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HomeMy WebLinkAbout24-040.00AAASweepingLLCStormDrainCleaningServices I Contract No. 24-040 PURCHASED SERVICES AGREEMENT AAA Sweeping LLC THIS PURCHASED SERVICES AGREEMENT (the "Agreement") is made by and between the City of Spokane Valley, a code City of the State of Washington ("City") and AAA Sweeping LLC, ("Contractor")jointly referred to as the "Parties". IN CONSIDERATION of the terms and conditions contained herein the Parties agree as follows: 1. 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 services to be provided (the "Work") in accordance with the Scope of Work outlined in Exhibit B and in accordance with this Agreement 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 2, 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 the 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. 2. Term of Contract. This Agreement shall be in full force and effect upon execution and shall remain in effect until the end of the 2024 calendar year. As it deems, the City reserves the right to exercise or not, optional subsequent contract years for up (3) three additional one-year contract terms from 2025 up to and including 2027. It is anticipated that the option years shall start in January of each year and end on December 31 each year. 3. Compensation. In consideration of Contractor performing the Work, City agrees to pay Contractor in accordance with the Contract Documents an amount not to exceed the sum of $219,549.50, including Washington State Sales Tax, based on the costs submitted by Contractor (Exhibit C),and as may be adjusted in accordance with the Contract Documents. Prevailing wages are required to be paid for this work as outlined in the General Conditions and RCW 39.12. City of Spokane Valley - Storm Drain Cleaning Services Purchased Services Agreei5nent Page 1 of 2 Contract No. 24-040 4. Notice. Notice other than applications for payment shall be given in writing as follows: TO THE CITY: TO THE CONTRACTOR: Name: Marci Patterson, City Clerk Name: AAA Sweeping LLC Phone: (509) 720-5000 Phone: (509) 922-1363 Address: 10210 East Sprague Avenue Address: 3808 N Sullivan Rd., Bldg 107B Spokane Valley, WA 99206 Spokane Valley, WA 99216 5.Entire Agreement. This Agreement constitutes the entire and complete agreement between the parties and supersedes any prior oral or written agreements. This Agreement may not be changed, modified, or altered except in writing signed by the Parties. 6. Exhibits. The terms of the following attached exhibits are incorporated into this Agreement in their entirety (which are by this reference incorporated herein and made part hereof and referred to as the "Contract Documents"): A. General Conditions B. Scope of Work C. Cost Statement D. Insurance Endorsements E. Performance and Payment Bond ,� 6. Execution. The Parties have executed this Agreement this 2h day of !'/�"�/g-e if ?o , 20 CITY OF SPOKANE VALLEY: Contractor: John Hohman, City Manager g Y Its: Aut rized Representative APPROVED AS TO FORM: ffi o th City Attorney City of Spokane Valley Storm Drain Cleaning Services Purchased Services Agreement Page 2 of 2 Exhibit A Contract No. 24-040 1. RELATIONSHIP OF THE PARTIES It is understood and agreed that Contractor shall be an 5. VACANT independent contractor and not the agent or employee This section is intentionally vacant. of City, that City is interested only in the results to be achieved, and that the right to control the particular 6. INSURANCE manner, method, and means in which the services are The Contractor shall procure and maintain for the performed is solely within the discretion of Contractor. duration of the Agreement, insurance against claims Any and all employees who provide services to City for injuries to persons or damage to property which under this Agreement shall be deemed employees may arise from or in connection with the performance solely of Contractor. Contractor shall be solely of the work hereunder by the Contractor, their agents, responsible for the conduct and actions of all its representatives, employees or subcontractors. employees under this Agreement and any liability that may attach thereto. No Limitation. Contractor's maintenance of insurance as required by the agreement shall not be construed to 2. COMPLIANCE WITH LAWS AND limit the liability of the Contractor to the coverage PERMITS provided by such insurance, or otherwise limit the The Contractor shall comply with and give notices City's recourse to any remedy available at law or in required by all laws, ordinances, codes, rules, equity. regulations, and permits relating to the conduct of the 6A. MINIMUM SCOPE OF INSURANCE work. Except as specifically otherwise provided herein, the Contractor shall obtain and pay for all Contractor shall obtain insurance of the types permits and licenses necessary to conduct the work. described below: The Contractor shall comply with Chapter 49.28 1. Automobile Liability insurance covering all RCW, Hours of Labor. owned, non-owned, hired and leased vehicles. Coverage shall be written on Insurance Services 3. CONTRACTOR REGISTRATION Office (ISO) form CA 00 01 or a substitute form, The Contractor shall be duly licensed, registered, and providing equivalent liability coverage. If bonded by the State of Washington at all times this necessary, the policy shall be endorsed to provide Agreement is in effect. Prior to commencement of contractual liability coverage. Work under this Agreement, Contractor shall register 2. Commercial General Liability insurance shall be with the City as a business if it has not already done so. written on ISO occurrence form CG 00 01 or the 4. TIME OF THE ESSENCE equivalent and shall cover liability arising from Time is of the essence for completion of the Work premises, operations, independent contractors, identified in the Agreement. The Contractor shall start products-completed operations, stop gap liability, work within 10 days after the effective date of the personal injury and advertising injury, and liability written Notice to Proceed issued by the City or assumed under an insured contract. The execution of the Agreement if no formal Notice is to commercial general liability insurance shall be be issued. The Contractor shall plan and prosecute the endorsed to provide a per project aggregate limit work diligently so that the various portions of the work using ISO form CG 25 03 05 09 or an equivalent shall be completed within the time set forth in the endorsement. There shall be no endorsement or Contract Documents. modification of the commercial general liability insurance for liability arising from explosion, collapse, or underground property damage. The City of Spokane Valley Storm Drain Cleaning Services General Conditions Page 1 of 11 Exhibit A Contract No. 24-040 City shall be named as an insured under the 3. If the Contractor maintains higher insurance limits Contractor's Commercial General Liability than the minimums above,the City shall be insured insurance policy with respect to the work for the full available limits of commercial general performed for the City using ISO Additional and excess or umbrella liability maintained by the Insured endorsement CG 20 10 10 01 and Contractor, irrespective of whether such limits Additional Insured-Completed Operations maintained by the Contractor are greater than those endorsement CG 20 37 10 01 or substitute required or whether any certificate of insurance endorsements providing equivalent coverage. furnished to the City evidences limits of liability 3. Workers' Compensation coverage as required by lower than those maintained by the Contractor. the Industrial Insurance laws of the state of 4. Failure on the part of the Contractor to maintain the Washington. insurance as require shall constitute a material 6B. MINIMUM AMOUNTS OF INSURANCE breach of the Contract, upon which the Citymay, after giving at least five business days' notice to the Contractor shall maintain the following insurance Contractor to correct the breach, immediately limits: terminate the Agreement. Or at its sole discretion, 1. Automobile Liability insurance with a minimum the City may procure or renew such insurance and combined single limit for bodily injury and pay any and all premiums in connection therewith, property damage of$1,000,000 per accident. with any sums expended to be repaid to the City on 2. Commercial General Liability insurance shall be demand,or at the sole discretion of the City,deduct written with limits no less than $2,000,000 each against funds due the Contractor from the City. occurrence, $2,000,000 general aggregate and a 6D. ACCEPTABILITY OF INSURERS $2,000,000 products-completed operations Insurance is to be placed with insurers with a current aggregate limit. A.M. Best rating of not less than A:VII. 6C. OTHER INSURANCE PROVISIONS 6E. EVIDENCE OF COVERAGE The insurance policies are to contain,or be endorsed to As evidence of the insurance coverages,the Contractor contain, the following provisions for Automobile shall furnish acceptable insurance certificates to the Liability and Commercial General Liability insurance: City at the time the Contractor returns the signed Agreement. The certificates shall specify all parties 1. The Contractor's insurance coverage shall be who are additional insured, and shall include primary insurance as respects the City. Any applicable policy endorsements, and the deduction or Insurance, self-insurance, or insurance pool coverage maintained by the City shall be excess of retention level. Insuring companies or entities are the Contractor's insurance and shall not contribute subject to City acceptance. If requested, complete with it. copies of insurance policies shall be provided to the City. The Contractor shall be financially responsible 2. The Contractor's insurance shall be endorsed to for all pertinent deductibles, self-insured retentions, state that coverage shall not be cancelled by either and/or self-insurance. party, except after thirty (30) days prior written notice by certified mail, return receipt requested, 6F. SUBCONTRACTORS has been given to the City. Contractor shall cause each and every subcontractor to provide insurance coverage that complies with all City of Spokane Valley Storm Drain Cleaning Services General Conditions Page 2 of 11 Exhibit A Contract No. 24-040 applicable requirements of the Contractor-provided incorporated by reference into these Contract insurance as set forth herein, except Contractor shall Documents. have sole responsibility for determining the limits of The prevailing wage rates as provided to the City by coverage to be required to be obtained by the Industrial Statistician of the Washington State subcontractors. Contractor shall ensure that the City is Depar latent of Labor and Industries is available for an additional insured on each and every download at URL subcontractor's commercial general liability insurance http://www.lni.wa.gov/TradesLicensing/PrevWage/W policy using an endorsement at least as broad as ISO ageRates/. additional insured endorsement CG 20 38 04 13. It is the Contractor's sole responsibility to determine 7. PERFORMANCE/PAYMENT BOND the most current wage rates it will actually have to pay. Pursuant to RCW 39.08.010 the Contractor, prior to These rates shall remain in effect for the duration commencing work, shall furnish a Performance and a throughout Contractor's performance of the Work. Payment Bond for the full contract sum including sales tax; however, if the Contract Sum does not exceed 9. WORKERS' BENEFITS $150,000 the Contractor may, in lieu of providing a The Contractor shall make all payments required for bond, request the City retain 10% of the Contract unemployment compensation under Title 50 RCW and amount earned for a period of 30 days following for industrial insurance and medical aid required under acceptance of the work or until receipt of all necessary Title 51 RCW and shall furnish proof of payment if releases and settlement of any liens filed under Chapter requested by the City. If any payment required by Title 60.28 RCW, whichever is later, at which time the City 50 or Title 51 is not made when due, the City may in ordinary course of business will make final payment. retain such payments from any money due the Contractor and pay the same into the appropriate fund. 8. PREVAILING WAGES The Contractor shall comply with the requirements of 10. PAYMENT AND RETAINAGE RCW 39.12 and shall pay each employee an amount Upon completion of the work or no more often than not less than the Prevailing Rate of Wage, as specified monthly, the Contractor shall submit an invoice for by the Industrial Statistician of the Washington State work completed to the attention of the City Finance Department of Labor and Industries (L&I). If Department and the Project Manager. The City will employing labor in a class not shown, the Contractor make payment within 30 days of receipt of the shall request a determination of the correct wage rate Contractor's properly completed invoice or receipt of for the class and locality from the Industrial the goods and services, whichever is later. Statistician. The Contractor shall provide a copy of The City will pay 95% of the amount of the approved any such determinations to the City. invoice and will retain 5% in accordance with Before commencement and upon completion of work, Retainage requirements of Chapter 60.28 RCW. the Contractor shall file the forms and pay the filing Pursuant to Chapter 60.28 RCW, the City will retain fees required by L&I. The Contractor shall indemnify the 5%for a period of 45 days after date of acceptance, and hold the City harmless from any claims related to or until receipt of all necessary releases and settlement the payment or non-payment of such wages by the of any liens filed under Chapter 60.28 RCW, Contractor. The schedule of Prevailing Wage Rates is whichever is later, at which time the City in ordinary course of business will make final payment. City of Spokane Valley Storm Drain Cleaning Services General Conditions Page 3 of 11 Exhibit A Contract No. 24-040 Additional Retainage In Lieu of Bond: As set forth in 12. CONTRACT DOCUMENT section 7 of this Agreement, for contracts of$150,000 INTERPRETATION or less, the Contractor may request that the City retain The intent of the contract documents is to prescribe a 10% of payments in lieu of providing payment and complete work. The Contractor shall furnish all labor, performance bonds pursuant to Chapter 39.08.010 materials, equipment, and incidentals necessary or RCW. If Contractor makes such a request, then the convenient to complete all parts of the work. City will retain the 10% from each payment, which Compensation for the cost of furnishing the foregoing retained amount shall be in addition to the 5%retained and for full performance of the contract shall be under Chapter 60.28 RCW. The City shall hold the considered as included in the contract sum. This retained amount for a period of 30 days after date of Agreement shall be governed by, and interpreted in, acceptance, or until receipt of all necessary releases accordance with Washington law. and settlement of any liens filed under Chapter 60.28 RCW, whichever is later, at which time the City in 13. OWNERSHIP OF DOCUMENTS ordinary course of business will make final payment. All Drawings, plans, specifications, and other related Payment of retainage shall neither(a) waive or release documents prepared by the Contractor under this the City's rights, nor (b) relieve the Contractor of any Agreement are, and shall be, property of the City, and obligations under this Contract or by law. may be subject to disclosure pursuant to RCW 42.56, or other applicable public record laws. 11. AUTHORITY OF THE PROJECT MANAGER 14. RECORDS The Project Manager or his/her Representative is the The City or State Auditor, or any of their representative of the City,and the Contractor shall look representatives, shall have full access to and the right to the Project Manager in matters relating to to examine during normal business hours all of compliance with Contract requirements. The work Contractor's records with respect to all matters covered shall be done to the complete satisfaction of the Project in this Agreement. Such representatives shall be Manager. The Project Manager will decide all permitted to audit, examine, make excerpts or questions which may arise concerning the quality and transcripts from such records, and to make audits of all acceptability of materials and equipment furnished and contracts, invoices, materials, payrolls, and record of work performed, the rate of progress of the work, and matters covered by this Agreement for a period of three interpretation of the contract documents. The Project years from the date final payment is made hereunder. Manager has the authority to reject work which is 15. CHANGES defective or does not otherwise conform to the contract The City may make changes in the work within the documents. The Project Manager is not responsible for scope of this Contract and such changes may be made and will not have control or charge of the means, without notice to any sureties. If any change causes an methods, techniques, sequences, or procedures of construction, or for safety precautions or programs increase or decrease in the Contractor's cost of, or the incidental thereto,these being the sole responsibility of time required for the performance of, any part of the the Contractor. work under this Contract, an equitable adjustment will be made consistent with such change and the Contract modified in writing accordingly, provided, however, that the Contractor notifies the City of the change in City of Spokane Valley Storm Drain Cleaning Services General Conditions Page 4 of 11 Exhibit A Contract No. 24-040 cost or time before commencing the changed work. local retail sales tax),bonding and insurance costs, Records pertaining to changes in the work shall be delay, acceleration or other impact and any other maintained sufficiently to document all costs. Failure costs of doing business; to maintain and disclose the required records shall 5. Subcontractor's work costs shall be calculated in constitute a waiver of the Contractor's claim for costs accordance with subparagraphs 1 through 4 above. not documented. To the total (excluding all markups for overhead The value of any work covered by a change order or of and profit) shall be added 10%for the Contractor's any claim for increase or decrease in the Contract price supervision and overhead support; will be determined by one or more of the following 6. All costs of the Contractor and any subcontractor methods in the order of precedence listed below, if not attributable to a change in the work are either specified in the bidding schedule: specifically listed or covered by the multipliers 15.A.UNIT PRICES specified in paragraphs 1 through 5 above. Unit prices set forth in the Contract Documents. 16. QUALITY 15.B.LUMP SUM The Contractor shall supervise and direct the work Lump sum as agreed,provided that the Contractor may using its best efforts, skills and attention. The be required to provide a detailed cost estimate for the Contractor shall be solely responsible for, and shall proposed change. have full control and charge of construction means, 15.C.TIME AND MATERIALS methods, techniques, sequences, and procedures, and for coordinating all portions of the work under the Time and materials basis at rates set forth in the contract. The Contractor is for all purposes an Contract Documents or, if not specified, as follows: independent Contractor and not an agent or employee 1. Labor not to exceed applicable Prevailing Rates of of the City. Wage, plus 10% for overhead, profit and all other Unless otherwise specifically stated in the Contract, costs incurred in supplying labor; the Contractor shall provide and pay for materials, 2. Materials and supplies incorporated in and labor, tools, equipment, water, light, power, necessary for the work, plus 10% for overhead, transportation, supervision, and temporary profit and all other costs incurred in supplying the construction, and other services and facilities of any materials and supplies; nature necessary to execute, complete and deliver the 3. Equipment,excluding small hand tools,at up to the work within the Contract Time. Material and maximum hourly rates set forth in the current equipment shall be new and of a quality equal to or "AGC-DOT Equipment Rental Agreement" at better than that specified. Equipment offered shall be current models which have been in successful regular such rates as approved by the Engineer, plus 10% operation under comparable conditions. The work for overhead, profit and all other costs incurred in performed shall be in conformity with the best modern supplying such equipment; practice of the trade with the intent to secure the best 4. "Overhead" shall include, but not be limited to: standard of construction and equipment of work as a field and office engineering, estimating, general whole and in part. superintendence,purchasing, office expense, small hand tools, all applicable taxes (except state and City of Spokane Valley Storm Drain Cleaning Services General Conditions Page 5of11 Exhibit A Contract No. 24-040 17. SAFETY information showing actual dimensions and locations The Contractor shall maintain the work site and along with changes made during execution of the work. perform the work in a manner which meets all legal 21. COMPLETION OF WORK requirements for the provision of a safe workplace. The Contractor shall comply with safety standards and The Contractor shall notify the Engineer when it provisions of applicable laws, building and considers the work complete. If, upon inspection, the construction codes, and the safety regulations set forth City determines that all work has been completed in in "Safety Standards for Construction", Chapter 296- accordance with the terms of this Contract, the City 155 WAC, and "General Safety Standards", Chapter will accept such work, which acceptance shall be 296-24 WAC, issued by the Washington State evidenced by a written letter of acceptance to the Department of Labor and Industries. Contractor. The City shall not be barred by acceptance from requiring the Contractor to remove, replace, 18. HAZARDOUS MATERIALS repair, or dispose of unauthorized or defective work, The Contractor shall give immediate notice to the City material,or equipment or from recovering damages for upon the discovery of any hazardous or petroleum- the same. contaminated materials not specifically identified in 22. GUARANTEE the Contract Documents and proceed thereafter only as directed by the City or as set forth in the specifications. 