06-044.00 Eller Corporation: Barker Improvements Boone to Spokane River,~
~~
Sp~o~]~ane
Valley
DEPARTMENT OF PUBLIC N/ORKS
,~
CHANGE ORDER TO CONSTRUCTION CONTRACT NO: 04-003
PROJECT: Barker Road Improvements CONTRACT DATE: 4/3/2006
CONTRACTOR: Eller Corporation CHANGE ORDER NO: 3
SCHEDULE A - Barker Road Improvements -Boone Ave. to Spokane River PROJECT N0: 323679.CM
SCHEDULE B - South Greenacres Sanitary Sewer Project No. 1038, Phase 2
DESCRIPTION OF CHANGES
Schedule A -Change storm drain pipe from 12-inch PVC to 8-inch Ductile Iron between CB-15 and Swale No. 3 at
approximate Station 39+00.
Total Amount of this Change Order: $400.00
SUBSTANTIAL COMPLETION
Original Date: 916!2006 Prior to this Change Order: 9!612006 Including this Change Order: 916/2006
ESE CHANGES RESULT IN THE FOLLOWING ADJUSTMENTS OF CONTRACT PRICE (excluding sales tax):
ORIGINAL CONTRACT AMOUNT $ 1,673,984.78
TOTAL PRIOR CHANGE ORDER AMOUNT
CONTRACT PRICE PRIOR TO THIS CHANGE ORDER (thru CO#2) .,$.
NET THIS CHANGE ORDER _$.
CONTRACT AMOUNT INCLUDING THIS CHANGE ORDER $
(73, 287.30)
1,600,697.48
400.00
1, 601, 097.48
CONTRACTOR ACCEPTANCE: ~ ~J DATE: (p ~ ~ ' D
The Contractor hereby accepts this adjustment In performance, time, and Comp sation as a final and c mplete equitable adjustment In full accord end safistaction of a0
past, present, and future liabf6ties originating under any clause of th[s Contract by reason of the fat15 and cirwmstances gluing rise to this nrodllicetion or by reason of the
cumulative impaU of atl previously executed modifitaUo~ns to this con•,racL The Contractor agrees that tho pr6ce to this change order, includit-g profit or fee. shall bo
adiusled to exclude arty signilkant sums by K4~ich the City of Spokane Valley finds that such price wag inueased bacause the Contractor-furnished cost or prlGng data
+n~as inaccurate, incomplete Or not current as of iho date agreed upon between tho City OS Spokane Valley and the Contractor.
RECOMMENDED BY:
far
ACCEPTED BY:
(Req'd for Schedule B Changes) Mark Stiltz, Spokane County Project Manager
APPROVED BY:
DATE: 5 '1,,ap ~,
DATE:
DATE: ~ ,
APPROVED BY:
Dave Merder, City Manager
DATE: (~~/S %~~
ATTACHMENTS:
Distrtbutior7: '
ORIGINALS TO: Contractor, City of Spokane Valley Clerk's Office, PW Project File
COPIES TO: CH2M HILL Project Manager, CH2M HILL Resident Observer, Spokane County
P:PYV1FomeslTemplatefslCO (Apr 06)
C06-44
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Spokane
Valley
DEPARTMENT OF PUBLIC NlORKS
CHANGE ORDER TO CONSTRUCTION CONTRACT NO: 04-003
PROJECT: Barker Road Improvements CONTRACT DATE: 4!312006
,CONTRACTOR: Eller Corporation CHANGE ORDER NO: 4 Revised
SCHEDULE A - Barker Road Improvements -Boone Ave. to Spokane River PROJECT NO: 323679.CM
SCHEDULE B - South Greenacres Sanitary Sewer Project No. 1038, Phase 2
DESCRIPTION OF GNANGES
Schedule A -Provide five (5) additional Type III traffic control barricades for cost of $112.00 for each.
Total Amount of this Change Order: $560.00
SUBSTANTIAL COMPLETION
Original Date: 916/2006 Prior to this Change Order: 9/6/2006 Including this Change Order: 9/6/2006
HESE CHANGES RESULT IN THE FOLLOWING ADJUSTMENTS OF CONTRACT PRICE (excluding sales tax):
ORIGINAL CONTRACT AMOUNT $ 1,673,984.78
TOTAL PRIOR CHANGE ORDER AMOUNT $ (72,887.30)
CONTRACT PRICE PRIOR TO THIS CHANGE ORDER (thru CO#3 $ 1,601,097.48
NET THIS CHANGE ORDER $ 560.00
CONTRACT AMOUNT INCLUDING THIS CHANGE ORDER S 1,601,657.48
CONTRACTOR ACCEPTANCE: ~1 ~ r \ ~j,~.~Lt~ l . ~'r~ ~~.- DATE: ~ `~~j ~ a (D
The wntractor hereby accepts Eh(s adjustment (n performsnce, time, and compensation as a final'Snd complete equltabte adjustment in full accord and satisiacilon of a0
past, present, and Eu?ure liebllities originating under any clause of the Contract by reason of the facts and citcumslances giving rise to this modification or by mason of the
cumulathre Impact of all previously executed modifications to this oonlrecL The ContrsCttsr sgrees that the price to thss change order, including profit or fee, shall be
adjusted to exclude any significant sums by which the City of Spokane Valley Rnds that mach price vras inueaseC because the Contractordumished cos? or pricing data
was inaccurate, inoomploto or not current ar of the date agreed upon behrreen the City of Spokane Valley and the Contractor.
RECOMMENDED BY:
for (Consultant)
ACCEPTED BY:
(Req'd for Schedule B Changes) Mark Stiltz. Spokane County Project Manager
APPROVED BY;
DATE: 'tea
DATE:
DATE:
APPROVED BY:
Dave Mercier, City Manager
DATE: ~' ~~ ~~
ATTACHMENTS:
Distribuffon:
ORIGINALS TO: Contractor, City of Spokane Valley Clerk's Office, PW Project File '
COPIES TO: CH2M HILL Project Manager, CH2M HILL Resident Observer, Spokane County
P:PVJ/formslrempkitesJCO (Apr 06)
V '~ ~
Spokane
Valley
DEPARTMENT OF PUBLIC WORKS
.~. .
CHANGE ORDER TO CONSTRUCTION CONTRACT NO: 04-003
PROJECT: Barker Road Improvements CONTRACT DATE: 413f2006
CONTRACTOR: Eller Corporation CHANGE ORDER NO: 6
SCHEDULE A - Barker Road Improvements -Boone Ave. to Spokane River PROJECT N0: 323679.CM
SCHEDULE B - South Greenacres Sanitary Sewer Project No. 1038, Phase 2
DESCRIPTION OF CHANGES
Perform Schedule A revisions as summarized in the attached April 24, 2006 Technical Memorandum and as shown on
drawing sheets 9, 10, 14, 15, 23, 25, 34, 36, 37, 38, and 39 revised 4114106.
As applicable, payment for the revisions will be based on existing Schedule A unit price payment items and actual field
measured quantities. An additional lump sum payment of $3,981.60 will be made for Traffic Signal System Revisions.
t oval ~amounc of tnts ~nange taraer. y3,yu I .ou
SUBSTANTIAL COMPLETION
Original Date: 9/612006 Prior to this Change Order: 916!2006 Including this Change Order: 916!2006
E CHANGES RESULT IN THE FOLLOWING ADJUSTMENTS OF CONTRACT PRICE (excluding sales tax):
ORIGINAL CONTRACT AMOUNT S 1,673,984.78
TOTAL PRIOR CHANGE ORDER AMOUNT $ (59,427.30)
CONTRACT PRICE PRIOR TO THIS CHANGE ORDER (thru CO#5) $ 1,614,557.48
NET THIS CHANGE ORDER $ 3,981.60
CONTRACT AMOUNT INCLUDING THIS CHANGE ORDER $ 1,618,539.08
CONTRACTOR ACCEPTANCE: ~'l °V DATE: ~ ~ 7~~
The Contractor hereby acoepL,lhis adjustment ui peRortnanCO, time, and Co pertsation es a real and Complete eQui?able adjustment in lull aCCOM find satis:action of all
pflst, present, and futuro liabililicv origlnalurog under any dauso or U-e Contrad by reason of rho facts ared dreumstances giving rise to this modiflCation or by reason of the
Cumula?iva impact or aft provtously executed mod'fications ?o this contract. Tho Comractor agrees that the prFte to this change order, including profit or fee, sh~stl be
adjusted to exclude any signSfignl sump try vrhich the Ci?y of Spokane Volley finds that such price was increased because the Contractor-rvrn~hCd Cost or pricing data
vras inaouvrdte, incomplete or trot curten? as of the da?a agread upon be?rveen the City of Spokane Valley and the Contractor.
