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25-004.00 21stUSAWestSquareDanceConvention2025LodgingTaxGrant 25-004.00 THE CITY OF SPOKANE VALLEY GRANT AGREEMENT—LODGING TAX Grant Recipient: 21st USA West Square Dance Convention Project: 21st USA West Square Dance Convention Award Amount: $30,000. Contract#: 25-004.00 Term Period: January 1,2025 To December 31,2025 THIS AGREEMENT is made by and between the City of Spokane Valley,a non-charter code City of the State of Washington, hereinafter referred to as "City," and 21st USA West Square Dance Convention,hereinafter referred to as"Entity,"jointly referred to as"Parties." DEFINITIONS 1. Tourism Promotion. "Tourism promotion"means activities,operations,and expenditures designed to increase tourism,including but not limited to advertising,publicizing,or otherwise distributing information for the purpose of attracting and welcoming tourists;developing strategies to expand tourism; operating tourism promotion agencies;and funding the marketing of or the operation of special events and festivals designed to attract tourists. 2. Fund(s). "Fund(s)" is defined as any amount of compensation derived from the lodging tax monies of the City of Spokane Valley which is allocated to Entity for tourism promotion. IN CONSIDERATION of the terms and conditions contained herein, the Parties covenant and agree as follows: 1. Purpose of Agreement. The purpose of this Agreement is for City and Entity to promote tourism in the City of Spokane Valley. City agrees to make lodging tax funds available to Entity for the purpose of tourism promotion in an effort to attract visitors and create business and revenue in the City of Spokane Valley. 2. Administration. The Accounting and Finance Program Manager shall administer and be the primary contact for Entity regarding terms of this Agreement. For good cause,as solely determined by City, City may direct that Entity is no longer entitled to the use of said funds for tourism promotion and terminate this Agreement. 3. Representations. Entity shall use the funds received from City for tourism promotion and advertising solely for the purposes and in accordance with the proposal submitted by Entity to the City, attached as Exhibit 1 and incorporated herein by reference. Entity shall perform the services and work set forth in the proposal and promptly cure any failure in performance. City shall not be obligated to and shall not provide any funds for uses other than those set forth in the proposal. City has relied upon the representations made by Entity in the proposal. By execution of this Agreement, Entity represents that the funds will be used for tourism promotion as defined by this Agreement in accordance with all current laws, rules,and regulations and solely for the purposes set forth in the proposal attached as Exhibit 1. No substitutions of purpose or use of the funds shall be made without the written consent of City. City shall make decisions and carry out its other responsibilities in a timely manner. Page 1 of 13 25-004.00 4. Reporting. RCW 67.28.1816 includes reporting requirements for the Entity and the City on the use of funds distributed pursuant to this Agreement and the estimated and actual number of increased visitors. These reports are required to be provided from the Entity to City and from the City to the Joint Legislative Audit and Review Committee(JLARC). The following provisions allow the Entity and City to meet their respective requirements under RCW 67.28.1816. A. Estimated Increase in Visitors. As part of the Entity's proposal in Exhibit 1,the Entity provided an estimate of the number of visitors resulting from the use of funds under this Agreement. This estimate shall be provided to JLARC as part of annual reporting. B. Final Report on Increase in Visitors. Upon completion of the tourism promotion as specified in Exhibit 1 of this Agreement,the Entity shall complete a report substantially in the form of Exhibit 3 and provide to the City a final report of the number of visitors resulting from the use of funds under this Agreement and expenditures and uses of funds under this Agreement. The number of visitors shall be based on an actual count,or if it is not practical to make an actual count, a good faith best-estimate of the number of visitors resulting from the use of funds under this Agreement. The final report shall describe the methods used to determine the actual number of visitors, or in the event such numbers were determined from an estimate, the methods used to determine such estimates. The final report shall accompany the Entity's final reimbursement request submission. If the report is not filed with the final request, the City may elect to withhold payment until the Entity submits the report. C. City Reporting. The City shall provide the Entity's estimates in Exhibit 1 and final report in Exhibit 3 to JLARC prior to the reporting deadline set by JLARC for the 2025 awards. 5. Modifications. City may modify this Agreement and order changes in the work whenever necessary or advisable. Entity will accept modifications consistent with state and local law when directed in writing by the City Manager or his designee,the Accounting and Finance Program Manager. 6. Term of Contract. This Agreement shall be in full force and effect upon full execution and shall remain in effect until terminated when(a) Entity expends all of the funds granted by City and(b) Entity provides the annual report required pursuant to Section 4 of this Agreement. Tourism promotion activities and work set forth in the proposal and presentation shall be completed from January 1, 2025 to December 31,2025. Either Party may terminate this Agreement by 30-days written notice to the other Party or with no notice upon a determination by the City that the funds will not be or have not been used for the purpose as stated in this Agreement. In the event of such termination,City shall cease and desist from distributing any further funds to Entity for work performed or otherwise. 7. Total Grant Amount. City agrees to reimburse Entity for out-of-pocket costs incurred in an amount not to exceed $30,000. USD. The Parties agree that such amount is contingent upon the City receiving sufficient lodging tax revenues from the tax imposed pursuant to SVMC 3.20.010(A). In the event that lodging taxes are not sufficient,the compensation amount shall be modified based on amounts actually collected by the City and available for disbursement at the time of the request. 8. Process and Requirements for Reimbursement from Available Grant Funds. City shall reimburse Entity periodically upon presentation of an invoice to City. Entity shall be responsible for providing written evidence demonstrating that the City funds were used for tourism promotion for the purposes set forth in the proposal. Accordingly, the City shall not reimburse any expenses until Entity provides the City's required summary/cover sheet, a detailed description of the services, goods, or other costs incurred and expended,as well as copies of the invoices and receipts and proof of payment for which Page 2 of 13 25-004.00 Entity is requesting reimbursement. For any payroll related reimbursement requests, a description of the work performed for the hours being requested must be submitted, along with any timesheets or similar payroll documents. In the event no invoice was provided to Entity, Entity shall provide an affidavit under penalty of perjury that contains a detailed description of the use of the funds expended. Qualified expenditures shall be incurred in calendar year 2025 and paid by Entity no later than January 15, 2026. City shall not reimburse any expenditures incurred prior to or after calendar year 2025 or paid after January 15,2026. The proof of expenses and payment shall be forwarded to the Accounting and Finance Program Manager at the below stated address no later than January 21,2026. If the amount awarded is less than the requested amount in the application,Entity shall be reimbursed for line items or projects in the application up to the amount actually awarded.Also, Entity provided,and the City approved,an updated budget for the project identified in Entity's application to the City for this grant award,which updated budget is attached hereto as Exhibit 2. Entity shall not be reimbursed for a specific line item in an amount greater than the amount identified in Exhibit 2 for that line item. City reserves the right to withhold reimbursement for any expenses that the City Manager or their designee determines (A) is not authorized for reimbursement under this Agreement; (B) is not supported by the documentation required by this Agreement; or (C) was incurred in violation of, or in furtherance of a violation of City standards,City ordinances,federal law, or state law. All payments shall be subject to the availability of funds at the time the request is made. 9. Notice. Notice shall be given in writing as follows: TO CITY: TO ENTITY: Name: Sarah Fan,MBA Name:Jenn Devine Accounting and Finance Program Manager Chairman 5835 Phone Number: 509-720-5041 Phone Number: 509=323=St32"5 ?