments made under Coverage A for obligated to pay as damages caused by damages or under Coverage C for medical "occurrences" under Section I — Coverage A, and expenses shall reduce the Designated for all medical expenses caused by accidents Construction Project General Aggregate Limit under Section I — Coverage C, which can be for that designated construction project. Such attributed only to ongoing operations at a single payments shall not reduce the General designated construction project shown in the Aggregate Limit shown in the Declarations nor Schedule above: shall they reduce any other Designated 1. A separate Designated Construction Project Construction Project General Aggregate Limit General Aggregate Limit applies to each for any other designated construction project designated construction project, and that limit shown in the Schedule above. is equal to the amount of the General 4. The limits shown in the Declarations for Each Aggregate Limit shown in the Declarations. Occurrence, Damage To Premises Rented To 2. The Designated Construction Project General You and Medical Expense continue to apply. Aggregate Limit is the most we will pay for the However, instead of being subject to the sum of all damages under Coverage A, except General Aggregate Limit shown in the damages because of "bodily injury" or Declarations, such limits will be subject to the "property damage" included in the "products- applicable Designated Construction Project completed operations hazard", and for medical General Aggregate Limit. expenses under Coverage C regardless of the number of: a. Insureds; b. Claims made or"suits"brought; or c. Persons or organizations making claims or bringing "suits". CG 25 03 05 09 Page 1 of 2 • Alaska National INSURANCE COMPANY B. For all sums which the insured becomes legally C. When coverage for liability arising out of the obligated to pay as damages caused by "products-completed operations hazard" is "occurrences" under Section I — Coverage A, and provided, any payments for damages because of for all medical expenses caused by accidents "bodily injury" or"property damage" included in the under Section I — Coverage C, which cannot be "products-completed operations hazard" will attributed only to ongoing operations at a single reduce the Products-completed Operations designated construction project shown in the Aggregate Limit, and not reduce the General Schedule above: Aggregate Limit nor the Designated Construction 1. Any payments made under Coverage A for Project General Aggregate Limit. damages or under Coverage C for medical D. If the applicable designated construction project expenses shall reduce the amount available has been abandoned, delayed, or abandoned and under the General Aggregate Limit or the then restarted, or if the authorized contracting Products-completed Operations Aggregate parties deviate from plans, blueprints, designs, Limit, whichever is applicable; and specifications or timetables, the project will still be 2. Such payments shall not reduce any deemed to be the same construction project. Designated Construction Project General E. The provisions of Section III — Limits Of Insurance Aggregate Limit. not otherwise modified by this endorsement shall continue to apply as stipulated. This endorsement changes the policy to which it is attached and, unless otherwise stated, is effective on the date issued at 12:01 A.M. standard time at your mailing address shown in the policy. The information below is required only when this endorsement is issued subsequent to commencement of the policy. Endorsement Effective Policy No. Insured Endorsement No. 22 Countersigned By ©Insurance Services Office, Inc., 2008 CG 25 03 05 09 Page 2 of 2 Alaska National t-' INSURANCE COMPANY BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM Various provisions in this endorsement restrict SECTION IV — Business Auto Conditions, coverage. Read the entire policy carefully to Paragraph A. 5. — Transfer of Rights of Recovery determine rights, duties, and what is and is not Against Others To Us is amended to include: covered. 