RECOMMENDED BY:
for
DATE: (~
ACCEPTED BY:
(Req'd for Schedule B Changes) Mark Sli1tY, Spokane County Project Manager
APPROVED BY:
DATE:
DATE:
APPROVED BY:
Dave Merrier, City Manager
DATE: !~ "ICS ~Os%
ATTACHMENTS:
Distrrbutron:
ORIGINALS TO: Contractor, City of Spokane Valley Clerk's Office, PW Project File
COPIES TO: CH2M HILL Project Manager, CH2M HILL Resident Observer, Spokane County
P:PWlFOrmslrempla'es1CO (Apr 06)
...
i _.,
TECHNICAL MEA90RANDUAI 1
CH2MHILL
Proposed Design Changes
PREPARED FOR: Louis Graf/City of Spokane Valley
PREPARED BY: Clark COSb}'/SPK
Jim Dingfield/SPK
coaiES: Karat Rinaldi/Eller Corporation
tii~rk Stiltz/Spokane County
DarE: April 24, 2006
PROJECT NUMBER: 323679.A1
The following changes to the Barker Road Improvements project are proposed:
1. Property Line conflicts: Adjust location of Drainage Swale No.1
• Reduce length of "SOLID 4~TALL PVC STO1ZivI PIPE 12 IN. DIAM." b}~ 8LF total
2. Reduce signal pole offset location at NE corner of Mission/Barker intersection; revise
method of adjusting sideti~alk to grade atback of curb rvnp with signal poles; add right-
hurt arro~~s and "ONLY" to INB lane on Mission.
• Additional "ROADWAY EXCAVATION L~TCL. HAUL" +63 CY
• Additional "CRUSHED SUItFAC tNG BASE COURSE" +42 TON
• Additional "CRUSHED SURFAC tNG TOP COURSE" +33 TON
• Additional "1-IMA CL.. 1/2" PG 70-28" +19 TON
• Additional "HMA CL. 1" PC 70-28" +28 TON
• Additional "PL.ASTIC WIDE LII~rE" +142 LF
• Additional "PLASTIC TRAFFIC ARROW" +2 EA
• Additional "I'I~.4STIC TIi;.4FFIC LET"TER" -~4 EA _
• Modify "TRAFFIC SIGNAL SYSTEM"
- LLUninaire arm length increased from 8' to "15' for all 41LUninaires
- Signal. mast arm length decreased 10' far Pole #3
- Reduced nlunber of Type 1 Junction Box by 2 (ltivo)
- Relocate 1 (one) Type 2 Junction lox from NW corner to NE comer
- Changed luminaire conductor size from #8 to #6
- Revised ~~ire type for 2 (tN~o) signal heads from 7C to 2-5C
- Added wiring runs for Opticom system - 2C wire from Opticom to controller
- Added 3 (three) detector loops on ~^~estbou.nd Mission right-turn lade
- Modified signal pule foundation detail to account for Sideti~alk
• Additional "CEl~4ENT CONCRETE S.IDEWAI_..K" +32 SY
• Additional "CE1vIENT CONCRETE SIDEWALK, DECORATIVE S"I'AMC'ED" +64 SY
• Revise club ramp type to "CEM:1r1~jT CONCRETE SIDEWALK RA~ZP TYPE 1B" +2
EA
PR4POSEDDESlGNC:-IG TECHI/,EI/A.DOC
_ _ ~y
d. ~ ~ '~
-PROPOSED DESIGI! CHkNGES-
._ L -
• f7educe quantity of "CEMENT CONCRETE 5[C~1:.W.4L1: RAMP 7"YPE 2" -1 EA
3. Add pedestrian crossing at north side of intersection of Bald~1~in Ave on $arker Rd
• Reduce quantity of "CRUSHED SURFACING BASE COURSE" -C TON
• Reduce quantity of "CRUSHED SURFACING TOP COURSE" -~ TON
• Reduce quantity of "I~MA C1~. 1 /2" PG 70-2$" ~ TON
• Reduce quantity of "1-iMA CL. 1" PC 70-28" -4 TON
• Additional "C>=MI=~~1T COI~jCRETE TRAFFIC CURB" +b8 LF
• Additional "CEME~~1T CONCRETE 5.IDEWALK" +23 SY
• Reduce quantity of "EXTRU17E17 CURB" -E LF
• Additional "CEMENT CONCRETEr SIDEWALK, DECORATIVE STA;<tiII'ED" +14 SY
• Add curb ramp "CEMENT C0~1CRE'fE SIDEWALK RAMP TYPE 1B" +1 EA
• Add quantity of "PLASTIC CROSSWALK LII~TE" +108 SF
Additional impacts to project include adding signs on Barker Road and Mission Avenue (by
others).
PROPOSEDaESIGNG}{G_TE-GHMEh16.DOC ~.,t., 2
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ACORD
OF LIABILITY INSURA`„~;E
CERTIFICA'v °A a`9128;OE'
,~
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PRODUl.17 509-358.3800 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ACOrdia Northwest ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
CA License #/0531007 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
601 W. Main Ave. Suite 1400
Spokane, WA 99201 INSURERS AFFORDING COVERAGE
INSURED
Ell
C
i INSURER a EmpID ers of Wausau
er
orporat
on
INSURER B: Arch S ecialt Insurance Co
P.O. Box 1 17
INSURER C:
Newman Lake WA 99025
INSURER 0:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BEL01b HAVE BEEN ISSUED TO THE INSURED NAPAED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREA4ENT, TER~.4 OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WRH RESPECT TO WHICH TWfS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS ANO CONDITIONS OF SUCH
POLICIES. AGGREGATE LIPAfTS SH04VN h1AY HAVE BEEN REDUCED BY PAID GLAIMS.
INSR TYPE OF WSURAXCE POLICY NUAI6ER POLICY EFFECTIVE POLICY EXPIRATION
f A9/D0 Y LIMITS
A oENERALUABIUrr 91-545310026 9/30/06 9130!07 EACH OCCURRENCE s looaooo
X COMMEnCIAL GENERAL LIAEILITY FIRE DAMAGE IAny One lirGl ! 300000
CLAIMS MADE a OCCUR MED EXP [Any one IDerSON 5 5000
P£RSONALR ADV[NJURY s 1000000
GENERAL AGGAE{aATE 3 2000000
GEI*rL AGGREGATE LIJAIT A??6,IES PFs"i: PRODUCTS -COb1PlOP AGG S 2000000
POLICY X Pea LOC
A AVTOM081LE LIABILITY 91545310016 9!30106 9130107 COA131NED SINGLE LIMIT
X ANY AUrO
IEa eccideml s 1000000
AL.L OWNED AUTOS 90DILY INJURY
SCH[OULED AUTOS IPet persoN 9
X HIRED AUTOS
30DIlY INJURY
X
NON-01VNED AUTOS
IFos mld°mJ 6
PROPERTY DAMAGE
6
1Per eceimenU
OARAOE LIABIITTV AUTO ONLY - EA ACCIDENT 8
ANY AUTO OTHER T1iAN EA ACC 9
aui0 ONLY: AGG s
B EXCESS LIABILITY EX0002200102 9130106 9/30107 EAL}i OCCURRENCE 3 4000000
X OCCUR a CLAIMS MADE AGGREGATE s
X000000
5
DEDUCTIBLE _
X RETENTION s 10000 0
Q VlORKERS COMPENSATION AND 9 1-545 310026 9/30106 9130!07 WC STATU- f OTM-
FiYIPLOYENS' 11A81LIT
WA STOP GAP ONLY
E.L. [ACH ACCIDEKI'
L 1000000
E.L. DISEASE • EA 6VIPLOYEE 6 1000000
E.L.DISEA$E-POLICYLIMI7 8 1000000
A OTHER 9i-545310026 9130106 9130107
INSTALL FLOATERI ALL RISK 51,000,000 COC LIMIT
BUILDER'S RISK INCL EO & FL S1 000 DEO/826 000 DED EO & FL
D£SCNIPTION OK OPERATIONSILOCATIONSlVEHICIESJEXCLUStONS ADDED BY ENDORSEAIENTISPECIAL PROVISIONS
RE: BARKER ROAD IMPROVEMENT PROJECT. PRIMARY &NON-CONTRIBUTORY
ADDITIONAL INSURED STATUS IS GIVEN TO THE CITY OF SPOKANE VALLEY;
CH2M HILL.; SPOKANE COUNTY & THE STATE OF WASHINGTON, THEIR OFFICERS
AGENTS & EMPLOYEES PER ENDORSMENT ATTACHED. WAIVER OF SUBROGATION &
AND CROSS LIABILITY DOES APPLY.
