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12-097.00 Spokane Rock Products: University OverlayContract THIS AGREEMENT, made and entered into this day of 2012, between the City of Spokane Valley under and by virtue of Title 35 RCW, as amended and Spokane Rock Products, Inc. Hereinafter called the Contractor. WITNESSETH: That in consideration of the terms and conditions contained herein and attached and made a part of this agreement, the parties hereto covenant and agree as follows: I. The Contractor shall do all work and furnish all tools, materials, and equipment for: University Overlay Project SVPW Contract 12 -028 in accordance with and as described in the project plans and specification, and the standard specification of the Washington State of Department of Transportation which are by this reference incorporated herein and made part hereof and, shall perform any changes in the work in accord with the Contract Documents. The Contractor shall provide and bear the expense of all equipment, work and labor, of any sort whatsoever that may be required for the transfer of materials and for constructing and completing the work provided for in these Contract Documents except those items mentioned therein to be furnished by the City of Spokane Valley. II. The City of Spokane Valley hereby promises and agrees with the Contractor to employ, and does employ the Contractor to provide the materials and to do and cause to be done the above described work and to complete and finish the same in accord with the project plans and specification and the terms and conditions herein contained and hereby contracts to pay for the same according to the referenced specifications and the schedule of unit or itemized prices at the time and in the manner and upon the conditions provided for in this contract. III. The Contractor for himself/herself, and for his/hers heirs, executors, administrators, successors, and assigns, does hereby agree to full performance of all covenants required of the Contractor in the contract. s CITY OF SPOKANE VALLEY CONSTRUCTION CONTRACT UNIVERSITY OVERLAY PROJECT BID NO: 12 -028 CV i'�'o �7 IV. It is further provided that no liability shall attach to the City of Spokane Valley by reason of entering onto this contract, except as provided herein. V. The project was awarded for the bid amount of $ 2 IN WITNESS WHEREOF, the Contractor has executed this instrument, on the day and year first below written and the City of Spokane Valley has caused this instrument to be executed by and in the name of the said City of Spokane Valley the day and year first above written. Executed by Contractor -� — l 3 — ! a , 2012. Date Printed Name I-� S Q I LAS l o O (" A-a 9?—_ Title Signature City of Spokane Valley Printed Name CITY OF SPOKANE VALLEY CONSTRUCTION CONTRACT UNIVERSITY OVERLAY PROJECT BID NO: 12 -028 Ia r r BONDNO; 105803965 CONTRACTOR'S PERFORMANCE AND PAYMENT BOND TO DUAL OBLIGEES KNOW ALL MEN BY THESE PRESENTS, that Spokane Rock Products, Inc. (Contractor), as Principal, and Travelers Casualty and Surety Company of America (Bonding Company), as Surety, a corporation of Connecticut whose principal office is located at One Tower Square, Hartford CT, 06183 , are firmly bound unto the State of Washington and the City of Spokane Valley, a political subdivision the State of Washington, as Obligees, to fulfill the obligations of the Principal and the Surety under the Contract to which reference is hereafter made, in the amount of $ 2 2 6, 4 81.0 0 (including Washington State sales tax) for payment whereof Principal and Surety bind themselves, their