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HomeMy WebLinkAbout24-040.01AAASweepingStormDrainCleaningServices Spokane Valle 10210 E Sprague Avenue ♦Spokane Valley WA 99206 tJ Phone: (509)720-5000•Fax:(509)720-5075 •www.spokanevalley.org .000 �J Email:cityhall@spokanevalley.org November 14th,2024 Contract No. 24-040.01 AAA Sweeping LLC Attn: Brett Sargent 3808 N Sullivan Rd 3808 Bldg 107B Spokane Valley,WA 99216 Re: Implementation of 2025 option year, Agreement.for Storm Drain Cleaning Services, Contract number 24-040, executed March 26th, 2024. Dear Mr. Sargent: The City executed an Agreement for provision of Storm Drain Cleaning Services on March 26, 2024, by and between the City of Spokane Valley, hereinafter "City", and AAA Sweeping LLC,hereinafter"Contractor"and jointly referred to as"Parties." The original Agreement states that it was for one year, with three optional one-year terms possible if the parties mutually agree to exercise the options each year. This is the first of three possible option years that can be exercised and runs through December 31,2025. The City would like to exercise the 2025 option year of the Agreement. The Compensation as outlined in Exhibit A, 2025 to the Agreement, includes contract allowed increases for the labor and material cost negotiated and shall not exceed $219,549.50. The history of the annual renewals, including dollar amounts, is set forth as follows: Original contract amount $ 219,549.50 2025 Renewal $ 219,549.50 All of the other contract provisions contained in the original Agreement shall remain in place and remain unchanged in exercising this option year. If you are in agreement with exercising the 2025 option year, please sign below to acknowledge the receipt and concurrence to perform the 2025 option year. Please return two copies to the City for execution, along with current insurance information. A fully executed original copy will be mailed to you for your files. CITY OF SPOKANE VALLEY AAA SWEEPING, LLC Jo n Hohmann,City Manager Name Title ATTEST: ,001,0 Marci atterson,City Clerk APPROVED AS TO FORM: ff e of the C. y Attorney Exhibit A - 2025 Cost Proposal 2025 Storm Drain Cleaning Services Contractor : AAA Sweeping Task Unit 2024 Rate 2025 Rate Structure Cleaning Hour $ 210.50 $ 215.97 Laborer Hour $ 75.00 $ 76.95 Traffic Control/ Flagging Hour $ 111.80 $ 114.71 Absorbant Liquid Hold Each $ 60.00 $ 61.56 Absorbant Material Each $ 800.00 $ 820.80 Debris Transfer Hour $ 210.50 $ 215.97 11/19/24,9:54 AM AAA SWEEPING LLC ar STATE OF WASHINGTON Department of Labor& Industries Certificate of Workers' Compensation Coverage November 19, 2024 WA UBI No. 602 346 432 L&I Account ID 500,499-04 Legal Business Name AAA SWEEPING LLC Doing Business As AAA SWEEPING LLC Workers'Comp Premium Status: Account is current. Estimated Workers Reported Quarter 3 of Year 2024"21 to 30 Workers" (See Description Below) Account Representative Employer Services Help Line, (360)902-4817 Licensed Contractor? Yes License No. AAASWL"963CA License Expiration 02/01/2026 What does "Estimated Workers Reported" mean? Estimated workers reported represents the number of full time position requiring at least 480 hours of work per calendar quarter. A single 480 hour position may be filled by one person, or several part time workers. Industrial Insurance Information Employers report and pay premiums each quarter based on hours of employee work already performed, and are liable for premiums found later to be due. Industrial insurance accounts have no policy periods, cancellation dates, limitations of coverage or waiver of subrogation (See RCW 51 .1 2.050 and 51 .16.190). https://secu re.lni.wa.gov/verify/Details/IiabilityCertificate.aspx?U B 1=602346432&LI C=AAASWL`963CA&V1O=&SAW=false&ACCT=50049904 1/1 Client#: 1926592 AAASWE2 YI� ACORDr. CERTIFICATE OF LIABILITY INSURANCE 10/2 DATE(M2/2024 MIDD/YYWDD/YY 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 ACT Jordynn Crouse USI Insurance Services NW CL PHONE 509-606-0245 F4X 610-362-8530 Ext): (A/C,No): 601 Union Street, Suite 1000 EIL SS: orY Jd nn.Crouse usi.com A-MADDRE Seattle,WA 98101 INSURER(S)AFFORDING COVERAGE NAIL# _ INSURER A:Alaska National Insurance Company 38733 INSURED INSURER B:Steadfast Insurance Company 26387 AAA Sweeping, LLC P INSURER C Westchester Surplus Lines Insurance Co. 10172 : 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 LTRINSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY X X 24JPS30908 10/19/2024 10/19/2025 EACH OCCURRENCE $1,000,000 1 CLAIMS-MADE X OCCUR PREMISES TO RENTED occu 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- POLICY