Loading...
HomeMy WebLinkAbout24-120.03 Frontier Behavioral Health - Homeless Outreach Services Program24-120.03 CONTRACT AMENDMENT TO THE AGREEMENT BETWEEN THE CITY OF SPOKANE VALLEY AND FRONTIER BEHAVIORAL HEALTH Spokane Valley Contract # 24-120.03 For good and valuable consideration, the legal sufficiency of which is hereby acknowledged, City and Frontier Behavioral Health ("Frontier") mutually agree as follows: 1. Purpose: This Amendment is for the Contract for Homeless Outreach Services by and between the Parties, executed by the Parties on September 10, 2025, and which terminates on June 30, 2027. Said contract, contract number 24-120.02 is referred to as the "Original Contract" and its terms are hereby incorporated by reference. 2. Provisions of Original Contract: The Parties agree to continue to abide by those terms and conditions of the Original Contract and any amendments thereto which are not specifically modified by this Amendment. 3. Amendment Provisions: The Original Contract is subject to the following amended provisions, which are attached hereto as Appendix "A". All such amended provisions are hereby incorporated by reference herein and shall control over any conflicting provisions of the Original Contract, including any previous amendments thereto. 4. Compensation Amendment History: This is Amendment #1 of the Original Contract. On November 25, 2025, City Council approved the City's Homeless & Housing Task Force recommendation to allocate an additional $50,000 to cover costs for animal boarding and housing related expenses for clients. Pursuant to the terms of the Original Contract, this results in an increase of $10,500 for indirect costs, for a total increase of $60,500 as shown below. The history of amendments to the compensation on the Original Contract and all amendments is as follows: Date Compensation Original Contract Sept 10, 2025 $476,739.00 Amendment 24-120 03 to be executed $60,500.00 Total Amended Compensation $537,239.00 The parties have executed this Amendment # 1 to the Original Contract this/6ptay of January, 2026. CITY OF SPOKANE VALLEY: Jo Hohman City Manager ;;S;? By: Kelli L. Miller Its: CEO 24-120.03 APPENDIX "A" 1. Paragraph 3 (Compensation) of the Original Contract is hereby amended to change the total compensation paid from $476,739.00 USD to $537,239.00 inclusive of any applicable sales tax. Paragraph 3 of the Original Contract is amended to read as follows: Compensation. City agrees to reimburse Frontier for out-of-pocket costs incurred and expensed in an amount not to exceed $537,239.00 USD inclusive of any applicable sales tax. This amount reflects the additional $50,000 approved by Council on November 25, 2025, designated for rental assistance and pet boarding, and includes the resulting increases related to the negotiated 21 % indirect costs. Frontier shall submit monthly requests for reimbursement of actual allowable costs incurred and expended in performance of this agreement and in accordance with the Scope of Services (Exhibit A-1) and in accordance with the agreed upon Budget identified in Exhibit B-1 attached hereto. Requests for reimbursement shall be submitted with a 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 Frontier 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. Unless the Term is extended, qualified expenditures shall be incurred between the Effective date of this Agreement, and June 30, 2027, and paid by Frontier no later than July 30, 2027. Frontier shall not perform any extra, further, or additional services for which it will request additional compensation from City without a prior written agreement for such services and payment for such services. 2. The Scope of Work (Exhibit A) of the Original Contract, is hereby replaced with Exhibit A-1, which is attached to this Appendix "A", and incorporated herein by this reference. Any and all references to Exhibit A in the Original Contract shall mean Exhibit A-1. 3. The Budget (Exhibit B) in the Original Contract, is hereby replaced with Exhibit B-1, which is attached to this Appendix "A", and incorporated herein by this reference. Any and all references to Exhibit B in the Original Contract shall mean Exhibit B-1. 2 24-120.03 Exhibit A-1 - Scope of Services Frontier shall provide services to people experiencing homelessness and services to promote recovery, resiliency, and connection to vital community resources for individuals experiencing behavioral health and co-occurring challenges in addition to homelessness. The City's Outreach model combines a SVPD Homeless Outreach Officer and a social worker that co - deploy as a single unit in the field, each specializing in and focusing on their respective roles to provide more versatile and responsive services to those experiencing homelessness and the community at large. A second case -worker may spend half of their time in the office connecting individuals with resources and providing the tools to receive assistance such as obtaining identifications, making appointments, arranging transportation to appointments, etc. The Outreach team is responsible for conducting pro -active outreach activities to contact and engage those who may be experiencing homelessness. The Outreach Team is also responsible for helping to respond to concerns directed to the City regarding issues related to homelessness. This requires close coordination and cooperation with City staff and the Homeless Outreach Officers to ensure that the follow-up needed to address the situation is occurring. Frontier obligations: • Frontier shall maintain a minimum two full time employee (2.0 FTE) case manager team in coordination with Spokane Valley Homeless Outreach Officer(s). If at any time Frontier cannot maintain this level of service, Frontier will inform the City immediately and work to reach an agreement on a plan to increase staffing levels to the 2.0 FTE case manager team. • Identify needs and screen individuals experiencing homelessness, and those at imminent risk of becoming homeless. • Outreach and engagement with individuals that build relationships, provide vital connection to needed services, and assess individual needs. • Managing individual cases by connecting people to relevant community resources, benefits, and all programs or services determined to be appropriate by Frontier to assist individuals experiencing homelessness and those at risk of becoming homeless. This includes but is not limited to developing unique plans for individuals based on their specific needs. • Providing mental health treatment referrals. • Providing substance use disorder treatment referrals. • Referrals for primary health care, job training, educational services, and housing services. • Daily communication, coordination and outreach with Spokane Valley Homeless Outreach Officer(s) for this project. • Frontier will maintain cell phone access during day-to-day operations and outreach. Staff will check in with the program supervisor/lead each morning and night and keep supervisor/lead informed of daily schedule. 24-120.03 • Maintain eligibility/access to the Homeless Management Information System (HMIS) to facilitate referrals; Ensure HMIS Release of Information (ROI) is completed for clients and uploaded to HMIS; Enter relevant client notes/information into HMIS. a) Use database to participate in and inform local and regional Homeless Outreach case conferencing efforts. b) Initiate and manage local case conferencing in partnership with other area providers. • Use City's data collection apps during regular course of work duties. • Proactively monitor and perform outreach in less accessible areas where known camping activities occur, including those areas that may not be accessible with a standard vehicle. This may include areas along the Spokane river, the Centennial Trail, Appleway Trail, and Dishman Hills. Provide necessary equipment to facilitate access to these areas. Obtain and maintain law -enforcement and personal protection related safety equipment for use by Frontier personnel while assisting the SVPD Homeless Outreach Deputies. Such equipment may be used during outreach service activities as deemed necessary and appropriate by Frontier. Frontier maintains sole responsibility for determining what safety equipment is necessary to provide their services pursuant to this Agreement, obtaining such equipment, and for properly utilizing such safety equipment in performing its obligations herein. Frontier may request reimbursement for such equipment from the City. Upon termination or expiration of this Agreement all safety equipment acquired by Frontier and reimbursed by the City shall be the property of the City. Frontier shall offer temporary pet boarding services, as deemed appropriate. Frontier is currently working with SpokAnimal via a Guardian Angel Program which offers up to 14 days of free housing and care for client pets. Frontier shall follow all applicable local, state, and federal laws, rules, and regulations relating to pet boarding services. In addition, Frontier shall establish and follow a written policy for animal boarding which complies with all such laws, rules and regulations. For reimbursement requests submitted to the City specific to this service, Frontier shall provide reporting evidencing the number of days and date ranges that each animal was boarded, the type of animal (cat or dog), and the aggregate number of spays, neuters, microchips and/or other services provided by SpokAnimal or other entity. This is in addition to any other reporting and payment documentation required elsewhere by this Agreement. The City shall only reimburse Frontier for these services at the following rates: $30/day for dogs and $20/day for cats, with no cost for the first 14 days. The City shall not be responsible for any other costs related to these services, and in no case shall the reimbursements exceed the budget as described in budget category G of Exhibit B-1. Frontier shall continue to provide outreach services specifically to include assisting Spokane Valley clients in finding long-term housing options. This may consist of housing navigation, assistance with the application process, paying for move -in costs, or other related housing costs. Additional funds specific to these services are listed in budget category F in Exhibit B-1, and shall not exceed the budgeted amount listed therein. 