heirs, executors, administrators, successors and assigns jointly and severally, firmly by these presents. WHEREAS, Principal has by written Proposal dated July 9, 2012 offered to enter into a Contract with the City of Spokane Valley for Contract No. 12-028 pursuant to the terms and conditions set forth in the Contract Documents dated 7-/3-12- , NOW, THEREFORE, the condition of this obligation is such that if the Principal shall faithfully perform all the provisions of the Contract on its part, and pay all laborers, mechanics, subcontractors and material suppliers, and all persons who supply such person or persons or subcontractors with provisions and supplies for the carrying on of such work, and indemnify and hold harmless the Obligees from all loss, cost or damage which it may suffer by reason of the failure to do any of the foregoing, then this obligation shall be null and void; otherwise it shall remain in full force and effect. All persons who have furnished labor, materials or supplies for use in and about the work provided for in the Contract shall have a direct right of action under this bond, to the extent and in the manner set forth in RCW 39.08. Th.e said Surety for value received hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Contract or to the WORK to be performed thereunder or the SPECIFICATIONS accompanying the same shall in any way affect its obligation on this BOND, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Contract or to the WORK or to the SPECIFICATIONS. No final settlement between the OWNER and the CONTRACTOR shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied. SIGNED AND SEALED THIS 13th DAY OF July YEAR 2012. Travelers Casud1tv and Suretv ComT)anv of America SURETY Signature` Typed Name Title (SEAL) Spokane Rock Products, Inc. PRINCIPAL l SignaturaeH � �M Jaff _ N Typed Typed N and Title Attorney -In -Fact 10 CITY OF SPOKANE VALLEY CONSTRUCTION CONTRACT UNIVERSITY OVERLAY PROJECT BID NO: 12 -028 WARNING: THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER Q POWER OF ATTORNEY TRAVELERS.1 Farmington Casualty Company St. Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters, Inc. Travelers Casualty and Surety Company of America St. Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St. Paul Guardian Insurance Company Attorney -In Fact No. 223257 Certificate No. 004563996 KNOW ALL MEN BY THESE PRESENTS: That St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company and St. Paul Mercury Insurance Company are corporations duly organized under the laws of the State of Minnesota, that Farmington Casualty Company, Travelers Casualty and Surety Company, and Travelers Casualty and Surety Company of America are corporations duly organized under the laws of the State of Connecticut, that United States Fidelity and Guaranty Company is a corporation duly organized under the laws of the State of Maryland, that Fidelity and Guaranty Insurance Company is a corporation duly organized under the laws of the State of Iowa, and that Fidelity and Guaranty Insurance Underwriters, Inc., is a corporation duly organized under the laws of the State of Wisconsin (herein collectively called the "Companies "), and that the Companies do hereby make, constitute and appoint Pamela L. Thurman, Jacqueline F. Hernandez, JoHanna E. Zerb, Charles E. Hudon, Karen E. Alley, Jared Haff, and Sarah Scott of the City of Paecn , State of Washington , their true and lawful Attomey(s) -in -Fact, each in their separate capacity if more than one is named above, to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF, the Companies have caused this instrument to be signed and their corporate seals to be hereto affixed, this day of September 2011 Farmington Casualty Company Fidelity and Guaranty Insurance Company_ . Fidelity and Guaranty Insurance Underwriters, Inc. St. Paul Fire and Marine Insurance Company St. Paul Guardian Insurance Company 28th St. Paul Mercury Insurance Company Travelers Casualty and Surety Company Travelers Casualty and Surety Company of America United States Fidelity and Guaranty Company G CVTq' a ! y1r + •9 •• 7 '7 �'b� ' q, 1951 iya4r ��� 'sh� Fn. �. IAmRmN ER.N.