X JECT LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: WA StopGap $1,000,000 A AUTOMOBILE LIABILITY X X 24JAS30908 10/19/2024 10/19/2025 COMBINEDaccident)SI �NGLE LIMIT 1>OOO>00O (Ea 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 X UMBRELLA LIAB X OCCUR X X 24JLU30908 10/19/2024 10/19/2025 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000__ DED RETENTION$ _ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN 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 $ B Excess Liability AEC318087300 10/19/2024 10/19/2025 $5,000,000 A L/R/H 24JIA30908 10/19/2024 10/19/2025 $100,000/$5,000 ded C Pollution Liab G24330746013 10/19/2024 10/19/2025 $1,000,000/$5,000 ded DESCRIPTION OF OPERATIONS/LOCATIONS/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 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) 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 99206-0000 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #546773693/M46769307 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 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 7of7 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 this policy. If such person or organization SECTION III — PHYSICAL DAMAGE COVERAGE, 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 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 forSECTION III — PHYSICAL DAMAGE COVERAGE, incurred temporary transportation expenses Paragraph A.3. — Glass Breakage — Hittinga Bird during the period beginning 48 9 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 National 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. (4) Panel; or SECTION III — PHYSICAL DAMAGE COVERAGE, 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, onlyif the incurred during the policy period beginning 24 hours after the "loss" Declarations indicate that and ending, regardless of the policy's Comprehensive Coverage is provided 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 t 1T1 (O�� Val ley BOND NO: 107866697 CONTRACTOR'S NON-FEDERAL PAYMENT BOND to City of Spokane Valley, Washington The City of Spokane Valley, Washington, in Spokane County, has awarded to AAA Sweeping, L.L.C. (Contractor), as Principal, a contract for the construction of the project designated as Storm Drain Cleaninq Project No24-040.01 in Spokane Valley, Washington, and said Principal is required under the terms of the Contract to famish a payment bond in accord with Title 39.08 Revised Code of Washington (RCW). The Principal, and Travelers Casualty and Surety Company of America (Surety), a corporation organized under the laws of the State of Washington and licensed to do business in the State of Washington as surety and named in the current list of "Surety Companies Acceptable in Federal Bonds" as published in the Federal Register by the Audit Staff' Bureau of Accounts, U.S. Treasury Deft.. are jHointly and nvcrally held and firmly bound to the City of Spokane Valley, to the Sum of Two Hundred Nine en Th usand Five undre Fifty Dol ars and 0 100 US Dollars ($219,550.00 ) Total Contract Amount, subject to the provisions herein. The statutory payment bond shall become null and void, if and when the Principal, its heirs, executors, administrators, successors, or assigns shall pay all persons in accordance with RCW 39.08 and 39.12 including all workers, laborers, mechanics, subcontractors, and materiatmen, and all persons who shall supply such contractor or subcontractor with provisions and supplies for the carrying on of such work. and all taxes incurred on said Contract under Title 50 and 51 RCW and all taxes imposed on the Principal under Title 82 RCW and if such payment obligations have not been fulfilled, this bond shall remain in full force and effect. The Surety for value received agrees that no change, extension of time, alteration or addition to the terms of the Contract, the specifications accompanying the Contract, or to the work to be performed under the Contract shall in any way affect its obligation on this bond, except as provided herein, and waives notice of any change, extension of time, alteration or addition to the terms of the Contract or the work performed. The Surety agrees that modifications and changes to the tenns and conditions of the Contract that increase the total amount to be paid the Principal shall automatically increase the obligation of the Surety on this bond and notice to Surety is no required fbr such increased obligation. This bond may be executed in two (2) original counterparts, and shall be signed by the parties' duty authorized officers. This