a.cn 1 rnt,sa 1 c n~~ucn ~ ADDITIONAL INSURED: INSURER LETTER: I.AIVIaLL.A I WIV
SHOULD ANY OF THE ABOVE DESCRIH£O POLICIES BE CANCELLED BEFORE TKE EXPIRATION
THE CITY OF SPOKANE VALLEY DATE THEREOF, THE ISSUING INSURER VlILLX~XA616~151 AIAtL 45 DAYS 1'JRITTEN
ATTN: CHRISTINE BAINBRIDGE NOTICE TO TKE CERTIFICATE HOLDER NAMED TO THE LEFT, AU7~x~7)f13tX0000JC9Ch56XUC
11707 E SPRAGUE AVE. >•110 ~exxov~ae;K~ewx~oxxaaeaoexsEx~axxwa~ocovw~eer~sxvt3wa~eaea~x~x~
SPOKANE VALLLEY, WA 99206 ~~~'~
AUTtI0R12LD REPRC•SGVT IVFA. A
ACORD 25--S (7197)
17- 43
RPORATIOPI 1968
~ ~\
1
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IMPORTANT
It the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsementlsl.
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(si, authorized representative or producor, and tho certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25-S (7197)
~~
.,
Policy Number -91-x,45310026
Issued by EMPLOYERS INSURANCE COMPANY OF WAUSAU
THIS ENDORSEA'IENT CHANG>~S T>3E POLICY. PLEASE READ 1T CAREFULLY.
Wausau EXPRESS" Liability Endorsement
This endorsement modi5es insurance pra~*ided under the following:
COlv1I~fERCIAL GENERAL LIABII.TTY COVERAGE PART
1. Broad Form Additional Insured
2. Waiver of Right of Recovery by Written Contract or Agreement
3. Duties in the Event of Occurrence, Offense, Claim or Suit
4. Unintentional l=mars or Omissions
S. Supplementary Payments
6. Two ar Mare Coverage Parts or Polices Issued by Us
7. Expected ar Intended Injury from Reasonable Force
8. Non-Owned Watercraft
9. Limited Tenants Legal Liability
10. Bodily Injury Redefined
11. Insured Contract Redefined
12. Personal and Advertising Injury Redefined
1. Broad Farm Additional Insured
Paragraph 2. of SECTION II -WHO IS AI\` TI~TSURED is amended to add the following:
e. Additional Insured by Written. Contract or Written Agreement
The following are insureds under the policy when yon have agreed in a written contract ar aitten agreement to
provide them coverage as additional insureds under your policy:
(l.) Lessors of Leased Equipment: the person(s) or organization(s) but only w~[h respect to liability for "bodily
injury", "property damage" or "personal and advertising injury" caused, in whole qr in p;irt, by your maintenance,
operation ar use of equipment leased to you by such p;.rson(S) ar organization(s).
With respect to the insurance afforded to these additional insureds, this insurance does not apply to any
'occurrene~e" which takes place after the equipment lease expires.
(Z) Owners, managers, or lessors of premises or land: any owner, manager or lessor of premises or land, but only
with respcd to liability caused; in whole or in part, by the ownership, maintenance or use of that part of the
premises ar land leased to yon
This insurance does not apply to:
(a) Any "oeeurrence" which takes place after you cease to be a tenant in that premises or to lease that land; or
(b) Structural alterations, new construdian ar demolition operations performed by or on behalf of the owner,
manager or lessor of that premises or land
GL0566 Page 1
Ob-04 See next page
f '
(3) Mortgagees, assignees or receivers: any person(s) or organization(s) with respect to their liability as mortgagee,
d.5signee, or receiver and arising out of the ov~~ncrship, maintenance or use of your premises.
This insurance does not apply to stnictural alterations, new construction and demolition operations performed by
or far that person or organization.
(4) Any person or organization other than a joint venture, for which you have agreed by written contrail to procure
'bodily injur}r' or "property damage" liability insurance, but only far liability caused, in whole or in part, by
operations performed by you or on your behalf, provided that:
(a) This subparagraph (4) does not apply to any agreement to provide insurance to:
(i) An "employee," association of "employees' or labor union, except vti~th respect to work performed by or
for you or for such "employee; association of `employees" car labor union under direct contract between
you as contractor and such "emp]oyee," association of "employees" or labor union as owners;
(ii) Any raikoad company except with respell to work performed by or for you for such railroad company
under diced contrail or agreement between you and such railroad company;
(iii) Any person or organization whose profession, business or occupation is that of an architect, surveyor or
engineer with respect to liability arising out of the preparation or approval of maps, drawings, opinions,
reports, surveys, change orders, designs, specification or the performance of any other professional
services by such person or organization;
(iv) Any of your subcontractors, or any partner, officer, agent or "employee" of such subcontractor; ar
(v) Anyone more spe~cally covered in subparagraphs e.(1) through (3) above.
(b) The insurance afforded to any person or organization as an insured under this subparagraph (4):
(i) Shall include only the insurance that is required to be provided by the terms of such agreement to procure
insurance, and then only to the extent that such insurance is included within the terms of this policy, and
a person or organiT.ation's status as an insured under this endorsement ends when your operations for that
insured are completed; and
(ii) Does not apply to 'bodily injur}~' or "property damage" included within the "products/completed
operations haryard' unless such coverage is required by an "insured contrail" betvvccn you-and the
additional insured.
The limits of insurance applicable to such insurance shall be the lesser of the limits required by the agreement between
the parties or the limits pro~ridcd by this policy.
The insurance afforded to any person or organization as an insured under this subparagraph 2.e. does not apply to
"bodily injur}~' or "property damage" which occurs prior to the date of your contrail or written agreement with such
person or organization.
2. Waiver of Right of Recovery by WrittEn Contract or Agreement
R'e waive any right of recovery because of payments we make for injury or damage arising out of your ongoing operations
or "your worl-" included in the "products-completed operations hazard" that we may have against any parson or
organization with whom you have agreed, in a written contrail or a~eement made prior to the date of the "occurrence:," to
waive your rights of recovery from such person or organization, but only far payments made Hader the policy and resulting
from that contract
GI.0566 Page 2
Q6-04 Sac next page
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3. Duties in the Event of Occurrence, Offense, Claim or Suit
Paragraph 2. of SECTION IV -COMMERCIAL GEN>rRAL LIABILITY CONDITIONS is deleted a.nd replaced with the
following:
2. Ducks in the Event of Occurrence, Offense, Claim or Suit
a. You, your insurance manager or any other person you designate must see to it that we, or our authorized agents,
are notified as soon as reasonably possible of an "occurrence° or offense which may result in a claim. Notice
should include:
(1) How, when and v;here the "occurrence" or offense took place;
_ (2) .The names and addresses of any injured persons and witnesses; and
(3) The nature and location of any injury or damage arising out of the "occurrence" or offense.
Knowledge of an "occurrence" or offense by your agent, sen*ant or "employee" is not considered knowledge by
you unless your insurance manager or other designated person has received notice from your agent, servant or
'employee.°
b. If a claim is made or °snit" is brought against any insured, you must:
(1) Immediately retard the sPecifi~s of the claim or "suit" and l:hc date received; and
(2) Notify ns as soon as reasonably possible.
If yen report any °occurrence", offense, claim or snit to your workers compensation or automobile liability
insurance carrier and the "occurrence", offense, claim or "suit" later develops into a claim under this policy,
failure to report such- "occurrence", offense, rlaim or ''suit" shall not be considered a ~nolation of this condition.