22.A.REPAIRS If the material proves positive as containing asbestos, For a period of 365 days after the date of acceptance of such material shall be handled in compliance with the work, the Contractor, upon notification from the WAC 296-62-077 through 296-62-07753. Hazardous City, shall promptly schedule and make all repairs to materials include asbestos, PCBs, lead, radioactive the Contractor-furnished materials, equipment and/or materials, explosives and other materials defined as workmanship which may be necessary to make such hazardous or dangerous wastes in WAC Chapters 173- materials, equipment and/or workmanship equal to that 303 and 173-305. specified in the Contract. 19. PROTECTION OF UTILITIES 22.B.WARRANTY The Contractor shall protect from damage public and Unless provided otherwise in the Contract Documents, private utilities encountered during the work. Prior to Contractor warrants that all Work and materials beginning work, the Contractor shall give proper performed or installed under this Agreement are free notification as required by RCW 19.122.030 to the from defect or failure for a period of one year agencies that have utilities in place and shall cooperate following final acceptance by City,unless a supplier or with these agencies in the protection and relocation of manufacturer has a warranty for a greater period, underground utilities, facilities and structures. The which warranty shall be assigned or transferred to City. number to call is 1-800-424-5555. In the event a defect or failure occurs in work or materials,Contractor shall,within the warranty period, 20. RECORD DRAWINGS remedy the same at no cost or expense to City. This Upon completion of work and before requesting final warranty provision shall not be construed to establish payment, provide the Project Manager with record a period of limitation with respect to Contractor's other drawings and all operation and maintenance obligations under this Agreement. City of Spokane Valley Storm Drain Cleaning Services General Conditions Page 6 of 11 Exhibit A Contract No. 24-040 23. NON-DISCRIMINATION with the Contract Documents, and (b) ten (10) have The Contractor shall fully comply with all federal, expired after the City delivered notice of the state, and local laws, regulations, and ordinances default/violation to Contractor. Upon termination the pertaining to non-discrimination and equal City may exclude the Contractor from the site and shall employment. take possession of the work and all of the materials and equipment for which the City has paid any amount on 24. INDEMNIFICATION to the Contractor. The Contractor shall be entitled to The Contractor shall defend, indemnify and hold the payment for portions of the work satisfactorily City, its officers, officials, employees and volunteers completed prior to termination, less costs incurred by harmless from any and all claims, injuries, damages, the City as a result of the Contractor's default. losses or suits including attorney fees, arising out of or The City shall have the right to terminate this Contract in connection with the performance of this Agreement, for any reason whatsoever by written notice to the except for injuries and damages caused by the sole Contractor identifying the effective date of negligence of the City. termination, provided said notice is delivered to Should a court of competent jurisdiction determine that Contractor at least ten (10) days prior to the effective this Agreement is subject to RCW 4.24.115, then, in teunination date. The Contractor shall discontinue the event of liability for damages arising out of bodily work by the effective termination date unless the notice injury to persons or damages to property caused by or specifies otherwise. Upon such termination, the resulting from the concurrent negligence of the Contractor shall be paid in ordinary course of business Contractor and the City, its officers, officials, for all work satisfactorily completed to the effective employees, and volunteers, the Contractor's liability date of termination. hereunder shall be only to the extent of the Contractor's 26. ASSIGNMENT OF CONTRACT negligence. It is further specifically and expressly understood that the indemnification provided herein The Contractor shall not assign this contract, or constitutes the Contractor's waiver of immunity under subcontract the work, in whole or in part, except with Industrial Insurance, Title 51 RCW, solely for the the prior written consent of the City. The Contractor purposes of this indemnification. This waiver has been shall require each subcontractor to comply with the mutually negotiated by the parties. The provisions of requirements of these Contract Documents. this section shall survive the expiration or termination Subcontractors will not be recognized as having a of this Agreement. direct relationship with the City,nor are subcontractors intended or incidental third-party beneficiaries to this The Contractor shall pay all attorney's fees and Contract. expenses incurred by the City in establishing and enforcing the City's rights under this paragraph, 27. WAIVER whether or not a suit was instituted. No officer, employee, agent, or other individual acting 25. TERMINATION OF CONTRACT on behalf of either party has the power, right, or authority to waive any of the conditions or provisions The City may terminate the Contract whenever (a) the of this Agreement. No waiver in one instance shall be Contractor is deemed to be in default or violates the held to be waiver of any other subsequent breach or provisions of the Contract by failing, neglecting, or nonperformance. All remedies afforded in this refusing to proceed according to and in full compliance Agreement or by law shall be taken and construed as City of Spokane Valley Storm Drain Cleaning Services General Conditions Page 7 of 11 Exhibit A Contract No. 24-040 cumulative and in addition to every other remedy 31. JURISDICTION AND VENUE provided herein or by law. Failure of either party to This Agreement is entered into in Spokane County, enforce at any time any of the provisions of this Washington. The venue of any action arising out of Agreement or to require at any time performance by this Agreement shall be in Spokane County, State of the other party of any provision hereof shall in no way Washington. be construed to be a waiver of such provisions nor shall it affect the validity of this Agreement or any part 32. ANTI-KICKBACK thereof. No officer or employee of City, having the power or 28. CONFIDENTIALITY duty to perform an official act or action related to this Agreement, shall have or acquire any interest in this The Contractor may, from time-to-time, receive Agreement, or have solicited, accepted, or granted a information which is deemed by City to be present or future gift, favor, service, or other thing of confidential. The Contractor shall not disclose such value from any person with an interest in this information without the prior express written consent Agreement. of City or upon order of a Court of competent jurisdiction. 33. DEBARMENT, SUSPENSION,AND OTHER RESPONSIBILITY MATTERS— 29. DISPUTES AND DISPUTE EXPENSES PRIMARY COVERED TRANSACTIONS All disputes arising under or related to this Agreement 33A. CERTIFICATION that cannot be resolved through informal discussion By executing this Agreement, the Contractor certifies and negotiations shall be resolved by litigation filed in to the best of its knowledge and belief, that it and its the Superior Court of the State of Washington for principals: Spokane County, unless otherwise required by applicable federal or state law. The prevailing party in 1. Are not presently debarred, suspended, proposed any lawsuit or other legal proceeding seeking to for debarment, declared ineligible, or voluntarily enforce any term of this Agreement shall be entitled to excluded from covered transactions by any federal recover their reasonable attorney fees and costs depai tuient or agency; incurred in said action. 2. Have not within a three-year period preceding this 30. SUBCONTRACTOR RESPONSIBILITY proposal been convicted of or had a civil judgment As required by RCW 39.06.020, the Contractor shall rendered against them for commission of fraud or verify responsibility criteria for each first tier a criminal offense in connection with obtaining, attempting to obtain, or performing a public subcontractor and its subcontractors of any tier that (federal, state, or local) transaction or contract hires other subcontractors shall verify responsibility under a public transaction; violation of federal or criteria for each of its subcontractors. Verification state antitrust statutes or commission of shall include that each subcontractor, at the time of embezzlement, theft, forgery, bribery, falsification subcontract execution, meets the responsibility criteria or destruction of records, making false statements, listed in RCW 39.04.350(1) and possesses an electrical or receiving stolen property; contractor license, if required by RCW 19.28, or an elevator contractor license if required by RCW 70.87. 3. Are not presently indicted for or otherwise This verification requirement shall be included in criminally or civilly charged by a governmental every subcontract of every tier. entity (federal, state, or local) with commission of City of Spokane Valley Storm Drain Cleaning Services General Conditions Page 8 of 11 Exhibit A Contract No. 24-040 any of the offenses enumerated in paragraph(A)(2) Including Procurements of Materials and Equipment. of this certification; and In all solicitations, either by competitive bidding, or 4. Have not within a three-year period preceding this negotiation made by Contractor for work to be application/proposal had one or more public performed under a subcontract, including transactions (federal, state, or local) terminated for procurements of materials, or leases of equipment, cause or default. each potential subcontractor or supplier shall be notified by Contractor of Contractor's obligations 33B. DOCUMENTATION under this Agreement and the Acts and the Regulations Where the prospective primary participant is unable to relative to non-discrimination on the grounds of race, certify to any of the statements in this certification, color, or national origin. such prospective participant shall attach an explanation 34D. INFORMATION AND REPORTS to this Agreement. Contractor shall provide all information and reports 34. ASSURANCE OF COMPLIANCE WITH required by the Acts, the regulations, and directives APPLICABLE FEDERAL LAW issued pursuant thereto, and shall permit access to its During the performance of this Agreement, the books,records, accounts, other sources of information, Contractor, for itself, its assignees, and successors in and its facilities as may be determined by the City or interest agrees as follows: the WSDOT to be pertinent to ascertain compliance with such Acts, regulations, and instructions. Where 34A. COMPLIANCE WITH REGULATIONS any information required of Contractor is in the The Contractor shall comply with the federal laws set exclusive possession of another who fails or refuses to forth in subsection 34G, below ("Pertinent Non- furnish the information, Contractor shall so certify to Discrimination Authorities") relative to non- the City or the WSDOT, as appropriate, and shall set discrimination in federally-assisted programs as forth what efforts it has made to obtain the information. adopted or amended from time-to-time, which are 34E. SANCTIONS FOR NONCOMPLIANCE herein incorporated by reference and made a part of this Agreement. In the event of a Contractor's noncompliance with the nondiscrimination provisions of this Agreement, the 34B. NON-DISCRIMINATION City will impose such contract sanctions as it or the The Contractor, with regard to the work performed by WSDOT may determine to be appropriate, including, it during this Agreement, shall not discriminate on the but not limited to: grounds of race, color, or national origin in the 1. Withholding payments to Contractor under the selection and retention of subcontractors, including Agreement until Contractor complies; and/or procurements of materials and leases of equipment. Contractor shall not participate directly or indirectly in 2. Cancelling, terminating, or suspending the the discrimination prohibited by the Acts and the Agreement, in whole or in part. Regulations identified in subsection 34G below, 34F. INCORPORATION OF PROVISIONS including employment practices when the contract covers any activity, project, or program set forth in Contractor shall include the provisions of paragraphs Appendix B of 49 CFR Part 21. of these Contract Clauses in every subcontract, including procurements of materials and leases of 34C. SOLICITATIONS FOR SUBCONTRACTS equipment,unless exempt by the Acts, regulations and City of Spokane Valley Storm Drain Cleaning Services General Conditions Page 9 of 11 Exhibit A Contract No. 24-040 directives issued pursuant thereto. Contractor shall 5. The Age Discrimination Act of 1975, as amended, take action with respect to any subcontract or (42 U.S.C. §6101 etseq.),(prohibits discrimination procurement as the City or the WSDOT may direct as on the basis of age); a means of enforcing such provisions, including 6. Airport and Airway Improvement Act of 1982, (49 sanctions for noncompliance. Provided, that if U.S.C. §471, Section 47123), as amended, Contractor becomes involved in, or is threatened with (prohibits discrimination based on race, creed, litigation by a subcontractor or supplier because of color, national origin, or sex); such direction, Contractor may request that the City enter into any litigation to protect the interests of the 7. The Civil Rights Restoration Act of 1987,(PL 100- City. In addition, Contractor may request the United 209), (Broadened the scope, coverage and States to enter into the litigation to protect the interests applicability of Title VI of the Civil Rights Act of of the United States. 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 34G.PERTINENT NON-DISCRIMINATION activities of the Federal-aid recipients, sub- AUTHORITIES recipients and contractors, whether such programs or activities are Federally funded or not); During the performance of this Agreement, the Contractor agrees to comply with the following non- 8. Titles II and III of the Americans with Disabilities discrimination statutes and authorities; including but Act, which prohibit discrimination on the basis of not limited to: disability in the operation of public entities,public and private transportation systems,places of public 1. Title VI of the Civil Rights Act of 1964 (42 U.S.C. accommodation, and certain testing entities (42 §2000d et seq., 78 stat. 252), (prohibits U.S.C. §§12131-12189) as implemented by discrimination on the basis of race, color, national Department of Transportation regulations at 49 origin); and 49 CFR Part 21; and 49 Part 26; C.F.R. parts 37 and 38; 2. The Uniform Relocation Assistance and Real 9. The Federal Aviation Administration's Non- Property Acquisition Policies Act of 1970, (42 discrimination statute (49 U.S.C. §47123) U.S.C. §4601), (prohibits unfair treatment of (prohibits discrimination on the basis of race, persons displaced or whose property has been color, national origin, and sex); acquired because of Federal or Federal-aid programs and projects); 10. Executive Order 12898, Federal Actions to Address Environmental Justice in Minority 3. Federal-Aid Highway Act of 1973, (23 U.S.C. Populations and Low-Income Populations, which §324 et seq.), (prohibits discrimination on the basis ensures Non-discrimination against minority of sex); populations by discouraging programs, policies, 4. Section 504 of the Rehabilitation Act of 1973, (29 and activities with disproportionately high and U.S.C. §794 et seq.), as amended, (prohibits adverse human health or environmental effects on discrimination on the basis of disability); and 49 minority and low-income populations; CFR Part 27; 11. Executive Order 13166, Improving Access to Services for Persons with Limited English City of Spokane Valley Storm Drain Cleaning Services General Conditions Page 10 of 11 Exhibit A Contract No. 24-040 Proficiency, and resulting agency guidance, 32. SEVERABILITY national origin discrimination includes If any section, sentence, clause, or phrase of this discrimination because of Limited English Agreement should be held to be invalid for any reason proficiency (LEP). To ensure compliance with by a court of competent jurisdiction, such invalidity Title VI, you must take reasonable steps to ensure shall not affect the validity of any other section, that LEP persons have meaningful access to your sentence, clause, or phrase of this Agreement. programs (70 Fed. Reg. at 74087 to 74100); and 12 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.). City of Spokane Valley Storm Drain Cleaning Services General Conditions Page 11 of 11 EXHIBIT B SCOPE OF WORK Provided Services: Storm Drain Cleaning Services Purchased Services Agreement Contract No.:24-040 Scope of Work Specifications for Storm Drain Cleaning 1 SCOPE OF SERVICES 1.1 OVERVIEW General work includes the regular and as-needed cleaning of culverts,pipes,vaults, drywells, catch basins, inlets, and other stormwater facilities. The Contractor will be required to supply an Eductor-equipped truck continuously and full-time during non-freezing weather for approximately nine months. The contractor will also provide associated traffic control on arterial streets as required. The contractor must have equipment and staff available to perform emergency work within two hours of notification, seven days a week. Collected debris will be transported and disposed of by the Contractor at the Spokane Valley Regional Decant Facility, 12116 E. Montgomery Ave. City approved loads collected with absorbents or hazardous material will be held for a short residence time until the load can be transferred by the Contractor to proper disposal locations as directed by the City. The contractor will be required to enter all cleaning records into a GIS database using an electronic tablet provided by the city. 1.2 APPROXIMATE QUANTITIES OF WORK • The approximate total number of storm drain structures to be cleaned in 2024 is: o 950 Catch Basins o 600 Sidewalk/curb Inlets o 550 Drywells o 10 Culverts o 4 Pump Station Vaults • The estimated total units for specified tasks in 2024 are: o 690 Hours "Structure Cleaning" o 340 Hours "Traffic Control with Flagging" o 3 Each "Absorb Liquid Hold" o 125 Hours "Debris Transport"to Disposal Sites o 120 Hours "Laborer" 1.3 ESTIMATED ANNUAL COST The estimated probable cost for this work in 2024 is $240,000. 1.4 OTHER CONSIDERATIONS • It is expected that the quantity of work may require more than one eductor trucks to complete the work within the approximate nine-month working window. • Water utility service costs to supply clean water to eductor trucks must also be included in Bid proposal. City of Spokane Valley Specifications for Storm Drain Cleaning 24-040—Storm Drain Cleaning Services EXHIBIT C COST STATEMENT Provided Services: Storm Drain Cleaning Services Purchased Services Agreement Contract No.:24-040 Cost Statement BID TABULATION `t Storm Drain Cleaning Services Spokane Contract No.24-040 400100 Va l ley. Engineers Estimate AAA Sweeping Big Sky Industrial Services Clean Harbors Description Units Qty. Unit Price Total Cost Unit Price Total Cost Unit Price Total Cost Unit Price Total Cost Structure Cleaning Hours 690 $241.00 $166,290.00 $210.50 $145,245.00 $223.00 $153,870.00 $442.00 $304,980.00 Laborer Hours 120 $97.00 $11,640.00 $75.00 $9,000.00 $91.00 $10,920.00 $95.00 $11,400.00 Traffic Control w/Flagging Hours 340 $90.00 $30,600.00 $111.80 $38,012.00 $120.00 $40,800.00 $95.00 $32,300.00 Absorb Liquid Hold Each 3 $56.55 $169.65 $60.00 $180.00 $58.00 $174.00 $2,400.00 $7,200.00 Absorbent Material Est 1 $800.00 $800.00 $800.00 $800.00 $800.00 $800.00 $800.00 $800.00 Debris Transfer Hours 125 $241.00 $30,125.00 $210.50 $26,312.50 $223.00 $27,875.00 $347.00 $43,375.00 Total Annual Bid $239,624.65 $219,549.50 $234,439.00 $400,055.00 CHECKUST Competitive bids were opened on February 9th,2024. I Bid Proposal Checklist X X x hereby certify to the best of my ability that this is a true and Bid Proposal Form X X x correct bid tabulation for the Storm Drain Cleaning Services Addendas Acknowledged contract 24-040. Cert-Wage Pymt.Compliance X X x Contractor Info X X x n Bid Qualifications X X x (i(�( Subcontractor List Cory Olson Bid Bond X X x Engineering Technician/Contract Manager Reps&Certs X X x Note:Highlighted cells have been corrected for math errors 2/12/2024 P:\Public Works\01 Administration\Contracting\2024\Storm Drain Cleaning\SDC Bid Documents 2024\Bid Tab\2024 SDC-Bid Tabulation BID PROPOSAL STORM DRAIN CLEANING SERVICES Having carefully examined the Request for Bid and Specifications, the undersigned proposes to furnish Storm Drain Cleaning Services and meet all other terms and conditions of this Request for Proposals and referenced Specifications within (30) days of full execution of such Agreement for unit price amounts set forth below. Task/Item Est. Unit Unit Price Annual Bid Qty Structure Cleaning 690 Hours ,/2/0 se $/ 44S 2 9S Laborer 120 Hours . 7.S' $ q O O O Traffic Control 340 Hours 41',r// $ 3g 0/2. w/Flagging Absorb Liquid Hold 3 Each it 60 $ / 80 Absorbent Material I Est $800.00 $ 800 Debris Transfer 125 Hours "2/0 S� $ 2 S/2 Total Annual Bid: $ 2, / SS�p'_---� NOTE: The quantities of work listed in the Bid Schedule are for bid comparison between bidders only. The City does not guarantee a minimum specified amount of work for this contract. The undersigned inc.ividual represents and warrants that he or she is duly authorized to execute the bid on behalf of any��// partnership,joint venture, or corporation. Company Name: ,IMA S e < ' Street Address: 3808 4/,,S / ,'v /7eJ . 7 /o 7 — 8 City, State, & Zip Code: — 5 e A , e X 1(6/ i _ 1 9 2 / 6 Signature: Printed Name& Title: ,�r�e '`�' 7� s,��� 4j 4 * 60,— Phone Number: 9 — g Z,2 ^/3 e5. 3 Email Address: ,e/45) g.,r q _.t'-�t+�•e,a _.• e oft__ Date: /.