4 24-120.03 • Provide reporting as required by Exhibit C. City of Sookane Valley (City) Outreach Team oblizations Provide two SVPD Homeless Outreach Officers to assist Frontier outreach personnel in delivering outreach services, whether through grant funding, other third -party funding, or through use of internal funds, so long as economically feasible as determined solely by the City; and • Assist Frontier by analyzing and, at the City's sole discretion, implementing potential technical solutions for collecting and using data regarding those served; and • Participation and assistance by the City's Housing and Homeless Coordinator on an as -needed basis Mutual obligations Collaborative planning for each entity's outreach programs for the upcoming year, with initial discussions to occur no later quarter two of each year so that the recommendations may be timely included in the budget planning process for the next year; and • Collaborative planning on how to prioritize calls for service when they are received by either Party; and Regular attendance by key personnel at weekly meetings between the respective outreach teams that should include a focus on effective delivery of services, safety for outreach teams, and ways to better collect, maintain, and utilize data to further the mutual goals of the Parties 24-120.03 Exhibit B - 1 Annual ContractY1 Annuat Contract Y2 Total amended Contra, July 1, 2025-June 30, July 1, 2026-June 30, AmountJuly 1, 2025 - 2026 2027 June 30, 2027 Category Direct Costs - Operating Salary A Supervisor 0.20 FTE 18,535 18,535 37,070 Case Manager 11 - 2.0 FTE 107,703 107,703 215,406 Salary Subto tat 126,238 126,238 252,476 Benefits @ 30% B 37,871 37,871 75,743 Other Direct Costs C Rent Expenses (Copier/Bldg) Z458 2,458 4,916 Depreciation - - - Office/Operating Supplies 1,765 1,765 3,530 Repairs/Maintenance 4,704 4,704 9,408 Transportation 2,117 2,117 4,234 Training 339 339 678 Professional Fees 792 792 1,584 Telephone/Postage 1,811 1,811 3, 622 Insurance 576 576 1,152 Printing/Due/Subscriptions 133 133 266 Other Direct Costs Subtotal 14,695 14,695 29,390 Discretionary D 16,195 16,195 32,390 Startup costs E 4,000 4,000 Housing Assistance F 30,001► "(1) 301000 Pet Boarding Assistance G XWO "(1) - 2.000 Subtotal Direct Costs 248,999 194,999 443,999 Indirect Costs H Indirect (21 % or d irect costs) 52,290 40,950 93,240 537,239 235,949 301,289 NOTES: 1) Other Direct costs approx @ $7,350 per FTE 2) Startup costs (Y1) include $4,000 which includes office furniture, Laptops, cellphones, etc.; remaining allowance from previous budget 3) Contractarnendment adds budget categories F and G; Council approved Nov 25, 2025 (1) Approximate in Yl; reamaining unexpended funding may be carried Into Y2. Totat is for an estimated 12 month period Frontier may incur cost variances of no more than 10% within the direct costs categories of the approved project budget after receiving prior written City approval. Regardless of any variance allowed herein the total contract amount of $537,239.00 USD shall not be exceeded. G FRONBEH-01 KOLIVER ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYY) 5/16/2025 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 NWE cT Gerry Bulger Spokane Office PHONE FAX Marsh McLennan Agency LLC (AIC, No, Ext): (509) 30-4M2 (A/C, No): 501 N. Riverpoint Blvd., Ste 403 RE ;_Ge1rry.Bulgelr@MarshMMA.com Spokane, WA 99202 _...'.,...� ...., . INSURED Frontier Behavioral Health 107 South Division St. Spokane, WA 99202 INSURER D - INSURER E : INSURER F : CAVFRAr%FA CFRTIFICATF NIIMRFR• RFVISRIAN NIIMRFP- 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 SUER POLICY NUMBER EFF POLICY EXP LTR IN D . MPM/DD,YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE : 1,000,000 X CLAIMS -MADE OCCUR X PHPK2685999-023 5/1Wn25 5/15/2026 PREMISES NTED I ETOREn $ 100,000 X Retro Date 3/5/1987 MED EXP (Any one arson $ 5,000 1,000,000 PERSONAL 3 ADV INJURY $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY JERCOT LOC PRODUCTS-COMP/OPAGG S 3,000,000 WA STOP GAP 1/0001000 OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident)$ 1,000,000 _ _- X ANY AUTO X PHPK2685999-023 5/15/2025 5115M026 BOOILYINJURY(P erson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -AWNED PROPERTY GE $ AUTOS ONLY AUTOS ONLY -.(Per accident _ $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 EXCESS LIAB CLAIMS -MADE! ___- PHUB911615-023 5/15/2025 5/15/2026 AGGREGATE $ 2,000,000 DIED X RETENTION$ 10,000 1 WORKERS COMPENSATION PER OTI+ STATUTER ;AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE QFFICER/MEMBER EXCLUDED? ❑ NIA E.L_. EACH ACCIDENT $ (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Job #1.5 FTE Street Outreach City of Spokane Valley is additional insured additional insured in accordance with the terms and conditions of the policy. rF:RTIFICATF Nni ITFR CANCFI I ATIAN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Spokane Valle Y P Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 10210 East Sprague Avenue Spokane Valley, WA 99206 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD PI-GLD-HS (10/11) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY DELUXE ENDORSEMENT: HUMAN SERVICES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE It is understood and agreed that the following extensions only apply in the event that no other specific coverage for the indicated loss exposure is provided under this policy. If such specific coverage applies, the terms, conditions and limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted on this endorsement. The following is a summary of the Limits of Insurance and additional coverages provided by this endorsement. For complete details on specific coverages, consult the policy contract wording. Coverage Applicable Limit of Insurance Page # Extended Property Damage Included 2 Limited Rental Lease Agreement Contractual Liability $50,000 limit 2 Non -Owned Watercraft Less than 58 feet 2 Damage to Property You Own, Rent, or Occupy $30,000 limit 2 Damage to Premises Rented to You $1,000,000 3 HIPAA Clarification 4 Medical Payments $20,000 5 Medical Payments — Extended Reporting Period 3 years 5 Athletic Activities Amended 5 Supplementary Payments — Bail Bonds $5,000 5 Supplementary Payment— Loss of Earnings $1,000 per day 5 Employee Indemnification Defense Coverage $25,000 5 Key and Lock Replacement — Janitorial Services Client Coverage $10,000 limit 6 Additional Insured — Newly Acquired Time Period Amended 6 Additional Insured — Medical Directors and Administrators Included 7 Additional Insured — Managers and Supervisors (with Fellow Employee Coverage) Included 7 Additional Insured — Broadened Named Insured Included 7 Additional Insured — Funding Source Included 7 Additional Insured — Home Care Providers Included 7 Additional Insured — Managers, Landlords, or Lessors of Premises Included 7 Additional Insured — Lessor of Leased Equipment Included 7 Additional Insured — Grantor of Permits Included 8 Additional Insured — Vendor Included 8 Additional Insured — Franchisor Included 9 Additional Insured —When Required by Contract Included 9 Additional Insured — Owners, Lessees, or Contractors Included 9 Additional Insured — State or Political Subdivisions Included 10 Page 1 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) Duties in the Event of Occurrence, Claim or Suit Included 10 Unintentional Failure to Disclose Hazards Included 10 Transfer of Rights of Recovery Against Others To Us Clarification 10 Liberalization Included 11 Bodily Injury — includes Mental Anguish Included 11 Personal and Advertising Injury — includes Abuse of Process, Discrimination Included 11 A. Extended Property Damage SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph a. is deleted in its entirety and replaced by the following: a. Expected or Intended Injury "Bodily injury" or property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. B. Limited Rental Lease Agreement Contractual Liability SECTION I — COVERAGES, COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph b. Contractual Liability is amended to include the following: (3) Based on the named insured's request at the time of claim, we agree to indemnify the named insured for their liability assumed in a contract or agreement regarding the rental or lease of a premises on behalf of their client, up to $50,000. This coverage extension only applies to rental lease agreements. This coverage is excess over any renter's liability insurance of the client. C. Non -Owned Watercraft SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph g. (2) s deleted in its entirety and replaced by the following: (2) A watercraft you do not own that is: (a) Less than 58 feet long; and (b) Not being used to carry persons or property for a charge; This provision applies to any person, who with your consent, either uses or is responsible for the use of a watercraft. This insurance is excess over any other valid and collectible insurance available to the insured whether primary, excess or contingent. D. Damage to Property You Own, Rent or Occupy SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE Page 2 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) LIABILITY, Subsection 2. Exclusions, Paragraph j. Damage to Property, Item (1) is deleted in its entirety and replaced with the following: (1) Property you own, rent, or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for ropair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another's property, unless the damage to property is caused by your client, up to a $30,000 limit. A client is defined as a person under your direct care and supervision. E. Damage to Premises Rented to You 1. If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part, the word "fire" is changed to "fire, lightning, explosion, smoke, or leakage from automatic fire protective systems' where it appears in: a. The last paragraph of SECTION I —COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions; is deleted in its entirety and replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in SECTION III — LIMITS OF INSURANCE. b. SECTION III — LIMITS OF INSURANCE, Paragraph 6. is deleted in its entirety and replaced by the following: Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems while rented to you or temporarily occupied by you with permission of the owner. c. SECTION V — DEFINITIONS, Paragraph 9.a., is deleted in its entirety and replaced by the following: 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, explosion, smoke, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract"; 2. SECTION IV— COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other Insurance, Paragraph b. Excess Insurance, (1) (a) (ii) is deleted in its entirety and replaced by the following: That is insurance for fire, lightning, explosion, smoke, or leakage from automatic fire protective systems for premises rented to you or temporarily occupied by you with permission of the owner; 3. The Damage To Premises Rented To You Limit section of the Declarations is amended to the greater of: Page 3 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) a. $1,000,000; or b. The amount shown in the Declarations as the Damage to Premises Rented to You Limit. This is the most we will pay for all damage proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective systems or any combination thereof. F. HIPAA SECTION I — COVERAGES, COVERAGE B PERSONAL. AND ADVERTISING INJURY LIABILITY, is amended as follows: 1. Paragraph 1. Insuring Agreement is amended to include the following: We will pay those sums that the insured becomes legally obligated to pay as damages because of a "violation(s)" of the Health Insurance Portability and Accountability Act (HIPAA). We have the right and the duty to defend the insured against any "suit," "investigation," or "civil proceeding" seeking these damages. However, we will have no duty to defend the insured against any "suit" seeking damages, "investigation," or "civil proceeding" to which this insurance does not apply. 