However, as soon as you become aware Lhat the particular "occurrence", offense, claim or "suit" is a commercial
general liability claim or "suit", yon must give prompt notification to us.
G You and any other involved insured must:
(l) Immediately send us copies of any demands, notices, summonses or legal papers received in connection with
the claim or ':suit';
(2) Authorize us to obtain records and other information;
(3) Cooperate with to in the investigation, settlement or defense of the claim or "suit'; and
(4) Assist us, upon our request, in the enforcement of any right agaim't any person or organization which maybe
liable to the insured because of injury or damage to which this insurance may also apply.
d. No insureds will, except al their own cost, voluniarily make a payment, assume any obligation, or incur any
expense, other than for first aid, without our consent.
4. Unintentional Errors and Omissions
Any unintentional error or omission in the description of, or failure to completely describe, any premises or operations
intended to be covered by this Commercial General Liability Coverage Part will not invalidate or affect coverage for those
premises or operations. However, you must report any such error or omission to us as soon as reasonably passible after its
discovery.
GL0566 Page 3
06-04 Sec next page
tip'
a~. Suppleunent• Payments
.>'aragraghs 1.b. and 1.d. of ~>~CTTOEV l = SUPPLEI+~TARY Fr~.~'~I4tEIVT•S - COVERAGE A ACID 8 are deleted and
replaced with the following•
L. I,?p to 3Q00 for the cost of baii bonds required because of accidents or traffic law vioJa~oas arising out of the use of
any vehicle to which tLe .~odilp Injury Liability Coverage agpZiGS_ a do not have to furnish These bonds-
d. All r~asanable expenses incturcd by the in~~ed at our request to assis[ ua in the investigation or defense of tht clasm
or'"suit" including actual loss of earnings up to $500 a dapbecanse of tjme off ffauo worl€.
~i. 'I~rro or Mare Coverage Parts ur Polic'ses Issued by l!s
If any claims ~ "suit" arising out of an "occwrcncc;" or offense covered under. this ~vverage Part is also subject to co~~erage
t~uder any other fvoverage Part or policy is~sucd by us or by anp company uffiliatcd veith us, the total ~aaon]wn 1i~tt of
liability tinder all coverage Party nr poli~ies.shall not exceed tJ,e.l~i~hcst applicable }emit of liabi]ity under any one
Coverage Part or policy. Thi~~ cvnditian does not apple to any Coverage Part ar policy that is specilieally issued as excess
insurance over Ibis coverage Part
7. Er~pec:ted or Io6euded firjnry from Reasonable Force
Paragraph ~.a, of E~71~1~1 I = COVERAGES, CpVEOE A = $~I}ILY II~dTLFRY AN>;l PR~1'ERTY I}.4DriAGE
i,IABE.TTY is de]eled and replaced arith the follo~ng:
2. Exclusions
Thi_ insurance doe. not apple to:
am Expected Or Intended Injury
"Bodily injmr~' or "property damage" expected or inta:nded frarn the standpoint of tl~e instived_ 'Phis exclusion
does not apply to 'bodily injury' or "property da~oa age" resulting from the use of reasonable farce to protect
persons or property.
8. Noo-owned aberctaFk
T'~agraph 2.g.{2~ of SE~77ON [ - ~~YEItAES, COERACrE A - PO~1L~i' INJLTRY~.I~FD PROPERTY DAAC>~
LIABILITY is deleted and replaced with the following; ~ .
{~) A c~atercraft yom da not own that is:
~a) .Less than trr equal to 5~ feet in length; or
fib) Not being used to carry persons od property foz a charge-
~. Limited 'I'enant~ Legal Liability
A. 1'he Damage 'Fo Premises Rcntcd To'You Linvt sbo~•a on the Ileclarations is changed to the Limited Tenan~•s i,.egal
I.siability Limit, and is the greater of the amount shown or $3Q0,00~•
B. Para~aph 6. of SFsCTIC} III - LIMIT'S OF ~SSURAA]C>~ is deleted and replaced with the following:
Gf~05~6 Page 4
~6-04 ee next gage
6. Subject to S above, the Limited Tenants Legal. Liability Limit is the most we gill pay ender Coverage A for
damages be.canse of "property damage" to premises rented to you, as a result of an "occurrence° caused by fire,
lightning, explosion, smoke, leakage from fire protective systems, or any combination thereof.
C. Paragraph 4.b.(1)(b.) of SECTION IV - CONIIvIERCIAL GENERAL LIABILITY CONDITIONS is deleted and
replaced with the following:
(b) That is insurance for premises rented to you for damage to such premises resulting from fire, lightning, explosion,
smoke, leakage from fire protective systems, or any combination thereof.
D. The last paragraph of SECTION I, COVERAGE A (after the exclusions) is deleted and replaced with the following:
Exclusions c. through n. do not apply to damage by fire, lightnin{;, explosion, smoke, leakage from fire protective
systems, or any combination thereof, to premises while rented to }'ou. A separate limit of insurance applies to this
coverage as descaibed in~SECTION III - I.,IMITS' OF INSURANCE.
10. Bodily Injury Redefined
Paragraph 3. o[ S1/CTION V - DEFII~~ITIOI~'S is deleted and replaced with the following:
3. `Bodily injur}~' means physical:
a. Injury;
b. $1Clmcss; or
G Disease;
Sustained by a person, including; death, humiliation, mental anguish or mental injury which directly results from the
ph}~ic;al injury, siclmess or disease.
11. Insured Contract Redefined
Paragraph 9. £ of SECTION V - DEFINITIONS is deleted and replaced with the following:
C That part of any other contract or agreement pertai.ni.ng to pour business (including an indemnification of~a
municipality in connection with work performed for a municipality) tinder which yon assume the tort liability of
another party to pay for 'bodily injury" or "property damage" to a third person or organization, prodded the 'bodily
injury" or "property damage" is caused, i.n whole or in part, by you or by those acting on your behalf. Tort liability
means a liability that would be imposed bylaw in the absence of anp contrail or agreement.
Paragraph £ does not include that part of any contract or agreement:
(1) That indemnifies a railroad for "bodily injury" or "property damage" arising out of construction or demolition
operations, within 50 feet of any railroad property and affecting any railroad bri ~=e or trestle, tracks, road-beds,
tunnel, underpass or crossing;
(2) That indemnifies an architect, engineer or surveyor for injury or damage arising nut of:
(a) Preparing, approving, or failing to prepare ur approve, maps, shop drawings, opinions, reports, surveys, field
orders, change orders or drawings and specifications; or
GL0566 Page 5
06-04 See next page
J ,~
1
(b) Giving directions or instruetions, or failing to give them, if that is the primary cause of the injury or damage;
or
(3) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising
out of the insured's rendering or failure to render professional services, including those listed in (~) above and
snper~~sory, inspection, architectural or engineering activities.
12. Personal and Advertising Injury Redefined
Paragraph 14. of SECTION V - DEFiTFITIONS is amended to add the following:
h. Discrimination against a natural person on the basis of race, color, ethnic origin, gender or religion, but only if such
discrimination is not
(1) At the direction of or with the knowledge or consent of:
(a) Yon.;
(b) Your spouse, if you are an indi~tidnal;
(c) Your members or your partners and their spouses, if you are a partnership or joint venture; or
(d) Your "egecative officers" and directors and your stockholders, if you arc a corporation; or
(2) Directly or indirectly related to the employment, prospective employment, or termination of any persan.
GL0566 Page 6
06-04 Last page
i
ACORD
f~- E
CERTIFICA'~~~-` OF LIABILITY INSURA~~
DAT09/25107)
~,
:
PRnDUCER 509-358-3800 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Wells Fargo Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Services !CAL#0531007 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
601 W. Main Ave. Suite 1400
I
Spokane, WA 99201
INSURERS AFFORDING COVERAGE
INSURED
Ell
C
ti [NSURER A: COI1LIItOni81 WeStE:rn Ins. CO.
er
orpora
on
P
1 17
B
O ursuRER e:
.
ox
.