$-4_3, City of Spokane Valley 3 Hid Proposal Documents 24-040-Storm Drain Cleaning Services EXHIBIT D INSURANCE ENDORSEMENTS Provided Services: Storm Drain Cleaning Services Purchased Services Agreement Contract No.:24-040 Insurance Endorsements Client#: 1926592 AAASWE2 ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)• 3/12/2024 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Sage Ryan-Wutherich USI Insurance Services NW PHONE 208-917-5692 FAX 610-362-8530 (A/C,No,Ext): (A/C No): 9016 E. Indiana Ave.,Suite A E-MAIL ADDRESS: ry sag e. an-wutherich@usi.com Spokane Valley,WA 99212 INSURER(S)AFFORDING COVERAGE NAIL# 509 456-2648 Alaska National Insurance Com an 38733 INSURER A: Company INSURED INSURER B:Westchester Surplus Lines Insurance Co. 10172 AAA Sweeping, LLC INSURER C:Navigators Specialty S ecial Insurance Co. 36056 PO Box 624 INSURER D Veradale,WA 99037 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 EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY X X 23JPS30908 10/19/2023 10/19/2024 EACH OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR PREMISES(Ea occur ence) $100,000 X PD Ded:1,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO PRODUCTS-COMP/OP AGG $2,000,000 POLICY X JECT LOC OTHER: WA Stop Gap $1,000,000 A AUTOMOBILE LIABILITY X X 23JAS30908 10/19/2023 10/19/2024 (o°aBccideD SINGLE LIMIT $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ _ AUTOS ONLY _ AUTOS $ HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY (Per accident) $ A )( UMBRELLA LIAB X OCCUR X X 23JLU30908 10/19/2023 10/19/2024 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A L/R/H 23JPS30908 10/19/2023 10/19/2024 $100,000/$5,000ded B Pollution G24330746012 10/19/2023 10/19/2024 $1,000,000/$5,000ded C Excess SE23EXCZOOQJBIC 10/19/2023 10/19/2024 $5,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached it more space is required) RE:City of Spokane Valley Storm Drain Cleaning Services Contract 24-040 The General Liability and Automobile Liability policies includes an automatic Additional Insured endorsement that provides Additional Insured status to the Certificate Holder only when there is a written contract that requires such status,and only with regard to work performed by or on behalf of the named insured.The General Liability policy contains a special endorsement with Primary and Noncontributory (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION Cityof Spokane ValleySHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE P THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10210 E Sprague Ave. ACCORDANCE WITH THE POLICY PROVISIONS. Spokane Valley,WA 99206 AUTHORIZED REPRESENTATIVE l . /q ( ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #544027666/M42337176 RAKZR DESCRIPTIONS (Continued from Page 1) wording,when required by written contract.The General Liability and Automobile Liability policies includes a Waiver of Subrogation endorsement in favor of the Certificate Holder as referenced above. SAGITTA 25.3(2016/03) 2 of 2 #S44027666/M42337176 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 13. Blanket Waiver of Subrogation 8 additional insured extensions. Waiver of subrogation where required by written contract or written agreement. Primary and Noncontributory Insurance 14. In Rem Actions 2. Damage To Premises Rented to You Limit increased to$500,000. 15. Voluntary Property Damage Limits added: $5,000 occurrence, $10,000 3. Medical Payments aggregate. Limits increased to$15,000. Reporting period increased to three years from 1. MISCELLANEOUS ADDITIONAL INSUREDS the date of accident. Section II Who Is An Insured is amended to 4. Non-owned Watercraft include as an additional Insured any person or Increased to 50 feet. organization described in Paragraphs 2.a. through 2.h. below whom you are required to add 5. Supplementary Payments as an additional insured on this policy under a Cost of bail bonds increased to$10,000. written contract or written agreement. However, Daily loss of earnings increased to$500. the written contract or written agreement must be: 6. Newly Formed Or Acquired Organizations 1. Currently in effect or becoming effective Coverage extended to the end of the policy period during the term of this policy;and or the next anniversary of this policy's effective date. 2. Executed prior to the "bodily injury", "property damage"or"personal injury and 7. Liberalization Clause advertising injury", but 8. Unintentional Failure To Disclose Hazards Only the following persons or organizations are additional insureds under this 9. Notice of Occurrence endorsement and coverage provided to such additional insureds is limited as provided 10. Broad Knowledge of Occurrence herein: 11. Bodily Injury-Extension of Coverage a. State or Governmental Agency or Subdivision or Political Subdivi- 12. Expected Or Intended Injury sions Reasonable force - bodily injury or property damage. ANIC GL 1187 08 21 Page 1 of 7 Any state or governmental agency or (2) Structural alterations, new con- subdivision or political subdivision struction or demolition operations that has issued a permit in performed by or on behalf of connection with operations performed such additional insured. by you or on your behalf and that you are required by any ordinance, law or d. Mortgagee,Assignee or Receiver building code to include as an additional insured on this coverage A mortgagee, assignee or receiver part is an additional insured, but only but only with respect to their liability with respect to liability for "bodily as mortgagee, assignee, or receiver injury", "property damage", "personal and arising out of the ownership, and advertising injury" arising out of maintenance, or use of a premises by such operations. you. The insurance provided to such state This insurance does not apply to or political subdivision does not apply structural alterations, new construc- to any "bodily injury", "property tion or demolition operations damage"or"personal and advertising performed by or for such additional injury" arising out of operations insured. performed for that state or political subdivision. e. Owners or Other Interests From Whom Land Has Been Leased b. Controlling Interest An owner or other interest from whom Any persons or organizations with a land has been leased by you but only controlling interest in you but only with respect to liability arising out of with respect to their liability arising the ownership, maintenance or use of out of: that specific part of the land leased to you and subject to the following (1) Their financial control of you,or additional exclusions: (2) Premises they own, maintain or This insurance does not apply to: control while you lease or occupy these premises. (1) Any "occurrence" which takes place after you cease to lease This insurance does not apply to that land;or structural alterations, new construc- tion and demolition operations (2) Structural alterations, new con- performed by or for such additional struction or demolition operations insured. performed by or on behalf of such additional insured. c. Managers or Lessors of Premises f. Co-owner of Insured Premises A manager or lessor of premises but only with respect to liability arising out A co-owner of a premises co-owned of the ownership, maintenance or use by you and covered under this of that specific part of the premises insurance but only with respect to the leased to you and subject to the co-owners liability as co-owner of following additional exclusions: such premises. This insurance does not apply to: (1) Any "occurrence" which takes place after you cease to be a tenant in that premises; or ANIC GL 1187 08 21 Page 2 of 7 g. Lessor of Equipment Such person(s) or organization(s) is an additional insured only with Any person or organization from respect to liability for "bodily injury", whom you lease equipment. Such "property damage" or "personal and person or organization is an advertising injury" caused, in whole or additional insured only with respect to in part, by: their liability for "bodily injury", "property damage" or "personal and a. Your acts or omissions; or Advertising injury" caused, in whole or in part, by your maintenance, oper- b. The acts or omissions of ation or use of equipment leased to those acting on your behalf; you by such person or organization. or A person's or organization's status as an additional insured under this c. "Your Work" performed for endorsement ends when their written the additional insured contract or written agreement with described in Paragraph 1. or you for such leased equipment ends. 2. above and included in the "products-completed With respect to the insurance operations hazard." afforded these additional insureds, the following additional exclusions In the performance of your ongoing apply: operations or completed operations for the additional insured described in This insurance does not apply: Paragraph 1. or 2. above. (1) To any "occurrence" which takes However, the insurance afforded to place after the equipment lease such additional insured described expires;or above: (2) To "bodily injury", "property a. Only applies to the extent damage", or "personal and permitted by law;and advertising injury" arising out of the sole negligence of such b. Will not be broader than that additional insured. which you are required by the contract or agreement to h. Owners, Lessees or Contractors — provide for such additional Ongoing Operations and insured. Completed Operations 3. With respect to the insurance 1. Any person or organization for afforded to these additional whom you are performing insureds, the following additional operations or have performed exclusions apply: operations when you and such person or organization have This insurance does not apply to: agreed in writing in a contract or agreement that such person or 1. "Bodily injury", "property organization be added as an damage" or "personal and additional insured on your policy; advertising injury" arising out and of the rendering of, or the failure to render, any 2. Any other person or organization professional architectural, you are required to add as an engineering or surveying additional insured under the services, including: contract or agreement described in Paragraph 1.above. ANIC GL 1187 08 21 Page 3 of 7 a. The preparing, Section III - Limits of Insurance, the following is approving, or failing to added: prepare or approve, maps, shop drawings, With respect to the insurance afforded to the opinions, reports, additional insureds described in Paragraphs a. surveys, field orders, through h. above, the most we will pay on behalf change orders or of such additional insured is the amount of drawings and specifica- insurance: tions; or (1) Required by the contract or b. Supervisory, inspection, agreement; or architectural or engineering activities. (2) Available under the applicable Limits of Insurance shown in the This exclusion applies even if Declarations; the claims against any insured allege negligence or whichever is less. other wrongdoing in the supervision, hiring, employ- This provision shall not increase the applicable ment, training or monitoring Limits of Insurance shown in the Declaration. of others by that insured, if the "occurrence" which 2. Damage To Premises Rented to You caused the "bodily injury" or "property damage", or the SECTION III — LIMITS OF INSURANCE, offense which caused the Paragraph 6. is replaced by the following: "personal and advertising injury", involved the rendering 6. Subject to Paragraph 5. above, the of, or the failure to render, Damage to Premises Rented to You Limit any professional is the most we will pay under Coverage A architectural, engineering or for damages because of "property surveying services. damage" to any one premises, while rented to you, or in the case of damage Primary And Noncontributory Insurance by fire, while rented to you or temporarily occupied by you with permission of the The following is added to the Other Insurance owner. Condition and supersedes any provision to the contrary: If a limit is shown for Damage to Premises Rented to You the most we will pay under This insurance is primary to and will not seek Coverage A for damages because or "property contribution from any other insurance available to damage" to any one premises is the Limit shown an additional insured under your policy provided in the Declarations or $500,000, whichever is that: greater. (1) The additional insured is a 3. MEDICAL PAYMENTS Named Insured under such other insurance;and A. Section III—Limits of Insurance, Paragraph 7.is replaced by the following: (2) You have agreed in writing in a contract or agreement that this 7. Subject to Paragraph 5. above the insurance would be primary and Medical Expense Limit is the most we will would not seek contribution from pay under Coverage C for all medical any other insurance available to expenses because of "bodily injury" the additional insured. sustained by any one person. ANIC GL 1187 08 21 Page 4 of 7 If a limit is shown for Medical Expense in 5. SUPPLEMENTARY PAYMENTS the Declarations the most we will pay under Coverage C for all medical A. Under Section I -Supplementary Payments expenses because of "bodily injury" - Coverage A and B, Paragraph 1.b., the sustained by any one person is the Limit limit of$250 shown for the cost of bail bonds shown in the Declarations or $15,000, is replaced by$10,000; whichever is greater. B. In Paragraph 1.d.,the limit of$250 shown for B. This provision 5. (Medical Payments) does daily loss of earnings is replaced by$500. not apply if Section I - Coverage C Medical Payments is excluded either by the 6. NEWLY FORMED OR ACQUIRED provisions of the Coverage Part or by ORGANIZATIONS endorsement. Paragraph 3.a.of Section II-Who Is An Insured C. Paragraph 1.a.(3)(b) of Section I -Coverage is deleted and replaced by the following: C - Medical Payments, is replaced by the following: Coverage under this provision is afforded only until the end of the policy period or the next (b) The expenses are incurred anniversary of this policy's effective date after you and reported to us within acquire or form the organization, whichever is three years of the date of the earlier. accident; and 7. LIBERALIZATION CLAUSE 4. NON-OWNED WATERCRAFT If we adopt a change in our forms or rules which A. If endorsement CG 21 09, CG 21 10, CG 24 would broaden coverage for contractors under 50, or CG 24 51 is attached to the policy, this endorsement without an additional premium Paragraph A. 2. g. (2) (b) is replaced by the charge, your policy will automatically provide the following: additional coverages as of the date the revision is effective in your state. (b) A watercraft that you do not own that is: 8. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS (I) Less than 50 feet long: and SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS — Paragraph 6. — (ii) Not being used to carry Representations is replaced by the following: persons or property for a charge. 6. Representations B. If Paragraph A. does not apply, Paragraph g. By accepting this policy,you agree: (2) of 2. EXCLUSION under SECTION I — COVERAGES, COVERAGE A — BODILY a. The statements in the Declarations are INJURY AND PROPERTY DAMAGE accurate and complete; LIABILITY is replaced by the following: b. Those statements are based upon (2) A watercraft that you do not own representations you made to us; and that is: c. We have issued this policy in reliance (a) Less than 50 feet long; and upon your representations. (b) Not being used to carry persons or property for a charge. ANIC GL 1187 08 21 Page 5 of 7 The unintentional omission of, or (4) A manager, if you are a limited unintentional error in, any information you liability company. provided to us which we relied upon in issuing this policy will not prejudice your 11. EXPANDED BODILY INJURY rights under this insurance. However, this provision does not affect our right to collect Section V - Definitions, the definition of "bodily additional premium or to exercise our rights of injury" is changed to read: cancellation or nonrenewal in accordance with applicable laws and regulations. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including death, 9. NOTICE OF OCCURRENCE humiliation, shock, mental anguish or mental injury by that person at any time which results as The following is added to Paragraph 2.of Section a consequence of the bodily injury, sickness or IV - Commercial General Liability Conditions - disease. Duties In The Event of Occurrence, Offense, Claim or Suit: 12. EXPECTED OR INTENDED INJURY Your rights under this Coverage Part will not be Exclusion a. of Section I - Coverage A - Bodily prejudiced if you fail to give us notice of an Injury and Property Damage Liability is "occurrence", offense, claim or "suit" and that replaced by the following: failure is solely due to your reasonable belief that the "bodily injury" or "property damage" is not a. "Bodily injury" or "property damage" covered under this Coverage Part. However, you expected or intended from the shall give written notice of this "occurrence", standpoint of the insured. This offense, claim or "suit" to us as soon as you are exclusion does not apply to "bodily aware that this insurance may apply to such injury" or"property damage" resulting "occurrence", offense,claim or"suit." from the use of reasonable force to protect persons or property. 10. BROAD KNOWLEDGE OF OCCURRENCE 13. BLANKET WAIVER OF SUBROGATION The following is added to Paragraph 2.of Section IV - Commercial General Liability Conditions - The Transfer Of Rights Of Recovery Against Duties in The Event of Occurrence, Offense, Others To Us Condition (Section IV - Claim or Suit: Commercial General Liability Conditions) is amended by the addition of the following: You must give us or our authorized representative notice of an "occurrence", offense, claim, or"suit" We waive any right of recovery against any only when the "occurrence", offense, claim or person or organization, because of any payment "suit' is known to: we make under this Coverage Part, to whom the insured has waived its right of recovery in a (1) You, if you are an individual; written contract or agreement. Such waiver by us applies only to the extent that the insured has (2) A partner, if you are a waived its right of recovery against such person partnership; or organization prior to loss. (3) An executive officer or the employee designated by you to give such notice, if you are a corporation; or ANIC GL 1187 08 21 Page 6 of 7 14. IN REM ACTIONS For the purpose of this coverage only, Section I— Coverage A — Bodily Injury and Property Any action in rem against any vessel owned, Damage Liability 2. Exclusions J. (4.) is operated by or for, or chartered by or for you will deleted. be treated in the same manner as though the action were in personam against you. As respects coverage afforded under Voluntary Property Damage, the following is added to 15. VOLUNTARY PROPERTY DAMAGE Section III—Limits of Insurance: The following is added, Section I—Coverage A— Regardless of the number of insureds, claims or Bodily Injury and Property Damage Liability 1., "suits" brought, or persons or organizations Insuring Agreement: making claims or bringing"suits": We will pay, at your request, for "property 1. Subject to 2. Below, the most we will pay for damage" to property of others while in the care, "property damage" arising from any one custody or control of an insured, arising out of "occurrence" arising out of "property damage your business operations away from your to property of others caused by you and while insured premises for which this policy is written in your care, custody or control is$5,000. and occurring during the policy period. 