°S . p 4 Address: 10210 E. Sprague Avenue Address: •pn 130 519 Spokane Valley, WA 99206 CoL.bc.-4,L.)A qq 10. Applicable Law. The Parties,in the performance of this Agreement,agree to comply with all applicable federal, state, and local laws, ordinances, and regulations. In any legal action arising out of this Agreement,Washington law shall be applied to interpret,construe,and/or enforce the Agreement. 11. Assurance of Compliance with Applicable Federal Law. During the performance of this Agreement,the Entity,for itself, its assignees,and successors in interest agrees as follows: A. Compliance with Regulations. Entity shall comply with the federal laws set forth in subsection G,below("Pertinent Non-Discrimination Authorities")relative to non-discrimination in federally- assisted programs as adopted or amended from time-to-time, which are herein incorporated by reference and made a part of this Agreement. B. Non-discrimination. Entity, with regard to the work performed by it during this Agreement, shall not discriminate on the grounds of race,color,or national origin in the selection and retention of subcontractors, including procurements of materials and leases of equipment. Entity shall not participate directly or indirectly in the discrimination prohibited by the Acts and the Regulations, including employment practices when the contract covers any activity,project,or program set forth in Appendix B of 49 CFR Part 21. C. Solicitations for Subcontracts, Including Procurements of Materials and Equipment. In all solicitations,either by competitive bidding,or negotiation made by Entity for work to be performed under a subcontract, including procurements of materials, or leases of equipment, each potential Page 3of13 25-004.00 subcontractor or supplier shall be notified by Entity of Entity's obligations under this Agreement and the Acts and the Regulations relative to non-discrimination on the grounds of race, color, or national origin. D. Information and Reports. Entity shall provide all information and reports required by the Acts, the regulations,and directives issued pursuant thereto,and shall permit access to its books,records, accounts, other sources of information, and its facilities as may be determined by the City or the WSDOT to be pertinent to ascertain compliance with such Acts, regulations, and instructions. Where any information required of Entity is in the exclusive possession of another who fails or refuses to furnish the information,Entity shall so certify to the City or the WSDOT,as appropriate, and shall set forth what efforts it has made to obtain the information. E. Sanctions for Noncompliance. In the event of an Entity's noncompliance with the non- discrimination provisions of this Agreement, the City will impose such contract sanctions as it or the WSDOT may determine to be appropriate, including,but not limited to: 1. Withholding payments to Entity under the Agreement until Entity complies; and/or 2. Cancelling,terminating,or suspending the Agreement, in whole or in part. F. Incorporation of Provisions. Entity shall include the provisions of Section 21 of this Agreement in every subcontract,including procurements of materials and leases of equipment,unless exempt by the Acts,regulations and directives issued pursuant thereto.Entity shall take action with respect to any subcontract or procurement as the City or the WSDOT may direct as a means of enforcing such provisions,including sanctions for noncompliance. Provided,that if Entity becomes involved in, or is threatened with litigation by a subcontractor or supplier because of such direction, Entity may request that the City enter into any litigation to protect the interests of the City. In addition, Entity may request the United States to enter into the litigation to protect the interests of the United States. G. Pertinent Non-Discrimination Authorities: During the performance of this Agreement, the Entity agrees to comply with the following non-discrimination statutes and authorities; including but not limited to: Title VI of the Civil Rights Act of 1964(42 U.S.C. §2000d et seq., 78 stat.252),(prohibits discrimination on the basis of race,color,national origin);and 49 CFR Part 21;and 49 Part 26; The Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, (42 U.S.C. §4601),(prohibits unfair treatment of persons displaced or whose property has been acquired because of Federal or Federal-aid programs and projects); Federal-Aid Highway Act of 1973,(23 U.S.C. §324 et seq.), (prohibits discrimination on the basis of sex); Section 504 of the Rehabilitation Act of 1973, (29 U.S.C. §794 et seq.), as amended, (prohibits discrimination on the basis of disability); and 49 CFR Part 27; The Age Discrimination Act of 1975, as amended, (42 U.S.C. §6101 et seq.), (prohibits discrimination on the basis of age); Airport and Airway Improvement Act of 1982, (49 U.S.C. §471, Section 47123), as amended, (prohibits discrimination based on race,creed, color,national origin,or sex); Page 4 of 13 25-004.00 The Civil Rights Restoration Act of 1987,(PL 100-209),(Broadened the scope,coverage and applicability of Title VI of the Civil Rights Act of 1964,The Age Discrimination Act of 1975 and Section 504 of the Rehabilitation Act of 1973,by expanding the definition of the terms"programs or activities"to include all of the programs or activities of the Federal- aid recipients, sub-recipients and contractors, whether such programs or activities are Federally funded or not); Titles II and III of the Americans with Disabilities Act, which prohibit discrimination on the basis of disability in the operation of public entities,public and private transportation systems,places of public accommodation,and certain testing entities(42 U.S.C. §§12131- 12189)as implemented by Department of Transportation regulations at 49 C.F.R.parts 37 and 38; The Federal Aviation Administration's Non-discrimination statute (49 U.S.C. §47123) (prohibits discrimination on the basis of race,color,national origin,and sex); Executive Order 12898, Federal Actions to Address Environmental Justice in Minority Populations and Low-Income Populations, which ensures Non-discrimination against minority populations by discouraging programs, policies, and activities with disproportionately high and adverse human health or environmental effects on minority and low-income populations; Executive Order 13166, Improving Access to Services for Persons with Limited English Proficiency, and resulting agency guidance, national origin discrimination includes discrimination because of Limited English proficiency(LEP). To ensure compliance with Title VI,you must take reasonable steps to ensure that LEP persons have meaningful access to your programs(70 Fed. Reg. at 74087 to 74100);and Title IX of the Education Amendments of 1972, as amended, which prohibits you from discriminating because of sex in education programs or activities(20 U.S.C. §1681 et seq.). 12. Relationship of the Parties. It is understood,agreed,and declared that(1)this Agreement is an arms-length transaction, (2) Entity, its employees, agents, and assigns are not and shall not be considered to be agents or employees of City; and (3) nothing herein shall be construed to create a joint venture, partnership, agency, or similar relationship. Entity shall be solely responsible for the conduct and actions of all agents and employees of Entity and any liability that may attach thereto. 13. Records. The City and/or State Auditor or any of their representatives shall have full access to and the right to examine during normal business hours all of Entity's records with respect to all matters covered in this Agreement. Such representatives shall be permitted to audit, examine, and make excerpts or transcripts from such records and to make audits of all contracts, invoices, materials, payrolls, and record of matters covered by this Agreement for a period of three years from the date final payment is made hereunder. 