INSURER C:
Newman Lake I~VA 99025
INSURER D:
I LY$URER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW RAVE BEEN ISSUED TO THE INSURED NAA4ED ABOVE FOR THE POLICY PERIOD INDICATED. NOTINITMSTANDING
ANY REQUIREIv1ENT, TERM OR CO)JDITION OF ANY CONTRACT OR OTHER OOCUtv1ENT 4VIT11 RESPECT TO ~NHIGH THIS CERTIFICATE A4AY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERtviS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIA4ITS SHOWN A4AY HAVE BEEN REDUCED BY PAID GIRTHS.
INSR
TYPE OF INSURANCE
POIICY NUhSBER POLICY EFFECTIVE POLICY EXPIRATION
I .
LIlA1TS
A GENERAL uADIL/TV CWP2706341 9/30!07 9130108 EACH OCCUR=ENCE a looooao
X COMh{ERCIAL GE,t:ERAi LIADIUTY FIRE DAJAAGE (Arvy ono flre) b 300D00
CLAI~dS MADE ~ OCCUfl h1E0 [XP (Any one Pcrwnl 5 5000
PE:iSONAt E ADV INJURY L 1000000
GEN=RAL AGGREGATE S Z 000006
~G~-NTL AGGREGATE LIMIT APPLIES ?-cR: PAOOUCT$ • COMPJOP AGG 5 2000000
n PAS n
I f PDUCY
40C
A AUTOMOD1lE LIAB1LITY CWP2706341 9130!07 9!30108 COMBINED SINGLE LIMIT ~'
X A.YY AUTO {Eo occident) 9 1000000
ALL OLVNEO AUTOS
DODILY INJURY
$CHEOULED AUTOS
{por person) s
X HLRED AUTOS
PAOILY INJURY
X
MOCFOVJNED AUTOS
(Pnr nncidem) '
PROP[P:TY OA1
IAGE
I .
(Pet eccidenil L
GARAGE LIADIUTY AUTO ONLY - EA ACCIDErh' 8
MJY AUTO OTHER THAN EA ACC r
AUTO ONLY: AGG 6
A [7(CESS LIADWTY CU2706343 9130!07 9130!08 EACH OCCURRENCE 8 4000000
X OCCUR ~ CLAIMS h(ADE AGGREGATE 5
4000000
3
DEDUCTIBLE 9
X RETENTION 5 0 8
A WORKERS COhSPENSATION AND
~ C4VP2706341 9130107 9134f08 L'!C STATU• OTH-
'~
EMPLQYF.RS' I.IAf31LITY WA STOP GAP ONLY E.L. EACH ACCIDENT s 1000000
E.L. DISEASE • EA Eh1PL0YEE : 1000000
E.L. DI5EA.SF.-POLICY LUAIT 5 1000000
A OTHER CWP2706341 9130107 9130!08
INSTALLATION ALL RISK S1,000,000 COC LIMIT
FtOATER INCL EO & FL S1 000 DED S25 000 OED EOIFI.
DESCRIPTION OP OPtRAT10NSJLOCA71tlV5NEFiICLESJEXClUSIONS ADDED 8Y EN DORSEALENTJSPECIAL Pft0VIS10NS '
RE: BARKER ROAD IMPROVEMIENTS PROJEC'T'. PRIMARY &NON-CONTRIBUTORY
ADDITIONAL INSURED STATUS IS GIVEN TO THE CITY OF SPOKANE VALLEY;
CH2hA HILL; SP{IKANE CC}UN'fY & TFEE STATE OF WASHINGTON, THEIR OFFICERS,
AGENTS & EMPLOYEES PER ENDORSEMENTS ATTACHED. WAIVER OF SUBROGATION
& CROSS LIABLI7Y DOES APPLY.
tali I ItII:A I t 1-fULUtH I ~ I ADIRTIONAL INSURED; INSURER LETTER; GANGELLATION
THE CITY OF SPOKANE VALLEY SHOULD ANY OF THE ABOVE DESCRIBER POLICIES DE CANCELLED D>:FORE THL• EXPIRATION
DATE THEREOF, THE ISSUING INSURER VlILL,~'OYI~XSx?~S~M h1AlL 45 DAYS 1'lAITTEN
ATTN: CHRISTINE BAINBRIDGE NOTICE TO THE CERTIFICATE FIOLDER NAN.EOTO'1'!IE LEFT, F1}1'~(Q~ftKxIXOQX9(DC,~3xIXX
11707 E SPRAGUE AVE. JY10 acaos~xaox~exo~cl:oxpxxaacavcx>~xwx>n,+aaxocx>>~v~xaax~caaxx~
SPOKANE VALLEY, WA 99206 ~~
AUTHORIZED REPRESENT/A'IVFw. _
AcoRO 25-s (7/971
5 7 _ ,91
P~RATION 19RR
i
IIVIP~RT~4NT
If thG certificaxe holder is arr ADDITIOf~AL INSURED, the policy{iesl anust be endorsed. A st~tgment
on this certificate does not conFer riglxts t~ tape oertitioetE Yrplder in lieu at such endorsement{s},
if SUBR~GATIDN l5 WAIVED, subfeck ko the terms a+~d oonditipns pt thG Policy, certain policies may
reCiuire X91 endorsg,ngnt_ A Sxatement on this certificate does nox con#er rights to the certificate
holder in lieu of such erldorsement~sf,
DI~iwLL11MER
The Certificate of Insurance an the reverse side of this f~rGn does not constitute ~ contraot between
the I$SUFrF~ irlsurer[SM, Slrtl3pri~ed rei~r~S~fltQtl+f4 ^r producer, and the certificate holder, nor does it
atfirmati~+eiy or neflatively amend, extend or alter the covera+~e a#forded by the policies listed tk~ereon,
ACORN 2~-S 1797]
4 , ' ~'
THIS ENDORSEMENT CHANGES TfiE POLICY. PLEASE Rt.;~ IT CAREFULLY.
CONTRACTORS' CO(V1(VIERCIAL GENERAL LIABILITY
ENHANCEMENT ENDORSEMENT
This endorsement modr+es insurance provided under ti7e follo.~ring:
COtv1MERClAL GENEP.AL LIABILITY COVERAGE PART
A. f~,EDICAL PAYMENTS
If SECTION I - COVERAGE C MEDICAL PAY-
MENTS is not othen~rise excluded from this
Coverage Part:
1. The I,~edical Expense Limit provided by this
policy, subject to the terms of SECTION llf -
LlM1TS OF INSURANCE, shall be the
greater of:
a. $10,000; or
b. The Phedical Expense Limit sho~,vn in the
Geclarations of this Coverage Part.
B SPRINKLER~LIEAKAGELDAPI AGE 70KPR M
ISES YOU RENT
If damage to premises rented to }rou under Cov-
erage A. is not otherwise excluded from this pol-
icy, the following applies:
1. The last paragraph of SECTION I - COV-
ERAGE A.2. Exclusions is deleted and re-
placed by the foUo~~.~ng:
Exclusions c. through n. do not apply to
damage by fire, lightning, explosion or spnn-
klerleakage to~premises while rented to your
or temporarily occupied by you with perri~+is-
sion of the owner. A separate limit of insur-
ance applies to this coverage as described
in SECTION 111 - L1P.91TS OF INSURANCE.
2. Paragraph 6. of SECTION III -LIMITS OF
WSURANCE is deleted and replaced by the
following:
6. Subject io 5. above, the greater oh
a. 5300,000; or
b. the Darr,ag~e To Premises Rented
To You Lirpit shown in the Declara-
#ions;
is the most eve vn11 pay under COVER-
AGE Afor damages because of °prop-
ertydamage" to any one premises, ~:ahife
rented to you, or temporarily occupied by
you with the permission of the owner
arising out of any one fire, lightning, ex-
plosion or sprinkler leakage incident.
Paragraph 4.b.(1}{b) Other Insurance of
SECTION IV - COMA4ERCIAL GENERAL
LIABILITY COPJDITIONS is deleted and re-
placed by the follo~.ving:
(b) That is Fire, Lightning, Explosion or
Sprinkler Leakage insurance for prem-
ises rented to you or temporarily occu-
pied by you arith the permission of the
owner;
4. Paragraph 9.a. of SECTION V -- DEFINI-
TIONS is deleted and replaced by the follow-
ing:
a. A contract for a lease of premises.