✓ 1.SL11�>(.j F L;j roi m I f Z 'ov f ` .~I0 r. RSAte fiq) "-E``'� . ° o F F w e° p O VlP iATR Y f FAON R. 0 D a, Le 9r° + �'°@' �' , �ti i4 fiff6Fv?D� , e SBR. . ..... .... � l � MI y 1 8AY 9N 'w6 �h d0 � D � p State of Connecticut City of Hartford ss. By: Georg Thompson, enior ice President On this the 28th day of September 2011 before me personally appeared George W. Thompson, who acknowledged himself to be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters, Inc., St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company, and that he, as such, being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. p,TET In Witness Whereof, I hereunto set my hand and official seal. � My Commission expires the 30th day of June, 2016. RN * 58440 -6 -11 Printed in U.S.A. IS INVALID WITHOUT THE Marie C. Tetreault, Notary Public IS INVALID WITHOUT THE RED BORDER This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters, Inc., St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company, which resolutions are now in full force and effect, reading as follows: RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys -in -Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her; and it is FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary; and it is FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary; or (b) duly executed (under seal, if required) by one or more Attorneys -in -Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys -in -Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached. I, Kevin E. Hughes, the undersigned, Assistant Secretary, of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters, Inc., St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company do hereby certify that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies, which is in,full force and'effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and, affixed the seals of said Companies this 13th day of July 20 12 Kevin E. Hughes, Assistant Sec tart' °�/.cSmU,�� F10.E6 \0.N..�NfG P�.1NSUgq Jp�'fV AA. °m llO SYp�, fJSfYdy�. 1982' O � m �I F:m fW:cpRPORAlf:�� y i To verify the authenticity of this Power of Attorney, call 1- 800 - 421 -3880 or contact us at www.travelersbond.com. Please refer to the Attomey -In -Fact number, the above -named individuals and the details of the bond to which the power is attached. WARNING: THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER 1 ® ACORO CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD /YYYY) 7/13/2012 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 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 Conover Insurance 1804 West Lewis Street CONTACT Jacqueline Hernandez, ACSR NAME: 9u PHONE (509)545 -3800 FAX (509)547 -7960 IA1C AIC No E -MAIL A DRESS: INSURERS AFFORDING COVERAGE NAIC # LIMITS INSURERA -.American Economy Ins Co GENERAL LIABILITY Pasco WA 99301 INSURED INSURER B American States Ins Company INSURERC:Starr Indemnity & Liability Co. EACH OCCURRENCE Spokane Rock Products Inc. P.O. Box 3808 INSURER D:Nav1 ators Insurance Coma piny $ 200,000 INSURER E:Liberty Northwest Ins CO INSURER F: ,Spokane WA 99220 i+C'nTICI­ = Au lReeGO.201 2 -2013 REVISION NUMBER: COVERAGE,-) vc-r. �� ..., .. ... ... .