14. Community Relations:Entity shall recognize"The City of Spokane Valley"as a"funder" in all social media, websites, brochures, banners, posters, press releases, and other promotional material related to the tourism promotion project. Entity shall recognize "The City of Spokane Valley" on any signage as "funder" of the promotional activity or project. Entity is required to obtain approval from the City Manager or designee to use the City logo on any signage and communications. If approved, the appropriate City logo will be provided by the City. Page 5 of 13 25-004.00 15. Insurance. Entity shall procure and maintain insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by Entity, its agents, representatives, employees, or subcontractors. At minimum, Entity shall maintain said insurance coverage for the entire timeframe during which Entity may take any action in regard to the tourism promotion project or activity. Entity may not take any action for which it will seek reimbursement from the grant funds unless and until Entity has secured the insurance coverage required by this Agreement. Entity's failure to secure such insurance before taking such an action shall be a material breach of this Agreement, and City may terminate this Agreement and deny reimbursement for any expenses Entity incurs in connection with this Agreement. A. Minimum Scope of Insurance. Entity shall obtain insurance of the types described below: 1. Automobile liability insurance covering all owned, non-owned, hired, and leased vehicles. Coverage shall be written on Insurance Services Office(ISO)form CA 00 01 or a substitute form providing equivalent liability coverage. If necessary,the policy shall be endorsed to provide contractual liability coverage. If use of vehicles pursuant to the Agreement is only incidental,and Entity will not transport any persons not directly related or affiliated with Entity,then Entity is only required to have automobile liability insurance to meet at least minimum Washington state requirements. 2.Commercial general liability insurance shall be at least as broad as ISO occurrence form CG 00 01 and shall cover liability arising from premises,operations,stop-gap independent contractors, and personal injury and advertising injury. City shall be named as an additional insured under Entity's commercial general liability insurance policy with respect to the work performed for the City using an additional insured endorsement at least as broad as ISO CG 20 26. 3. Workers' compensation coverage as required by the industrial insurance laws of the State of Washington. X. Does not apply; Entity is not required to carry Workers' compensation coverage B. Minimum Amounts of Insurance. Entity shall maintain the following insurance limits: 1. Automobile liability insurance with a minimum combined single limit for bodily injury and property damage of no less than $1,000,000 per accident. If Entity will not use its vehicles in the performance of this Agreement, automobile liability insurance is only required to meet Washington statutory minimum requirements. T Does not apply; Entity does not own or operate automobiles 2. Commercial general liability insurance shall be written with limits no less than $2,000,000 for each occurrence,and$2,000,000 for general aggregate. C.Other Insurance Provisions. The policies are to contain,or be endorsed to contain,the following provisions for automobile liability, professional liability, and commercial general liability insurance: 1. Entity's insurance coverage shall be primary insurance with respect to the City. Any insurance, self-insurance, or insurance pool coverage maintained by the City shall be in excess of Entity's insurance and shall not contribute with it. Page 6 of 13 25-004.00 2. Entity shall fax or send electronically in .pdf format a copy of insurer's cancellation notice within two business days of receipt by Entity. 3. If Entity maintains higher insurance limits than the minimums shown above, City shall be insured for the full available limits of commercial general and excess or umbrella liability maintained by Entity, irrespective of whether such limits maintained by Entity are greater than those required by this Agreement or whether any certificate of insurance furnished to the City evidences limits of liability lower than those maintained by Entity. 4. Failure on the part of Entity to maintain the insurance as required shall constitute a material breach of the Agreement, upon which the City may, after giving at least five business days'notice to Entity to correct the breach,immediately terminate the Agreement, or at its sole discretion, procure or renew such insurance and pay any and all premiums in connection therewith,with any sums so expended to be repaid to City on demand,or at the sole discretion of the City,offset against funds due Entity from the City. D.Acceptability of Insurers. Insurance is to be placed with insurers with a current A.M.Best rating of not less than A:VII. E. Evidence of Coverage. As evidence of the insurance coverages required by this Agreement, Entity shall furnish acceptable insurance certificates to the City at the time Entity returns the signed Agreement, which shall be Exhibit 4. The certificate shall specify all of the parties who are additional insureds, and shall include applicable policy endorsements, and the deduction or retention level. Insuring companies or entities are subject to City acceptance. If requested, complete copies of insurance policies shall be provided to the City. Entity shall be financially responsible for all pertinent deductibles, self-insured retentions,and/or self-insurance. 16. Indemnification and Hold Harmless. Entity shall,at its sole expense,defend,indemnify, and hold harmless City and its officers, agents, and employees, from any and all claims, actions, suits, liability, loss, costs, attorney's fees, costs of litigation, expenses, injuries, and damages of any nature whatsoever relating to or arising out of the wrongful or negligent acts, errors, or omissions in the services provided by Entity, Entity's agents, subcontractors, subconsultants, and employees to the fullest extent permitted by law, subject only to the limitations provided below. However, should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the Entity and the City, its officers, officials,employees,and volunteers,the Entity's liability, including the duty and cost to defend,hereunder shall be only to the extent of the Entity's negligence. It is further specifically and expressly understood that the indemnification provided herein constitutes the Entity's waiver of immunity under Industrial Insurance, Title 51, RCW, solely for the purpose of this indemnification. This waiver has been mutually negotiated by the parties. The provisions of this section shall survive the expiration or termination of this Agreement. 17. Waiver. No officer, employee, agent or other individual acting on behalf of either Party has the power,right or authority to waive any of the conditions or provisions of this Agreement. A waiver in one instance shall not be held to be a waiver of any other subsequent breach or nonperformance. All remedies afforded in this Agreement or by law, shall be taken and construed as cumulative,and in addition to every other remedy provided herein or by law. Failure of either Party to enforce at any time any of the provisions of this Agreement or to require at any time performance by the other Party of any provision hereof shall in no way be construed to be a waiver of such provisions nor shall it affect the validity of this Agreement or any part thereof. Page 7 of 13 25-004.00 18. Assignment and Delegation. Neither Party may assign,transfer or delegate any or all of the responsibilities of this Agreement or the benefits received hereunder without prior written consent of the other Party. 19. Subcontracts. Except as otherwise provided herein, Entity shall not enter into subcontracts for any of the work contemplated under this Agreement without obtaining prior written approval of City. 20. Confidentiality. Entity may, from time to time, receive information which is deemed by the City to be confidential. Entity shall not disclose such information without the prior express written consent of the City or upon order of a Court of competent jurisdiction. 21. Jurisdiction and Venue. This Agreement is entered into in Spokane County,Washington. Disputes between the City and Entity shall be resolved in the Superior Court of the State of Washington in Spokane County. Notwithstanding the foregoing, Entity agrees that it may,at the City's request,be joined as a party in any arbitration proceeding between the City and any third party that includes a claim or claims that arise out of,or that are related to Entity's services under this Agreement. Entity further agrees that the Arbitrator(s) decision therein shall be final and binding on Entity and that judgment may be entered upon it in any court having jurisdiction thereof. 