However, that portion of the contract for
a lease of premises that indemnries any
person or organization for damage by
fire, lightning, explosion or spnnkler
leakage to premises arnile rented to you
or temporarily occupied by you with
permission of the owner is not an "in-
sured contract";
C. NON-OWNED WATERCRAFT
1. Paragraph g.(2) of SECTION I - COVER-
AGE A.2. Exclusions is deleted and re-
placed by the following:
A watercraft you do not own that is:
{a) Less than 51 feet long; and
(b) Not used to carry persons or property for
a charge.
D. SUPPLEMENTARY PAYMENTS
SECTION 1 -SUPPLEMENTARY PAYMENTS
- COVERAGES A AND B is amended as fal-
lo~a+s:
1. The limit of insurance in paragraph 1.b. is
increased from 5250 40 52,500; and
2. The limit of insurance in paragraph 1.d. is
increased from 525fl to 5500.
E. AUTOMATIC ADDITIONAL INSURED -
SPECIFIED RELATIONSHIPS
The following is added to Paragraph 2. ofi SEC-
TION II -WHO IS AN INSURED:
e. Any person or organization described in
paragraph f. below, t~~horn you and such per-
son or organization have agreed irti writing +n
a contract or agreement that such person or
organization be added 4s an additional in-
sured on your policy.
+nciu~es cot~Y^ghte~ malarial of Insurance Serirces Page 1 of 6
GL CG 00 20 03 07
CJffCe, Inc., with 6ts permissetm
i
- ~.i -
' _
f
such person or organization is an insured
pravide~~ {c) T~~ au~mership, maintenance, or use
of ar~y~ eleva~ers,
{~I~ Ths 4vrit#en Or oral cont;eGf or agrea- F. ,4DQIX[OhfA~ Ih~#l1l~Ef~ ~ 01+~+N~f~
l
E~~~S
mans is: ,
_
DR ~O#JTRACTOR~ - ALJTDMATIC 7A7!!
(a}'urrenlly in effect or becomes ef;eo- ~. SEGTfON IC - MO ~ Ah! II~SIfRED is
ti~~+e durino ~e policy period; arEd amended ~o include ~s an 2dditionea insured
(~} Execu#ed prior #o an "or,rrence" or any person or orp2ni~ztion fpr v~om you are
offense #o v,~hicn this insurance perfarmi~7g op8ra#ions whin you ancf such
would apply, person or organ¢a[iorl have 2greed ir3 v~~Ti#-
{t} They are not spec-fcally ~esiCdrlatvd 25 arEg in a cor+irack or agr~?emen# That such per-
son or or~2nization be added os an ~od~
2r1 2ddiiianal ins~rr~d under err}~ other
~ #ional insured on your policy.
Itch person or
provision of, or endorsemer~k
2dded fo,
[his policy .
ar~anizaticn is an addi#ional insured only
i
"
. w
th respect #a liabili#y foe
bodily intur'~~
f. only the Following p°rsons or arr~2rli~atior75 "prapee#y dam2~e" ar "persenel 2nd adv~r-
are addi#ional insureds under this endorse- #isir,g injurf' c2used, in whole cr ~n part, by:
ment, 2ntf coverage provided to suc;~ 2ddr a. Your acts or omissions; or
#ional in5areds is limi#ed as provided Ylerein;
~1) Tne manager ar lessor of o premise b. The ac#s or orzissiorrs of 4hase ac#ing on
yoar behalf;
leased Eo you, but enly ~.vith respec# #o li-
-o~liliky arising from the o5rrner5hi~, mairw- ire the perform~nca of yo4rr ongoing opera-
t~n2rice or use Of #h~t par# of the pram- tions for the additional ins~rred_
ices leased ko you and SUbjecs to U'~e #ol-
lowing $[tditional,eciusipn5: A person's or drganizatipn's status as arti ad-
ditional insured udder khis policy ends when
This insurance does not aopty td: your op°r'otians for thak addikianal i~~sured
~
~) Any "occurrence" which takes pace arc compleked.
. titer Yo~~ cease to be a #en2nk of tha€ ~_ i{h respec4 to tltie insuraF7c~ affC~rded to
#iremises. #hese addilior~a! ins~lreds, the 4ollowir~g addM
{b~ #r4r~tural alter~iior~s, ne}x con~truc: #ional exclusions apply:
Sion or dernoHt~or7 opera ions per- This insurance does no# apply ta=
forrrlad by or on bci~arf of #17e man-
agar or I~ssor. a. "Bodil
y fnjur~', "property cl2mage" or
~~~ An
y person or crgani~Gtion from whom "personal ar~d ad~+a,~ising infury" arising
oul of the rendering ot
or the failure #a
you le~~e equipmer7l, but only ~viEh re-
spec# to liability for "bodily injurya'
~~P
- ,
render, any professional architeckur~l,
,
P
erty darT,age" or "person2l 2nd adverkis-
' ar~oineering or ss~rv8ying services, in-
clu~irrg:
ing +n~ur
caused, in whole or in pert, by
your maintenat3ce, operation or use of {~} Tfle preparing, approving, or ifaili~~rg
equipri-I~r,# leased lp you by sr~ch pet- #o ~rapare or approve, rnags, shop
sons} or org~nization(s}. drawings, opir,iOris, re;~orks, surveys,
Havrever, kl~is insurance does not a I
pp ~'
"
" veld orders, change orders or dr2wv-
ings 2nd specifiC.~tions; or
Eo 2ny
a~currer~c~
v~rhich k~kas plsca
after the e~uiprnenE lease expires. {~} upervi3ory, inSpeGtion, arc~iteC-
~3} Any st2ke or poiiticai subdnrisiorr, su~jcct t~r~i or °ngirleering 2Gkiviiies.
#o the foilo~ving odditianal provision= b. "B~dily injr~r or "property damage"
1'I~~s insurance a
ppiies only with respec# OCCUrrIrYg after.
kc th° fallowing h~z~rds for vrhich the {'i} All worst, inrludirra materials
oasts
state cr poli4ical subdivision has issued a ,
or e:~uipmen# furnished in corlnec-
~ermi# in conned#ion ~r~~i#h premises yeu tion with such ~~~ork, oar khe project
own, rant, or can[rpl and to which finis in- (other #h2n service, main€enance or
suranee applies: repairs} fo bo performed by or on
(a~ one 2xib#cnce, m~irl~en~nce, repair, be1721f of the atCditior7al insureds) a#
cogs[ruction, erection, cr removal of the loco#iprr o. the cover8d opera-
adver:ising sFgns, awnings, car«o- #ions has been cor,~pleted; or
pies, cellar entrances, t.~al nol8s,
drive~v~ys
manholes
rnar
~lees (~~ 7h2# poflio~ of "your work" aui of
,
,
~
,
hois# aw2y openlrfgs, Sldew+alrt which the in~~~ry or damage arises
has been ~lJi fo Its Irntenoed use b
r
vaults, s#r~ek banners, or decora-
tions 2,~d similar exposures; or ;
2rEy person or arg~rE~#ion other
#han 2r7other corliractor or subpon-
{b) The constrr~efion, erection, or re- 4ractor enoaged in p8~~ormin~ Op-
moval cf ele~+aiors; ar era#ions fir a principal as d par# of
the sale pro~e~k,
C ~ C ~Q 20 03 t77 includes ~,~yrighl~d m-oter,'21 wf Ins~~rznca Services 1~age 2 ~f G
O`~ce, Int.. v.~ii:, its penni5slon
f( ~
~.