-...— -- CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD THIS IS TO ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS INDICATED. NOTWITHSTANDING 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. IN RI LTR TYPE OF INSURANCE DDL B POLICY NUMBER POLICY EFF MMIDDlYYYY POLICY EXP MM /DDIYYYY LIMITS Chuck Hudon /JACKS GENERAL LIABILITY non w T, ^►I A n EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 200,000 X COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) $ 10,000 A CLAIMS -MADE X❑ OCCUR OICG68716480 /1/2012 /1/2013 PERSONAL & ADV INJURY $ 1,000,000 X Constructual Includes X, C, U GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 COMBINED SINGLE LIMIT Ea accident $ $ 1,000,000 POLICY X PR O LCC AUTOMOBILE LIABILITY A BODILY INJURY (Per person) $ X B ANY AUTO ALL OWNED SCHEDULED OIC154636510 /1/2012 /1/2013 BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE Per accident $ HIRED AUTOS Hired Auto Liability $ 1,000,000 UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 X AGGREGATE $ 4,000,000 EXCESS LIAB CLAIMS -MADE ISIGCE50027812 C XCESS AUTO LIABILITY 2/1/2012 /1/2013 $ DED RETENTION$ WC STATU- OTH- A WORKERS COMPENSATION I TO LIMITS E.L. EACH ACCIDENT $ 1 000 000 AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR /PARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYEE 000 $ L000,000 OFFICER /MEMBER EXCLUDED? NIA 1CG68716480 /1/2012 /1/2013 (Mandatory in NH) E.L. DISEASE - POLICY LIMIT $ 2,000,000 If yes, describe under STOP GAP DESCRIPTION OF OPERATIONS below A CONTRACTORS POLLUTION 1CG68716480 /1/2012 /1/2013 LIMIT 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) #SEI2EXC745030IC, 2/1/2012 TO 1/1/2013, $9,000,000 Company D: Excess Liability, Policy Occurrence /Aggregate Limit. Company E: ID /MT Workers Compensation, Policy #WC41NC011995011, 10/1/2011 to 10/1/2012, $1,000,000 Limit. Project #0162 University Overlay SVPW Contract 12 -028. City of Spokane Valley and its officers, elected officials, employees, agents, and volunteers are additional insured. Business Auto additional insured applies per attached blanket Form #CA 71 10 03 07. Additonal Insured /Primary Additional Insured apply per attached blanket Form #CG 79 00 07 87. Waiver of Subrogation applies per attached blanket Form #CG 24 04 05 09.Per- Project Agg per Form #CG 25 03 05 09. CERTIFICAT t MULUtrc _� -- -- - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Spokane Valley 11707 E. Sprague Ave Suite 106 Spokane Valley, WA 99206 AUTHORIZED REPRESENTATIVE Chuck Hudon /JACKS non w T, ^►I A n ACORD 25 (2010/05) INS025 (201005).01 v -ISoo -[Ulu AVUr[v V,vrcrvrcr+i rvr.. r ,,y ..w ­_­ . The ACORD name and logo are registered marks of ACORD Ltaerty riinrfhyvest. POLICY NUMBER: CflmmeRCIAL GENERAL LIABILITY CG 24 04 05 09 01 —CG- 687164 -8 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US 'This endorsement muddies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS./COMPLETED OPERATIONS LIABIUTY COVERAGE PART SCHEDULE Name & Person or Organization: Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragrapphh 8. Transfer Ooff Rights Of Recovery Agait Section ill — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or CG 24 04 05 09 damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard ". This waiver applies only to the person or organization shown in the Schedule above. o Insurance Services Mce, Inc.., 2008 Safeeo and tfie SOWO logo aro reglstarad trademarfe: at Soma cmparatian EP C.Uxa 3PRINTOM 4 008{11 ECG I�I>G>rty