2. The most we will pay for the sum of all However, the "property damage" must be the "property damage" in an annual policy period result of unintentional damage or destruction but is $10,000. This amount is part of and not in does not include disappearance, theft, or loss of addition to the General Aggregate Limit use. described in Paragraph 2. of Section III — Limits of Insurance. You agree with us that we shall have no duty to defend any claims and/or "suits" for which the only coverage provided is under this coverage extension. Includes copyrighted material of Insurance Services Office, Inc., with its permission ANIC GL 1187 08 21 Page 7 of 7 Alaska National INSURANCE COMPANY BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM Various provisions in this endorsement restrict subrogation against that person or coverage. Read the entire policy carefully to organization is waived prior to the "accident" determine rights, duties, and what is and is not or the "loss" under a contract with that person covered. or organization. Throughout this policy, the words "you" and "your" SECTION II — COVERED AUTO LIABILITY refer to the Named Insured shown in the COVERAGE, Paragraph A.2.a. (2) —Supplementary Declarations. The words "we", "us", and "our" refer to Payments is replaced by the following: the company providing this insurance. (2) Up to $10,000 for cost of bail bonds Other words and phrases that appear in quotation (including bonds for related traffic law marks have special meaning. Refer to SECTION V— violations) required because of an DEFINITIONS in the Business Auto Coverage Form. "accident"we cover. We do not have The coverages provided by this endorsement apply to furnish these bonds. per "accident" and, unless otherwise specified, are SECTION II — COVERED AUTO LIABILITY subject to all of the terms, conditions, exclusions and COVERAGE, Paragraph A.2.a. (4) —Supplementary deductible provisions of the policy, to which it is Payments is replaced by the following: attached. (4) All reasonable expenses incurred by SECTION II — COVERED AUTO LIABILITY the "insured"at our request, including COVERAGE, Paragraph A.1. Who Is An Insured is actual loss of earnings up to $500 a amended to include: day because of time off from work. d. Any "employee" of yours while operating SECTION II — COVERED AUTO LIABILITY an"auto" hired or rented under a contract COVERAGE, Paragraph A.2.c. —Voluntary Property or agreement in an "employee's" name, Damage is added as follows: with your permission, while performing c. Voluntary Property Damage duties related to the conduct of your business. At your written request, we may make a voluntary payment for Property Damage e. Any person or organization for whom you caused by an "insured", but without have agreed in writing to provide liability to a third party, up to$25,000. We insurance such as is afforded by this will not make a Voluntary Property Coverage Form, but only with respect to Damage payment to anyone who is an liability arising out of the ownership, "insured"under this policy. maintenance or use of"autos"covered by SECTION III — PHYSICAL DAMAGE COVERAGE, this policy. If such person or organization has other insurance then this insurance is Paragraph A.2. —Towing is replaced by the following: primary to and we will not seek Towing contribution from the other insurance. We will pay up to $500 for towing and labor SECTION IV — Business Auto Conditions, costs incurred each time a covered "auto" Paragraph A. 5. — Transfer of Rights of Recovery that is a: Against Others To Us is amended to include: a. Private passenger; 5. Transfer of Rights of Recovery Against Others to Us This condition does not apply to any person(s) or organization(s)to the extent that ANIC CA 1150 10 13 Page 1 of 4 Alaska National k INSURANCE COMPANY b. Truck; (3) Pick-up truck; c. Pick-up truck; (4) Panel; or d. Panel; or (5) Van e. Van type vehicle under 20,000 lbs. of Gross type vehicle under 20,000 lbs. of Gross Vehicle Weight. We will pay only for Vehicle Weight is disabled. However, the those covered "autos"for which you carry labor must be performed at place of either Comprehensive or Specified disablement. Causes of Loss Coverage. We will pay for temporary transportation expenses SECTION III — PHYSICAL DAMAGE COVERAGE, incurred during the period beginning 48 Paragraph A.3. — Glass Breakage — Hitting a Bird hours after the theft and ending, or Animal — Falling Objects or Missiles is replaced regardless of the policy's expiration, by the following: when the covered "auto" is returned to Glass Breakage—Hitting a Bird or Animal use or we pay for its"loss". —Falling Objects or Missiles SECTION III — PHYSICAL DAMAGE COVERAGE, If you carry Comprehensive Coverage for the Paragraph A.4.b. — Loss of Use Expenses is damaged covered "auto", we will pay the replaced by the following: following under Comprehensive Coverage: b. Loss of Use Expenses—Hired, Rented, a. Glass Breakage; or Borrowed Automobiles b. "Loss"caused by hitting a bird or animal; We will pay expenses for which an and "insured" becomes legally responsible to c. "Loss" caused by falling objects or pay for loss of use of a vehicle hired, missiles. rented or borrowed without a driver under a written rental contract or agreement. However, you have the option of having glass We will pay for loss of use expenses, if breakage caused by a covered "auto's" caused by: collision or overturn considered a"loss"under Collision Coverage. (1) Other than Collision, only if the Declarations indicate that Glass Repair—Waiver of Deductible Comprehensive Coverage is provided No deductible applies to glass breakage, if for the vehicle withdrawn from the glass is repaired rather than replaced. service. SECTION III — PHYSICAL DAMAGE COVERAGE, (2) Specified Causes of Loss only if the Paragraph A.4.a. — Transportation Expenses is Declarations indicate that Specified replaced by the following: Causes of Loss Coverage is provided a. Transportation Expenses for the vehicle withdrawn from service. We will pay up to $200 per day to a maximum of $1,500 for temporary (3) Collision only if the Declarations transportation expense incurred by you indicate that Collision Coverage is because of the total theft of a covered provided for the vehicle withdrawn "auto"that is a: from service. (1) Private passenger; (2) Truck; ANIC CA 1150 10 13 Page 2 of 4 Alaska 111aiwonal t INSURANCE COMPANY However, the most we will pay for any (2) Truck; expenses for loss of use is$200 per day, to a (3) Pick-up truck; maximum of$1,500. SECTION III — PHYSICAL DAMAGE COVERAGE, (4) Panel; or Paragraph A.4.c. —Non-Transportation Loss of Use (5) Van Expenses is added as follows: type vehicle under 20,000 lbs. of Gross c. Non-Transportation Loss of Use Vehicle Weight. Payment applies in Expenses addition to the otherwise applicable amount of each coverage you have on a We will pay up to $2,000 for non- covered "auto". No deductibles apply to transportation expense incurred by you, this coverage. because of "loss" to a covered "auto", if caused by: (1) We will pay only for those expenses (1) Other than Collision, only if the incurred during the policy period Declarations indicate that beginning 24 hours after the "loss" Comprehensive Coverage is provided and ending, regardless of the policy's expiration, with the lesser of the for the"auto"withdrawn from service; following number of days: (2) Specified Causes of Loss only if the (a) The number of days reasonably Declarations indicate that Specified required to repair or replace the Causes of Loss Coverage is provided covered "auto". for the "auto"withdrawn from service; or (b) 30 days. (3) Collision only if the Declarations (2) This coverage does not apply while indicate that Collision Coverage is there are spare or reserve "autos" provided for the "auto" withdrawn available to you for your operations. from service. (3) The Rental Reimbursement Cov- SECTION III — PHYSICAL DAMAGE COVERAGE, erage described above does not Paragraph A.4.d. — Airbag Coverage is added as apply to a covered "auto" that is follows: described or designated as a covered "auto" on Rental Reimbursement d. Airbag Coverage Coverage Form CA 99 23. We will pay for the cost to repair, replace, SECTION IV — BUSINESS AUTO CONDITIONS — or reset an airbag that inflates for any Paragraph B.2. —Concealment, Misrepresentation Or reason other than as a result of a Fraud is amended by adding Unintentional Failure collision, if the Declarations indicate that to Disclose Hazards at the end of Paragraph B.2. as the covered "auto" has Comprehensive follows: Coverage or Specified Causes of Loss Coverage. Unintentional Failure to Disclose Hazards SECTION III — PHYSICAL DAMAGE COVERAGE, If you unintentionally fail to disclose any Paragraph A.4.e. — Rental Reimbursement hazards existing at the inception date of your Coverage is added as follows: policy, we will not deny coverage under this Coverage Form because of such failure. e. Rental Reimbursement Coverage However, this provision does not affect our We will pay up to $75 per day for rental right to collect additional premium or exercise reimbursement expenses incurred by you our right of cancellation or non-renewal. for the rental of an "auto" because of "loss"to a covered"auto"that is a: (1) Private Passenger; ANIC CA 1150 10 13 Page 3 of 4 • Alaska National INSURANCE COMPANY SECTION IV — BUSINESS AUTO CONDITIONS — SECTION V — DEFINITIONS — Paragraph C. — Paragraph B.5.b. — Other Insurance is replaced by "Bodily injury" is replaced by the following: the following: C. "Bodily injury" means bodily injury, sickness or b. For Hired Auto Physical Damage disease sustained by a person including death or Coverage, the following are deemed to mental anguish resulting from any of these. be covered"autos"you own: Mental anguish means any type of mental or (1) Any covered "auto" you lease, hire, emotional illness or disease rent, or borrow; and (2) Any covered "auto"" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any"auto" that is leased, hired, rented or borrowed with a driver is not a covered"auto". ANIC CA 1150 10 13 ©Insurance Services Office, Inc., 2009 Page 4 of 4 EXHIBIT E PERFORMANCE AND PAYMENT BONDS Provided Services: Storm Drain Cleaning Services Purchased Services Agreement Contract No.:24-040 Performance and Payment Bonds Exhibit E -Performance and Payment Bond ROF .000Vier al BOND NO: 107866697 CONTRACTOR'S PERFORMANCE AND PAYMENT BOND TO DUAL OBLIGEES KNOW ALL MEN BY THESE PRESENTS,that MA Sweeping, L.L.C. (Contractor),as Principal,and Travelers Casualty and Surety Company of America (Bonding Company), as Surety,a corporation of Connecticut ,whose principal office is located at One Tower Square, Hartford,CT 06183 . are firmly bound unto the State of Washington and the City of Spokane Valley,a political subdivision the State of Washington,as Obligees,to fulfill the obligations of the Principal and the Surety under the Contract to which reference is hereafter made,in the amount of$ 219,549.50 (including Washington State sales tax)for payment whereof Principal and Surety bind themselves,their heirs,executors,administrators,successors and assigns jointly and severally,firmly by these presents. WHEREAS,Principal has by written Proposal dated 2-5-2024 _offered to enter into a Contract with the City of Spokane Valley for Contract No.24-040 pursuant to the terms and conditions set forth in the Contract Documents dated NOW,THEREFORE,the condition of this obligation is such that if the Principal shall faithfully perform all the provisions of the Contract on its part,and pay all laborers,mechanics,subcontractors and material suppliers,and all persons who supply such person or persons or subcontractors with provisions and supplies for the carrying on of such work,and indemnify and hold harmless the Obligees from all loss,cost or damage which it may suffer by reason of the failure to do any of the foregoing,then this obligation shall be null and void;otherwise it shall remain in full force and effect. All persons who have furnished labor,materials or supplies for use in and about the work provided for in the Contract shall have a direct right of action under this bond,to the extent and in the manner set forth in RCW 39.08. The said Surety for value received hereby stipulates and agrees that no change,extension of time,alteration or addition to the terms of the Contract or to the WORK to be performed thereunder or the SPECIFICATIONS accompanying the same shall in any way affect its obligation on this BOND,and it does hereby waive notice of any such change.extension of time,alteration or addition to the terms of the Contract or to the WORK or to the SPECIFICATIONS. No final settlement between the OWNER and the CONTRACTOR shall abridge the right of any beneficiary hereunder. whose claim may be unsatisfied. SIGNED AND SEALED THIS 8th DAY OF March YEAR 20 24 . Travelers Casualty and Surety Company of America AAA Sweeping, L.L.C. SURETY PRINCIPAL '1)1cMCjak_QnS,:kt Signature Signature Roxana Palacios Bret Sargent Typed Name Typed Name Attorney-in-Fact Managing Member Title (SEAL) Title Travelers Casualty and Surety Company of America .A� Travelers Casualty and Surety Company TRAVELERS J St. Paul Fire and Marine Insurance Company POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein collectively called the"Companies"),and that the Companies do hereby make,constitute and appoint Roxana Palacios of SEATTLE , Washington , their true and lawful Attorney(s)-in-Fact to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF,the Companies have caused this instrument to be signed,and their corporate seals to be hereto affixed,this 21st day of April, 2021. Iv e` II r- tociat. O4 r 1 State of Connecticut By: City of Hartford ss. Robert L.Rane , enior Vice President On this the 21st day of April, 2021, before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior Vice President of each of the Companies, and that he, as such, being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of said Companies by himself as a duly authorized officer. IN WITNESS WHEREOF,I hereunto set my hand and official seal. kP autezd My Commission expires the 30th day of June,2026 Anna P.Nowik,Notary Public 4�1T�c This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of each of the Companies,which resolutions are now in full force and effect,reading as follows: RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President,any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her;and it is FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary;and it is FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary; or (b) duly executed (under seal, if required) by one or more Attorneys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority;and it is FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President,any Assistant Vice President,any Secretary,any Assistant Secretary,and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys-in- Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached. I, Kevin E. Hughes, the undersigned, Assistant Secretary of each of the Companies, do hereby certify that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies,which remains in full force and effect. Dated this 8th day of March , 2024 . 'Lfr Aqo py r : r Off, "+6 ,.— + • 11/ Kevin E.Hughes,Assi tant Secretary To verify the authenticity of this Power of Attorney,please call us at 1-800-421-3880. Please refer to the above-named Attorneys)-in-Fad and the details of the bond to which this Power of Attorney is attached. Client#: 1926592 AAASWE2 2-L1go ACORD,,., CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 10/22/2024 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER USI Insurance Services NW CL CONTACT NAME: Jordynn Crouse ?,"�"N EM 509-606-0245 FAX ac ",: 610-362-8530 601 Union Street, Suite 1000 E-MAIL ADDRESS: JordY nn.Crouse usi.com Seattle, WA 98101 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Alaska National Insurance Company 38733 INSURED INSURER B : Steadfast Insurance Company 26387 AAA Sweeping, LLC INSURER C : Westchester Surplus Lines Insurance Co. 10172 PO Box 624 Veradale, WA 99037 INSURER D : 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 CONTRACTOR 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 LTR TYPE OF INSURANCE ADDLSUBR INSR WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY X X 24JPS30908 0/19/2024 10/19/2025 EACHOCCURRENCE $1 000 000 CLAIMS -MADE �X OCCUR PREMISES ERENTED occu ence $100 000 X MED EXP (Any one person) $5,000 PD Ded:1,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY FXI JECOT LOC PRODUCTS - COMP/OP AGG $2,000,000 WA StopGap $1,000,000 OTHER: A AUTOMOBILE LIABILITY X X 24JAS30908 0/19/2024 10/19/202 MBINED Ea acciden SINGLE LIMIT 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ OWNED SCHEDULED AUTOS ONLY AUTOS X AUTOS ONLY X NON -OWNED AUTOS ONLY PROPERTY DAMAGE (per. $ $ A X UMBRELLA LIAB X OCCUR X X 24JLU30908 10/19/2024 10119/2025 EACH OCCURRENCE s5,000,000 AGGREGATE s5,000,000 EXCESS LIAB CLAIMS -MADE DIED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNEWEXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N / A _ PER OUTE TH- T E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) E.L. DISEASE - POLICY LIMIT I $ If yes, describe under DESCRIPTION OF OPERATIONS below B Excess Liability AEC318087300 10/19/2024 10/19/202 $5,000,000 A UR/H 24JIA30908 0/19/2024 10/19/202 $100,000/$5,000 ded C Pollution Liab G24330746013 10/19/2024 10/19/202 $1 000 000/$5 000 ded DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached II mom space is required) RE: City of Spokane Valley Storm Drain Cleaning Services Contract 24-040 The General Liability and Automobile Liability policies includes an automatic Additional Insured endorsement that provides Additional Insured status to the Certificate Holder only when there is a written contract that requires such status, and only with regard to work performed by or on behalf of the named insured. The General Liability policy contains a special endorsement with Primary and Noncontributory wording, when required by written contract. (See Attached Descriptions) City of Spokane Valley 10210 E Sprague Ave. Spokane Valley, WA 99206-0000 LgdU Pf lal arG\ 116191 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) 1 of 2 #S46773693/M46769307 © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SLSZR DESCRIPTIONS (Continued from Page 1) The General Liability and Automobile Liability policies includes a Waiver of Subrogation endorsement in favor of the Certificate Holder as referenced above. SAGITTA 25.3 (2016/03) 2 of 2 #S46773693/M46769307 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 13. Blanket Waiver of Subrogation 8 additional insured extensions. Waiver of subrogation where required by written contract or written agreement. Primary and Noncontributory Insurance 2. Damage To Premises Rented to You Limit increased to $500,000. 3. Medical Payments Limits increased to $15,000. Reporting period increased to three years from the date of accident. 4. Non -owned Watercraft Increased to 50 feet. 5. Supplementary Payments Cost of bail bonds increased to $10,000. Daily loss of earnings increased to $500. 6. Newly Formed Or Acquired Organizations Coverage extended to the end of the policy period or the next anniversary of this policy's effective date. 7. Liberalization Clause 8. Unintentional Failure To Disclose Hazards 9. Notice of Occurrence 10. Broad Knowledge of Occurrence 11. Bodily Injury - Extension of Coverage 12. Expected Or Intended Injury Reasonable force - bodily injury or property damage. 14. In Rem Actions 15. Voluntary Property Damage Limits added: $5,000 occurrence, $10,000 aggregate. 1. MISCELLANEOUS ADDITIONAL INSUREDS Section II Who Is An Insured is amended to include as an additional Insured any person or organization described in Paragraphs 2.a. through 2.h. below whom you are required to add as an additional insured on this policy under a written contract or written agreement. However, the written contract or written agreement must be: 1. Currently in effect or becoming effective during the term of this policy; and 2. Executed prior to the "bodily injury", "property damage" or "personal injury and advertising injury", but Only the following persons or organizations are additional insureds under this endorsement and coverage provided to such additional insureds is limited as provided herein: a. State or Governmental Agency or Subdivision or Political Subdivi- sions ANIC GL 1187 08 21 Page 1 of 7 Any state or governmental agency or subdivision or political subdivision that has issued a permit in connection with operations performed by you or on your behalf and that you are required by any ordinance, law or building code to include as an additional insured on this coverage part is an additional insured, but only with respect to liability for "bodily injury", "property damage", "personal and advertising injury" arising out of such operations. The insurance provided to such state or political subdivision does not apply to any "bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for that state or political subdivision. b. Controlling Interest Any persons or organizations with a controlling interest in you but only with respect to their liability arising out of: (1) Their financial control of you, or (2) Premises they own, maintain or control while you lease or occupy these premises. This insurance does not apply to structural alterations, new construc- tion and demolition operations performed by or for such additional insured. c. Managers or Lessors of Premises A manager or lessor of premises but only with respect to liability arising out of the ownership, maintenance or use of that specific part of the premises leased to you and subject to the following additional exclusions: This insurance does not apply to: (1) Any "occurrence" which takes place after you cease to be a tenant in that premises; or (2) Structural alterations, new con- struction or demolition operations performed by or on behalf of such additional insured. d. Mortgagee, Assignee or Receiver A mortgagee, assignee or receiver but only with respect to their liability as mortgagee, assignee, or receiver and arising out of the ownership, maintenance, or use of a premises by you. This insurance does not apply to structural alterations, new construc- tion or demolition operations performed by or for such additional insured. e. Owners or Other Interests From Whom Land Has Been Leased An owner or other interest from whom land has been leased by you but only with respect to liability arising out of the ownership, maintenance or use of that specific part of the land leased to you and subject to the following additional exclusions: This insurance does not apply to: (1) Any `occurrence" which takes place after you cease to lease that land; or (2) Structural alterations, new con- struction or demolition operations performed by or on behalf of such additional insured. f. Co-owner of Insured Premises A co-owner of a premises co -owned by you and covered under this insurance but only with respect to the co -owners liability as co-owner of such premises. ANIC GL 1187 08 21 Page 2 of 7 g. Lessor of Equipment Such person(s) or organization(s) is an additional insured only with Any person or organization from respect to liability for "bodily injury", whom you lease equipment. Such "property damage" or "personal and person or organization is an advertising injury" caused, in whole or additional insured only with respect to in part, by: their liability for "bodily injury", "property damage" or "personal and a. Your acts or omissions; or Advertising injury" caused, in whole or in part, by your maintenance, oper- b. The acts or omissions of ation or use of equipment leased to those acting on your behalf; you by such person or organization. or A person's or organization's status as an additional insured under this c. "Your Work" performed for endorsement ends when their written the additional insured contract or written agreement with described in Paragraph 1. or you for such leased equipment ends. 2. above and included in the "products -completed With respect to the insurance operations hazard." afforded these additional insureds, the following additional exclusions In the performance of your ongoing apply: operations or completed operations for the additional insured described in This insurance does not apply: Paragraph 1. or 2. above. (1) To any "occurrence" which takes However, the insurance afforded to place after the equipment lease such additional insured described expires; or above: (2) To "bodily injury", "property a. Only applies to the extent damage", or "personal and permitted by law; and advertising injury" arising out of the sole negligence of such b. Will not be broader than that additional insured. which you are required by the contract or agreement to h. Owners, Lessees or Contractors — provide for such additional Ongoing Operations and insured. Completed Operations 3. With respect to the insurance 1. Any person or organization for afforded to these additional whom you are performing insureds, the following additional operations or have performed exclusions apply: operations when you and such person or organization have This insurance does not apply to: agreed in writing in a contract or agreement that such person or 1. "Bodily injury", "property organization be added as an damage" or "personal and additional insured on your policy; advertising injury" arising out and of the rendering of, or the failure to render, any 2. Any other person or organization professional architectural, you are required to add as an engineering or surveying additional insured under the services, including: contract or agreement described in Paragraph 1. above. ANIC GL 1187 08 21 Page 3 of 7 a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifica- tions; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employ- ment, training or monitoring of others by that insured, if the `occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. Primary And Noncontributory Insurance The following is added to the Other Insurance Condition and supersedes any provision to the contrary: This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. Section III - Limits of Insurance, the following is added: With respect to the insurance afforded to the additional insureds described in Paragraphs a. through h. above, the most we will pay on behalf of such additional insured is the amount of insurance: (1) Required by the contract or agreement; or (2) Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This provision shall not increase the applicable Limits of Insurance shown in the Declaration. 