..'\
'~\
3. i ha insulrante provided by this endorssrrel~~
is primary inst~ranoe and ~~V Will nak seek
cpntribuEion under any insurance policy un-
dsr ~.+hich suc~ additional insured is a
named ir<sured, fi such polity was procured
and paid gar ~y such sddikion2~ insured, or a
o~rent ar rekat2d entity of such additiana! in=
svred_
4. V~+ith respect fo the insur~nc° ~fi~orded #o
these ad[~iliortal '9nsur~~s, SE~TC~N Ill
LkF,rIIT~ OF CNkl1~ANGE 9s amended as fo!-
1~+rrs;
The lirf~iks applicable to tkre additional in-
sured are kFtose sp~?ci~ted in the written con-
4r~ct or ~c~reement o~ 4he lirriits skated in the
paclar~ki~r<s, whichever is less. li na ~imi~
2ro s~ecRtec~ in khe vvri#ken con{r2,c# or
~areement, khe limits appCicable ko t~~t~ addi-
kion2l insured artz these s~ecixred in kl'ti8 Dnc-
iar~tions. Tf1e limits pf insurance ire in~1~~-
si~~e of and rnuk in addition ko the lirrrits oT in-
surance sha~~ in khe Dec~erat~ons,
G. PROM=RTY DAf1~A~1= 70 SORROWED
EQ~CPC~+>=~T
1. ~arat~r~oh 2.j. of 1=~TION 1 - C01fER-
AGE~, QV1=RA~1= A E01]CLl' IhIJkJ~Y
ANA PftOEE1~7 DA,1'lJA~E ~IA131~.l7Y ~s
¢rnended as foklas;
F~ragr2phs {3} and (4) of tFris exclusion do
r3pk ap;~ly to tools or eq~IOment loaned to
You, provlde[1 they are noM beirtig used to per-
form Operatipns ek the kirne of lass-
2. ~CTIO~J all - LIhM1l7 01= lhISUC~ANC1= +s
deleted and repk2ced by the #ollo5n~ing;
`The mast we will pay in any one "occ+~r-
rence" tar "property damage" to borrowed
equipment is ~15,0~~_ 71~Cs liinik of ir~sur-
~rrce ~s tie iros# ~~~° will pay regardless of
#kne number of-
a, Insureds;
~, Claims made or "5ttiks° brought; or
c. persons ar argarrizations making ciairrs
~r bringing "suits",
3. pe~uct+ble
a. Cur of>ligatian to pay damages an behalf
o. kh° insured applies only ka the amount
or damages an excess of ~0 as a~pli-
cal~4e to °{7roperty d~ma+~e° ~s the Tesult
of any one "occurrence", regardless pf
khe number ~f persons or orgar7i~iiarrs
~,r~ho }ust~sin damages bec2use of t~'ta#
"oc~vrrence°.
b, The terms o. this insurance, irrclu~ding
t~ro~e u+ikh~ respect ko our right ar~d duty
ko defend tltie instilred against any "suits'
seekinC #hase damag85; 2nd Your tl~rties
in th° event of an `occurrence", claim, or
"sulk" apply irres~ectiv° of khe ~~pli~tiar~
of ih° oedl~ctible amount.
I
~e may PAY any part ~r alb of sha de-
d~.~ctible amount la efieck settlement of
any ci~irri or stai# and, u~ori notinG~kion
o. khe action talte,~; you shill promokly
reimburse t~s for suer p~rE o. the de-
duetible amount as we have pai~4,
F~C. S1~OAD1=k~EO NAMED CN~iC~E~
Par~t~raph 3. of SECFION lC - WHO I Ah! Irk1-
1<1R~i~ is deleted and replaced by khe foMCor~~.~ng:
,4ny oraaniz~tiort, other than ~ joirt4 vYnkure, aver
which you mainkei~l owner5~ip or major9~+ irr#er-
est of more than 5Q°l~ v~riCl be a Famed Ensure[! if
kl`aere is rtio akhar sirrtilar insurance ~vailaole to
that organiz~tkan_ l~a'wever;
Covorage under this pro~+'ssion is ¢fforded
only until tine '4SQil~ day after you acquire ar
farm the'org~nition ar kha end of khe policy
period, whiche~+er is earlier-
h, COVEi~A~E A does na# apply ko "bO~iEy in-
}ur{" or °prpperh{ damage" chat occurred be-
Tore you ~cauired or for~;+e~ khe organ~z2-
kio rt,
~, CpVERAGI= ~ does not ~pp1}~ ko "persorl~l
acrd ad~+e~~ising injury" arising gut of an o>i-
#ense commikte~i before you acquired or
forr~+ed kY~e or~anizat~on.
CONTRU~TIO~I PRO,lE~T GENERAL AG-
~RE~A7E LIMIT
1. Far all s~.~ms which khe insured becomes
legally obligated to pay 2s damages caused
by "o~turrences" Under COI~ERA~~ A
{SECTION I}, and far alt rriedical expAr+s°s
C~usad by ~~:cidents u~'~der COVEI~A~~ C
{S1=G~lOf~4 I}, which can be ~kk~ihuted only #o
ongoing operations ak a single conskructian
oro~2Ck avray from premises o~s~~ed by or
Tented to Lilo Insured;
~_ ~, ar~gCe ~onskruCiion Project General
A~gr8g21e C-imit applies to eacr~ can-
skruckion pro}euk aaiay from prern~ses
awned by or rented #a tlhe insured, and
that lim'tk is equal to khe amouni of the
Gersefal Aggre9ake Limit s~non in khe
Oecl~r¢tions,
b. The ingke ~onstruution Pro}et# Genera!
Agoregate Limit is thv most }ve iCl pay
fvr the surer o. etl damages under ~OV-
EftAOE ~, except damages bec~Lrse of
"bodily in~ur}~' or "property damage" in-
cluded Cn the `prod~,~Gts~ompl8ked ap-
erations hazard", end for medical ex-
penses r~n~er COVERAGE C ragardCeSs
of the number o~-
('I) Insureds;
{~} Glaims made or "suits° brougi7k; or
Is3) Persons ar oro2ni~~#ions n3ak~ng
c!2irns or brino~ng "sLEi15".
a.
tnciu~ea copy'righ~ed maten23 pi Insurance S~vicES Page 3 01=
~L f.G 0~ ~l] t73 ~7
Office, !~c„ wish its pEr.':ilssiG~rr
.. a~ ' ,-
,Any payments made under CO~JERAGE
A for damages or under COVERAGE C
for medical expenses shall reduce the
Single Construction Project General Ag-
gregate Limit for that construction pro-
jest aaray from premises o~~vned by or
rented to the insured. Such payments
shall not reduce the General Aggregate
Limit shotiti~n in the Declarations nor shall
they reduce any other Single Construc-
tion Project General Aggregate Limit for
any other separate consfr~JCfion project
a+r••ay from premises owned by or rented
to the insured.
d. The limits shown in the Declarations for
Each Occurrence, Fire Damage and
lJiedical Expense continue #o apply.
However, instead of being subject to the
General Aggregate Limit shown in the
Declarations, such limits will be subject
to the applicable Single Construction
Project General Aggregate Limit.
For all sums which the insured becomes
legally obligated to pay as damages caused
by "occurrences" under COVERAGE A
{SECTION I), and for all medical expenses
caused by accidents under COVERAGE C
{SECTION I), which cannot be attributed
only to ongoing operations at a single desig-
nated consUuction project a+r.~y from prem-
ises named by or rented to the insured:
a. Any payments made under COVERAGE K
A for damages or under COVERAGE C
for medical expenses shall reduce the
amount available under the General Ag-
gregate Limit or the Products-Completed
Operations Aggrega#e Limit, whichever
is applicable; and
b, Such payments shall not reduce any
Single Construction Project General Ag-
gregate Limit.
3. VVhen coverage for liability arising out of the
"products-completed operations hazard' is
provided, any payments for damages be-
cause of "bodily injury' or 'property damage'
included in the "products-completed opera-
tions hazard" teill reduce the Products-
Completed Operations ,Aggregate Limit, and
not reduce the General Aggregate Limi# nor
the Single Construction Praject General Ag-
gregate Limit.
4. If the applicable construction project away
from premises ovrned by or rented to the in-
sured has bean abandoned, delayed, or
abandoned anti then restarted, or if the au-
thorized contracting parties deviate from
plans, blueprints, designs, spec cations or
timetables, the project will still be deemed to
be the same construction project.
5. The provisians of Limits Of Jnsurance
(SECTION !II) not otherrhse modified by this
endorsement shalt continue to apply as
stipulated.
J. KNOV,ILEDGE OF OCCURRENCE
Ti-,e foflovring is added to paragraph 2. Duties In
The Event Of Occurrence, Offense, Claim Or
Suit of SECTION IV -COMMERCIAL GEN-
ERAL LIABILITY CONDITIONS:
e. A report of an "occurrence", offense, claim
or "suit" to:
(1) You, if you are an u~dividual,
(2) A partner, if you are a partnership
(3) An executive officer, if you are a
Corporation, or
(4) A manager, if you are a limited liability
company, '
is considered knov~{edoe and rettuires you to
notify us of the `occurrence", offense, claim,
or "suit' as soon as practicable.