5. Transfer of Rights of Recovery Against Throughout this policy, the words "you" and "your" Others to Us refer to the Named Insured shown in the Declarations. The words "we", "us", and "our" refer to This condition does not apply to any the company providing this insurance. person(s) or organization(s) to the extent that subrogation against that person or Other words and phrases that appear in quotation organization is waived prior to the "accident" marks have special meaning. Refer to SECTION V— or the "loss" under a contract with that person DEFINITIONS in the Business Auto Coverage Form, or organization. The coverages provided by this endorsement apply SECTION II — COVERED AUTO LIABILITY per "accident" and, unless otherwise specified, are COVERAGE, Paragraph A.2.a. (2)— Supplementary subject to all of the terms, conditions, exclusions and Payments is replaced by the following: deductible provisions of the policy, to which it is attached. (2) Up to $10,000 for cost of bail bonds (including bonds for related traffic law SECTION II -- COVERED AUTO LIABILITY violations) required because of an COVERAGE, Paragraph A.1. Who Is An Insured is "accident" we cover. We do not have amended to include: to furnish these bonds. d. Any "employee" of yours while operating SECTION II — COVERED AUTO LIABILITY an "auto" hired or rented under a COVERAGE, Paragraph A.2.a. (4)— Supplementary contract or agreement in an "employee's" Payments is replaced by the following: name, with your permission, while performing duties related to the conduct (4) All reasonable expenses incurred by of your business. the "insured" at our request, including actual loss of earnings up to $500 a e. Any person or organization for whom you day because of time off from work. have agreed in writing to provide insurance such as is afforded by this Coverage Form, but only with respect to liability arising out of the ownership, maintenance or use of"autos" covered by this policy. If such person or organization has other insurance then this insurance is primary to and we will not seek contribution from the other insurance. ANIC CA 1150 10 13 Page 1 of 4 Alaska National INSURANCE COMPANY C. "Loss" caused by falling objects or SECTION Il — COVERED AUTO LIABILITY missiles. COVERAGE, Paragraph A.2.c.—Voluntary Property Damage is added as follows: However, you have the option of having glass breakage caused by a covered "auto's" c. Voluntary Property Damage collision or overturn considered a "loss" under Collision Coverage. At your written request, we may make a voluntary payment for Property Damage Glass Repair—Waiver of Deductible caused by an "insured", but without liability to a third party, up to$25,000. We No deductible applies to glass breakage, if will not make a Voluntary Property the glass is repaired rather than replaced. Damage payment to anyone who is an "insured" under this policy. SECTION III — PHYSICAL DAMAGE COVERAGE, Paragraph A.4.a. — Transportation Expenses is SECTION III — PHYSICAL DAMAGE COVERAGE, replaced by the following: Paragraph A.2.—Towing is replaced by the following: a. Transportation Expenses Towing We will pay up to $200 per day to a We will pay up to $500 for towing and labor maximum of $1,500 for temporary costs incurred each time a covered "auto" transportation expense incurred by you that is a: because of the total theft of a covered "auto"that is a: a. Private passenger; (1) Private passenger; b. Truck; (2) Truck; c. Pick-up truck; (3) Pick-up truck; d. Panel ; or (4) Panel; or e. Van (5) Van type vehicle under 20,000 lbs. of Gross Vehicle Weight is disabled. However, the t labor must be performed at place of type vehicle under 20,000 lbs. of Gross Vehicle Weight. We will pay only for disablement. those covered "autos"for which you carry SECTION III — PHYSICAL DAMAGE COVERAGE, either Comprehensive or Specified Paragraph A.3. — Glass Breakage — Hitting a Bird Causes of Loss Coverage. We will pay for temporary transportation expenses or Animal — Falling Objects or Missiles is replaced incurred during the period beginning 48 by the following: hours after the theft and ending, regardless of the policy's expiration, Glass Breakage—Hitting a Bird or Animal —Falling Objects or Missiles when the covered "auto" is returned to use or we pay for its"loss". If you carry Comprehensive Coverage for the damaged covered "auto", we will pay the following under Comprehensive Coverage: a. Glass Breakage; b. "Loss" caused by hitting a bird or animal; and ANlC CA 1150 10 13 Page 2 of 4 - µ, 7. � Alaska National INSURANCE COMPANY (2) Specified Causes of Loss only if the SECTION III — PHYSICAL DAMAGE COVERAGE, Declarations indicate that Specified Paragraph A.4.b. — Loss of Use Expenses is Causes of Loss Coverage is provided replaced by the following: for the "auto"withdrawn from service; or b. Loss of Use Expenses—Hired, Rented, (3) Collision only if the Declarations or Borrowed Automobiles indicate that Collision Coverage is provided for the "auto" withdrawn We will pay expenses