bond will only be accepted if it is accompanied by a fully executed and original power of attorney for the officer executing on behalf of the surety. PRINCIPAL (CONTRACTOR) AAA Sweeping, L.L.C. Pra�cipat'S ture DSte r-0' A/L � Printed Name •�- r / Title SURETY Travelers Casualty and Surer Company of America 12a Surety Signature Date Kristine Santamaria Printed Name Attorney -in -Fact _ Title Name. address, and telephone of local office/agent of Surety Company is: USI Insurance Services Northwest 601 Union Street, Suite 1000, Seattle, WA 98101 206-441-6300 Approved as to form: City of Spokane Valley Attorney, County of Spokane Date N,« «kane ,,;W0 Va11ey BOND N0: 107866697 CONTRACTOR'S PERFORMANCE BOND to City of Spokane Valley, Washington The City of Spokane Valley, Washington, in Spokane County, has awarded to AAA Sweeping. L.L.C. (Contractor), as Principal, a contract for the construction of the project designated as Storm Drain Cleaning , Project No.24-040.01 in Spokane Valley, Washington, and said Principal is required to furnish a bond for performance of all obligations under the Contract. The Principal, and Travelers Casualty and Surety Company of America (Surety), a corporation, organized under the laws of the State of Washington and licensed to do business in the State of Washington as surety and named in the current list of "Surety Companies Acceptable in Federal Bonds" as published in the Federal Register by the Audit Staff Bureau of Accountst UHS. Tre surd eft. ire irjtl� t even lolW, Neld and firmly bound to the City of Spokane Valley, in the sum of "° undyed mete n o sartd ive un re i y o ars an US Dollars ($219,550.00 1 Total Contract Amount, subject to the provisions herein. The statutory performance bond shall become null and void, if and when the Principal, its heirs, executors, administrators, successors, or assigns shall well and faithfully perform all of the Principal's obligations under the Contract and fulfill all the terms and conditions of all duly authorized modifications, additions, and changes to said Contract that may hereafter be made, at the time and in the manner therein specified; and if such performance obligations have not been fulfilled, this bond shall remain in full force and effect. The Surety for value received agrees that no change, extension of time, alteration or addition to the terms of the Contract, the specifications accompanying the Contract, or to the work to be performed under the Contract shall in any way affect its obligation on this bond, and waives notice of any change, extension of time, alteration or addition to the terms of the Contract or the work performed. The Surety agrees that modifications and changes to the terms and conditions of the Contract that increase the total amount to be paid the Principal shall automatically increase the obligation of the Surety on this bond and notice to Surety is no required for such increased obligation. This bond may be executed in two (2) original counterparts, and shall be signed by the parties' duly authorized officers. This bond will only be accepted if it is accompanied by a fully executed and original power of attorney for the officer executing on behalf of the surety. PRINCIPAL (CONTRACTOR) AAA Sweeping, L.L.C. PrMI, Signature � Date Al -'/— Printed Name Title 1GY 1.73M Travelers Casualty and Surety Company of America �y 12/31 /2624 Surety Signature - Date Kristine Santamaria Printed Name Attorney -in -Fact Title Name, address, and telephone of local office/agent of Surety Company is: US] Insurance Services Northwest 601 Union Street, Suite 1000, Seattle, WA 98101 206-441-6300 Approved as to form: City of Spokane Valley Attorney, County of Spokane Date TRAVELERS JM Travelers Casualty and Surety Company of America Travelers Casualty and Surety Company 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 Kristine Santamaria 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. �HAMW'n fJAlt\4ty, J'.tr Ah0 a , A col a MAN7TOA0pr�obA 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. Ql..— My Commission expires the 30th day of June, 2026etio `'Anna P. Nowik, Notary Public 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 Bach cf -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 31st day of December, 2024 . EOP"O* CONN. $ Kevin E. Hughes, Assistant Secretary To verify the authenticity of this Power of Attorney, please call us at 1-800-421-3880, Please refer to the above -named Attorney(s)-in-Fact and the details of the bond to which this Power ofAttorney is attached. 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