We are considered on notice of an
"occurrence', offense, claim or "suit" that is
reported to your Workers' Compensation
insurer for an event which later develops info
an "occurrence", offense, claim or "suit" for
which there is coverage under this policy.
Hovrever, we will only be considered on
notice if you notify us as soon as you know
the claim should be addressed by this policy
rather than your Workers' Compensation
policy.
UNINTENTIONAL OMISSIONS
The following is added to paragraph 6. Repre-
sentations of SECTION IV -COMMERCIAL
GENERAL LIABILITY CONDITIONS:
d. If you unintentionally fail to disclose 2ny ex-
posures existing at the inception date of your
policy, ~,•,re ~.vill not deny coverage under this
Coverage Part solely because of such failure
is disclose. However, this provision does
not affect our right to collect additional pre-
mium or exercise our right of cancellation or
non-renee~al.
This provision does not Gpply to any known
injury or damage v/hich is excluded under
any other provision of this policy.
L. F~IENTAL ANGUISH
Paragraph 3. of SECTION V -DEFINITIONS is
deleted and replaced by the following:
3. "13adity injury' means bodily injury, sickness
or disease sustained by a person, including
mental anguish or death resulting from any
of these at any time.
M. WAIVER OF TRANSFER OF RIGHTS OF RE-
COVERY AGAINST OTHERS
Paragraph 8. Transfer Of Rights Of Recovery
Against Others To'Us of SECTION IV - COM-
MERCIAL GENERAL LIABILITY CONDITIONS
is amended by the addition of the following:
CL CG 00 20 03 07 tnciudes cn~yright°<i maEerial of Insurance Services Page 4 of 6
Office, Irc., with is ~erfiission
. ~ ~_ s
V'ti'e ~,vaive any right of recovery we may have be-
cause of payments wee ma}:e for injury or dam-
age arising out of your ongoing operations or
"your +n+ork" done under a contract requiring such
waiver with that person or organization and in-
cluded in the "products-co~~pleted operations
h+azard".
~',owever, our rights may only be waived prior to
the °occurrence" giving rise to the injury or dam-
age for which we make payment under this Cov-
erage Part. The insured must do nothing after a
loss to irr+pair our rights. At our request, the in-
sured vrill bring °suit" or transfer those rights to
us and help us enforce those rights.
N. LIMITED JOB Sl7E POLLUTION
1. Exclusion f. under Section I -Coverage A
is replaced by the follov.4ng:
2. Exclusions
This insurance does not appyy' to
f. Pollution
(i) "Bodily injury" or "property dam-
age" ansing out of the actual, al-
leged or threatened discharge,
dispersal, seepage, migration,
release or escape of "po!lut-
• ants":
(a)
(b)
.At or from any premises,
site or location on which any
insured or any contractors
or subcontractors t~vorkinG
directly or indirectly on any
insur~d's behalf are per-
forming operations if the
operations are to test for,
monitor, clean up, remove,
contain, treat, detoxifid or
neutralize, or in any way re-
spond io, or assess the ef-
fects of, "pollutants"; or
At or from a storage tank or
other container, ducts or
piping which is belovd or par-
iially below the surface of
the ground or water or
which, at any time, has been
buried under the surface of
the ground or water and
then subsequently exposed
by erasion, excavation or
any ot~ per means if the ac-
tual, alleged or threatened
discharge, dispersal, seep-
age, migration, release or
escape of "pollutants" arises
at or from any premises, site
or location which arty in-
sured or any contractors or
subcontractors working di-
rectly or indirectly on any in-
sured's behalf are perform-
ing operations if the "po!lut-
ants" are brought on or to
the premises, site or loca-
tion !n connection with such
operations by such insured,
contractor or subcontractor.
Subparagraph (b) does not
apply to "bodily ~njur}r' or
"property damage" arrsing
out of heat, smoke or fumes
from a "hostile fire".
(2) Any loss, cost or expense aris-
ingout of any.
(a) Request., demand, order or
statutory or regulatory re-
quirement issued or made
pursuant to any environ-
mental protection or envi-
ronmental liability statutes or
regulations that any insured
test for, monitor, clean up,
remove, contain, treat., de-
toxify ar neutralize, or in any
4vay respond to, or assess
the effects of, "pollutants";
or
(b) Claim or suit by or on behalf
of a governmental authority
for damages because of
testing for, monitoring,
cleaning up, removing, con-
taining, treating, detoxifying
or neutralizing or in any way
responding to or assessing
the effects oi, "pollutants".
However, this paragraph does
not apply to liability for those
sums the insured becomes le-
gally obligated to pay as dam-
ages because of "property dam-
age" that the insured would
have in the absence of such re-
quest, demand, order or statu-
tory or regulatory requirement,
or such claim or "suit" by or on
behalf of a governmental author-
ity.
V~Jith respect to "bodily injury" or "properly
damage" arising out of the actual, alleged or
threatened discharge, dispersal, seepage,
migration, release or escape of "pollutants":
a. The "Each Occucrence Limit" shown in
the Declarations does not appy.
b. Paragraph 7. of Limits Of Insurance
(Section III) does not apply.
c. Paragraph 1. of Section III -Limits Of
Insurance is replaced by the follavring:
The limits C}f Insurance show~•~ in this
endorsEment, or in the Declarations and
the rules belove fix the most we will pay
regardless of the number of:
(1 j insureds;
CL CG 00 20 03 07 Indud°s capy;iYhted ma!eriat of Insurance Services Page S of 6
O~c°. Inc.. v~rith its ~~rnission
_~ '' ,
(2} Claims made or "suits" brought; or
(3) Persons or organizations ma'{ing
claims or bringing "suits".
d. The following are added to Section III -
Limits Of Insurance:
8. Subiert to 2. or 3, above, tivhichever
app{ies, the most eve will pay for the
sum of:
a. Damages under Coverage A;
and
b. Medical expenses under Cover-
age C
because of "bodily injury" or "prop-
erty damage" arising out of ti-ie ao-
' iual, alleged or threatened dis-
charge, dispersal, seepage, migra-
tion, release or escape of "pollut-
ants" is $100,000.
CL CG 00 20 03 07
9. Sut~ject to 8. abov?, the Ivtedical
expense Limii is the most we «~ill
pay under Coverage C for all medi-
cal expenses because of "bodily in-
jury" sustained by any one person
arising out of the actual, ageged or
threatened discharge, dispersal,
seepaoe, migration, release or es-
cape of "pollutants".
0. Oi'HER INSURANCE
If t;-tis policy includes a Coverage dorm or an
Endorsemer-t which provides coverage for loss
or damage covered by one or more of the Ex-
tensions of this endorsement, the limit and the
coverage provided by this endorsement are de-
leted and replaced by the Limit and coverage
provided by that Coverage Fora, or a_ndorse-
ment.
Includes copyrighted rn2t~;al of Ins~~nce Se; eices
oti~ce, inc., with ifis partnissio~
Page 6 of 5
~. ~
' T H1S ENDORSEh4ENT CHANGES TFiE POLICY. PLEASE READ IT CAREFULLY.
ADDiTlONAL INSURED -OWNERS; LESSEES OR
CONTRACTORS -COMPLETED OPERATIONS AUTOMATIC
STATUS WHEN REQUIRED BY WRITTEN CONTRACT
This endorsement modi~ries insurance provided under the follovring:
COMP~IEftC1AL GENcRAL LIABILITY COVErJaGE PART
Section I) -Who Is Fn lnsured is amended to include as an additional insured any person or organization
for whom you are performing operations when you and such person or organization have agreed in writing-
in acontract or agreement that such person or organization be added as a1-r additional inst.~red on your
policy. Such person or organization is nn additional insured only v.~ith respect to "bodily injury" and
"property damage" caused, in whole or in part, by 'your work" at locations specified in the ~n~ritten contract
or agreement anG included in the "products-comoleted operations hazard".
With respect to the insurance afforded to these additional insureds, this insurance Goes not apply io
"bodily injury" or "property darnage" that occurs prior to the execution of, or subsequent to the expiration
of, the contraei or agreement in which you agreed that such person or organization be added as an
additional insured on your policy.
In~tud~s copyrighted matcrt2l o. l~sur2nce Servi es Page 1 of 1
CL CG 20 1 a 0~ 0`r
C~aces, Inc., with its permission