2. Damage To Premises Rented to You SECTION III — LIMITS OF INSURANCE, Paragraph 6. is replaced by the following: 6. Subject to Paragraph 5. above, the Damage to Premises Rented to You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, while rented to you or temporarily occupied by you with permission of the owner. If a limit is shown for Damage to Premises Rented to You the most we will pay under Coverage A for damages because or "property damage" to any one premises is the Limit shown in the Declarations or $500,000, whichever is greater. 3. MEDICAL PAYMENTS A. Section III — Limits of Insurance, Paragraph 7. is replaced by the following: 7. Subject to Paragraph 5. above the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of "bodily injury" sustained by any one person. ANIC GL 1187 08 21 Page 4 of 7 If a limit is shown for Medical Expense in the Declarations the most we will pay under Coverage C for all medical expenses because of "bodily injury" sustained by any one person is the Limit shown in the Declarations or $15,000, whichever is greater. B. This provision 5. (Medical Payments) does not apply if Section I - Coverage C Medical Payments is excluded either by the provisions of the Coverage Part or by endorsement. C. Paragraph 1.a.(3)(b) of Section I - Coverage C - Medical Payments, is replaced by the following: (b) The expenses are incurred and reported to us within three years of the date of the accident; and 4. NON -OWNED WATERCRAFT A. If endorsement CG 21 09, CG 21 10, CG 24 50, or CG 24 51 is attached to the policy, Paragraph A. 2. g. (2) (b) is replaced by the following: (b) A watercraft that you do not own that is: (i) Less than 50 feet long: and (ii) Not being used to carry persons or property for a charge. B. If Paragraph A. does not apply, Paragraph g. (2) of 2. EXCLUSION under SECTION I — COVERAGES, COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following: (2) A watercraft that you do not own that is: (a) Less than 50 feet long; and (b) Not being used to carry persons or property for a charge. 5. SUPPLEMENTARY PAYMENTS A. Under Section I - Supplementary Payments - Coverage A and B, Paragraph 1.b., the limit of $250 shown for the cost of bail bonds is replaced by $10,000; B. In Paragraph 1.d., the limit of $250 shown for daily loss of earnings is replaced by $500. 6. NEWLY FORMED OR ACQUIRED ORGANIZATIONS Paragraph 3.a. of Section II - Who Is An Insured is deleted and replaced by the following: Coverage under this provision is afforded only until the end of the policy period or the next anniversary of this policy's effective date after you acquire or form the organization, whichever is earlier. 7. LIBERALIZATION CLAUSE If we adopt a change in our forms or rules which would broaden coverage for contractors under this endorsement without an additional premium charge, your policy will automatically provide the additional coverages as of the date the revision is effective in your state. 8. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS — Paragraph 6. — Representations is replaced by the following: 6. Representations By accepting this policy, you agree: a. The statements in the Declarations are accurate and complete; b. Those statements are based upon representations you made to us; and c. We have issued this policy in reliance upon your representations. ANIC GL 1187 08 21 Page 5 of 7 The unintentional omission of, or unintentional error in, any information you provided to us which we relied upon in issuing this policy will not prejudice your rights under this insurance. However, this provision does not affect our right to collect additional premium or to exercise our rights of cancellation or nonrenewal in accordance with applicable laws and regulations. 9. NOTICE OF OCCURRENCE The following is added to Paragraph 2. of Section IV - Commercial General Liability Conditions - Duties In The Event of Occurrence, Offense, Claim or Suit: Your rights under this Coverage Part will not be prejudiced if you fail to give us notice of an "occurrence", offense, claim or "suit" and that 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." 10. BROAD KNOWLEDGE OF OCCURRENCE The following is added to Paragraph 2. of Section IV - Commercial General Liability Conditions - Duties in The Event of Occurrence, Offense, Claim or Suit: You must give us or our authorized representative notice of an "occurrence", offense, claim, or "suit" only when the "occurrence", offense, claim or "suit' is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) An executive officer or the employee designated by you to give such notice, if you are a corporation; or (4) A manager, if you are a limited liability company. 11. EXPANDED BODILY INJURY Section V - Definitions, the definition of "bodily injury" is changed to read: "Bodily injury" means bodily injury, sickness or disease sustained by a person, including death, humiliation, shock, mental anguish or mental injury by that person at any time which results as a consequence of the bodily injury, sickness or disease. 12. EXPECTED OR INTENDED INJURY Exclusion a. of Section I - Coverage A - Bodily Injury and Property Damage Liability is replaced by the following: a. "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. 13. BLANKET WAIVER OF SUBROGATION The Transfer Of Rights Of Recovery Against Others To Us Condition (Section IV - Commercial General Liability Conditions) is amended by the addition of the following: We waive any right of recovery 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. ANIC GL 1187 08 21 Page 6 of 7 14. IN REM ACTIONS Any action in rem against any vessel owned, operated by or for, or chartered by or for you will be treated in the same manner as though the action were in personam against you. 15. VOLUNTARY PROPERTY DAMAGE The following is added, Section I — Coverage A — Bodily Injury and Property Damage Liability 1., Insuring Agreement: We will pay, at your request, for "property damage" to property of others while in the care, custody or control of an insured, arising out of your business operations away from your insured premises for which this policy is written and occurring during the policy period. However, the "property damage" must be the result of unintentional damage or destruction but does not include disappearance, theft, or loss of use. You agree with us that we shall have no duty to defend any claims and/or "suits" for which the only coverage provided is under this coverage extension. For the purpose of this coverage only, Section I — Coverage A — Bodily Injury and Property Damage Liability 2. Exclusions J. (4.) is deleted. As respects coverage afforded under Voluntary Property Damage, the following is added to Section III — Limits of Insurance: Regardless of the number of insureds, claims or "suits" brought, or persons or organizations making claims or bringing "suits": 1. Subject to 2. Below, the most we will pay for "property damage" arising from any one "occurrence" arising out of "property damage to property of others caused by you and while in your care, custody or control is $5,000. 2. The most we will pay for the sum of all "property damage" in an annual policy period is $10,000. This amount is part of and not in addition to the General Aggregate Limit described in Paragraph 2. of Section III — Limits of Insurance. Includes copyrighted material of Insurance Services Office, Inc., with its permission ANIC GL 1187 08 21 Page 7 of 7 Alaska National INSURANCE COMPANY BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following BUSINESS AUTO COVERAGE FORM Various provisions in this endorsement restrict subrogation against that person or coverage. Read the entire policy carefully to organization is waived prior to the "accident" determine rights, duties, and what is and is not or the "loss" under a contract with that person covered. or organization. Throughout this policy, the words "you" and "your" refer to the Named Insured shown in the Declarations. The words "we", "us", and "our" refer to the company providing this insurance. Other words and phrases that appear in quotation marks have special meaning. Refer to SECTION V — DEFINITIONS in the Business Auto Coverage Form. The coverages provided by this endorsement apply per "accident" and, unless otherwise specified, are subject to all of the terms, conditions, exclusions and deductible provisions of the policy, to which it is attached. SECTION II — COVERED AUTO LIABILITY COVERAGE, Paragraph A.1. Who Is An Insured is amended to include: d. Any "employee" of yours while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your business. e. Any person or organization for whom you 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. SECTION IV — Business Auto Conditions, Paragraph A. S. — Transfer of Rights of Recovery Against Others To Us is amended to include: 5. Transfer of Rights of Recovery Against Others to Us This condition does not apply to any person(s) or organization(s) to the extent that SECTION II — COVERED AUTO LIABILITY COVERAGE, Paragraph A.2.a. (2) — Supplementary Payments is replaced by the following: (2) Up to $10,000 for cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. SECTION II — COVERED AUTO LIABILITY COVERAGE, Paragraph A.2.a. (4) — Supplementary Payments is replaced by the following: (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. SECTION II — COVERED AUTO LIABILITY COVERAGE, Paragraph A.2.c. —Voluntary Property Damage is added as follows: c. Voluntary Property Damage At your written request, we may make a voluntary payment for Property Damage caused by an "insured", but without liability to a third party, up to $25,000. We will not make a Voluntary Property Damage payment to anyone who is an "insured" under this policy. SECTION III — PHYSICAL DAMAGE COVERAGE, Paragraph A.2. —Towing is replaced by the following: Towing We will pay up to $500 for towing and labor costs incurred each time a covered "auto" that is a: a. Private passenger; ANIC CA 1150 10 13 Page 1 of 4 Alaska National INSURANCE COPANY b. Truck; c. Pick-up truck; d. Panel ; or e. Van type vehicle under 20,000 Ibs, of Gross Vehicle Weight is disabled. However, the labor must be performed at place of disablement. SECTION III — PHYSICAL DAMAGE COVERAGE, Paragraph A.3. — Glass Breakage — Hitting a Bird or Animal — Falling Objects or Missiles is replaced by the following: Glass Breakage — Hitting a Bird or Animal — Falling Objects or Missiles 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 c. "Loss" caused by falling objects or missiles. However, you have the option of having glass breakage caused by a covered "auto's" collision or overturn considered a "loss" under Collision Coverage. Glass Repair —Waiver of Deductible No deductible applies to glass breakage, if the glass is repaired rather than replaced. SECTION III — PHYSICAL DAMAGE COVERAGE, Paragraph AA.a. — Transportation Expenses is replaced by the following: a. Transportation Expenses We will pay up to $200 per day to a maximum of $1,500 for temporary transportation expense incurred by you because of the total theft of a covered "auto" that is a: (1) Private passenger; (2) Truck; (3) Pick-up truck; (4) Panel; or (5) Van type vehicle under 20,000 lbs. of Gross Vehicle Weight. We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage. We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its "loss". SECTION III — PHYSICAL DAMAGE COVERAGE, Paragraph AA.b. — Loss of Use Expenses is replaced by the following: b. Loss of Use Expenses — Hired, Rented, or Borrowed Automobiles We will pay expenses for which an "insured" becomes legally responsible to pay for loss of use of a vehicle hired, rented or borrowed without a driver under a written rental contract or agreement. We will pay for loss of use expenses, if caused by: (1) Other than Collision, only if the Declarations indicate that Comprehensive Coverage is provided for the vehicle withdrawn from service. (2) Specified Causes of Loss only if the Declarations indicate that Specified Causes of Loss Coverage is provided for the vehicle withdrawn from service. (3) Collision only if the Declarations indicate that Collision Coverage is provided for the vehicle withdrawn from service. ANIC CA 1150 10 13 Page 2 of 4 AV Alaska All ional INSURANCE COMPANY However, the most we will pay for any expenses for loss of use is $200 per day, to a maximum of $1,500. SECTION III — PHYSICAL DAMAGE COVERAGE, Paragraph AA.c. — Non -Transportation Loss of Use Expenses is added as follows: c. Non -Transportation Loss of Use Expenses We will pay up to $2,000 for non - transportation expense incurred by you, because of "loss" to a covered "auto", if caused by: (1) Other than Collision, only if the Declarations indicate that Comprehensive Coverage is provided for the "auto" withdrawn from service; (2) Specified Causes of Loss only if the Declarations indicate that Specified Causes of Loss Coverage is provided for the "auto" withdrawn from service; or (3) Collision only if the Declarations indicate that Collision Coverage is provided for the "auto" withdrawn from service. SECTION III — PHYSICAL DAMAGE COVERAGE, Paragraph AAA. — Airbag Coverage is added as follows: d. Airbag Coverage We will pay for the cost to repair, replace, or reset an airbag that inflates for any reason other than as a result of a collision, if the Declarations indicate that the covered "auto" has Comprehensive Coverage or Specified Causes of Loss Coverage. SECTION III — PHYSICAL DAMAGE COVERAGE, Paragraph AA.e. — Rental Reimbursement Coverage is added as follows: e. Rental Reimbursement Coverage We will pay up to $75 per day for rental reimbursement expenses incurred by you for the rental of an "auto" because of "loss" to a covered "auto" that is a: (1) Private Passenger; (2) Truck; (3) Pick-up truck; (4) Panel; or (5) Van type vehicle under 20,000 lbs. of Gross Vehicle Weight. Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered "auto". No deductibles apply to this coverage. (1) We will pay only for those expenses incurred during the policy period beginning 24 hours after the "loss" and ending, regardless of the policy's expiration, with the lesser of the following number of days: (a) The number of days reasonably required to repair or replace the covered "auto". (b) 30 days. (2) This coverage does not apply while there are spare or reserve "autos" available to you for your operations. (3) The Rental Reimbursement Cov- erage described above does not apply to a covered "auto" that is described or designated as a covered "auto" on Rental Reimbursement Coverage Form CA 99 23. SECTION IV — BUSINESS AUTO CONDITIONS — Paragraph B.2. — Concealment, Misrepresentation Or Fraud is amended by adding Unintentional Failure to Disclose Hazards at the end of Paragraph 13.2. as follows: Unintentional Failure to Disclose Hazards If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non -renewal. ANIC CA 1150 10 13 Page 3 of 4 Alaska National INSURANCE COMPANY SECTION IV — BUSINESS AUTO CONDITIONS — Paragraph B.5.b. — Other Insurance is replaced by the following: b. For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: (1) Any covered "auto" you lease, hire, rent, or borrow; and (2) Any covered "auto"" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". SECTION V — DEFINITIONS — Paragraph C. — "Bodily injury" is replaced by the following: C. "Bodily injury" means bodily injury, sickness or disease sustained by a person including death or mental anguish resulting from any of these. Mental anguish means any type of mental or emotional illness or disease ANIC CA 1150 10 13 © Insurance Services Office, Inc., 2009 Page 4 of 4 60 ! cO) AAOSWFF.09 RGARrIO ACO/eO CERTIFICATE OF LIABILITY INSURANCE `� DATE(MM/DD/YYYY) 1 10/27/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Devin Bland NAME: PHONE FAX (A/C, No, E:t): (509) 545-3800 (A/C, No):(509) 547-7960 Hub International Northwest LLC PO Box 3144 Spokane, WA 99220 ML ADDRESS: Devin.bland@hubinternational.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Selective Insurance Company of America 12572 INSURED INSURERB:Westchester Surplus Lines Insurance Co. 10172 INSURER C : AAA Sweeping, LLC INSURER D : P.O. Box 624 Veradale, WA 99037 INSURER E ; INSURER F : rA\/FRAnPR rFRTIFIrATF NIIMRFR• RFVI-RlnN NIIMRFR- 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 LT TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR X X S 2707559 10/19/2025 10/19/2026 DAMAGE TO RENTED PREMISE Ea occurrence 500,000 $ MED EXP (Any oneperson) $ 15,000 PERSONAL BADVINJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 GEN'L POLICY 7 PRO LOC PRODUCTS -COMP/OP AGG $ 2,000,000 WA STOP GAP $ 1,000,000 OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 $ BODILY INJURY Perperson) $ X ANY AUTO X X S 2707559 10/19/2025 10/19/2026 BODILY INJURY Per accident $ OWNED SCHEDULED AUTOS ONLY AUTOS PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY S A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 10,000,000 AGGREGATE $ 10,000,000 EXCESS LIAB CLAIMS -MADE X S 2707559 10/19/2025 10/19/2026 DIED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OTH- STERER E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N / A E.L. DISEASE - EA EMPLOYEE S E.L. DISEASE - POLICY LIMIT S If yes, describe under DESCRIPTION OF OPERATIONS below B Pollution / Environm X X G24330746014 10/19/2025 10/19/2026 Pollution Lia Agg 2,000,000 A Leased/Rented Equip S 2707559 10/19/2025 10/19/2026 Ded: $1,000 100,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: City of Spokane Valley Storm Drain Cleaning Services Contract 24-040 City of Spokane Valley is an Additional Insured when required by written contract. Coverage includes Primary and Non Contributory, Ongoing and Completed Operations; Waiver of Subrogation Applies. Policy Forms Attached. r 9:0TIFIf ATF I-IAI IIFR rAN('.FI I ATInN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Spokane Valle tY p y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Public Works Dept. 10210 E. Sprague Avenue Spokane Valley, WA 99206-0000 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) @ 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Contracting, Installation, Service and Repair General Liability Extended ElitePac® Endorsement COMMERCIAL GENERAL LIABILITY CG 79 88 10 23 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. BLANKET ADDITIONAL INSUREDS 1. Ongoing Operations SECTION II — WHO IS AN INSURED is amended to include as an additional insured: a. Any person or organization for whom you are performing operations when you and such person or organization have agreed in a written contract, written agreement or written permit that such person or organization be added as an additional insured on your commercial general liability policy; and b. Any other person or organization, including any architects, engineers or surveyors not engaged by you, whom you are required to 2 add as an additional insured under your policy in the contract or agreement in Paragraph 1. above; If the written contract, written agreement, or written permit does not require that the additional insured be added with respect to liability arising out of your ongoing operations, or requires coverage for the additional insured to be included by the use of ISO's Additional Insured — Owners, Lessees or Contractors — Scheduled Person Or Organization endorsement CG 20 10 07-04 (or subsequent) edition or its equivalent, then such person or organization is an additional insured only with respect to "bodily injury", "property damage" or "personal and advertising injury' caused in whole or in part by your ongoing operations performed under that contract, agreement, or permit. Completed Operations SECTION II — WHO IS AN INSURED is amended to include as an additional insured: If the written contract, written agreement, or a. Any person or organization for whom you written permit requires the additional insured be are performing or have performed added with respect to liability arising out of your operations when you and such person or ongoing operations, or requires coverage for the organization have agreed in a written additional insured to be included by the use of contract, written agreement or written permit ISO's Additional Insured — Owners, Lessees or that such person or organization be added Contractors — Scheduled Person Or as an additional insured on your commercial Organization endorsement CG 20 10 10-01 general liability policy; and edition or its equivalent, such person or b. Any other person or organization, including organization is an additional insured only with any architects, engineers or surveyors not respect to liability arising out of your ongoing engaged by you, whom you are required to operations performed under that contract, add as an additional insured under your agreement, or permit. policy in the contract or agreement in Paragraph 1. above; Copyright, 2023 Selective Insurance Company of America. All rights reserved. CG 79 88 10 23 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 4 If the written contract, written agreement, or written permit requires the additional insured be added with respect to liability arising out of "your work" performed under that contract, agreement, or permit and included in the "products - completed operations hazard", or requires coverage for the additional insured to be included by the use of ISO's Additional Insured — Owners, Lessees or Contractors — Completed Operations endorsement CG 20 37 10-01 edition or its equivalent, such person or organization is an additional insured only with respect to their liability arising out of "your work" performed under that contract, agreement, or permit and included in the "products -completed operations hazard". If the written contract, written agreement, or written permit does not require that the additional insured be added with respect to liability arising out of "your work" performed under that contract, agreement, or permit and included in the "products -completed operations hazard", or requires coverage for the additional insured to be included by the use of ISO's Additional Insured — Owners, Lessees or Contractors — Completed Operations endorsement CG 20 37 07-04 (or subsequent) edition or its equivalent, then such person or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by "your work" performed under that contract, agreement, or permit and included in the "products -completed operations hazard". The insurance afforded to the additional insureds in Paragraphs 1. and 2. above: a. Does not apply unless the written contract or written agreement has been signed by the Named Insured or written permit issued prior to the "bodily injury", "property damage" or "personal and advertising injury"; b. Only applies to the extent permitted by law; and c. Will not be broader than that which you are required by the written contract, written agreement, or written permit to provide to such additional insured. This insurance does not apply to "bodily injury", "property damage", or "personal and advertising injury" occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. b. With respect to the insurance afforded to these additional insureds under a. Ongoing Operations and b. Completed Operations, the following is added to 2. Exclusions under SECTION I — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY: This insurance does not apply to: "Bodily injury", "property damage", or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. 