tvprthvCSt. POLICY NUMBER: 01-CG- 687164 -8 GOMMERCIAL GENERAL LIABILITY CG 25 03 05 09 THIS ENDORSEMENT CHANGES THE P©UCY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following:. COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): ALL PROJEC'T'S OF TKE NAMED INSURED UNLESS SPECIFICALLY EXCLUDED Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. For all sums which the insured becomes legally obligated to pay as damages caused by occurrences" under Section I — Coverage A, and for all medical expenses caused by acci- dents under Section 1 — Coverage C, which can be attributed only to ongoing operations at a sin- gle designated construction project shown in the Schedule above: .1. A separate Designated Construction Project General Aggregate Limit applies to each designated construction project, and that limit is equal to the amount of the General Aggregate limit shown in the Declarations. 2. The Designated Construction Project Gen- eral Aggregate Limit is the most we will pay for the sum of all damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the ' products - completed operations hazard ", and for medical expenses under Coverage C regardless of the number of: a. insureds; b. Claims made or "Musts" brought; or Construction Project General Aggregate Limit for that designated construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above:. 4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense con- tinue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Con- struction Project General Aggregate Limit. B. For all sums which the insured becomes legally obligated to pay as damages caused by occurrences" under Section I — Coverage A and for all medical expenses caused by acci- dents under Section I — Coverage C, which cannot be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: c. Persons or organizations making claims 1. Any payments made under Coverage A for or bringing "sins ". damages or under Coverage C for medical Any payments made under Coverage R for expenses shall reduce the amount available 3. under the General Aggregate Limit or the damages or under Coverage C for medical Products- completed Operations Aggregate expenses shall reduce the Designated Limit, whichever is applicable; and o insurance Services Office, Inc., 2009 Safcco and the sateeo logo are reglslored trademarks of Safeca GOrfieratlen CG 25 03 05 09 Page t of 2 EP r tt" - vmm" rc m" r 2 Such payments shall not reduce any Desig- nated Construction Project General Aggre- gate Limit. C, When coverage for liability arising out of the "products- completed operations hazard" is pro- vided, any payments for damages because of 'bodily injury" or `propery damage" included in the "products- completed operations hazard" will reduce the Products - completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Designated Construction Project General Aggregate limit. 0. N the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. Imo. The provisions of Section ttl — Limits of insur- ance not otherwise modified by this endorsement shall continue to apply as stipulated. Page 2 of 2 i.ilFF.S 3A P.!tlTi*!.fS71 668 Libcrt. COMMERCIAL GENERAL LIABILITY Northwest. CG 79 00 07 87 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREI~UI.LY. POLICY CHANGES IL 12 0111 85 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART .. . OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART PHYSICIANS, SURGEONS AND DENTISTS PROFESSIONAL LIABILITY INSURANCE BLANKET ADDITIONAL INSURED (CONTRACTORS) 1. WHO IS AN INSURED - (SECTION 1) IS AMENDED TO INCLUDE ANY PERSON OR ORGANIZATION THAT YOU AGREE IN A "WRITTEN