22. Cost and Attorney's Fees. The prevailing party in any litigation or arbitration arising out of this Agreement shall be entitled to its attomey's fees and costs of such litigation(including expert witness fees). 23. Entire Agreement. This written Agreement constitutes the entire and complete agreement between the Parties and supersedes any prior oral or written agreements. This Agreement may not be changed,modified or altered except in writing signed by the Parties hereto. 24. Anti-kickback. No officer or employee of City,having the power or duty to perform an official act or action related to this Agreement shall have or acquire any interest in this Agreement,or have solicited,accepted or granted a present or future gift,favor,service or other thing of value from any person with an interest in this Agreement. 25. Severability. If any section,sentence,clause or phrase of this Agreement should be held to be invalid for any reason by a court of competent jurisdiction,such invalidity shall not affect the validity of any other section, sentence,clause or phrase of this Agreement. 26. Exhibits. Exhibits attached and incorporated into this Agreement are: Exhibit 1: Entity's Proposal—on file with the City Clerk Exhibit 2: Updated Project Budget Exhibit 3: Final Report on Number of Visitors—to be provided at close of grant project with final reimbursement request Exhibit 4: Insurance Certificate(s) s The Parties have executed this Agreement this C ay of t 1U{'1.l Ll f'� ,2025. CITY OF SPOKANE VALLEY Entity: n Manager Hohman,City By Its: • rized Representatives '�,� Page 8 of 13 25-004.00 Exhibit 1 ON FILE WITH CITY CLERK Page 9 of 13 25-004.00 Exhibit 2 Updated Project Budget Please provide an attachment with an updated project budget pursuant to your proposal based on the funds allocated in your award. The budget should include a detailed breakdown of the expected expenses for the project in line with the scope of work and original proposed use of the funds. The grant recipient may incur cost variances of no more than 10%within any category of the approved project budget without further prior written City approval. Regardless of any variance allowed herein the total grant award of$30,000 USD shall not be exceeded in any circumstance. Page 10 of 13 2025 USA West Bid Budget Exhibit? Expenses :tent ilti iast I Operations-VPIP 1 i33.3111110 fatal Projected Vence&wises :3,331NBO Income kig7+ 11:, 1 hnooAt , 1 Operations-Vonue r i $30.000.00 egistrauo a:; i 13.300.00 'Total Prod Venue(1103612 manna nna 21st USA West Square Dance Convention Jen Devine PO Box 519 Colbert,WA 99005 USA tiles 208-704-5835 USA ooe in cuerjen@hotmail.com January 28, 2025 To Whom It May Concern, The LTAC grant funds that the 21 St USA West Square Dance Convention applied for will be used to pay for the rental of the Spokane Fair & Expo building(s) we are renting for the event. The event is scheduled to take place July 24-26, 2025. We will be receiving event insurance coverage through the Washington State Square & Folk Dance Federation to cover the dates of July 23-26, 2025. This policy will be available to us closer to the event and a copy of the policy will be furnished to you by July 16, 2025. Please reach out to me if you have any questions. Jen Devine General Chairperson 21st USA West Square Dance Convention ----04N SQUA&FO-01 SBARNE ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) `—� 6/24/2025 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 riqhts to the certificate holder in lieu of such endorsement(s). PRODUCER ' NAME: McDonald-Zaring Insurance, a Marsh & McLennan Agency LLC company PHONE, o, Ext : 509 525-5730 Fax Marsh McLennan Agency LLC ) (A/C, No): 22 E. Main ADURIE : mmanwmziinfo@marshmma.com Walla Walla, WA 99362 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Cincinnati Casualty Company 28665 INSURED INSURER B : Square & Folk Dance Federation of Washington, Inc. INSURERC: 5612 S Napa St INSURERD: Spokane, WA 99223 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 ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE ; INSD WVD, POLICY NUMBER imu/nnryyyyj I (MM/DDfYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X EPP 0346268 9/1/2024 9/1/2025 EACH OCCURRENCE $ 1,000,000 DAMAGEMLSETORENTEDoccurrencel $ 500,000 MED EXP (Any oneperson) $ 5,000 PERSONAL & ADV INJURY 1,000,000 GEN'L AGGREGATE LLkJTAN(PP41ES PER; , POLICY JEGO1 LOC GENERAL AGGREGATE 21000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 OTHER: AUTOMOBILE 7 LIABILITY COMBINED SINGLE LIMIT accident) $ BODILY INJURY Perperson) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS '_;,=`�g� ? ._- BODILY INJURY Per accident $ rROPERTY AMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY A X UMBRELLA LIAB X OCCUR ! EACH OCCURRENCE $ 1,000,000 AGGREGATE $ EXCESS LIAB CLAIM'S MADE EPP 0346268 9/1/2R24 911/2025. _ 1,000,000 DIED I X I RETENTION$ 01, _ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY �,/N ANY PROP RIETOR/PARTNER/EXECUTNE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) Ifyes, describe under N /A : >'•,;' -; '' •• " '. PER ."`'% OTH- ER__ E.L. EACH ACCIDENT $ — - IT DISEASE - EA EMPLOYE $ ---_--- - - DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Club: Spokane Area Council (SAC) Event: 2025 USA West Square and Round Dance Convention to be held July 23,2025 through July 26, 2025 at the Spokane Fair and Expo Center located @ 404 N Havana St, Spokane Valley, WA 99212 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Spokane Valle THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN y p y ACCORDANCE WITH THE POLICY PROVISIONS. 10210 E Sprague Ave Spokane Valley, WA 99206 AUTHORIZEEnD REPREES�ENNTAATIpV-E{/X}- ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NOTICE TO POLICYHOLDERS ADDITIONAL INSURED ENDORSEMENTS This is a summary of the major changes found in new editions of additional insured endorsements. NO COVERAGE IS PROVIDED BY THIS SUMMARY. Nor can it be construed to replace any provision of your policy. YOU SHOULD READ YOUR POLICY AND REVIEW YOUR DECLARATIONS PAGE CAREFULLY for complete information on the coverages that you are provided. If there is any conflict, between the policy and this summary, THE PROVISIONS OF THE POLICY SHALL PREVAIL. The major areas within the endorsements that broaden or reduce coverage, and other changes, are highlighted below. This notice does not reference every editorial change made in the endorsements. Clarification of Coverage: The following additional insured endorsements are revised to indicate that when these endorsements are attached to a policy, if coverage provided to the additional insured is required by contract or agreement, coverage to the additional insured will be afforded to the extent permitted by law and to the extent the named insured is required by the contract or agreement to provide insurance available under the applicable Limits of Insurance shown in the Declarations, whichever is less: CG 20 03 0413 ADDITIONAL INSURED - CONCESSIONAIRES TRADING UNDER YOUR NAME • CG 20 05 0413 ADDITIONAL INSURED - CONTROLLING INTEREST • CG 20 07 04 13 ADDITIONAL INSURED - ENGINEERS, ARCHITECTS OR SURVEYORS • CG 20 10 0413 ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION • CG 2011 0413 ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES • CG 20 12 0413 ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS • CG 20 13 0413 ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS RELATING TO PREMISES • CG 20 15 0413 ADDITIONAL INSURED -VENDORS • CG 2018 0413 ADDITIONAL INSURED - MORTGAGEE, ASSIGNEE OR RECEIVER • CG 20 23 0413 ADDITIONAL INSURED - EXECUTORS, ADMINISTRATORS, TRUSTEES OR BENEFICIARIES • CG 20 24 0413 ADDITIONAL INSURED - OWNERS OR OTHER INTERESTS FROM WHOM LAND HAS BEEN LEASED • CG 20 26 0413 ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION • CG 20 27 04 13 ADDITIONAL INSURED - CO-OWNER OF INSURED PREMISES • CG 20 28 04 13 ADDITIONAL INSURED - LESSOR OF LEASED EQUIPMENT • CG 20 29 0413 ADDITIONAL INSURED - GRANTOR OF FRANCHISE • CG 20 30 04 13 OIL OR GAS OPERATIONS - NONOPERATING, WORKING INTERESTS • CG 20 31 04 13 ADDITIONAL INSURED - ENGINEERS, ARCHITECTS OR SURVEYORS • CG 20 32 04 13 ADDITIONAL INSURED - ENGINEERS, ARCHITECTS OR SURVEYORS NOT ENGAGED BY THE NAMED INSURED • CG 20 34 04 13 ADDITIONAL INSURED - LESSOR OF LEASED EQUIPMENT - AUTOMATIC STATUS WHEN REQUIRED IN LEASE AGREEMENT WITH YOU • CG 20 35 04 13 ADDITIONAL INSURED - GRANTOR OF LICENSES - AUTOMATIC STATUS WHEN REQUIRED BY LICENSOR GA 4496 09 18 Pagel of 2 • CG 20 36 0413 ADDITIONAL INSURED - GRANTOR OF LICENSES • CG 20 37 04 13 ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS • CG 29 35 04 13 ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS • GA 4248 09 17 ADDITIONAL INSURED - PICK UP OR DELIVERY - SCHEDULED PERSON OR ORGANIZATION • GA 4397 0917 ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION (VICARIOUS LIABILITY) GA 472 09 18 CONTRACTORS ADDITIONAL INSURED - AUTOMATIC STATUS AND AUTOMATIC WAIVER OF SUBROGATION WHEN REQUIRED IN WRITTEN CONTRACT, AGREEMENT, PERMIT OR AUTHORIZATION GA 4255 09 18 CONTRACTORS ADDITIONAL INSURED - AUTOMATIC STATUS AND AUTOMATIC WAIVER OF SUBROGATION WHEN REQUIRED IN WRITTEN CONTRACT OR AGREEMENT The above forms have the following changes: Broadening of Coverage: • Coverage is no longer restricted to entities for whom work is performed by you. Reduction of Coverage: • Coverage has been removed for oral contracts. Clarification of Coverage: • Expressly address, in part, claims alleging negligence or other wrongdoing in the hiring, employment, training, supervision or monitoring of others by any insured. • Expressly states the exclusion applies only in your capacity as an engineer, architect or surveyor and not within construction means, methods, techniques, sequences and procedures employed by you in connection with your operations in your capacity as a construction contractor. CG 20 08 0413 ADDITIONAL INSURED - USERS OF GOLFMOBILES The above form has the following change: Reduction of Coverage: • Golfmobile was added as a defined term. GA 4496 09 18 Page 2 of 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENDED LIABILITY ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Endorsement - Table of Contents: Coverage: Begins on Page: 1. Employee Benefit Liability Coverage................................................................................................. 2 2. Unintentional Failure to Disclose Hazards......................................................................................... 8 3. Damage to Premises Rented to You................................................................................................. 8 4. Supplementary Payments.................................................................................................................. 9 5. 180 Day Coverage for Newly Formed or Acquired Organizations..................................................... 9 6. Waiver of Subrogation....................................................................................................................... 9 7. Automatic Additional Insured - Specified Relationships: ................................................................. 10 • Managers or Lessors of Premises, - Lessor of Leased Equipment; • Vendors; and • State or Political Subdivisions - Permits Relating to Premises 8. Property Damage to Borrowed Equipment........................................................................................12 9. Employees as Insureds - Specified Health Care Services: .............................................................13 • Nurses; • Emergency Medical Technicians; and • Paramedics 10. Broadened Notice of Occurrence...................................................................................................... 13 B. Limits of Insurance: The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorse- ment, except as provided below: 1. Employee Benefit Liability Coverage Each Employee Limit: $ 1,000,000 Aggregate Limit: $ 3,000,000 Deductible: S 1.000 3. Damage to Premises Rented to You The lesser of: a. The Each Occurrence Limit shown in the Declarations; or t b. $500,000 unless otherwise stated $ 4. Supplementary Payments a. Bail bonds: $ 1,000 b. Loss of earnings: $ 350 8. Property Damage to Borrowed Equipment Each Occurrence Limit $ 10,000 Deductible $ 250 Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 1 of 13 C. Coverages 1. Employee Benefit Liability Coverage a. The following is added to SECTION - COVERAGES: Employee Benefit Liability Coverage. (1) Insuring Agreement (a) We will pay those sums that the insured becomes legally obligated to pay as dam- ages caused by any act, er- ror or omission of the in- sured, or of any other per- son for whose acts the in- sured is legally liable, to which this insurance applies. We will have the right and duty to defend the insured against any "suit' seeking those damages. However, we will have no duty to de- fend against any "suit' seek- ing damages to which this insurance does not apply. We may, at our discretion, investigate any report of an ;:,Ad, error or omission and " e any claim or "suit' that rr*Iresult. But: 1) '`,'�"he amount we will pay "br damages is limited as described in SEC- TION III - LIMITS OF INSURANCE; and 2) Our right and duty to defend ends when we have used up the appli- cable limit of insurance in the payment of judg- ments or settlements. No other obligation or liabil- ity to pay sums or perform ads or services is covered unless explicitly provided for under Supplementary Pay- ments. (b) This insurance applies to damages only if the act, er- ror or omission, is negli- gently committed in the "administration" of your "em- ployee benefit program"; and 1) Occurs during the policy period; or 2) Occurred prior to the ef- fective date of this en- dorsement provided: a) You did not have knowledge of a claim or "suit" on or before the effective date of this en- dorsement. You will be deemed to have knowledge of a claim or "suit" when any "author- ized representa- tive"; i) Reports all, or any part, of the act, error or omission to us or any other insurer; ii) Receives a written or ver- bal demand or claim for dam- ages because of the act, er- ror or omis- sion; and b) There is no other applicable insur- ance. (2) Exclusions This insurance does not apply to: (a) Bodily Injury, Property Damage or Personal and Advertising Injury "Bodily injury", "property damage" or "personal and advertising injury (b) Dishonest, Fraudulent, Criminal or Malicious Act Damages arising out of any intentional, dishonest, fraudulent, criminal or mali- cious act, error or omission, committed by any insured, including the willful or reck- less violation of any statute. Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 2 of 13 (c) Failure to Perform a Con- effort and cooperation of the tract insured, from the applicable Damages arising out of fail- funds accrued or other col- ure of performance of con- lectible insurance. tract by any insurer. (1) Taxes, Fines or Penalties (d) Insufficiency of Funds Taxes, fines or penalties, in - Damages arising out of an cluding those imposed un- der the Internal Revenue insufficiency of funds to Code or any similar state or meet any obligations under local law. any plan included in the "employee benefit program". (j) Employment -Related Prac- (e) Inadequacy of Perform- tices ance of Investment / Ad- Any liability arising out of vice Given with Respect to any: Participation (1) Refusal to employ; Any claim based upon: (2) Termination of employ- 1 ) Failure of any invest- ment; ment to perform; (3) Coercion, demotion, 2) Errors in providing in- evaluation, reassign - formation on past per- ment, discipline, defa- formance of investment mation, harassment, vehicles; or humiliation, discrimina- 3) Advice given to any tion or other employ- ment - related practices, person with respect to that person's decision to acts or omissions; or participate or not to par- (4) Consequential liability ticipate in any plan in- as a result of (1), (2) or eluded in the "employee (3) above. benefit program". This exclusion applies (f) Workers' Compensation whether the insured may be and Similar Laws held liable as an employer Any claim: arising out of your or in any other capacity andto failure to comply with the any obligation to share mandatory provisions of any damages with or repay someone else who must pay workers' compensation, un- damages because of the in - employment compensation jury insurance, social security or disability benefits law or any (3) Supplementary Payments similar law. SECTION I - COVERAGES, (g) ERISA SUPPLEMENTARY PAYMENTS Damages for which any in- - COVERAGES A AND B alsoapply sured is liable because of li- . to this Coverage. ability imposed on a fide rFa'.