5. Conditions With respect to the insurance afforded to these additional insureds under a. Ongoing Operations and b. Completed Operations the following is added to Paragraph 4. Other Insurance, a. Primary Insurance under SECTION IV— COMMERCIAL GENERAL LIABILITY CONDITIONS: 4. Exclusions This insurance is primary to and will not seek a. With respect to the insurance afforded to contribution from any other insurance available additional insureds under a. Ongoing to an additional insured under this policy Operations the following is added to 2. provided that: Exclusions under SECTION I — COVERAGE A— BODILY INJURY AND a. The additional insured is a Named Insured PROPERTY DAMAGE LIABILITY: under such other insurance; and Copyright, 2023 Selective Insurance Company of America. All rights reserved. CG 79 88 10 23 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 4 b. You have agreed in a written contract, written agreement or written permit that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. B. PROPERTY DAMAGE CARE, CUSTODY OR CONTROL 1. The following is added to Exclusion j. under SECTION I — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY: Paragraphs (4) and (5) of this exclusion do not apply for the limited purpose of providing the coverage and sub -limits of liability as set forth below. We will pay those sums that the insured becomes legally obligated to pay as damages because of "property damage" to: a. Personal property, including keys, in the care, custody or control of an insured; and b. That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations, if the "property damage" arises out of those operations. The most we will pay under a. and b. above in any one "occurrence" or for all damages during any one policy period is a sub -limit of $100,000. These limits are included in and not in addition to the Limits of Insurance shown in the Declarations of the Commercial General Liability Policy. Our right and duty to defend the insured against any "suit" for damages under a. and b. above ends when we have used up the applicable sub - limit of liability in the payment of judgments or settlements under it. With respect this provision only, the following is added to Definition 17. under SECTION V — DEFINITIONS: "Property damage" also includes adjustment of locks to fit new keys or the cost of new locks, including their installation, when replacing keys covered in Paragraph 1.(a) above provided that such "property damage" is not a result of any dishonest act on the part of any insured, or the insured's employees or agents, whether acting alone or in collusion. C. OTHER INSURANCE AMENDMENT — SUPPLEMENTAL COVERAGE FOR INSURED'S INVOLVEMENT IN A CONTROLLED (WRAP-UP) INSURANCE PROGRAM 1. The following is added to SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 4. Other Insurance b. Excess Insurance (1)(a): (v) That is covered by a "controlled (wrap-up) insurance program" in which you are enrolled for your ongoing operations or operations included within the "products - completed operations hazard", unless such "controlled (wrap-up) insurance program" is specifically excluded from coverage on this policy. 2. The following is added to SECTION V — DEFINITIONS: "Controlled (wrap-up) insurance program" means a centralized insurance program under which one party has secured either insurance or self-insurance covering some or all of the contractors or subcontractors performing work on one or more specific project(s). D. FELLOW EMPLOYEE EXTENSION Under SECTION II — WHO IS AN INSURED Paragraphs 2.a. and 2.a. (1) are replaced by the following: Your "volunteer workers" only while performing duties related to the conduct of your business, or your "employees", other than either your "executive officers" (if you are an organization other than a partnership, joint venture, or limited liability company) or your managers (if you are a limited liability company), but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However, none of these "employees" or "volunteer workers" are insureds for "bodily injury' or "personal and advertising injury" arising out of his or her providing or failing to provide professional health care services. With respect to this provision only, Subparagraph (1) of Exclusion 2. e. Employer's Liability under SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY does not apply. Copyright, 2023 Selective Insurance Company of America. All rights reserved. CG 79 88 10 23 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 4 E. CONTRACTUAL LIABILITY (RAILROADS) Definition 9. under SECTION V — DEFINITIONS is amended as follows: 1. Paragraph c. is deleted in its entirety and replaced by the following: c. Any easement or license agreement; 2. Paragraph f.(1) is deleted in its entirety. F. CONTRACTUAL LIABILITY AMENDMENT — (PERSONAL AND ADVERTISING INJURY) If it is required in a written contract, written agreement or written permit with the insured that any contractual liability exclusion for personal injury be removed from the policy, then Exclusion e. Contractual Liability under COVERAGE B PERSONAL AND ADVERTISING INJURY, 2. Exclusions is deleted in its entirety and replaced by the following: e. Contractual Liability "Personal and advertising Injury" for which the insured has assumed liability in a contract or agreement arising out of an "advertisement". This exclusion does not apply to liability for damages that the insured would have in the absence of the contract or agreement". G. WAIVER OF GOVERNMENTAL IMMUNITY We will waive, both in the adjustment of claims and in the defense of "suits" against the insured, any governmental immunity of the insured, unless the insured requests in writing that we not do so. Waiver of immunity as a defense will not subject us to liability for any portion of a claim or judgment in excess of the applicable limit of insurance. H. DAMAGE TO PREMISES RENTED TO YOU The Limit of Insurance for Damage To Premises Rented To You is increased to $1,000,000. Copyright, 2023 Selective Insurance Company of America. All rights reserved. CG 79 88 10 23 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 4 ElitePac® General Liability Extension Endorsement COMMERCIAL GENERAL LIABILITY CG 73 00 04 25 SUMMARY OF COVERAGES (including index) This is a summary of the various additional coverages and coverage modifications provided by this endorsement. No coverage is provided by this summary. Refer to the actual endorsement (Pages 3-through-9) for changes affecting your insurance protection. DESCRIPTION PAGE FOUND Additional Insureds — Primary and Non -Contributory Provision Page 8 Blanket Additional Insureds — As Required By Contract Page 5 • Owners, Lessees or Contractors (includes Architects, Engineers or Surveyors) • Lessors of Leased Equipment • Managers or Lessors of Premises • Mortgagees, Assignees and Receivers • Any Other person or organization other than a joint venture • Grantors of Permits Broad Form Vendors Coverage Page 7 Damage To Premises Rented To You (Including Fire, Lightning or Explosion) Page 3 Electronic Data Liability ($100,000) Page 4 Employee Definition Amended Page 9 Employees As Insureds Modified Page 5 Employer's Liability Exclusion Amended (Not applicable in New York) Page 3 Incidental Malpractice Exclusion modified Page 7 Knowledge of Occurrence, Claim, Suit or Loss Page 7 Liberalization Clause Page 8 Mental Anguish Amendment (Not applicable to New York) Page 9 Newly Formed or Acquired Organizations Page 5 Non -Owned Aircraft Page 3 Non -Owned Watercraft (under 60 feet) Page 3 Not -for -profit Members — as additional insureds Page 5 Personal And Advertising Injury — Discrimination Amendment (Not applicable in New York) Page 8 Products Amendment (Medical Payments) Page 4 Supplementary Payments Amended — Bail Bonds ($5,000) and Loss of Earnings ($1,000) Page 4 Two or More Coverage Parts or Policies Issued By Us Page 8 Unintentional Failure to Disclose Hazards Page 8 Waiver of Transfer of Rights of Recovery (subrogation) Page 8 When Two or More Coverage Parts of this Policy Apply to a Loss Page 3 Copyright, 2024 Selective Insurance Company of America. All rights reserved. CG 73 00 04 25 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 9 THIS PAGE IS INTENTIONALLY LEFT BLANK. Copyright, 2024 Selective Insurance Company of America. All rights reserved. CG 73 00 04 25 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 9 ElitePac° General Liability Extension Endorsement COMMERCIAL GENERAL LIABILITY CG 73 00 04 25 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies the insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The SECTIONS of the Commercial General Liability Coverage Form identified in this endorsement will be amended as shown below. However, if (a) two or more Coverage Parts of this policy, or (b) two or more forms or endorsements within the same Coverage Part apply to a loss, coverage provision(s) with the broadest language will apply, unless specifically stated otherwise within the particular amendment covering that loss. With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. COVERAGES — Amendments B. The following is added to Exclusion g. Aircraft, SECTION I — COVERAGE A BODILY INJURY AND Auto Or Watercraft under COVERAGE A BODILY PROPERTY DAMAGE LIABILITY INJURY AND PROPERTY DAMAGE LIABILITY, 2. EXCLUSIONS Exclusions: Employer's Liability Amendment (This provision is not applicable in the State of New York). The following is added to Exclusion e. Employer's Liability under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions: This exclusion also does not apply to any "temporary worker". Non -Owned Aircraft, Auto or Watercraft A. Paragraph (2) of Exclusion g. Aircraft, Auto Or Watercraft under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions is deleted in its entirety and replaced with the following: (2) A watercraft you do not own that is: (a) Less than 26 feet long and not being used to carry persons or property for a charge; or (b) At least 26 feet, but less than 60 feet long, and not being used to carry persons or property for a charge. Any person is an insured who uses or is responsible for the use of such watercraft with your expressed or implied consent. However, if the insured has any other valid and collectible insurance for "bodily injury" or "property damage" that would be covered under this provision, or on any other basis, this coverage is then excess, and subject to Condition 4. Other Insurance, b. Excess Insurance under SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS. This exclusion does not apply to (6) Any aircraft, not owned or operated by any insured, which is hired, chartered or loaned with a paid crew. However, if the insured has any other valid and collectible insurance for "bodily injury" or "property damage" that would be covered under this provision, or on any other basis, this coverage is then excess, and subject to Condition 4. Other Insurance, b. Excess Insurance under SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS. Damage To Premises Rented to You A. The last paragraph of Paragraph 2. Exclusions under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE is deleted in its entirety and replaced with the following: Exclusions c. through n. do not apply to damage by fire, lightning or explosion to premises rented to you or temporarily occupied by you with the permission of the owner. A separate limit of insurance applies to this coverage as described in SECTION III — LIMITS OF INSURANCE. Copyright, 2024 Selective Insurance Company of America. All rights reserved. CG 73 00 04 25 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 9 B. Paragraph 6. under SECTION III — LIMITS OF INSURANCE is deleted in its entirety and replaced with the following: 6. Subject to Paragraph 5. above, the most we will pay under COVERAGE A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage caused by fire, lightning or explosion, while rented to you or temporarily occupied by you with permission of the owner, for all such damage caused by fire, lightning or explosion proximately caused by the same event, whether such damage results from fire, lightning or explosion or any combination of the three, is the amount shown in the Declarations for the Damage To Premises Rented To You Limit. C. Paragraph a. of Definition 9. "Insured contract' under SECTION V — DEFINITIONS is deleted in its entirety and replaced with the following: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning or explosion to premises while rented to you or temporarily occupied by you with the permission of the owner is not an "insured contract'; Electronic Data Liability A. Exclusion p. Electronic Data under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Paragraph 2. Exclusions is deleted in its entirety and replaced by the following: p. Electronic Data Damages arising out of the loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate "electronic data". However, this exclusion does not apply to liability for damages because of: (1) "Bodily injury"; or (2) Loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate "electronic data" that results from physical injury to tangible property. The exception in the paragraph above does not apply to claims for damages because of "bodily injury", "property damage", notification costs, credit or identity monitoring expenses, forensic expenses, public relations expenses, data restoration expenses, extortion expenses or any other similar cost or expense incurred by you or others arising out of a "cyber incident'. B. The following paragraph is added to SECTION III — LIMITS OF INSURANCE: Subject to the Each Occurrence Limit in Paragraph 5., the most we will pay under COVERAGE A for "property damage" because of all loss of "electronic data" arising out of any one `occurrence" is a sub -limit of $100,000. SECTION I — COVERAGE C MEDICAL PAYMENTS EXCLUSIONS Any Insured Amendment Exclusion a. Any Insured under COVERAGE C MEDICAL PAYMENTS, 2. Exclusions is deleted in its entirety and replaced with the following: a. Any Insured To any insured. This exclusion does not apply to: (1) "Not -for -profit members"; (2) "Golfing facility" members who are not paid a fee, salary, or other compensation; or (3) "Volunteer workers". This exclusion exception does not apply if COVERAGE C MEDICAL PAYMENTS is excluded by another endorsement to this Coverage Part. Product Amendment Exclusion f. Products -Completed Operations Hazard under COVERAGE C MEDICAL PAYMENTS, 2. Exclusions is deleted in its entirety and replaced with the following: f. Products -Completed Operations Hazard Included within the "products -completed operations hazard". This exclusion does not apply to "your products" sold for use or consumption on your premises, while such products are still on your premises. This exclusion exception, does not apply if COVERAGE C MEDICAL PAYMENTS is excluded by another endorsement to this Coverage Part. SECTION I — SUPPLEMENTARY PAYMENTS — COVERAGES A AND B Expenses For Bail Bonds And Loss Of Earnings A. Subparagraph 1.b. under SUPPLEMENTARY PAYMENTS — COVERAGES A AND B is deleted in its entirety and replaced with the following: b. Up to $5,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. Copyright, 2024 Selective Insurance Company of America. All rights reserved. CG 73 00 04 25 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 9 B. Subparagraph 1.d. under SUPPLEMENTARY PAYMENTS — COVERAGES A AND B is deleted in its entirety and replaced with the following: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $1,000 a day because of time off from work. SECTION II — WHO IS AN INSURED — Amendments Not -for -Profit Organization Members The following paragraph is added to SECTION II WHO IS AN INSURED: If you are an organization other than a partnership, joint venture, or a limited liability company, and you are a not -for -profit organization, the following are included as additional insureds: 1. Your officials; 2. Your trustees; 3. Your members; 4. Your board members; 5. Your commission members; 6. Your agency members; 7. Your insurance managers; 8. Your elective or appointed officers; and 9. Your "not -for -profit members". However only with respect to their liability for your activities or activities they perform on your behalf. Employees As Insureds Modified A B C Subparagraph 2.a.(1)(a) under SECTION II — WHO IS AN INSURED does not apply to "bodily injury" to a "temporary worker' caused by a co -"employee" who is not a "temporary worker". Subparagraph 2.a.(2) under SECTION II — WHO IS AN INSURED does not apply to "property damage" to the property of a "temporary worker" or "volunteer worker" caused by a co -"employee" who is not a "temporary worker" or "volunteer worker'. Subparagraph 2.a.(1)(d) under SECTION II —WHO IS AN INSURED does not apply to "bodily injury" caused by cardio-pulmonary resuscitation or first aid services administered by a co -"employee". With respect to this provision only, Subparagraph (1) of Exclusion 2. e. Employer's Liability under SECTION — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY does not apply. Newly Formed Or Acquired Organizations A. Subparagraph 3.a. under SECTION II — WHO IS AN INSURED is deleted in its entirety and replaced with the following: a. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier. However, COVERAGE A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization. B. The following paragraph is added to SECTION II — WHO IS AN INSURED, Paragraph 3: If you are engaged in the business of construction of dwellings three stories or less in height, or other buildings three stories or less in height and less than 25,000 square feet in area, you will also be an insured with respect to "your work" only, for the period of time described above, for your liability arising out of the conduct of any partnership or joint venture of which you are or were a member, even if that partnership or joint venture is not shown as a Named Insured. However, this provision only applies if you maintain or maintained an interest of at least fifty percent in that partnership or joint venture for the period of that partnership or joint venture. This provision does not apply to any partnership or joint venture that has been dissolved or otherwise ceased to function for more than thirty-six months. With respect to the insurance provided by this provision, Newly Formed or Acquired Organizations, the following is added to SECTION IV — COMMERCIAL GENERAL LIABILITY, Paragraph 4. Other Insurance, Subparagraph b. Excess Insurance: The insurance provided by this provision, Newly Formed or Acquired Organizations, is excess over any other insurance available to the insured, whether primary, excess, contingent or on any other basis. (All other provisions of this section remain unchanged) Blanket Additional Insureds — As Required By Contract A. Subject to the Primary and Non -Contributory provision set forth in this endorsement, SECTION II — WHO IS AN INSURED is amended to include as an additional insured: 1. Owners, Lessees or Contractors/Architects, Engineers and Surveyors a. Any person or organization for whom you are performing operations when you and such person or organization have agreed in a written contract, written agreement or written permit that such person or organization be added as an additional insured on your commercial general liability policy; and b. Any other person or organization, including any architects, engineers or surveyors not engaged by you, whom you are required to add as an additional insured under your policy in the contract or agreement in Paragraph a. above: Copyright, 2024 Selective Insurance Company of America. All rights reserved. CG 73 00 04 25 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 9 Such person or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: (1) Your acts or omissions; or (2) The acts of omissions of those acting on your behalf; in the performance of your ongoing operations performed for the additional insured in Paragraph a., above. However, this insurance does not apply to: "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services by or for you, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and (2) Supervisory, inspection, architectural or engineering activities. Professional services do not include services within construction means, methods, techniques, sequences and procedures employed by you in connection with your operations in your capacity as a construction contractor. A person or organization's status as an additional insured under this endorsement ends when your operations for the person or organization described in Paragraph a. above are completed. 