2. Paragraph 2. Exclusions is amended to include the following additional exclusions: This insurance does not apply to: a. Intentional, Willful, or Deliberate Violations Any willful, intentional, or deliberate "violation(s)" by any insured. b. Criminal Acts Any "violation" which results in any criminal penalties under the HIPAA. c. Other Remedies Any remedy other than monetary damages for penalties assessed. d. Compliance Reviews or Audits Any compliance reviews by the Department of Health and Human Services. 3. SECTION V — DEFINITIONS is amended to include the following additional definitions: a. "Civil proceeding" means an action by the Department of Health and Human Services (HHS) arising out of "violations." b. "Investigation" means an examination of an actual or alleged "violation(s)" by HHS. However, "investigation" does not include a Compliance Review. c. "Violation" means the actual or alleged failure to comply with the regulations included in the H I PAX Page 4 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) G. Medical Payments — Limit Increased to $20,000, Extended Reporting Period If COVERAGE C MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part: 1. The Medical Expense Limit is changed subject to all of the terms of SECTION III -LIMITS OF INSURANCE to the greater of: a. $20,000; or b. The Medical Expense Limit shown in the Declarations of this Coverage Part. 2. SECTION 1 — COVERAGE, COVERAGE C MEDICAL PAYMENTS, Subsection 1. Insuring Agreement, a. (3) (b) is deleted in its entirety and replaced by the following: (b) The expenses are incurred and reported to us within three years of the date of the accident. H. Athletic Activities SECTION I — COVERAGES, COVERAGE C MEDICAL PAYMENTS, Subsection 2. Exclusions, Paragraph e. Athletic Activities is deleted in its entirety and replaced with the following: e. Athletic Activities To a person injured while taking part in athletics. I. Supplementary Payments SECTION I — COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGE A AND B are amended as follows: 1. b. is deleted in its entirety and replaced by the following: 1. b. Up to $5000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these. 1.d. is deleted in its entirety and replaced by the following: 1. 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. J. Employee Indemnification Defense Coverage SECTION I — COVERAGES, SUPPLEMENTARY PAYMENTS — COVERAGES A AND B the following is added: We will pay, on your behalf, defense costs incurred by an "employee" in a criminal proceeding occurring in the course of employment. The most we will pay for any "employee" who is alleged to be directly involved in a criminal proceeding is $25,000 regardless of the numbers of "employees," claims or "suits" brought or persons or organizations making claims or bringing "suits. Page 5 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) K. Key and Lock Replacement — Janitorial Services Client Coverage SECTION I — COVERAGES, SUPPLEMENTARY PAYMENTS — COVERAGES A AND B is amended to include the following: We will pay for the cost to replace keys and locks at the "clients" premises due to theft or other loss to keys entrusted to you by your "client," up to a $10,000 limit per occurrence and $10,000 policy aggregate. We will not pay for loss or damage resulting from theft or any other dishonest or criminal act that you or any of your partners, members, officers, "employees", "managers", directors, trustees, authorized representatives or any one to whom you entrust the keys of a "client" for any purpose commit, whether acting alone or in collusion with other persons. The following, when used on this coverage, are defined as follows: a. "Client' means an individual, company or organization with whom you have a written contract or work order for your services for a described premises and have billed for your services. b. "Employee" means (1) Any natural person: (a) While in your service or for 30 days after termination of service; (b) Who you compensate directly by salary, wages or commissions; and (c) Who you have the right to direct and control while performing services for you; or (2) Any natural person who is furnished temporarily to you: (a) To substitute for a permanent "employee" as defined in Paragraph (1) above, who is on leave; or (b) To meet seasonal or short-term workload conditions; while that person is subject to your direction and control and performing services for you. (3) "Employee" does not mean: (a) Any agent, broker, person leased to you by a labor leasing firm, factor, commission merchant, consignee, independent contractor or representative of the same general character; or (b) Any "manager," director or trustee except while performing acts coming within the scope of the usual duties of an "employee." c. "Manager" means a person serving in a directorial capacity for a limited liability company. L. Additional Insureds SECTION II — WHO IS AN INSURED is amended as follows: 1. If coverage for newly acquired or formed organizations is not otherwise excluded from this Page 6 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) Coverage Part, Paragraph 3.a. is deleted in its entirely and replaced by the following: a. Coverage under this provision is afforded until the end of the policy period. 2. Each of the following is also an insured: a. Medical Directors and Administrators — Your medical directors and administrators, but only while acting within the scope of and during the course of their duties as such. Such duties do not include the furnishing or failure to furnish professional services of any physician or psychiatrist in the treatment of a patient. b. Managers and Supervisors — Your managers and supervisors are also insureds, but only with respect to their duties as your managers and supervisors. Managers and supervisors who are your "employees" are also insureds for "bodily injury" to a co - "employee" while in the course of his or her employment by you or performing duties related to the conduct of your business. This provision does not change Item 2.a.(1)(a) as it applies to managers of a limited liability company. c. Broadened Named Insured — Any organization and subsidiary thereof which you control and actively manage on the effective date of this Coverage Part. However, coverage does not apply to any organization or subsidiary not named in the Declarations as Named Insured, if they are also insured under another similar policy, but for its termination or the exhaustion of its limits of insurance. d. Funding Source — Any person or organization with respect to their liability arising out of: (1) Their financial control of you; or (2) Premises they own, maintain or control while you lease or occupy these premises. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. e. Home Care Providers — At the first Named Insured's option, any person or organization under your direct supervision and control while providing for you private home respite or foster home care for the developmentally disabled. f. Managers, Landlords, or Lessors of Premises — Any person or organization with respect to their liability arising out of the ownership, maintenance or use of that part of the premises leased or rented to you subject to the following additional exclusions: This insurance does not apply to: (1) Any "occurrence" which takes place after you cease to be a tenant in that premises; or (2) Structural alterations, new construction or demolition operations performed by or on behalf of that person or organization. g. Lessor of Leased Equipment — Automatic Status When Required in Lease Agreement With You — Any person or organization from whom you lease equipment when you and such person or organization have agreed in writing in a contract or agreement that such person or organization is to be added as an additional insured on your policy. Such person or Page 7 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) organization is an insured 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. A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. 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. h. Grantors of Permits — Any state or political subdivision granting you a permit in connection with your premises subject to the following additional provision: (1) This insurance applies only with respect to the following hazards for which the state or political subdivision has issued a permit in connection with the premises you own, rent or control and to which this insurance applies: (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. i. Vendors — 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, subject to the following additional exclusions: (1) 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. 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, except when 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 distribution or sale of the products; (f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; Page 8 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) (g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or (h) 'Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (I) The exceptions contained in Sub -paragraphs (d) or (f); or (ii) 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 distribution or sale of the products. (2) This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing. j. Franchisor — Any person or organization with respect to their liability as the grantor of a franchise to you. k. As Required by Contract — Any person or organization where required by a written contract executed prior to the occurrence of a loss. Such person or organization is an additional insured for "bodily injury," "property damage" or "personal and advertising injury" but only for liability arising out of the negligence of the named insured. The limits of insurance applicable to these additional insureds are the lesser of the policy limits or those limits specified in a contract or agreement. These limits are included within and not in addition to the limits of insurance shown in the Declarations I. Owners, Lessees or Contractors — Any person or organization, but 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 or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured when required by a contract. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: (a) 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 location 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 a principal as a part of the same project. Page 9 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) m. State or Political Subdivisions — Any state or political subdivision as required, subject to the following provisions: (1) This insurance applies only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit, and is required by contract. (2) This insurance does not apply to: (a) "Bodily injury," "property damage" or "personal and advertising injury" arising out of operations performed for the state or municipality; or (b) "Bodily injury" or "property damage" included within the "products -completed operations hazard." M. Duties in the Event of Occurrence, Claim or Suit SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 2. is amended as follows: a. is amended to include: This condition applies only when the 'occurrence" or offense is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; or (3) An executive officer or insurance manager, if you are a corporation. b. is amended to include: This condition will not be considered breached unless the breach occurs after such claim or "suit' is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; or (3) An executive officer or insurance manager, if you are a corporation. N. Unintentional Failure To Disclose Hazards SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, 6. Representations is amended to include the following: It is agreed that, based on our reliance on your representations as to existing hazards, if you should unintentionally fail to disclose all such hazards prior to the beginning of the policy period of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure. O. Transfer of Rights of Recovery Against Others To Us SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, 8. Transfer of Rights of Page 10 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) Recovery Against Others To Us is deleted in its entirety and replaced by the following: If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. Therefore, the insured can waive the insurer's rights of recovery prior to the occurrence of a loss, provided the waiver is made in a written contract. P. Liberalization SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, is amended to include the following: If we revise this endorsement to provide more coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state. Q. Bodily Injury — Mental Anguish SECTION V — DEFINITIONS, Paragraph 3. Is deleted in its entirety and replaced by the following: "Bodily injury" means: a. Bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of these; and b. Except for mental anguish, includes death resulting from the foregoing (Item a. above) at any time. R. Personal and Advertising Injury —Abuse of Process, Discrimination If COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is not otherwise excluded from this Coverage Part, the definition of "personal and advertising injury" is amended as follows: 1. SECTION V — DEFINITIONS, Paragraph 14.b. is deleted in its entirety and replaced by the following: b. Malicious prosecution or abuse of process; 2. SECTION V — DEFINITIONS, Paragraph 14. is amended by adding the following: Discrimination based on race, color, religion, sex, age or national origin, except when: a. Done intentionally by or at the direction of, or with the knowledge or consent of: (1) Any insured; or (2) Any executive officer, director, stockholder, partner or member of the insured; b. Directly or indirectly related to the employment, former or prospective employment, termination of employment, or application for employment of any person or persons by an insured; Page 11 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) c. Directly or indirectly related to the sale, rental, lease or sublease or prospective sales, rental, lease or sub -lease of any room, dwelling or premises by or at the direction of any insured; or d. Insurance for such discrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative ruling. The above does not apply to fines or penalties imposed because of discrimination. Page 12 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-MANU-1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY Business Auto Blanket Additional Insured THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE Section II - Liability Coverage - A.1. WHO IS AN INSURED provision is amended by the addition of the following: e. Any person or organization for whom you are required by an "insured contract" to name as additional insured is an "insured," subject to the following additional provisions: (1) The "insured contract" must be in effect during the policy period shown in the Declarations and must have been executed prior to the "bodily injury" or "property damage." (2) This person or organization is an "insured" only to the extent you are liable due to your ongoing operations for that insured, whether the work is performed by you or for you, and only to the extent you are held liable for an "accident" occurring while a covered "auto" is being driven by you or one of your employees. (3) Coverage for this person or organization shall be limited to the extent of your negligence or fault according to the applicable principles of comparative negligence or fault. (4) The defense of any claim or "suit" must be tendered by this person or organization as soon as practicable to all other insurers which potentially provide insurance for such claim or "suit." (5) The coverage provided will not exceed the lesser of: (a) The coverage and/or limits of this policy. (6) A person's or organization's status as an "insured" under this subparagraph d ends when your operations for that "insured" are completed. (7) The insured can waive the insurers rights of recovery prior to the occurrence of a loss, provided the waiver is made in a written contract. (8) There is no coverage provided to this person or organization for "bodily injury" or for "property damage" arising out of the placement of any individual as a professional driver including but not limited to truck drivers, public transportation drivers, courier services, school bus drivers, motor -coach operator/ bus drivers, shuttle drivers, ambulance drivers, delivery service drivers, flatbed drivers, valet drivers, repossessors, drive -away contractors, heavy equipment operators, All other terms and conditions of this Policy remain unchanged. Page 1 of 2 PI-MANU-1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY chauffeurs, limousine drivers and/ or taxi drivers. All other terms and conditions of this Policy remain unchanged. Page 2 of 2 STAFF Or wASWNGTON Department of Labor & Industries Certificate of Workers' Compensation Coverage WA UBI No. L&IAccount ID Legal Business Name Doing Business As Workers' Comp Premium Status: Estimated Workers Reported (See Description Below) Account Representative Licensed Contractor? September 10, 2025 600 335 200 306,702-00 FRONTIER BEHAVIORAL HEALTH FRONTIER BEHAVIORAL HEALTH Account is current. Quarter 2 of Year 2025 "Greater than 100 Workers" Employer Services Help Line, (360) 902-4817 No 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 51.12.050 and 51.16.1 90). 1'2 0 ,.b0;'.O 1;O'Z 03 FRONBEH-01 KOLIVER A CC; RO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD YYVY) 3/26/2026 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 Gerry Bulger Spokane Office PHONE FAX Marsh McLennan Agency LLC (A/C,No,Ext):(509)363-4012 (A/c,No): 501 N.Riverpoint Blvd.,Ste 403 E-MAILDRss:Gerry.Bulger@MarshMMA.com Spokane,WA 99202 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Philadelphia Indemnity Insurance Company 18058 INSURED INSURER B:Travelers Casualty and Surety Company of America 31194 Frontier Behavioral Health INSURER c:James River Insurance Company 12203 107 South Division St. INSURERD: Spokane,WA 99202 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 SUER POLICY NUMBER POLICY EFF POLICY EXP LIMBS LTRINSD WVD (MM/DD/YYYY) (MM/DD/YYYY1 A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X CLAIMS-MADE OCCUR X PHPK2685999-023 5/15/2026 5/15/2027 PREM SES(Ea occurrence) $ 100,000 X Retro Date 3/5/1987 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY 57 LOC PRODUCTS-COMP/OPAGG $ 3,000,000 OTHER: WA STOP GAP $ 1,000,000 A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ X ANY AUTO X 1.,PHPK2685999-023 5/15/2026 5/15/2027 BODILYINJURY(Perperson) $ OWNED SCHEDULED AUTOSRE ONLY AUTOSN BODILY INJURYp (Per accident) $ AUTOS ONLY _ AUTOS ONLY PROPERTY acEcident)DAMAGE A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE _ $ 4,000,000 EXCESS LIAB CLAIMS-MADE PHUB911615-023 5/15/2026 5/15/2027 AGGREGATE $ 2,000,000 DED X RETENTIONS 10,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y(N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBEER EXCLUDED? N/A (Mandatory m NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ B Crime 108052096 5/15/2025 5/15/2026 Cyber 5,000,000 C Excess Liability 00163830-0 5/15/2025 5/15/2026 Each Occurrence 2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Job#1.5 FTE Street Outreach CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Spokane ValleyTHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN p ACCORDANCE WITH THE POLICY PROVISIONS. 10210 East Sprague Avenue Spokane Valley,WA 99206 AUTHORIZED REPRESENTATIVE Nt6A-01)40GIV--4.- ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD FRANRFH-nl Knl IVFR ACORO CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 5/29/2026 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 Spokane Office Marsh McLennan Agency LLC 501 N. Riverpoint Blvd., Ste 403 Spokane, WA 99202 CONTACT Karly Oliver PHONE FAX (A/C, No, Ext): (509) 755-9327 (AIC, No): AUDRE , Karly.Oliver@MarshMMA.com INSURER(S) AFFORDING COVERAGE NAIC # _ INSURER A: Berkley Regional Insurance Company 29580 INSURED _ INSURER B : Travelers Casualty and Surety Company of America 31194 ANSURER C : SiriusPoint Specialty Insurance Corporation 16820 Frontier Behavioral Health INSURER D : 107 South Division St. Spokane, WA 99202 INSURER E INSURER F : CAVFRAnFR CFRTIFICOTF NIIMRFR• DCVICIn AI KII IM12CD• 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 LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP 5131/2027 LIMBS A X COMMERCIAL GENERAL LIABILITY X CLAIMS -MADE [:] OCCUR Retro Date 5/31/2023 X HHN $535385-10 5/31/2026 EACH OCCURRENCE $ 1,000,000 DDAMnAGETORENTEDISES (Ean PREX $ 100,000 MED EXP (Any one rson $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY D JE � LOC GENERAL AGGREGATE $ 3,000,000 GEN'L PRODUCTS - COMP/OP AGG $ 3,000,000 WA STOP GAP 1,000,000 OTHER: A AUTOMOBILE LIABILITY COMBIINdED .n1SINGLE LIMIT $ 1,000,000 BODILY INJURY Perperson) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X HHN8535385-10 5/31/2026 5/31/2027 BODILY INJURY Per accident $ PROPERTY AMAGE Per acc dent $ H RED NON -OWNED ANEOS ONLY AUTOS ONLY L — $ UMBRELLALIAS HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- TATLITER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under N / A E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT B Crime 108052096 5/15/2026 5/31/2027 Cyber 5000,000 C Excess E&O ISAEX10000007201 5/31/2026 5131/2027 Each Occurrence 3:000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached H more space Is required) Job #1.5 FTE Street Outreach City of Spokane Valley 10210 East Sprague Avenue Spokane Valley, WA 99206 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUT/H/OORIIZZ�ED, REPRESENTATIVE ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Certificate Disclaimer Due to the evolving changes and updates in state legislation across the country, Marsh McLennan Agency Northwest will no longer be adding additional verbiage to the Description of Operations on a Certificate of Insurance. We will not add Additional Insured, Primary & Non-contributory or Waiver of Subrogation language. The only exception will be project or name(s), project number(s), project locations. Instead, please see the attached endorsement copies that outline existing policy coverages. Coverage is determined by the policy, its terms and individual endorsements, and as established by the contract between the Named Insured and the Additional Insured. Thank you, Marsh McLennan Agency Northwest This document is not intended to be taken as advice regarding any individual situation and should not be relied upon as such. Marsh & McLennan Agency LLC shall have no obligation to update this publication and shall have no liability to you or any other party arising out of this publication or any matter contained herein. Any statements concerning actuarial, tax, accounting or legal matters are based solely on our experience as consultants and are not to be relied upon as actuarial, accounting, tax or legal advice, for which you should consult your own professional advisors. Any modeling ana►ytics or projections are subject to inherent uncertainty and the analysis could be materially affected if any underlying assumptions, conditions, information or factors are inaccurate or incomplete or should change. d/b/a in California as Marsh & McLennan Insurance Agency LLC; CA Insurance Lic: OH18131. Copyright © 2024 Marsh & McLennan Agency LLC. All rights reserved. MarshMMA.com Marsh & McLennan Agency LLC MarshMMA.com Certificate Verbiage Statutes by State 1. Montana a. MCA 33-2-1403 b. MT State Statute - Certificates of Insurance 2. Washington: a. WAC 284-30-355 b. WA State Statute - Certificate of Insurance 3. Oregon: a. ORS 742.003 b. OR State Statute - Certificates of Insurance 4. Idaho: a. 41-1850 b. ID State Statute - Certificates of Insurance This document is not intended to be taken as advice regarding any individual situation and should not be relied upon as such. Marsh & McLennan Agency LLC shall have no obligation to update this publication and shall have no liability to you or any other party arising out of this publication or any matter contained herein. Any statements concerning actuarial, tax, accounting or legal matters are based solely on our experience as consultants and are not to be relied upon as actuarial, accounting, tax or legal advice, for which you should consult your own professional advisors. Any modeling analytics or projections are subject to inherent uncertainty and the analysis could be materially affected if any underlying assumptions, conditions, information or factors are inaccurate or incomplete or should change. d/b/a in California as Marsh & McLennan Insurance Agency LLC; CA Insurance Lic: O1-118131. Copyright © 2024 Marsh & McLennan Agency LLC. All rights reserved. MarshMMA.com Marsh & McLennan Agency LLC MarshMMA.com COMMERCIAL GENERAL LIABILITY CG 83 91 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ CAREFULLY. GENERAL LIABILITY BROADENING ENDORSEMENT This endorsement modifies the insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Throughout this endorsement, the words "you" and "your' refer to the Named Insured shown in the Declarations. The word "we," "us," and "our" refer to the company providing this insurance. The following is only a summary of the additional coverages provided by this endorsement and is provided only for your reference and convenience. For the Limits of Insurance and the additional coverages provided by this endorsement, read the provisions on the following pages and the Coverage Form, which this endorsement modifies. SUBJECTS OF INSURANCE Broadened Bodily Injury Broadened Personal and Advertising Injury Broadened Property Damage Broadened Fire, Lightning, Explosion, and Sprinkler Leakage - $500,000 Broadened Medical Payments - $20,000 Broadened Supplementary Benefits a. Bail Bonds - $1,000 b. Expenses Incurred to Assist in Defense - $500 per Day Broadened Newly Acquired or Formed Organization Broadened Non -Owned or Chartered Watercraft or Aircraft Broadened Commercial General Liability Conditions a. Duties in the Event of Occurrence, Offense, Claim, or Suit b. Liberalization — Automatic Coverage If We Adopt Broader Coverages c. Notice to Company Automatic Coverage for "Special Events" Automatic Additional Insureds a. Athletic Activity Participants b. Contractual Obligations c. Funding Sources d. Manager or Lessor of Premises e. Owner, Manager, Operator, or Lessor of "Special Event" Premises f. Supervisors or Higher in Rank — Co -Employee Exclusion Removed g. Limitations Blanket Waiver of Subrogation Priority of Application for Multiple Insureds The coverages listed in this endorsement are provided as extensions or additions to your insurance program. CG 83 91 12 19 Includes copyrighted material of Insurance Services Page 1 of 8 Office, Inc., with its permission A. BROADENED BODILY INJURY Paragraph 3. of Section V — Definitions is deleted and replaced with the following: 3. "Bodily injury" means physical injury, sickness, or disease sustained by a person, including death resulting from any of these. "Bodily injury" also means mental injury, mental anguish, humiliation, or shock sustained by a person, if directly resulting from physical injury, sickness, or disease sustained by that person. B. BROADENED PERSONAL AND ADVERTISING INJURY 1. Paragraph 14. of Section V - Definitions is deleted and replaced with the following: 14. "Personal and advertising injury" means injury, including consequential "bodily injury" arising out of one or more of the following offenses during the policy period. a. False arrest, detention, or imprisonment; b. Malicious prosecution or abuse of process; c. The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room, dwelling, or premises that a person occupies by or on behalf of its owner, landlord, or lessor; d. Oral, written, televised, videotaped, or electronic publication of material that slanders or libels a person or organization, or disparages a person's or organization's goods, products, or services; e. Oral, written, televised, videotaped or electronic publication of material that violates a person's right of privacy; f. Misappropriation of advertising ideas or style of doing business; g. Infringement of copyright, title, or slogan; or h. Mental injury, mental anguish, humiliation, or shock, if directly resulting from Items 14.a. through 14.g. above. 2. Exclusions 2.b. and 2.c. under Coverage B - Personal and Advertising Injury Liability are deleted and replaced with the following: b. Material Published with Knowledge of Falsity "Personal and advertising injury" arising out of oral, written, televised, videotaped, or electronic publication of material, if done by or at the direction of the insured with knowledge of its falsity; c. Material Published Prior to Policy Period "Personal and advertising injury" arising out of oral, written, televised, videotaped, or electronic publication of material whose first publication took place before the beginning of the policy period; C. BROADENED PROPERTY DAMAGE Exclusion 2.a. under Coverage A - Bodily Injury and Property Damage Liability is deleted and replaced with the following: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. D. BROADENED FIRE, LIGHTNING, EXPLOSION AND SPRINKLER LEAKAGE 1. Paragraph 6. under Section III - Limits Of Insurance is deleted and replaced with the following: 6. Subject to 5. above, the Damage to Premises Rented to You Limit is the most we will pay under Coverage A for damages because of "property damage" to: a. Any one premises while rented to you, or in the case of damage by fire, while rented to you or temporarily occupied by you with permission of the owner; and b. Personal property of others in your care, custody, or control, while at premises rented to you or in the case of damage by fire, while rented to you or temporarily occupied by you with permission of the owner, arising out of any one fire, lightning, explosion, or sprinkler leakage occurrence. Page 2 of 8 Includes copyrighted material of Insurance Services CG 83 91 12 19 Office, Inc., with its permission The Damage to Premises Rented to You Limit is the greater of: c. $500,000; or d. The amount shown in the Declarations for Damage to Premises Rented to You Limit. 2. Paragraph 2. Exclusions of Coverage A - Bodily Injury and Property Damage Liability is amended as follows: Paragraphs c. through n., do not apply to damage by fire, lightning, explosion, or sprinkler leakage to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section III - Limits Of Insurance. 3. Paragraph 4. Other Insurance of Section IV - Commercial General Liability Conditions is amended as follows: Paragraph b.(1)(a)(ii) is deleted and replaced with the following: (ii) That is Fire, Lightning, Explosion, or Sprinkler Leakage insurance for premises rented to you or temporarily occupied by you with permission of the owner; or 4. Paragraph 9.a. under Section V - Definitions is deleted 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, explosion or sprinkler leakage to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract"; 5. This Broadened Coverage is subject to all the terms of Section III - Limits Of Insurance. 