• b. Who is an Insured ary by the Employeq:} tirement Income S ' • ty As respects Em to ee Benefit Liabil- P P Y Act of 1974, as now or ity Coverage, SECTION II - WHO IS hereafter amended, or by AN INSURED is deleted in its entirety any similar federal, state or and replaced by the following: local laws. (1) If you are designated in the Dec- (h) Available Benefits larations as: Any claim for benefits to the (a) An individual, you and your extent that such benefits are spouse are insureds, but available, with reasonable only with respect to the con - Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 3 of 13 duct of a business of which you are the sole owner. (b) A partnership or joint ven- ture, you are an insured. Your members, your part- ners, and their spouses are also insureds but only with respect to the conduct of your business. (c) A limited liability company, you are an insured. Your members are also insureds, but only with respect to the conduct of your business. Your managers are insur- eds, but only with respect to their duties as your manag- ers. (d) An organization other than a partnership, joint venture or limited liability company, you are an insured. Your "ex- ecutive officers" and direc- tors are insureds, but only with respect to their duties as your officers or directors. - Your stockholders are also reds, but only with re- ;'€ s to their liability as smolders. (e) A tryst, you are an insured. Your trustees are also in- sureds, but only with respect to their duties as trustees. (2) Each of the following is also an insured: (a) Each of your "employees" who is or was authorized to administer your "employee benefit program". (b) Any persons, organizations or "employees" having proper temporary authoriza- tion to administer your "em- ployee benefit program" if you die, but only until your legal representative is ap- pointed. (c) Your legal representative if you die, but only with re- spect to duties as such. That representative will have all your rights and duties under this Coverage Part. (3) Any organization you newly ac- quire or form, other than a part- nership, joint venture or limited liability company, and over which you maintain ownership or major- ity interest, will qualify as a Named Insured if no other similar insurance applies to that organi- zation. However, coverage un- der this provision: (a) Is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; and (b) Does not apply to any act, error or omission that was committed before you ac- quired or formed the organi- zation. c. Limits of Insurance As respects Employee Benefit Liabil- ity Coverage, SECTION III - LIMITS OF INSURANCE is deleted in its en- tirety and replaced by the following: (1) The Limits of Insurance shown in Section B. Limits of Insurance, 1. Employee Benefit Liability Coverage and the rules below fix the most we will pay regardless of the number of: (a) Insureds; (b) Claims made or "suits" brought; (c) Persons or organizations making claims or bringing "suits": (d) Acts, errors or omissions; or (e) Benefits included in your "employee benefit program". (2) The Aggregate Limit shown in Section B. Limits of Insurance, 1. Employee Benefit Liability Coverage of this endorsement is the most we will pay for all dam- ages because of ads, errors or omissions negligently committed in the "administration" of your "employee benefit program". (3) Subject to the limit described in (2) above, the Each Employee Limit shown in Section B. Limits of Insurance, 1. Employee Benefit Liability Coverage of this endorsement is the most we will pay for all damages sus- tained by any one "employee", including damages sustained by Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 4 of 13 such "employee's" dependents and beneficiaries, as a result of: (a) An act, error or omission; or (b) A series of related acts, er- rors or omissions, regard- less of the amount of time that lapses between such acts, errors or omissions. negligently committed in the :administration" of your "em- ployee benefit program". Hovv&er, the amount paid under this endorsement shall not ex- ceed, and will be subject to the limits and restrictions that apply to the payment of benefits in any plan included in the "employee benefit program." (4) Deductible Amount (a) Our obligation to pay dam- ages on behalf of the in- sured applies only to the amount of damages in ex- cess of the deductible amount stated in the Decla- rations as applicable to Each Employee. The limits of insurance shall not be re- duced by the amount of this deductible. (b) The deductible amount stated in the Declarations applies to all damages sus- tained by any one "em- ployee", including such "em- ployee's" dependents and beneficiaries, because of all acts, errors or omissions to which this insurance applies. (c) The terms of this insurance, including those with respect to: 1) Our right and duty to defend the insured against any "suits" seeking those dam- ages; and 2) Your duties, and the du- ties of any other in- volved insured, in the event of an act, error or omission, or claim, apply irrespective of the ap- plication of the deductible amount. (d) We may pay any part or all of the deductible amount to effect settlement of any claim or "suit" and, upon no- tification of the action taken, you shall promptly reim- burse us for such part of the deductible amount as we have paid. d. Additional Conditions As respects Employee Benefit Li- ability Coverage, SECTION IV - COMMERCIAL GENERAL LIABIL- ITY CONDITIONS is amended as fol- lows: (1) Item 2. Duties in the Event of Occurrence, Offense, Claim or Suit is deleted in its entirety and replaced by the following: 2. Duties in the Event of an Act, Error or Omission, or Claim or Suit a. You must see to it that we are notified as soon as practicable of an act, error or omission which may result in a claim. To the extent possible, notice should include: (1) What the act, error or omission was and when it oc- curred; and (2) The names and addresses of and one who may suf- fer damages as a result of the act, error or omission. b. If a claim is made or "suit" is brought against any insured, you must: (1) Immediately record the specifics of the claim or "suit" and the date received; and (2) Notify us as soon as practicable. You must see to it that we receive written no- tice of the claim or "suit" as soon as practicable. c. You and any other in- volved insured must: Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 5 of 13 (1) Immediately send method described in b. us copies of any below. demands, notices, summonses or le- b. Method of Sharing gal papers re- If all of the other insur- ceived in connec- ance permits contribu- tion with the claim tion by equal shares, or "suit"; we will follow this (2) Authorize us to ob- method also. Under tain records and this approach each in - other information; surer contributes equal amounts until it has (3) Cooperate with us paid its applicable limit in the investigation of insurance or none of or settlement of the the loss remains, claim or defense whichever comes first. against the suit"; and If any of the other in- surance does not permit (4) Assist us, upon our contribution by equal request, in the en- shares, we will contrib- forcement of any ute by limits. Under this right against any method, each insurer's person or organi- share is based on the zation which may ratio of its applicable be liable to the in- limit of insurance to the sured because of total applicable limits of an act, error or insurance of all insur- omission to which ers. this insurance may also apply. c. No Coverage d. insured will, except This insurance shall not .`iCWo It that insured's own cover any loss for which cost, voluntarily make a the insured is entitled to payment, assume any recovery under any obligation, or incur any other insurance in force expense without our previous to the effective consent. date of this Coverage Part. (2) Item 5. Other Insurance is de- leted in its entirety and replaced e. Additional Definitions by the following: As respects Employee Benefit Li- 5. Other Insurance ability Coverage, SECTION V - DEFINITIONS is amended as follows: If other valid and collectible insurance is available to the (1) The following definitions are insured for a loss we cover added: under this Coverage Part, 1. "Administration" means: our obligations are limited as follows: a. Providing information to "employees", including Primary a. Prima Insurance their dependents and This insurance is pri- beneficiaries, with re- mary except when c. spect to eligibility for or below applies. If this scope of "employee insurance is primary, benefit programs"; our obligations are not b. Interpreting the "em- affected unless any of ployee benefit pro - the other insurance is grams'; also primary. Then, we will share with all that c. Handling records in other insurance by the connection with the Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 6 of 13 "employee benefit pro- benefits and such bene- grams"; or fits are made generally available to all "employ- d. Effecting, continuing or ees" who are eligible terminating any "em- under the plan for such ployee's" participation in benefits; any benefit included in the "employee benefit c. Unemployment insur- program". ance, social security However, "administration" benefits, workers' com- pensation and disability benefits; and .' a. Handling payroll deduc- d. Vacation plans, indud- tions; or ing buy and sell pro- b. The failure to effect or grams; leave of ab- maintain any insurance sense programs, indud- or adequate limits of ing military, maternity, coverage of insurance, family, and civil leave; including but not limited tuition assistance plans; to unemployment insur- transportation and ance, social security health dub subsidies. benefits, workers' com- (2) The following definitions are de- pensation and disability leted in their entirety and re - benefits. placed by the following: 2. "Cafeteria plans" means 21. "Suit" means a civil proceed - plans authorized by applica- ing in which money dam- ble law to allow "employees" ages because of an act, er- to elect to pay for certain benefits with pre-tax dollars. ror or omission to which this insurance applies are al - "Employee benefit Pro- leged. "Suit" includes. 