2. Other Additional Insureds Any of the following persons or organizations with whom you have agreed in a written contract, written agreement or written permit that such persons or organizations be added as an additional insured on your commercial general liability policy: a. Lessors of Leased Equipment Any person or organization from whom you lease equipment, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. b. Managers or Lessors of Premises Any person or organization from whom you lease premises, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by you or those acting on your behalf in connection with the ownership, maintenance or use of that part of the premises leased to you. This insurance does not apply to any "occurrence" which takes place after you cease to be a tenant of that premises. c. Mortgagees, Assignees or Receivers Any person or organization with respect to their liability as mortgagee, assignee or receiver and arising out of the ownership, maintenance or use of your premises. This insurance does not apply to any "occurrence" which takes place after the mortgage is satisfied, or the assignment or receivership ends. d. Any Person or Organization Other Than A Joint Venture Any person or organization (other than a joint venture of which you are a member), but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts of omissions of those acting on your behalf in the performance of your ongoing operations or in connection with property owned by you. e. State or Governmental Agency or Political Subdivision — Permits or Authorizations Any state or governmental agency or subdivision or political subdivision, but only with respect to: (1) Operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization; or (2) The following hazards for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization in connection with premises you own, rent or control and to which this insurance applies: Copyright, 2024 Selective Insurance Company of America. All rights reserved. CG 73 00 04 25 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 9 (a) The existence, maintenance, repair, construction, erection or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures; (b) The construction, erection or removal of elevators; or (c) The ownership, maintenance or use of any elevators covered by this insurance. This insurance does not apply to: L "Bodily injury" or "property damage" arising out of operations performed for the federal government, state or municipality; or ii. "Bodily injury" or "property damage" included within the "products -completed operations hazard". With respect to Paragraphs 2.b. through 2.d., this insurance does not apply to structural alterations, new construction or demolition operations performed by or on behalf of such person or organization. B. The insurance coverage afforded to the additional insureds in this coverage extension: 1. Does not apply unless the written contract or written agreement has been signed by the Named Insured or written permit issued prior to the "bodily injury" or "property damage" or "personal and advertising injury"; 2. Only applies to the extent permitted by law; and 3. Will not be broader than that which you are required by the written contract, written agreement, or written permit to provide to such additional insured. Broad Form Vendors Coverage Subject to the Primary and Non -Contributory provision set forth in this endorsement, SECTION II — WHO IS AN INSURED is amended to include as an additional insured any person or organization (referred to below as vendor) for whom you have agreed in a written contract or written agreement to provide coverage as an additional insured under your policy. Such person or organization is an additional insured only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business. However, the insurance afforded the vendor does not apply to: a. "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement; however this exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; b. Any express warranty unauthorized by you; c. Any physical or chemical change in the product made intentionally by the vendor; d. Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; e. Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business in connection with the sale of the product; or f. Products which, after distribution or sale by you, have been labeled or re -labeled or used as a container, part of ingredient of any other thing or substance by or for the vendor; however this insurance does not apply to any insured person or organization, from who you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. The provisions of this coverage extension do not apply unless the written contract or written agreement has been signed by the Named Insured prior to the "bodily injury" or "property damage". Incidental Malpractice Subparagraph 2.a.(1)(d) under SECTION II — WHO IS AN INSURED is deleted in its entirety and replaced with the following: (d) Arising out of his or her providing or failing to provide professional health care services. This does not apply to nurses, emergency medical technicians or paramedics if you are not in the business or occupation of providing any such professional services. This also does not apply to "bodily injury" caused by cardio-pulmonary resuscitation or first aid services administered by a co -"employee". This provision does not apply if you are a Social Service or Senior Living risk. SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS — Amendments Knowledge Of Occurrence, Claim, Suit Or Loss The following is added to Paragraph 2. Duties in the Event of Occurrence, Offense, Claim or Suit under SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: Copyright, 2024 Selective Insurance Company of America. All rights reserved. CG 73 00 04 25 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 9 The requirements under this paragraph do not apply until after the 'occurrence" or offense is known to: 1. You, if you are an individual; 2. A partner, if you are a partnership; 3. An "executive officer" or insurance manager, if you are a corporation; 4. Your members, managers or insurance manager, if you are a limited liability company; or 5. Your elected or appointed officials, officers, members, trustees, board members, commission members, agency members, or your administrator or your insurance manager if you are an organization other than a partnership, joint venture, or limited liability company. Primary and Non -Contributory Provision The following is added to Paragraph 4. Other Insurance, b. Excess Insurance under SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: This insurance is primary to and we will not seek contribution from any other insurance available to an additional insured under this policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in a written contract, written agreement or written permit that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. Unintentional Failure To Disclose Hazards The following is added to Paragraph 6. Representations under SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: However, if you should unintentionally fail to disclose any existing hazards in your representations to us at the inception date of the policy, or during the policy period in connection with any additional hazards, we shall not deny coverage under this Coverage Part based upon such failure to disclose hazards. Waiver Of Transfer Of Rights Of Recovery The following is added to Paragraph 8. Transfer of Rights Of Recovery Against Others To Us under SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: We will waive any right of recovery against a person or organization because of payments we make under this Commercial General Liability Coverage Part. This waiver applies only if the insured has agreed in a written contract or written agreement to: 1. Waive any right of recovery against that person or organization; or 2. Assume the liability of that person or organization pursuant to a written contract or written agreement that qualifies as an "insured contract'; and 3. Include such person or organization as an additional insured on your policy. Such waiver by us applies only to that person or organization identified above, and only to the extent that the insured has waived its right of recovery against such person or organization prior to loss. Liberalization The following condition is added to SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: If we revise this Coverage Part to provide more coverage without additional premium charge, subject to our filed company rules, your policy will automatically provide the additional coverage as of the day the revision is effective in your state. Two or More Coverage Parts or Policies Issued By Us (This provision is not Applicable in the state of New York or Wisconsin). The following condition is added to SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: It is our intention that the various coverage parts or policies issued to you by us, or any company affiliated with us, do not provide any duplication or overlap of coverage. We have exercised diligence to draft our coverage parts and policies to reflect this intention. However, if the facts and circumstances that will respond to any claim or "suit' give rise to actual or claimed duplication or overlap of coverage between the various coverage parts or policies issued to you by us or any company affiliated with us, the limit of insurance under all such coverage parts or policies combined shall not exceed the highest applicable limit under this coverage, or any one of the other coverage forms or policies. This condition does not apply to any Excess or Umbrella policy issued by us specifically to apply as excess insurance over this coverage part or policy to which this coverage part is attached. SECTION V — DEFINITIONS Discrimination (This provision does not apply in New York). A. The following is added to Definition 14. "Personal and advertising injury": "Personal and advertising injury" also means "discrimination" that results in injury to the feelings or reputation of a natural person, however only if such "discrimination" or humiliation is: 1. Not done by or at the direction of: a. The insured; or b. Anyone considered an insured under SECTION II —WHO IS AN INSURED; 2. Not done intentionally to cause harm to another person. Copyright, 2024 Selective Insurance Company of America. All rights reserved. CG 73 00 04 25 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 8 of 9 3. Not directly or indirectly related to the employment, prospective employment or termination of employment of any person or persons by any insured. 4. Not arising out of any "advertisement" by the insured. B. The following definition is added to SECTION V — DEFINITIONS: "Discrimination" means: a. Any act or conduct that would be considered discrimination under any applicable federal, state, or local statute, ordinance or law; b. Any act or conduct that results in disparate treatment of, or has disparate impact on, a person, because of that person's race, religion, gender, sexual orientation, age, disability or physical impairment; or c. Any act or conduct characterized or interpreted as discrimination by a person based on that person's race, religion, gender, sexual orientation, age, disability or physical impairment. It does not include acts or conduct characterized or interpreted as sexual intimidation or sexual harassment, or intimidation or harassment based on a person's gender. Electronic Data The following definition is added to SECTION V — DEFINITIONS: "Electronic data" means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, including systems and applications software, hard or floppy disks, CD-ROMS, tapes, drives, cell, data processing devices or any other media which are used with electronically controlled equipment. For the purpose of the Electronic Data Liability coverage provided by this endorsement, Definition 17. "Property damage" is deleted in its entirety and replaced by the following: 17. "Property damage" means: a. Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it; or b. Loss of, loss of use of, damage to, corruption of, inability to access, or inability to properly manipulate "electronic data", resulting from physical injury to tangible property. All such loss of "electronic data" shall be deemed to occur at the time of the "occurrence" that caused it. For the purpose of the Electronic Data Liability coverage provided by this endorsement, "electronic data" is not tangible property. Employee Amendment Definition 5. "Employee" under SECTION V — DEFINITIONS is deleted in its entirety and replaced by the following: 5. "Employee" includes a "leased worker", or a "temporary worker". If you are a School, "Employee" also includes a student teacher. Golfing Facility The following definition is added to SECTION V — DEFINITIONS: "Golfing facility" means a golf course, golf club, driving range, or miniature golf course. Mental Anguish Amendment (This provision does not apply in New York). Definition 3. "Bodily injury" under SECTION V — DEFINITIONS is deleted in its entirety and replaced with the following: 3. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including death resulting from any of these at any time. This includes mental anguish resulting from any bodily injury, sickness or disease sustained by a person. (In New York, mental anguish has been determined to be "bodily injury"). Not -for -profit Member The following definition is added to SECTION V — DEFINITIONS: "Not -for -profit member" means a person who is a member of a not -for -profit organization, including clubs and churches, who receives no financial or other compensation. Copyright, 2024 Selective Insurance Company of America. All rights reserved. CG 73 00 04 25 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 9 of 9 ElitePaco Commercial Automobile Extension COMMERCIAL AUTO CA 78 09 04 24 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Business Auto Coverage Form apply unless modified by the endorsement. AMENDMENT TO SECTION I - COVERED AUTOS COVERAGES AND SECTION II - COVERED AUTOS LIABILITY COVERAGE If this policy provides Auto Liability coverage for Owned Autos, the following extension is applicable: EMPLOYEE OWNED AUTOS - BUSINESS USE Solely for purposes of the coverage extended by this endorsement: A. The following is added to SECTION I, A. Description of Covered Auto Designation Symbols: Coverage symbols 1, 2, 3, 4, 5, 6 and 7 are amended to include the following: Any "auto" owned by an "employee" specifically described on the Declarations page or on file with us when issued on a non -specified "auto" basis is considered an "auto" you own and not a covered "auto" you hire, borrow or lease; and B. The following is added to SECTION 11, A.I. Who Is An Insured: An "employee" who is the owner of a specifically described "auto" on the Declarations page or on file with us when issued on a non -specified "auto" basis is an "insured". If the "employee" owned "auto" is used: 1. Without your permission; 2. Outside the scope of any policies and procedures your business has for acceptable vehicle usage; 3. For any purpose other than the conduct of your business; or 4. By anyone other than the "employee" who owns the "auto", except another "employee", the limits of liability available to the "employee" or anyone other than a named "insured" under all coverages shall be limited to the higher of: 1. $250,000; or 2. The compulsory or financial responsibility law limits where the "auto" is licensed and principally garaged. AMENDMENTS TO SECTION II - LIABILITY COVERAGE A. If this policy provides Auto Liability coverage for Owned Autos, the following extensions are applicable accordingly: NEWLY ACQUIRED OR FORMED ORGANIZATIONS The following is added to SECTION II, A.I. - Who Is An Insured: Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no similar insurance available to that organization. However: 1. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; 2. Coverage does not apply to "bodily injury" or "property damage" resulting from an "accident' that occurred before you acquired or formed the organization. No person or organization is an "insured" with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. Copyright, 2023 Selective Insurance Company of America. All rights reserved. CA 78 09 04 24 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 7 B EXPENSES FOR BAIL BONDS AND LOSS OF EARNINGS Paragraphs (2) and (4) of SECTION II, A.2.a. - Supplementary Payments are deleted in their entirety and replaced with the following: (2) Up to the Limit of Insurance shown on the ElitePac Schedule for the cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" covered under this policy. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the "insured" at our request. This includes actual loss of earnings because of time off from work, which we will pay up to the Limit of Insurance shown on the ElitePac Schedule. EMPLOYEE INDEMNIFICATION AND EMPLOYER'S LIABILITY AMENDMENT The following is added to SECTION II, B.4. - Exclusions: This exclusion does not apply to a "volunteer worker" who is not entitled to workers compensation, disability or unemployment compensation benefits. FELLOW EMPLOYEE COVERAGE The Fellow Employee Exclusion, SECTION II, B.S. - is deleted in its entirety. CARE, CUSTODY OR CONTROL AMENDMENT The following is added to SECTION II, B.6. - Exclusions: This exclusion does not apply to property owned by anyone other than an "insured", subject to the following: 1. The most we will pay under this exception for any one "accident" is the Limit of Insurance stated in the ElitePac Schedule; and 2. A per "accident" deductible as stated in the ElitePac Schedule applies to this exception. This coverage extension does not apply to Emergency Services Organizations and Governmental Entities. If this policy provides Auto Liability coverage for Owned Autos, Non -Owned Autos or Hired Autos, the following extensions are applicable accordingly: LIMITED LIABILITY COMPANIES The following is added to SECTION II, A.1. - Who Is An Insured: If you are a limited liability company, your members and managers are "insureds" while using a covered "auto" you don't own, hire or borrow during the course of their duties for you. BLANKET ADDITIONAL INSUREDS - As Required By Contract The following is added to SECTION II, A.I. - Who Is An Insured: Any person or organization whom you have agreed in a written contract, written agreement or written permit that such person or organization be added as an additional "insured" on the Business Auto Coverage Part on your policy is an additional "insured", but only with respect to liability for "bodily injury' or "property damage" caused, in whole or in part, by your ownership, maintenance or use of a covered "auto". This coverage shall be primary and non-contributory with respect to the additional "insured". This provision only applies if: 1. It is required in the written contract, written agreement or written permit identified in this section; 2. It is permitted by law; and 3. The written contract or written agreement has been executed (executed means signed by a named insured) or written permit issued prior to the "bodily injury" or "property damage". C. If this policy provides Auto Liability coverage for Non -Owned Autos, the following extension is applicable accordingly: EMPLOYEES AS INSUREDS If this policy provides Auto Liability coverage for Non -Owned Autos, the following is added to SECTION II, A.1. -Who Is An Insured: Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in that "employee's" name with your permission, while performing duties related to the conduct of your business. AMENDMENTS TO SECTION III - PHYSICAL DAMAGE COVERAGE For those covered "autos" for which Comprehensive, Specified Causes of Loss or Collision coverage shown in the Declaration, the following extensions of coverage are applicable: Copyright, 2023 Selective Insurance Company of America. All rights reserved. CA 78 09 04 24 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 7 TOWING AND LABOR SECTION III, A.2. - Towing is deleted in its entirety and replaced with the following: We will pay all reasonable towing and labor costs up to the applicable Limit of Insurance shown on the ElitePac Schedule per tow each time a covered "Private Passenger Auto", "Social Service Van or Bus", "Light Truck" or any commercial "auto" with a gross vehicle weight rating or gross combination weight greater than 10,000 pounds is disabled. For labor charges to be eligible for reimbursement the labor must be performed at the place of disablement. Coverage for towing and labor costs afforded by any other endorsement added to the commercial auto policy shall apply in excess of the coverage afforded by this ElitePac. This coverage extension does not apply to Emergency Services Organizations and Governmental Entities. GLASS BREAKAGE DEDUCTIBLE The following is added to SECTION III, A.3. - Glass Breakage - Hitting A Bird Or Animal - Falling Objects or Missiles: If damaged glass is repaired rather than replaced, no deductible will apply for such repair. This extension does not apply to Emergency Services Organizations and Governmental Entities. ADDITIONAL TRANSPORTATION EXPENSES SECTION III, A.4.a. - Transportation Expenses is deleted in its entirety and replaced with the following: We will pay up to the Limit of Insurance shown on the ElitePac Schedule for temporary transportation expenses that you incur because of any "loss" to a covered "auto", but only if the covered "auto" carries the coverages and meets the requirements described in Paragraphs 1. or 2. below: 1. We will pay temporary transportation expenses for total theft of a covered "auto". We will only pay for such expenses incurred during the period beginning 24 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its "loss". 