CONTRACT REQUIRING INSURANCE" TO INCLUDE AS AN ADDITIONAL INSURED ON THIS COVERAGE PART, BUT* A. ONLY WITH RESPECT TO LIABILITY FOR "BODILY INJURY ", "PROPERTY DAMAGE" OR "PERSONAL INJURY "; AND B. IF, AND ONLY TO THE EXTENT THAT, THE . INJURY OR DAMAGE IS CAUSED BY ACTS OR OMISSIONS OF YOU OR YOUR SUBCONTRACTOR IN THE PERFORMANCE OF "YOUR WORK" TO WHICH THE "WRITTEN CONTRACT REQUIRING INSURANCE" .APPLIES. THE PERSON OR ORGANIZATIONS DOES NOT QUALIFY AS AN ADDITIONAL INSURED WITH RESPECT TO THE INDEPENDENT ACTS OR OMISSIONS OF SUCH PERSON OR ORGANIZATION. 2. THE INSURANCE PROVIDED TO THE ADDITIONAL INSURED BY THIS ENDORSEMENT IS LIMITED AS FOLLOWS: A. IN THE EVENT THAT THE LIMITS OF INSURANCE OF THIS COVERAGE PART SHOWN IN THE DECLARATIONS EXCEED THE LIMITS OF LIABILITY REQUIRED BY THE "WRITTEN CONTRACT REQUIRING INSURANCE", THE INSURANCE PROVIDED TO THE ADDITIONAL INSURED SHALL BE LIMITED TO THE LIMITS OF.: LIABILITY REQUIRED "BY THAT "WRITTEN CONTRACT ENDORSE- MENT SHALLENOTRINCREASERTHEELIMI TSIOFENSW INSUR- ANCE DESCRIBED IN SECTION III - LIMITS OF INSURANCE. B. THE INSURANCE PROVIDED TO THE ADDITIONAL INSURED DOES NOT APPLY TO "BODILY INJURY "PROPERTY DAMAGE" OR "PERSONAL INJURY" ARISING OUT OF THE RENDERING OF, OR FAILURE TO RENDER, ANY PROFESSIONAL ARCHITECTURAL, ENGINEERING OR SURVEYING SERVICES, INCLUDING: i. THE PREPARING, APPROVING, OR FAILING TO PREPARE OR APPROVE, MAPS, SHOP DRAWINGS, Copyright, Insurance Services Office, Inc., 1983 Page t of 2 EP CG79 00 07 87 . ,,.,..,,,,,,, — M — T,berty COMMERCIAL GENERAL LIABILITY IVotthwest. CG 79 00 07 87 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES IL 12 01 11 85 This endorsement modifies insurance provided under the fflNavAng: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART PHYSICIANS, SURGEONS AND DENTISTS PROFESSIONAL LIABILITY INSURANCE OPINIONS, REPORTS, SURVEYS, FIELD ORDERS OR CHANGE ORDERS, OR THE PREPARING, APPROVING, OR FAILING TO PREPARE OR APPROVE, DRAWINGS AND SPECIFICATIONS; AND ii. SUPERVISORY, INSPECTION, ARCHITECTURAL OR ENGINEERING ACTIVITIES. C. THE INSURANCE PROVIDED TO THE ADDITIONAL INSURED DOES NOT APPLY TO "BODILY INJURY" OR "PROPERTY DAMAGE" CAUSED BY "SCOUR WORK" AND INCLUDED IN THE "PRODUCTS - COMPLETED OPERA- TIONS HAZARD" UNLESS THE "WRI'T'TEN CONTRACT REQUIRING INSURANCE" SPECIFICALLY REQUIRES YOU TO PROVIDE SUCH COVERAGE FOR THAT ADDITIONAL INSURED, AND THEN THE INSURANCE PROVIDED TO THE ADDITIONAL INSURED APPLIES ONLY TO SUCH "BODILY INJURY" OR "PROPERTY DAMAGE" THAT OCCURS BEFORE THE END OF THE PERIOD OF TIME FOR WHICH THE "WRITTEN CONTRACT REQUIRING INSURANCE" REQUIRES YOU TO PROVIDE SUCH COVERAGE OR THE END OF THE POLICY PERIOD, WHICHEVER IS EARLIER. 3. THE INSURANCE PROVIDED TO THE ADDITIONAL INSURED BY THIS ENDORSEMENT IS EXCESS OVER ANY VALID AND COLLECTIBLE "OTHER INSURANCE ", WHETHER PRIMARY, EXCESS, CONTINGENT OR ON ANY OTHER BASIS, THAT IS AVAILABLE TO THE ADDITIONAL INSURED FOR A LOSS WE COVER UNDER THIS ENDORSEMENT. HOWEVER, IF THE "WRITTEN CONTRACT REQUIRING INSURANCE" SPECIFICALLY REQUIRES THAT THIS INSURANCE APPLY ON A PRIMARY BASIS OR A PRIMARY AND NON-CONTRIBU- TORY BASIS, THIS INSURANCE IS PRIMARY TO "OTHER INSURANCE" AVAILABLE TO THE ADDITIONAL INSURED WHICH COVERS THAT PERSON OR ORGANIZA- TION AS A NAMED INSURED FOR SUCH LOSS, AND WE WILL NOT SHARE WITH THAT "OTHER INSURANCE ". BUT THE INSURANCE PROVIDED TO THE ADDITIONAL INSURED BY THIS ENDORSEMENT STILL IS EXCESS OVER ANY VALID AND COLLECTI- BLE "OTHER INSURANCE ", WHETHER PRIMARY, EXCESS, CONTINGENT OR ON ANY O'T'HER BASIS, THAT IS AVAILABLE TO THE ADDITIONAL INSURED WHEN THAT PERSON OR