6. This Broadened Coverage does not apply if Fire Damage Liability of COVERAGE A (SECTION 1) is excluded either by the Declaration to this Coverage Part or by an endorsement to this Coverage Part. E. BROADENED MEDICAL PAYMENTS 1. The following provision is added to Paragraph 2. of Section III - Limits Of Insurance: The Medical Expense Limit shall be the greater of: a. $20,000; or b. The amount shown in the Declarations for Medical Expense Limit. 2. This Medical Expense Limit is subject to all the terms of Section III - Limits Of Insurance. 3. This above Medical Expense Limit does not apply if Coverage C - Medical Payments is excluded either by the Declaration to this Coverage Part or by an endorsement to this Coverage Part. F. BROADENED SUPPLEMENTARY PAYMENTS Paragraphs 1.b. and 1.d. under Supplementary Payments - Coverages A and B are deleted and replaced with the following: b. Up to $1,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 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 $500 a day because of time off from work. G. BROADENED NEWLY ACQUIRED OR FORMED ORGANIZATION Paragraph 3.a under Section II - Who Is An Insured is deleted and replaced by the following: a. Coverage under this provision is afforded only until the 120th day after you acquire or form the organization or the end of the policy period, whichever is earlier. H. BROADENED NON -OWNED OR CHARTERED WATERCRAFT OR AIRCRAFT Exclusion 2.g. under Coverage A - Bodily Injury and Property Damage Liability is deleted and replaced by the following: g. "Bodily injury" or "property damage" arising out of the ownership, maintenance, use, or entrustment to others of any aircraft, "auto," or watercraft owned by or operated by, or rented or loaned to, any insured. Use includes operation and "loading or unloading". CG 83 91 12 19 Includes copyrighted material of Insurance Services Page 3 of 8 Office, Inc., with its permission This exclusion does not apply to: (1) A watercraft while ashore on premises you own or rent; (2) A watercraft you do not own that is: (a) Less than 51 feet long; and (b) Not being used to carry persons or property for a charge; (3) Parking an "auto" on, or on the ways next to premises you own or rent, provided the "auto" is not owned by or rented, or loaned to you or the insured; (4) Liability assumed under any "insured contract" for the ownership, maintenance, or use of aircraft, watercraft, or "autos"; or (5) "Bodily injury" or "property damage" arising out of the operation of any of the equipment listed in Paragraph f. (2) or f. (3) of Section V - Definitions, Paragraph 12., "Mobile Equipment"; or (6) An aircraft you do not own that is: (a) Hired, chartered, or loaned with a crew; and (b) Not owned in whole or in part by any insured. (7) This insurance does not apply, under Paragraph g.(1) and g.(2) above, if the insured has any other insurance for "bodily injury" or "property damage" which would also apply to loss covered under this provision, whether the other insurance is primary, excess, contingent, or on any other basis. (8) This insurance is excess, under Paragraph g.(6) above, over any other insurance, whether the other insurance is primary, excess, contingent or on any other basis. BROADENED COMMERCIAL GENERAL LIABILITY CONDITIONS 1. Paragraph 2. Duties in The Event Of Occurrence, Offense, Claims Or Suit under Section IV - Commercial General Liability Conditions is amended to add the following provision: e. Your obligation to notify us as soon as practicable of an "occurrence," or offense under Paragraph 2.a. above, or a claim or "suit" or offense under Paragraphs 2.a., 2.b., and 2.c above, is satisfied if you send us written notice as soon as practicable after any of your "executive officers," directors, partners, insurance managers, or legal representatives becomes aware of, or should have become aware of, such "occurrence," offense, claim or "suit." 2. The following provisions are added to Section IV - Commercial General Liability Conditions: 10. Liberalization If we adopt any revision that would broaden the coverage under this coverage part without additional premium within 30 days prior to or during the policy period, the broadened coverage will immediately apply to this coverage part. 11. Notice To Company If you report an "occurrence" or offense to your Workers' Compensation insurer which later becomes a claim under this Coverage Part, failure to report such "occurrence" or offense to us at the time of the "occurrence" or offense will not be considered a violation of the Duties In The Event Of Occurrence, Offense, Claim Or Suit Condition, if you notify us as soon as practicable when you become aware that the "occurrence" or offense has become a liability claim. J. AUTOMATIC COVERAGE FOR SPECIAL EVENTS 1. You are automatically covered for all "special events" which you organize, promote, administer, sponsor, or conduct during the term of this policy. 2. Section V - Definitions is amended to add the following paragraph: 23. "Special Event" means any event: a. The purpose of which is to raise funds for you; or b. To recognize the accomplishments of your organization, your "employees," or your "volunteer workers"; or Page 4 of 8 Includes copyrighted material of Insurance Services CG 83 91 12 19 Office, Inc., with its permission c. Which you, or an individual or organization with whom you have entered into a contractor agreement, organize, promote, administer, sponsor, or conduct for the purposes described in Paragraphs a. or b. above; and d. Which takes place on premises owned by you, or on premises while rented or leased to you or to that organization described in Paragraph c. above. K. AUTOMATIC ADDITIONAL INSURED(S) The following provisions are added to Section II - Who Is An Insured: 4. Automatic Additional Insured(s) a. Additional Insureds - Athletic Activity Participants (1) This policy is amended to include as an insured any person(s) [hereinafter called Additional Insured(s)] representing you while participating in amateur athletic activities that you sponsor. However, no such person is an insured for: (a) "Medical expenses" under Coverage C - Medical Payments. (b) "Bodily Injury" to: (i) A co -participant, your "volunteer worker" or your "employee" while participating in amateur athletic activities that you sponsor; or (ii) You, or any partner or member, (if you area partnership or joint venture), or any member (if you are a limited liability company); or (c) "Property damage" to property owned by, occupied or used by, rented to , in the care, custody, or control of, or over which physical control is being exercised for any purpose by: (1) A co -participant, your "volunteer worker', or your "employee"; or (ii) You, or any partner or member, (if you area partnership or joint venture), or any member (if you are a limited liability company). b. Additional Insured - Contractual Obligations (1) This policy is amended to include as an insured any person or organization (hereinafter called Additional Insured) that you are required by a written "insured contract" to include as an insured, subject to all of the following provisions: (a) Coverage is limited to liability arising out of: (1) Your ongoing operations performed for such Additional Insured; or (2) Such Additional Insured's financial control of you; or (3) The maintenance, operation or use by you of equipment leased to you by such Additional Insured; or (4) A permit issued to you by a state or political subdivision. (b) Coverage does not apply to any "occurrence" or offense: (i) Which took place before the execution of, or subsequent to the completion or expiration of, the written "insured contract"; or (ii) Which takes place after you cease to be a tenant in that premises. (c) With respect to architects, engineers, or surveyors, coverage does not apply to "Bodily Injury," "Property Damage," "Personal Injury," or "Advertising Injury" arising out of the rendering or the failure to render any professional services by or for you including: (i) The preparing, approving, or failing to approve or prepare maps, drawings, opinions, reports, surveys, change orders, designs or specifications; and (ii) Supervisory, inspection, or engineering services. (d) Coverage provided herein shall be considered excess over any other valid and collectible insurance available to the Additional Insured whether that other insurance is primary, excess, contingent, or on any other basis unless a written contractual arrangement specifically requires this insurance to be primary. CG 83 91 12 19 Includes copyrighted material of Insurance Services Page 5 of 8 Office, Inc., with its permission (e) In the event that you are engaged in the manufacture or assembly of any goods or products for the benefit or at the direction of another party, pursuant to a contract or agreement with that party, this paragraph (e). does not extend coverage to that party as an Additional Insured. Coverage for such a party will be extended only by a specific endorsement issued by us and naming such party. c. Additional Insured - Funding Sources (1) This policy is amended to include as an insured any Funding Source (hereinafter called Additional Insured) which requires you in a written contract to name such Additional Insured but only with respect to liability arising out of your premises or "your work" for such Additional Insured, and only to the extent set forth as follows: (a) The Limits of Insurance applicable to the Additional Insured are the lesser of those specified in the written contract or agreement or in the Declarations for this policy and subject to all the terms, conditions and exclusions for this policy. The Limits of Insurance applicable to the Additional Insured are inclusive of, and not in addition to, the Limits of Insurance shown in the Declarations. (b) The coverage provided to the Additional Insured is not greater than that customarily provided by the policy forms specified in and required by the contract. (c) In no event shall the coverages or Limits of Insurance in this Coverage Form be increased by such contract. (d) Coverage provided herein shall be considered excess over any other valid and collectible insurance available to the Additional Insured whether that other insurance is primary, excess, contingent, or on any other basis unless a written contractual arrangement specifically requires this insurance to be primary. d. Additional Insured - Manager or Lessor of Premises (1) This policy is amended to include as an insured any person or organization (hereinafter called Additional Insured) from whom you lease or rent your premises and which requires you to add such person or organization as an Additional Insured in this policy under: (a) A written contract; or (b) An oral agreement or contract where a Certificate of Insurance has been issued showing that person or organization as an Additional Insured; but only if the written or oral agreement is an "insured contract'; (a) Currently in effect or to become effective during the term of this policy; and (b) Executed prior to the "bodily injury," "property damage," "personal injury", or "advertising injury." (2) With respect to the insurance afforded the Additional Insured identified in Paragraph d.