for which an from service. "insured" becomes legally responsible to pay for loss of use of a vehicle hired, SECTION III — PHYSICAL DAMAGE COVERAGE, rented or borrowed without a driver under Paragraph A.4.d. — Airbag Coverage is added as a written rental contract or agreement. follows: We will pay for loss of use expenses, if caused by: d. Airbag Coverage (1) Other than Collision, only if the We will pay for the cost to repair, replace, Declarations indicate that or reset an airbag that inflates for any Comprehensive Coverage is provided reason other than as a result of a for the vehicle withdrawn from collision, If the Declarations indicate that service. the covered "auto" has Comprehensive Coverage or Specified Causes of Loss (2) Specified Causes of Loss only if the Coverage. Declarations indicate that Specified Causes of Loss Coverage is provided SECTION III — PHYSICAL DAMAGE COVERAGE, for the vehicle withdrawn from Paragraph A.4.e. — Rental Reimbursement service. Coverage is added as follows: (3) Collision only if the Declarations e. Rental Reimbursement Coverage indicate that Collision Coverage is provided for the vehicle withdrawn We will pay up to $75 per day for rental from service. reimbursement expenses incurred by you for the rental of an "auto" because of However, the most we will pay for any "loss"to a covered"auto"that is a: expenses for loss of use is $200 per day, to a maximum of$1,500. (1) Private Passenger; SECTION III — PHYSICAL DAMAGE COVERAGE, (2) Truck; Paragraph A.4.c.—Non-Transportation Loss of Use Expenses is added as follows: (3) Pick-up truck; c. Non-Transportation Loss of Use (4) Panel; or Expenses (5) Van We will pay up to $2,000 for non- transportation expense incurred by you, type vehicle under 20,000 lbs. of Gross because of "loss" to a covered "auto", if Vehicle Weight. Payment applies in caused by: addition to the otherwise applicable amount of each coverage you have on a (1) Other than Collision, only if the covered "auto". No deductibles apply to Declarations indicate that this coverage. Comprehensive Coverage is provided for the"auto"withdrawn from service; ANIC CA 1150 10 13 Page 3 of 4 Alaska National L INSURANCE COMPANY (1) We will pay only for those expenses SECTION IV — BUSINESS AUTO CONDITIONS — incurred during the policy period Paragraph B.5.b. — Other Insurance is replaced by beginning 24 hours after the "loss" the following: and ending, regardless of the policy's expiration, with the lesser of the b. For Hired Auto Physical Damage following number of days: Coverage, the following are deemed to be covered "autos"you own: (a) The number of days reasonably required to repair or replace the (1) Any covered "auto" you lease, hire, covered "auto", rent,or borrow;and (b) 30 days. (2) Any covered "auto"" hired or rented by your "employee" under a contract (2) This coverage does not apply while in that individual `employee's" name, there are spare or reserve "autos" with your permission, while available to you for your operations. performing duties related to the conduct of your business. (3) The Rental Reimbursement Coverage described above does not However, any"auto" that is leased, hired, apply to a covered "auto" that Is rented or borrowed with a driver Is not a described or designated as a covered covered"auto". "auto" on Rental Reimbursement Coverage Form CA 99 23. SECTION V — DEFINITIONS — Paragraph C. — "Bodily injury" is replaced by the following: SECTION IV — BUSINESS AUTO CONDITIONS — Paragraph B.2. —Concealment, Misrepresentation Or C. "Bodily injury" means bodily injury, sickness or Fraud is amended by adding Unintentional Failure disease sustained by a person including death or to Disclose Hazards at the end of Paragraph B.2. as mental anguish resulting from any of these. follows: Mental anguish means any type of mental or emotional illness or disease Unintentional Failure to Disclose Hazards If you unintentionally fall to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal. This endorsement changes the policy to which it is attached and, unless otherwise stated, is effective on the date issued at 12:01 A.M. standard time at your mailing address shown in the policy. The information below is required only when this endorsement is issued subsequent to commencement of the policy. Endorsement Effective Policy No. Insured Endorsement No. 3 Countersigned By ©Insurance Services Office, Inc., 2009 ANIC CA 1150 10 13 Page 4 of 4 Jr Alaska National `' INSURANCE COMPANY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from a written