2. For "loss" other than total theft of a covered "auto" under Comprehensive or Specified Causes of Loss Coverage, or for any "loss" under Collision Coverage to a covered "auto", we will only pay for those temporary transportation expenses incurred during a period of time reasonably required to repair or replace the covered "auto", even if that time period extends beyond the policy expiration date. Paragraph 2. of this extension does not apply while there are spare or reserve "autos" available to you for your operations. The 24 hour waiting period found on any other form endorsed onto the Auto Coverage part does not apply for any covered Rental Reimbursement "loss". This coverage extension does not apply to Emergency Services Organizations and Governmental Entities. HIRED AUTO PHYSICAL DAMAGE COVERAGE If Comprehensive, Specified Causes of Loss or Collision coverage applies to a covered "auto", the following is added to SECTION III, A.4. - Coverage Extensions: Physical Damage coverage is hereby extended to apply to Physical Damage "loss" to "autos" leased, hired, rented or borrowed without a driver. We will provide coverage equal to the broadest coverage available to any covered "auto" shown on the Declarations; however, the most we will pay for "loss" to each "auto" under this coverage extension is the lesser of: The Limit of Insurance stated in the ElitePac Schedule; or 2. The actual cash value of the damaged or stolen property as of the time of the "loss"; or 3. The actual cost of repairing or replacing the damaged or stolen property with other property of like kind and quality. A part is of like kind and quality when it is of equal or better condition than the pre - accident part. We will use the original equipment from the manufacturer when: (a) The operational safety of the vehicle might otherwise be impaired; (b) Reasonable and diligent efforts to locate the appropriate rebuilt, aftermarket or used part have been unsuccessful; or (c) A new original equipment part of like kind and quality is available and will result in the lowest overall repair cost. For each leased, hired, rented or borrowed covered "auto" our obligation to pay each applicable "loss" will be reduced by the hired "auto" deductible on this policy. If there is no hired "auto" coverage symbol 8 for physical damage coverage on the policy, our obligation to pay for each "loss" will be reduced by the deductible equal to the highest deductible applicable to any owned "auto" for that coverage. No deductible will be applied to any "loss" caused by fire or lightning. Copyright, 2023 Selective Insurance Company of America. All rights reserved. CA 78 09 04 24 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 7 SECTION IV, 6.5. Other Insurance Condition, Paragraph 5.b. is deleted in its entirety and replaced by the following: For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos"' you own: 1. Any covered "auto" you lease, hire, rent, or borrow; and 2. Any covered "auto" hired or rented by your "employee" under a contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". This coverage extension does not apply to Emergency Services Organizations and Governmental Entities. HIRED AUTO LOSS OF USE COVERAGE If Comprehensive, Specified Causes of Loss or Collision coverage applies to a covered "auto", the following is added to SECTION III, A.4. - Coverage Extensions: We will pay expenses for which you are legally responsible to pay for loss of use of a leased, hired, rented or borrowed "auto" if it results from an "accident". The per day limit in the Business Auto Coverage form does not apply and the most we will pay per "accident" is the Limit of Insurance shown on the ElitePac Schedule. Loss of Use Expense limits afforded by any endorsement added to the commercial auto policy shall apply in excess of the coverage afforded by this ElitePac form. This coverage extension does not apply to Emergency Services Organizations, Governmental Entities, and Schools. AUTO LOAN/LEASE GAP COVERAGE (Not Applicable in New York) If Comprehensive, Specified Causes of Loss or Collision coverage applies to a covered "auto", the following is added to SECTION III, A.4. - Coverage Extensions: In the event of a total "loss" to a covered "auto" we will pay any unpaid amount due on the lease or loan for a covered "auto", less: 1. The amount paid under the Physical Damage Coverage Section of the policy; and 2. Any: a. Overdue or any deferred lease/loan payments at the time of "loss"; b. Financial penalties imposed under a lease for excessive use, abnormal wear and tear, high mileage or similar charges; c. Security deposits not refunded by the lessor or financial institution; . d. Costs for extended warranties, credit life, health, accident, or disability insurance purchased with the loan or lease; and e. Carry-over balances from previous leases or loans. You are responsible for the deductible applicable to the "loss" for the covered "auto". The insurance provided by this coverage provision is excess over any other collectible insurance including but not limited to any coverage provided by or purchased from the lessor or any financial institution. PERSONAL EFFECTS The following is added to SECTION III, A.4. - Coverage Extensions: If this policy provides Comprehensive Coverage for a covered "auto" you own and that covered "auto" is stolen, we will pay up to the Limit of Insurance shown on the ElitePac Schedule, without application of a deductible, for lost personal effects that were in the covered "auto" at the time of theft. Personal effects do not include jewelry, tools, money, or securities. This coverage is excess over any other collectible insurance. AIRBAG COVERAGE The following is added to SECTION III, 13.3.a. - Exclusions: Mechanical breakdown does not include the accidental discharge of an airbag. This coverage extension does not apply to Emergency Services Organizations and Governmental Entities. EXPANDED AUDIO, VISUAL, AND DATA ELECTRONIC EQUIPMENT COVERAGE SECTION III, 13.4. - Exclusions This exclusion does not apply to the following: 1. Global positioning systems; 2. "Telematic devices"; or 3. Electronic equipment that reproduces, receives or transmits visual or data signals and accessories used with such equipment, provided such equipment is: a. Permanently installed in or upon the covered "auto" at the time of the "loss"; Copyright, 2023 Selective Insurance Company of America. All rights reserved. CA 78 09 04 24 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 7 b. Removable from a housing unit that is permanently installed in the covered "auto" at the time of the "loss"; c. Designed to be solely operated by use of power from the "auto's" electrical system; or d. Designed to be used solely in or upon the covered "auto". For each covered "loss" to such equipment, a deductible of $50 shall apply, unless the deductible otherwise applicable to such equipment is less than $50, at which point the lower deductible, if any, will apply. COMPREHENSIVE DEDUCTIBLE - LOCATION TRACKING DEVICE The following is added to SECTION III, D. - Deductible: Any Comprehensive Coverage Deductible shown in the Declarations will be reduced by 50% for any "loss" caused by theft if the covered "auto" is equipped with a location tracking device and that device was the sole method used to recover the "auto". PHYSICAL DAMAGE LIMIT OF INSURANCE SECTION III, C. - Limit Of Insurance is deleted in its entirety and replaced with the following: The most we will pay for a "loss" in any one "accident" is the lesser of: 1. The actual cash value of the damaged or stolen property as of the time of the "loss"; or 2. The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality. This coverage extension does not apply to Emergency Services Organizations and Governmental Entities. GREEN AUTOMOBILE REPLACEMENT COVERAGE In the event of a total "loss" to an owned "auto" that is a "gasoline powered auto" for which Comprehensive, Specified Causes of Loss, or Collision coverage applies, Physical Damage coverage will be amended as follows: If the owned "gasoline powered auto" is replaced by you with a "green auto", we will pay an additional 10% of the "gasoline powered auto's" actual cash value up to a maximum of $3,000, provided the "auto" is replaced and a copy of a bill of sale or new lease agreement is received by us within 60 calendar days of the date of the "loss". Regardless of the number of "autos" deemed a total loss, the most we will pay under this coverage extension for any one "loss" is $10,000. AMENDMENTS TO SECTION IV - BUSINESS AUTO CONDITIONS DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS The following is added to SECTION IV, A.2.a. - Duties In The Event Of Accident, Claim, Suit Or Loss: The notice requirements for reporting "accident" claim, "suit" or "loss" information to us, including provisions related to the subsequent investigation of such "accident", claim, "suit" or "loss" do not apply until the "accident", claim, "suit" or "loss" is known to: 1. You, if you are an individual; 2. A partner, if you are a partnership; 3. An executive officer or insurance manager, if you are a corporation; 4. Your members, managers or insurance manager, if you are a limited liability company; 5. Your elected or appointed officials, trustees, board members or your insurance manager, if you are an organization other than a partnership, joint venture or limited liability company. However, this section does not amend the provisions relating to notification of police or protection or examination of the property that was subject to the "loss". WAIVER OF SUBROGATION SECTION IV, A.5. - Transfer Of Rights Of Recovery Against Others To Us is deleted in its entirety and replaced with the following: We waive any right of recovery we may have against any person or organization because of payments we make for "bodily injury" or "property damage" resulting from the ownership, maintenance or use of a covered "auto" but only when you have assumed liability for such "bodily injury" or "property damage" in an "insured contract". In all other circumstances, if a person or organization to or for whom we make payment under this Coverage Form has rights to recover damages from another, those rights are transferred to us. MULTIPLE DEDUCTIBLES The following is added to SECTION IV, A. - Loss Conditions: If a "loss" from one event involves two or more covered "autos" and coverage under Comprehensive or Specified Causes of Loss applies, only the highest applicable deductible will be applied. Copyright, 2023 Selective Insurance Company of America. All rights reserved. CA 78 09 04 24 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 7 CONCEALMENT, MISREPRESENTATION OR FRAUD The following is added to SECTION IV, B.2. - Concealment, Misrepresentation Or Fraud: If you should unintentionally fail to disclose any existing hazards in your representations to us prior to the inception date of the policy or during the policy period in connection with any newly discovered hazards, we will not deny coverage under this Coverage Form based upon such failure. POLICY PERIOD, COVERAGE TERRITORY SECTION IV, B.7. - Policy Period, Coverage Territory is deleted in its entirety and replaced with the following: Under this Coverage Form, we cover "accidents" and "losses" occurring: a. During the policy period shown in the Declarations; and b. Within the "Coverage Territory". We also cover "loss" to or "accidents" involving a covered "auto" while being transported between any of these places. TWO OR MORE COVERAGE FORMS OR POLICIES ISSUED BY US - DEDUCTIBLES The following is added to SECTION IV, B.B. - Two Or More Coverage Forms Or Policies Issued By Us: If a "loss" covered under this Coverage Form also involves a "loss" to other property resulting from the same "accident" that is covered under this policy or another policy issued by us or any member company of ours, only the highest applicable deductible will be applied. AMENDMENTS TO SECTION V - DEFINITIONS BODILY INJURY INCLUDING MENTAL ANGUISH (Not Applicable in New York) The definition of bodily injury is deleted in its entirety and replaced by the following: "Bodily injury" means bodily injury, sickness, or disease sustained by a person, including death resulting from any of these. "Bodily injury" includes mental anguish resulting from bodily injury, sickness or disease sustained by a person. ADDITIONS TO SECTION V - DEFINITIONS COVERAGE TERRITORY "Coverage Territory" means: 1. The United States of America (including its territories and possessions), Canada and Puerto Rico; and 2. Anywhere in the world, except for any country or jurisdiction that is subject to trade or other economic sanction or embargo by the United States of America, if a covered "auto" is leased, hired, rented, or borrowed without a driver for a period of 30 days or less, and the insured's responsibility to pay "damages" is determined in a "suit" on the merits in and under the substantive law of the United States of America (including its territories and possessions), Puerto Rico, or Canada, or in a settlement we agree to. If we are prevented by law, or otherwise, from defending the "insured" in a "suit" brought in a location described in Paragraph 2. above, the insured will conduct a defense of that "suit". We will reimburse the "insured" for the reasonable and necessary expenses incurred for the defense of any such "suit" seeking damages to which this insurance applies, and that we would have paid had we been able to exercise our right and duty to defend. GASOLINE POWERED AUTO An "auto" that is designed to be solely powered by petroleum -based fuel. GREEN AUTO An "auto" that is designed to be powered by both petroleum -based fuel and electric power; or solely by electricity or any other renewable energy source. LIGHT TRUCK "Light Truck" means a truck with a gross vehicle weight rating of 10,000 pounds or less. PRIVATE PASSENGER AUTO "Private Passenger Auto" means a four-wheel "auto" of the private passenger or station wagon type. A pickup, panel truck or van not used for business is included within the definition of a "private passenger auto". Copyright, 2023 Selective Insurance Company of America. All rights reserved. CA 78 09 04 24 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 7 SOCIAL SERVICE VAN OR BUS "Social Service Van or Bus" means a van or bus used by a government entity, civic, charitable or social service organization to provide transportation to clients incidental to the social services sponsored by the organization, including special trips and outings. TELEMATIC DEVICE "Telematic Device" includes devices designed for the collection and dissemination of data for the purpose of monitoring vehicle and/or driver performance. This includes Global Positioning System technology, wireless safety communications and automatic driving assistance systems, all integrated with computers and mobile communications technology in automotive navigation systems. VOLUNTEER WORKER "Volunteer worker" means a person who is not your "employee" and who donates their work and acts at the direction of you and within the scope of duties determined by you, and is not paid a fee, salary or other compensation by you or anyone else for their work performed for you. Copyright, 2023 Selective Insurance Company of America. All rights reserved. CA 78 09 04 24 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 7 OTHER INSURANCE CONDITION FOR ADDITIONAL INSUREDS - NON-CONTRIBUTORY - BLANKET BASIS COMMERCIAL UMBRELLA LIABILITY CXL 449 06 17 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL UMBRELLA LIABILITY COVERAGE PART The following is added to SECTION IV — CONDITIONS, Paragraph H. Other Insurance: With respect to each additional insured under SECTION II, WHO IS AN INSURED, Paragraph A.5., this insurance is (i) excess over any "underlying policy", and (ii) primary to, and we will not seek contribution from, any other insurance providing coverage to any such additional insured whether primary or excess. However, we will not waive our right to seek contribution from other insurance unless: a. The additional insured is a Named Insured under such other insurance; b. The additional insured is included as an additional insured on an "underlying policy'; c. You have agreed in a written contract, written agreement or written permit that this insurance would be primary to and/or would not seek contribution from any other insurance provided to the additional insured; and d. The written contract or written agreement has been executed (executed means signed by the Named Insured) or written permit issued prior to the "bodily injury' or "property damage" or "personal and advertising injury'. The most we will pay on behalf of the additional insured is the amount of insurance required by the written contract, written agreement or written permit, less any amounts payable by any "underlying insurance", subject to SECTION III — LIMITS OF INSURANCE. This provision is included within and does not act to increase the Limits of Insurance stated in the Declarations. Copyright, 2016 Selective Insurance Company of America. All rights reserved. CXL 449 06 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 Westchester A Chubb Company ADDITIONAL INSURED ENDORSEMENT — ONGOING WORK OR OPERATIONS Named Insured Endorsement Number AAA Sweeping, LLC Policy Symbol Policy Number I Policy Period Effective Date of Endorsement CID G24330746 014 10/19/2025 to 10/19/2026 10/19/2025 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE: Name of Person(s) or Organization(s): As required by written contract, prior to a loss to which this insurance applies. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. SECTION II - WHO IS AN INSURED is amended to include as an additional insured the persons or organizations shown in the Schedule, but only with respect to liability for injury or damage, to which this insurance applies, caused in ,whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insureds. However: i. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: Exclusions This insurance does not apply to injury or damage occurring after: a. All work or operations, including materials, parts or equipment furnished in connection with such work or operations, on the project (other than service, maintenance or repairs) to be performed by you or on your behalf at the site of the covered operations has been completed; or b. That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for the additional insured as a part of the same project. ENV-3250 (12/18) Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 1 of 2 (221012.1) Westchester A Chubb Company C. With respect to the insurance afforded to these additional insureds, the following is added to SECTION III — LIMITS OF INSURANCE: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. All other terms and conditions of this policy remain unchanged. ENV-3250 (12/18) Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 2 of 2 (221012.1) Westchester A Chubb Company ADDITIONAL INSURED ENDORSEMENT - PRODUCTS -COMPLETED OPERATIONS HAZARD Named Insured Endorsement Number AAA Sweeping, LLC Policy Symbol Policy Number I Policy Period Effective Date of Endorsement CID G24330746 014 10/19/2025 to 10/19/2026 10/19/2025 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization(s): As required by written contract, prior to a loss to which this insurance applies. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. SECTION II - WHO IS AN INSURED is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for injury or damage, to which this insurance applies, caused by or resulting from your work performed for that additional insured and included in the products -completed operations hazard, and only to the extent that such injury or damage is caused, in whole or in part, by your negligence or the negligence of those acting on your behalf. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to SECTION III - LIMITS OF INSURANCE: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: i. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. All other terms and conditions of this policy remain unchanged. ENV-3251 (12/18) Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 1 of 1 (221012.2) Westchester A Chubb Company PRIMARY AND NONCONTRIBUTORY — OTHER INSURANCE. CONDITION Named Insured Endorsement Number AAA Sweeping, LLC Policy Symbol Policy Number Policy Period Effective Date of Endorsement CPW G2433o746 o14 to 1 202 to io > 2026 tot 20z Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: CONTRACTOR'S POLLUTION LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary and Noncontributory Insurance This policy is primary to, and will not seek contribution from, any other insurance available to an additional insured under this policy, provided that: a. The additional insured is a named insured under such other insurance; and b. The named insured has agreed in a written contract or agreement that this insurance would: (1) act as primary insurance; and (2) would not seek contribution from any other insurance available to the additional insured. All other terms and conditions of this policy remain unchanged. ENV-3253 (12-15) Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 1 of t (266562.2) Westchester A Chubb Company PRIMARY AND NONCONTRTRITTORY — OTHER TNSTTRANCF. CONDITION Named Insured Endorsement Number AAA Sweeping, LLC Policy Symbol Policy Number Policy Period Effective Date of Endorsement CPW G2433o746 o14 10 1 202 to 10 1 2026 to i 202 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: CONTRACTOR'S POLLUTION LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary and Noncontributory Insurance This policy is primary to, and will not seek contribution from, any other insurance available to an additional insured under this policy, provided that: a. The additional insured is a named insured under such other insurance; and b. The named insured has agreed in a written contract or agreement that this insurance would: (1) act as primary insurance; and (2) would not seek contribution from any other insurance available to the additional insured. All other terms and conditions of this policy remain unchanged. ENV-3253 (12-18) Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 1 of 1 (266562.2) Named Insured Endorsement Number AAA Sweeping, LLC Policy Symbol Policy Number I Policy Period Effective Date of Endorsement CPW G24330746 014 10/19/2025 to 10/19/2026 10/19/2025 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: As required by written contract, prior to a loss to which this insurance applies. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or your work done under a contract with that person or organization and included in the products -completed operations hazard. This waiver applies only to the person or organization shown in the Schedule above. All other terms and conditions remain the same. ENV-3143 (03-05) Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 1 of 1