1.' grams" means a program a. An arbitration proceed - providing some of all of the ing in which such dam - following benefits to "em- ages are claimed and to ployees", whether provided which the insured must through a "cafeteria plan" or submit or does submit otherwise: with our consent; a. Group life insurance; b. Any other alternative group accident or health dispute resolution pro - insurance; dental, vision ceeding in which such and hearing plans; and damages are claimed flexible spending ac- and to which the in - counts; provided that no sured submits with our one other than an "em- consent; or ployee" may subscribe to such benefits and c. An appeal of a civil pro - such benefits are made ceeding. generally available to those "employees" who 8. "Employee" means a person satisfy the plan's eligibik actively employed, formerly ity requirements; employed, on leave of ab- sence or disabled, or retired. b. Profit sharing plans, "Employee" includes a employee savings "leased worker". "Em- plans, employee stock ployee" does not include a ownership plans, pen- "temporary worker". sion plans and stock subscription plans, pro- 2. Unintentional Failure to Disclose Haz- vided that no one other ards than an "employee" SECTION IV - COMMERCIAL GENERAL may subscribe to such LIABILITY CONDITIONS, 7. Representa- Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 7 of 13 tions is hereby amended by the addition to damage or de - of the following: stroy itself; Based on our dependence upon your rep- c) Smog; resentations as to existing hazards, if un- intentionally you should fail to disclose all d) Mechanical break - such hazards at the inception date of your down including policy, we will not reject coverage under rupture or bursting this Coverage Part based solely on such caused by cen- failure. trifugal force; 3. Damage to Premises Rented to You e) Settling, cracking, shrinking or ex - a. The last Subparagraph of Paragraph pansion; or SECTION I - COVERAGES, COV- ERAGE A. BODILY INJURY AND f) Nesting or infesta- PROPERTY DAMAGE LIABILITY 2., tion, or discharge Exclusions is hereby deleted and or release of waste replaced by the following: products or secre- tions, by insects, Exclusions c. through q. do not apply birds, rodents or to damage by fire, explosion, light- other animals. ning, smoke or soot to premises while rented to you or temporarily occupied (b) Loss caused directly or indi- by you with permission of the owner. rectly by any of the follow- ing: b. The insurance provided under SEC- TION I - COVERAGES, COVERAGE 1) Earthquake, volcanic A. BODILY INJURY AND PROP- eruption, landslide or ERTY DAMAGE LIABILITY applies any other earth move - to "property damage" arising out of . ment; water damage to premises that are 2) Water that backs up both rented to and occupied by you. overflows from a sewer, (1) As respects Water Damage Le- drain or sump; gal Liability, as provided in Para- 3) Water under the ground graph 3.b. above: surface pressing on, or tlhe exclusions under SECTION I flowing or seeping - COVERAGES, COVERAGE A. through: BODILY INJURY AND PROP- a) Foundations, walls, ERTY DAMAGE LIABILITY, 2. floors or paved Exclusions, other than L War surfaces; and the Nuclear Energy Liabil- ity Exclusion, are deleted and b) Basements, the following are added: whether paved or This insurance does not apply to: not, or (a) "Property damage": c) Doors, windows or other openings. 1) Assumed in any con- (c) Loss caused by or resulting tract; or - from water that leaks or 2) Loss caused by or re- flows from plumbing, heat - suiting from any of the ing, air conditioning, or fire following: r°`i protection systems caused by or resulting from freezing, a) Wear and tear; unless: b) Rust, corrosion, 1) You did your best to fungus, decay, de- maintain heat in the terioration, hidden building or structure; or or latent defect or any quality in prop- 2) You drained the equip- erty that causes it ment and shut off the Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 8 of 13 water supply if the heat was not maintained. (d) Loss to or damage to: 1) Plumbing, heating, air conditioning, fire protec- tion systems, or other equipment or appli- ances; or 2) The interior of any building or structure, or to personal property in the building or structure caused by or resulting from rain, snow, sleet or ice, whether driven by wind or not. c. Limit of Insurance The Damage to Premises Rented to You Limit as shown in the Declara- tions is amended as follows: (2) Paragraph 6. of SECTION III - LIMITS OF INSURANCE is hereby deleted and replaced by the following: 6. Subject to 5. above, the Damage to Premises Rented to You Limit is the most we will pay under COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY for damages because of "prop- erty damage" to premises while rented to you or tem- porarily occupied by you with permission of the owner, arising out of any one 'occurrence" to which this insurance applies. (3) The most we will pay is limited as described in Section B. Limits of Insurance, 3. Damage to Prem- ises Rented to You of this en- dorsement. 4. Supplementary Payments Under SECTION I - COVERAGE,rS14lp- PLEMENTARY PAYMENTS - CO!'ER- AGES A AND B: a. Paragraph 2. is replaced by the fol- lowing: the use of any vehicle to which the Bodily Injury Liability Coverage ap- plies. We do not have to furnish these bonds. b. Paragraph 4. is replaced by the fol- lowing: 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 the limit shown in Sec- tion B. Limits of Insurance, 4.b. Loss of Earnings of this endorsement per day because of time off from work. 5. 180 Day Coverage for Newly Formed or Acquired Organizations SECTION II - WHO IS AN INSURED is amended as follows: Subparagraph a. of Paragraph 4. is hereby deleted and replaced by the fol- lowing: a. Insurance under this provision is af- forded only until the 180th day after you acquire or form the organization or the end of the policy period, which- ever is earlier; 6. Waiver of Subrogation SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 9. Transfer of Rights of Recovery Against Others to Us is hereby amended by the addition of the following: We waive any right of recovery we may have because of payments we make for injury or damage arising out of your ongo- ing operations or "your work" done under a written contract requiring such waiver with that person or organization and in- cluded in the "products -completed opera- tions hazard". However, our rights may only be waived prior to the 'occurrence" giving rise to the injury or damage for which we make payment under this Cov- erage Part. The insured must do nothing after a loss to impair our rights. At our re- quest, the insured will bring "suit' or trans- fer those rights to us and help us enforce those rights. 7. Automatic Additional Insured - Speci- fied Relationships Up to the limit shown in Section B. a, The following is hereby added to Limits of Insurance, 4.a. Bail Bonds SECTION II -WHO IS AN INSURED: of this endorsement for cost of bail bonds required because of accidents (1) Any person or organization de - or traffic law violations arising out of scribed in Paragraph 7.a.(2) be - Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 9 of 13 low (hereinafter referred to as additional insured) whom you are required to add as an additional insured under this Coverage Part by reason of (a) A written contract or agree- ment; or (b) An oral agreement or con- tract where a certificate of insurance showing that per- son or organization as an additional insured has been issued, is an insured, provided: (a) The written or oral contract or agreement is: 1) Currently in effect or becomes effective dur- ing the policy period; and 2) Executed prior to an "occurrence" or offense to which this insurance would apply; and (b) They are not specifically named as an additional in- sured under any other provi- sion of, or endorsement added to, this Coverage Part. (2) Only the following persons or or- ganizations are additional insur- eds under this endorsement, and insurance coverage provided to such additional insureds is lim- ited as provided herein: (a) The manager or lessor of a premises leased to you with whom you have agreed per Paragraph 7.a.