contract that requires you to obtain this anyone liable for an injury covered by this policy. We agreement from us.) will not enforce our right against the person or organization named in the Schedule. (This agreement This agreement shall not operate directly or indirectly applies only to the extent that you perform work under to benefit any one not named in the Schedule. SCHEDULE Any person or organization for whom the Insured has agreed by written contract to furnish this waiver. This endorsement changes the policy to which it is attached and, unless otherwise stated, is effective on the date issued at 12:01 A.M. standard time at your mailing address shown in the policy. The information below is required only when this endorsement is issued subsequent to commencement of the policy. Endorsement Effective Policy No. 19JWS 09101 Insured Endorsement No. Countersigned By WC 00 03 13 (04 84) Alaska National INSURANCE COMPANY WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) -AUTOMATIC THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL LIABILITY UMBRELLA COVERAGE PART The following is added to Paragraph 9. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery against any person or organization, because of any payment we make under this Coverage Part, to whom the insured has waived its right of recovery in a written contract or agreement. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person or organization prior to loss. This endorsement changes the policy to which it is attached and, unless otherwise stated, is effective on the date issued at 12:01 A.M. standard time at your mailing address shown in the policy. The information below is required only when this endorsement is issued subsequent to commencement of the policy. Endorsement Effective June 30, 2019 Policy No. 19F PS 09101 Insured N.A. Degerstrom, Inc. Endorsement No. 66 • Countersigned By Sear 442Co€t Hub International NW/Spokane ©Insurance Services, Office, Inc., 2018 CU24801219 Alaska National ' INSURANCE COMPANY ADDITIONAL INSUREDS PRIMARY AND NON-CONTRIBUTORY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL LIABILITY UMBRELLA COVERAGE PART Paragraph a. of 5. Other Insurance of Section IV - (b) Intended to be excess of this Conditions is deleted and replaced by: insurance and non-contributory with this insurance as agreed under a 5. Other Insurance written contract or agreement into which you have entered that requires a. This insurance is excess over, and shall not that this insurance be primary and contribute with any of the other insurance, non-contributory. whether primary, excess, contingent or on any other basis. This condition will not apply Such insurance as is described in items (1) and to either: (2) above shall apply in excess of the Limits of Insurance of this Coverage Part and we will not (1) Other insurance that is specifically written seek contribution or indemnity from such as excess over this Coverage Part; or insurance for damages to which this Coverage Part applies. (2) Other insurance that is both: When this insurance is excess, we will have no (a) Issued to a Named Insured that is an duty under Coverages A or B to defend the additional insured under this insured against any "suit" if any other insurer has Coverage Part as described in a duty to defend the insured against that "suit". If paragraph 3. of Section II - Who Is no other insurer defends, we will undertake to do An Insured; and so, but will be entitled to the insured's rights against all those other insurers. This endorsement changes the policy to which it is attached and, unless otherwise stated, is effective on the date issued at 12:01 A.M. standard time at your mailing address shown in the policy. The information below is required only when this endorsement is issued subsequent to commencement of the policy. Endorsement Effective June 30, 2019 Policy No. 19F PS 09101 Insured N.A. Degerstrom, Inc. Endorsement No. 67 Countersigned By Seat 461C464 Hub International NW/Spokane Includes copyrighted material of Insurance Services Office, Inc., with its permission ANIC CU 1149 11 15 SAM Search Results List of records matching your search for : Search Term : N.A. DEGERSTROM, INC.* Record Status: Active ENTITY N.A. DEGERSTROM, INC. Status: Active DUNS: 008811960 +4: CAGE Code: 1Q284 DoDAAC: Expiration Date: 06/25/2021 Has Active Exclusion?: No Debt Subject to Offset?: No Address: 3303 N SULLIVAN RD City: SPOKANE State/Province: WASHINGTON ZIP Code: 99216-1676 Country: UNITED STATES April 29,2021 2:37 PM https://www.sam.gov Page 1 of 1