(1) immediately above, the following additional provisions apply: (a) This insurance applies only to liability arising out of the ownership, maintenance, or use of that portion of the premises leased to you; (b) The Limits of Insurance applicable to the Additional Insured are the lesser of those specified in the written contract or agreement or in the Declarations for this policy and subject to all this policy's terms, conditions, and exclusions. The Limits of Insurance applicable to the Additional Insured are inclusive of, not in addition to, the Limits of Insurance shown in the Declarations. (c) In no event shall the coverages or Limits of Insurance in this Coverage Part be increased by such contract or agreement. (d) Coverage provided herein shall be considered excess over any other valid and collectible insurance available to the Additional Insured whether that other insurance is primary, excess, contingent, or on any other basis unless a written contractual arrangement specifically requires this insurance to be primary. (3) This insurance does not apply to: (a) Any "occurrence" or offense which takes place after you cease to be a tenant in the premises covered by this endorsement; or Page 6 of 8 Includes copyrighted material of Insurance Services CG 83 91 12 19 Office, Inc., with its permission (b) Structural alterations, new construction, or demolition operations performed by or on behalf of the Additional Insured. e. Additional Insured - Owner, Manager, Operator or Lessor of "Special Events" Premises (1) This policy is amended to include as an insured any person or organization (hereinafter called Additional Insured) from whom you lease, rent or occupy the premises upon which a "special event" is held, sponsored or conducted by you, or on your behalf, under: (a) A written contract; or (b) An oral agreement or contract where a Certificate of Insurance has been issued showing that person or organization as an Additional Insured; but only if the written or oral agreement is an "insured contract," (i) Currently in effect or to become effective during the term of this policy; and (ii) Executed prior to the "bodily injury", "property damage" or "personal and advertising injury". (2) With respect to the insurance afforded the Additional Insured identified in Paragraph e. (1) of this endorsement, the following additional provisions apply: (a) This insurance applies only to liability arising out of the use of that portion of the premises while leased or rented to you for the specific "special event"; (b) The Limits of Insurance applicable to the Additional Insured are the lesser of those specified in the contract or agreement pertaining to the use of the premises or in the Declarations for this policy and subject to all of this policy's terms, conditions, and exclusions. The Limits of Insurance applicable to the Additional Insured are inclusive of, not in addition to, the Limits of Insurance shown in the Declarations. (c) In no event shall the coverage or Limits of Insurance in this Coverage Form be increased by such contract or agreement. (d) Coverage provided herein shall be considered excess over any other valid and collectible insurance available to the Additional Insured whether that other insurance is primary, excess, contingent, or on any other basis unless a written contractual arrangement specifically requires this insurance to be primary. (3) This insurance does not apply to: (a) Any "occurrence" or offense which takes place after you cease to be a tenant, licensee or occupant in the premises covered by this endorsement; or (b) Any acts or "occurrences" caused by or attributable to the owner, manager, operator, or lessor of the premises upon which the "special event" is held. Additional Insured - Supervisors or Higher in Rank (1) This policy is amended to include as insured any "employees" (hereinafter called Additional Insured), designated as supervisor or higher in rank, who are authorized by you to exercise direct or indirect supervision and control over "employees" and the manner in which work is performed, 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" designated as supervisor or higher in rank, is an insured for: (a) "Bodily injury" or "personal injury": (i) To you, to your partners or members (if you are a partnership or joint venture), or to your members (if you are a limited liability company); (ii) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in paragraph (a)(i) above; or (iii) Arising out of his or her providing or failing to provide professional health care services. (b) "Personal Injury": (1) To a co "employee" while in the course of his or her employment; (ii) To the spouse, child, parent, brother or sister of that co -"employee" as a consequence of Paragraph (b)(i) above; or CG 83 91 12 19 Includes copyrighted material of Insurance Services Page 7 of 8 Office, Inc., with its permission (iii) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraph (b)(i) or (b)(ii) above. (c) "Property damage" to property: (i) Owned, occupied or used by; or (ii) Rented to, in the care, custody, or control of, or over which physical control is being exercised for any purpose by you, any of your "employees," any partner, or member (if you are a partnership or joint venture), or any member (if you are a limited liability company). g. Additional Insured - LIMITATIONS (1) The persons, entities, or organizations to which coverage is extended under Paragraphs a. (Athletic Activity Participants), b. (Contractual Obligations), c. (Funding Sources), d. (Managers or Lessors of Premises), and e. (Owner, Manager, Operator, or Lessor of "Special Events" Premises) are Additional Insureds, but only: (a) With respect to each Additional Insured's vicarious liability for "actual damages" solely caused by you or by "your work" that is ongoing for such Additional Insured's supervision of "your work"; and (b) If the Additional Insured did not cause or contribute to the "occurrence" or act resulting in liability. (2) If an endorsement is attached to this policy and specifically names a person or organization as an Additional Insured, then the coverage extended under this paragraph 4. AUTOMATIC ADDITIONAL INSURED(S) does not apply to that person, entity, or organization. (3) The following is added to Section V - Definitions: 24. "Actual Damages" is to have its usual and customary legal meaning and excludes without limitation, punitive damages, restitution, penalties, and formula damages added to "actual damages" and any other enhanced damages. (4) All other terms and conditions of this Coverage Part which are not inconsistent with this Paragraph h. apply to coverage extended to the above referenced Additional Insureds REGARDLESS OF WHETHER OR NOT A COPY OF THIS COVERAGE PART AND/OR ITS ENDORSEMENTS ARE DELIVERED TO AN ADDITIONAL INSURED. L. BLANKET WAIVER OF SUBROGATION Paragraph 8. under Section IV - Commercial General Liability Conditions is deleted and replaced with the following: 8. Transfer of Rights Of Recovery Against Others To Us And Blanket Waiver Of Subrogation a. If an insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. b. If required by written "insured contract," we waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract for that person or organization and included in the "products -completed operations hazard." M. PRIORITY OF APPLICATION FOR MULTIPLE INSUREDS Section III - Limits Of Insurance is amended to add the following paragraph: 8. In the event a claim or "suit" is brought against more than one insured, due to "bodily injury" or "property damage" from the same "occurrence," or "personal injury," or "advertising injury," from the same offense, we will apply the Limits of Insurance in the following order: a. You; Your "executive officers," directors, "employees," and c. Any other insureds in any order that we choose. ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED. Page 8 of 8 Includes copyrighted material of Insurance Services CG 83 91 12 19 Office, Inc., with its permission COMMERCIAL AUTOMOBILE CA 83 40 03 23 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ CAREFULLY BUSINESS AUTO BROADENING ENDORSEMENT This endorsement modifies and is subject to the insurance provided under the following: BUSINESS AUTO COVERAGE FORM The following is only a summary of the additional coverages provided by this endorsement and is provided only for your reference and convenience. For the Limits of Insurance and the additional coverages provided by this endorsement, read the provisions on the following pages and the Coverage Form, which this endorsement modifies. The deductibles specified on your "auto" declarations page are applicable to these coverages unless a different deductible is indicated. If one or more of these coverages is provided by a specific endorsement, then the specific endorsement will apply. SUBJECTS OF INSURANCE Who Is An Insured 1. Broad Form Named Insured 2. Employees As Insureds 3. Volunteers As Insureds 4. Employee Hired Auto Broadened Liability Supplementary Payments 1. Bail Bonds - $3,000 2. Reasonable Expenses Incurred - $300 per day Physical Damage Coverage Amendments 1. Towing 2. Coverage Extensions a) Transportation Expenses b) Loss of Use Expenses c) Auto Loan/Lease Gap Coverage d) Personal Property Coverage e) Airbag Discharge 3. Hired Car Physical Damage 4. Rental Reimbursement Coverage 5. Audio, Visual and Data Electronic Equipment 6. Deductible Amendments a) 2 or more Autos b) Glass Deductible Business Auto Conditions Amendments 1. Knowledge of Occurrence 2. Blanket Waiver of Subrogation General Condition Amendment Unintentional Errors and Omissions The coverages listed in this endorsement are provided as extensions or additions to your insurance program. CA 83 40 03 23 Includes material copyrighted by Insurance Services Office, Inc., with its Page 1 of 6 permission COMMERCIAL AUTOMOBILE CA 83 40 03 23 1. Broad Form Named Insured The following is added to Section II — Covered Autos Liability Coverage, Paragraph A.1.: d. Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: 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. e. Your Board Members (or their spouses) are an "insured" while operating an "auto" hired or rented under a contract or agreement in that Board Member's or spouses name, with your permission, while performing duties related to the conduct of your business. 2. Employees As Insureds The following is added to Section II — Covered Autos Liability Coverage, Paragraph A.1.: f. Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow while performing duties related to the conduct of your business. 3. Volunteers As Insureds The following is added to Section II — Covered Autos Liability Coverage, Paragraph A.1.: g. A "volunteer" of yours while operating an "auto" hired or rented under a contract or agreement in a "volunteer's" name, with your permission, while performing duties related to the conduct of your business. This insurance does not apply to: Volunteer Injury "Bodily injury" to: (1) Any "volunteer" or any fellow "volunteer" of the "insured" if sustained while such "volunteer' is performing duties related to the conduct of your business. (2) The spouse, child, parent, brother or sister of that ''volunteer" as a consequence of paragraph g.(1) above. 4. Employee As Insured The following is added to Section II — Covered Autos Liability Coverage, Paragraph A.1.: h. An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contractor agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business. 5. Broadened Liability Supplementary Payments The following replaces Section II — Covered Autos Liability Coverage, Paragraphs A.2.a.(2) and A.2.a.(4): (2) Up to $3000 for cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. CA 83 40 03 23 Includes material copyrighted by Insurance Services Office, Inc., with its Page 2 of 6 permission (4) All reasonable expenses incurred by the "insured" at our request, including actual "loss" of earnings up to $300 a day because of time off from work. 6. Towing and Labor The following replaces Section III — Physical Damage Coverage, Paragraph A.2.: We will pay up to $ 75 for towing and labor costs incurred each time a covered "auto" that is a private passenger type, light truck or medium truck is disabled. However, the labor must be performed at the place of disablement. No deductible applies to this coverage. 7. Transportation Expenses The following replaces Section III — Physical Damage Coverage, Paragraph 4.a.: We will pay up to $50 per day to a maximum of $1500 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type. We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage. We will pay for temporary transportation expenses incurred during the policy period and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its "loss". 8. Loss Of Use Expenses The following replaces Section III — Physical Damage Coverage, Paragraph AA.b.: For Hired Auto Physical Damage, we will pay expense for which an "insured" becomes legally responsible to pay for "loss" of use of a vehicle rented or hired without a driver, under a written rental contract or agreement. We will pay for "loss" of use expenses if caused by: (1) Other than collision only if the Declarations indicate that Comprehensive Coverage is provided for any covered "auto"; (2) Specified Causes Of Loss only if the Declarations indicate that Specified Causes Of Loss Coverage is provided for any covered "auto"; or (3) Collision only if the Declarations indicate that Collision Coverage is provided for any covered "auto". However, the most we will pay for any expenses for loss of use is $80 per day, to a maximum of $1,200. 9. Auto Loan/Lease Gap Coverage The following is added to the Section III — Physical Damage Coverage, Paragraph 4.: c. Auto Loan/Lease Gap Coverage In the event of a total "loss" to a covered "auto" shown in the Schedule or Declarations, 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 the "loss"; (b) Financial penalties imposed under a lease; (c) Security deposits not returned by the lessor; (d) Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and CA 83 40 03 23 Includes material copyrighted by Insurance Services Office, Inc., with its Page 3 of 6 permission (e) Carry-over balances from previous loans or leases. The insurance provided by this Auto Loan/Lease GAP coverage extension 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. 10. Personal Property Coverage The following is added to Section III — Physical Damage Coverage, Paragraph AA.: c. Personal Property Coverage We will pay up to $500 for loss to any personal property which is: (1) owned by an "insured"; and (2) in or on your covered "auto". This coverage is applicable only in the event of a total theft of a covered "auto". No deductible applies to this coverage. 11. Airbag Discharge The following is added to Section III — Physical Damage Coverage, Paragraph AA.: d. Airbag Discharge If there is an accidental discharge of an airbag in your covered "auto", we will pay to have the airbag replaced. This extension is excess over any other collectible insurance or warranty. No deductible applies to this coverage. 12. Hired Car Physical Damage If this policy provides Comprehensive, Specified Causes of Loss or Collision Coverage, that coverage may be extended to hired "autos". The coverage available to a hired "auto" will be equal to the broadest coverage shown on the Declarations available to any covered "auto". The most we will pay for any one "accident" or "loss" is: (1) $40,000; or (2) The actual cash value or cost of repair of the damaged or stolen property. Section IV - Business Auto Conditions, Paragraph B.5.b. is replaced by the following: b. For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct of your business. (3) Any covered "auto" hired or rented by your Board Members (or their spouses) under a contract in that individual Board Member's (or spouses') 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. Page 4 of 6 Includes material copyrighted by Insurance Services Office, Inc., with its CA 83 40 03 23 permission 13. Rental Reimbursement Coverage a. We will pay for rental reimbursement expenses incurred by you for the rental of an auto because of "loss" to a covered "auto". Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered "auto". No deductibles apply to this coverage. b. We will pay only for those expenses incurred during the policy period and ending, regardless of the policy's expiration, with the lesser of the following number of days: (1) The number of days reasonably required to repair or replace the covered "auto". If loss is caused by theft, this number of days is added to the number of days it takes to locate the covered "auto" and return it to you. (2) 30 days. c. Our payment is limited to the lesser of the following amounts: (1) Necessary and actual expenses incurred. (2) $50 per day. d. This coverage does not apply while there are spare or reserve autos available to you for your operations. e. If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided for under Section III — Physical Damage Coverage, 4. Coverage Extensions, a. Transportation Expenses. 14. Audio, Visual And Data Electronic Equipment We will pay with respect to a covered "auto" for "loss" to any electronic equipment that receives or transmits audio, visual or data signals and that is not designed solely for the reproduction of sound. This coverage applies only if the equipment is permanently installed in the covered auto at the time of the loss or the equipment is removable from a housing unit which is permanently installed in the covered "auto" at the time of the "loss", and such equipment is designed to be solely operated by use of the power from the "auto" electrical system, in or upon the covered "auto". The most we will pay for "loss" to audio, visual or data electronic equipment as a result of any one "accident" is the lessor of: a. The actual cash value of the damaged or stolen property as of the time of the "loss'; b. The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality; or c. $400. This coverage does not apply if there is other coverage provided under this policy for the above described audio, visual and data electronic equipment. We will pay any deductible, up to $400, that is applicable to the other coverage. No deductible applies to this coverage. 15. Deductible Amendment The following is added to Section III — Physical Damage Coverage, Paragraph D.: In the event that a "loss" from one "accident" involves two or more covered "autos", only the largest applicable deductible for Comprehensive, Specified Causes Of Loss, or Collision coverage will apply. This provision applies only to those "autos" designated in the Schedule or Declarations to have Comprehensive, Specified Causes Of Loss, or Collision coverage. CA 83 40 03 23 Includes material copyrighted by Insurance Services Office, Inc., with its Page 5 of 6 permission 16. Glass Deductible The following is added to Section III — Physical Damage Coverage, Paragraph D.: No deductible applies to "loss" to glass used in the windshield, doors or windows of a covered "auto". 17. Knowledge Of Occurrence The following replaces Section IV — Business Auto Conditions, Paragraph A.2.a.: a. In the event of "accident", "claim", "suit" or "loss", you must give us or our authorized representative prompt notice of the "accident" or "loss". Include: (1) How, when and where the "accident" or "loss" occurred; (2) The "insured's" name and address; and (3) To the extent possible, the names and addresses of any injured persons and witnesses. Your obligation to provide prompt notice to us is satisfied if you send us notice as soon as practicable after: (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; becomes aware of, or should have become aware of such "accident", "claim", "suit" or "loss". 18. Blanket Waiver Of Subrogation The following is added to Section IV — Business Auto Conditions, Paragraph A.: 6. If required by written insured contract, 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" caused by an "accident" and resulting from the ownership, maintenance or use of a covered "auto". 19. Unintentional Errors And Omissions The following is added to Section IV — Business Auto Conditions, Paragraph B.2: However, if you should unintentionally misrepresent or conceal information to us at any time, we will not deny coverage under this policy based on this unintentional error or omission. This provision does not affect our right to cancel or non -renew your coverage or collect additional premium for any added exposures. Page 6 of 6 Includes material copyrighted by Insurance Services Office, Inc., with its CA 83 40 03 23 permission