(1) above to provide insurance, but only with respect to liability aris- ing out of the ownership, maintenance or use of that part of a premises leased to you, subject to the following additional exclusions: This insurance does not ap- ply to: 1) Any "occurrence" which takes place after you cease to be a tenant in that premises. 2) Structural alterations, new construction or demolition operations performed by or on be- half of such additional insured. (b) Any person or organization from which you lease equipment with whom you have agreed per Paragraph 7.a.(1) above to provide in- surance. Such person(s) or organization(s) are insureds solely with respect to their liability arising out of the maintenance, operation or use by you of equipment leased to you by such per- sons) or organization(s). However, this insurance does not apply to any "oc- currence" which takes place after the equipment lease expires. (c) Any person or organization (referred to below as ven- dor) with whom you have agreed per Paragraph 7.a.(1) above to provide in- surance, but only with re- spect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the ven- dor's business, subject to the following additional ex- clusions: 1) The insurance afforded the vendor does not apply to: a) 'Bodily injury" or "property damage" for which the ven- dor is obligated to pay damages by reason of the as- sumption of liability in a contract or agreement. 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 war- ranty unauthorized by you; Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 10 of 13 c) Any physical or nying or containing chemical change in such products; or the product made intentionally by the b) When liability in - vendor; cluded within the "products- d) Repackaging, completed opera - unless unpacked tions hazard" has solely for the pur- been excluded un- pose of inspection, der this Coverage demonstration, Part with respect to testing, or the sub- such products. stitution of parts under instructions (d) Any state or political subdi- from the manufac- vision with which you have turer, and then re- agreed per Paragraph packaged in the 7.a.(1) above to provide in- griginal container; surance, subject to the fol- lowing additional provision: 1 ;i; 'ny failure to make such . inspections, a its, tests (Wftrvi O: as the y �11or h "greed to ?;sake'• ,or nor - ma# .,, un&rtakes, to rtl'ke in tft S" `-cours$, M in- ss nectiontf' the distributi or sale of the octs: f) DemonstMiro" stallation, set%Np*V1' or repair opera- tions, except such rations per-. ied at the ven- *o s premises in ,ophnection with the stale of;jh product,- P rwws wht�.af. This insurance applies only with respect to the following hazards for which the state or political subdivision has issued a permit in connec- tion with premises you own, rent or control and to which this insurance applies: 1) The existence, mainte- nance, repair, construc- tion, erection, or re- moval of advertising signs, awnings, cano- pies, cellar entrances, coal holes, driveways, ', manholes, marquees, fj=" y.' hoist away openings, ri sidewalk vaults, street banners, or decorations -', ,,: nd similar exposures; been 1 labeled 4'. d as a container, part or ; ingredient of any , other thing or sub stance by or for the vendor. 2) This insurance doesk not apply to any insured person or organization: a) From whom you have acquired such products, or any ingredient, part or container, enter- ing into, accompa- �) The construction, erec- ,, tion',removal of ele- s, vak 3) Cie owners mainte- „ance, or of any re, elevators Bred by this insura': Z t: (3) Any , ' Provided to an addi?orisl insured desig- nated under Paragraph 7.a.(2) Subparagraphs (a), (b) and (d) does not apply to "bodily injury", "property damage" or, "personal and advertising injury" arising out of the sole negligence or willful misconduct of the ad- ditional insured or their agents, "employees" or any Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 11 of 13 other representative of the additional insured. b. SECTION IV - COMMERCIAL GEN- ERAL LIABILITY CONDITIONS is hereby amended as follows: Condition 5. Other Insurance is amended to include: (1) Where required by a written con- tract or agreement, this insur- anoe is primary and / or noncon- tributory as respects any other insurance policy issued to the additional insured, and such other insurance policy shall be excess and / or noncontributing, whichever applies, with this in- surance. (2) Any insurance provided by this endorsement shall be primary to other insurance available to the additional insured except: (a) As otherwise provided in SECTION IV - COMMER- CIAL GENERAL LIABILITY CONDITIONS, 5. Other In- surance, b. Excess Insur- ance; or (b) For any other valid and col- lectible insurance available to the additional insured as an additional insured by at- tachment of an endorsement to another insurance policy that is written on an excess basis. In such, case, the coverage provided under this endorsement shall also be excess. 8. Property Damage to Borrowed Equip- ment a. The following is hereby added to Ex- clusion j. Damage to Property of Paragraph 2., Exclusions SECTION I - COVERAGES, COVERAGE A. - BODILY INJURY AND PROPERTY DAMAGE LIABILITY: Paragraphs (3) and (4) of this exclu- sion do not apply to tools or equip- ment loaned to you, provided they are not being used to perform operations at the time of loss. b. With respect to the insurance pro- vided by this section of the endorse- ment, the following additional provi- sions apply: (1) The Limits of Insurance shown in the Declarations are replaced by the limits designated in Property Damage to Borrowed Equip- ment Section B. Limits of In- surance, 8. Property Damage to Borrowed Equipment of this endorsement with respect to coverage provided by this en- dorsement. These limits are in- clusive of and not in addition to the limits being replaced. The Limits of Insurance shown in Section B. Limits of Insurance, 8. Property Damage to Bor- rowed Equipment of this en- dorsement fix the most we will pay in any one 'occurrence" re- gardless of the number of: (a) Insureds; (b) Claims made or "suits" brought; or (c) Persons or organizations making claims or bring "suits". (2) Deductible Clause (a) Our obligation to pay dam- ages on your behalf applies only to the amount of dam- ages for each 'occurrence" which are in excess of the deductible amount stated in Section B. Limits of Insur- ance, 8. Property Damage to Borrowed Equipment of this endorsement. The lim- its of insurance will not be reduced by the application of such deductible amount. (b) SECTION I -COMMERCIAL LIABILITY CONDITIONS 2. Duties in the Event of Oc- currence, Offense, Claim or Suit, applies to each claim or "suit' irrespective of the amount. (c) We may pay any part or all of the deductible amount to effect settlement of any claim or "suit' and, upon no- tification of the action taken, you shall promptly reim- burse us for such part of the deductible amount as has been paid by us. 9. Employees as Insureds - Specified Health Care Services Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 12 of 13 It is hereby agreed that Paragraph 2.a.(1) (d) of SECTION If - WHO IS AN IN- SURED, does not apply to your "employ- ees" who provide professional health care services on your behalf as duly licensed: a. Nurses; b. Emergency Medical Technicians; or c. Paramedics, in the jurisdiction where an "occurrence" or offense to which this insurance applies takes place. 10. Broadened Notice of Occurrence Paragraph a. of Condition 2. Duties in the Event of Occurrence, Offense, Claim or Suit (SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS) is hereby deleted and replaced by the fol- lowing: 31 a. You must see to it that we are notified as soon as practicable of an "occur- rence" or an offense which may result in a claim. To the extent possible, notice should include: (1) How, when and where the "oc- currence" or offense took place; (2) The names and addresses of any injured persons and wit- nesses; and (3) The nature and location of any ijury or damage arising out of the "occurrence" or offense. This requirement applies only when the "occurrence" or offense is known to an "authorized representative". Includes copyrighted material of Insurance GA 227 02 07 Services Office, Inc., with its permission. Page 13 of 13