ORGANIZATION IS AN Copyright, Insurance Services Office, Inc., 1983 CG 79 00 07 87 f'ag31 of 2 E.P Liberty Norilnvc�t. COMMERCIAL GENERAL LIABILITY CG 79 00 07 87 THIS ENDORSEMENT C14 ANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES IL 12 01 11 85 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE -PART . OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART PHYSICIANS, SURGEONS AND DENTISTS PROFESSIONAL LIABILITY ADDITIONAL INSURED UNDER SUCH "OTHER INSURANCE 4. AS A CONDITION OF COVERAGE TO THE ADDITIONAL INSURED BY THIS ENDORSEMENT: A.. THE ADDITIONAL INSURED MUST GIVE US WRITTEN NOTICE AS SOON AS PRACTICABLE OF A INCAUCLAIIM. TO OFFENSE WHICH MA POSSIB Ey L SUCH NOTICE SHOULD INCLUDE: i. HOW, WHEN AND WHERE THE "OCCURRENCE" OR OFFENSE TOOK PLACE; ii. THE NAMES AND ADDRESSES OF ANY INJURED PERSONS AND WITNESSES; AND iii. THE NATURE AND LOCATION OF ANY INJURY OR DAMAGE ARISING OUT OF THE "OCCURRENCE" OR OFFENSE. B. IF A CLAIM IS MADE OR "SUIT" IS BROUGHT AGAINST THE ADDITIONAL INSURED, THE ADDITIONAL INSURED MUST:. i. IMMEDIATELY RECORD THE SPECIFICS OF THE CLAIM OR "SUIT" AND THE DATE RECEIVED; AND ii. NOTIFY US AS SOON AS PRACTICABLE. THE ADDITIONAL INSURED MUST SEE TO IT THAT WE RECEIVE WRITTEN NOTICE OF THE CLAIM OR. "SUIT" AS SOON AS PRACTICABLE, C. THE ADDITIONAL INSURED MUST IMMEDIATELY SEND US COPIES OF ALL LEGAL PAPERS RECEIVED IN CONNECTION WITH THE CLAIM OR "SUIT ", COOPERATE WITH US IN THE INVESTIGATION OR SETTLEMENT OF THE CLAIM OR DEFENSE AGAINST THE "SUIT ", AND OTHERWISE COMPLY WIH ALL POLICY CONDITIONS. D. THE ADDITIONAL INSURED MUST TENDER THE DEFENSE AND INDEMNITY OF ANY CLAIM OR "SUIT" TO ANY PROVIDER OF "OTHER INSURANCE" WHICH WOULD COVER THE ADDITIONAL INSURED FOR A LOSS WE COVER UNDER THIS ENDORSEMENT. HOWEVER, THIS CONDITION DOES NOT AFFECT WHETHER THE INSURANCE PROVIDED TO THE ADDITIONAL INSURED BY THIS ENDORSEMENT IS PRIMARY TO "OTHER INSURANCE" AVAILABLE TO THE ADDITIONAL INSURED WHICH COVERS THAT PERSON OR ORGANIZA- TION AS A NAMED INSURED AS DESCRIBED IN PART INSURANCE Copyright, Insurance Services Office, Inc:., 1983 Page 1 of 2 EP CG 79 00 07 87 . x Ir ►r I+r1 Ay pest. COMMERCIAL. GENERAL LIABILITY CG 79 00 07 87 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES IL 12 01 11 85 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART PHYSICIANS, SURGEONS AND DENTISTS PROFESSIONAL LIABILITY INSURANCE PARAGRAPH 3. ABOVE. 5. THE FOLLOWING DEFINITION IS ADDED TO SECTION V - DEFINITIONS: "WRITTEN CONTRACT REQUIRING INSURANCE" DEANS THAT PART OF ANY WRITTEN CONTRACT OR AGREE- MENT UNDER WHICH YOU ARE REQUIRED TO INCLUDE A PERSON OR ORGANIZATION AS AN ADDITIONAL INSURED ON THIS COVERAGE PART, PROVIDED THAT THE "BODILY INJURY" AND "PROPERTY DAMAGE" OCCURS AND THE "PERSONAL INJURY" IS CAUSED BY AN OFFENSE COMMITTED: A. AFTER THE SIGNING AND EXECUTION OF THE CONTRACT OR AGREEMENT BY YOUR B. WHILE THAT PART OF THE CONTRACT OR AGREEMENT IS'IN EFFECT; AND C. BEFORE THE END OF THE POLICY PERIOD. x Copyright, Insurance Services Office, Inc., 1983 CG 79 00 07 87 Page i of 2 EP COMMERCIAL AUTO CA 71 10 03 07 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ iT CAREFULLY. AUTO PLUS ENDORSEMENT This endorsement moddies insurance provided under the tollowing: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. EXTENDED CANCELLATiON CONDITION Paragraph 2.b. of the CANCELLATION Common Policy Condition is replaced by the following: b. 60 days before the effective date of cancellation if we cancel for any other reason. TEMPORARY SUBSTITUTE AUTO — PHYSICAL DAMAGE COVERAGE Under paragraph C. — CERTAIN TRAILERS, MO- BILE EQUIPMENT AND TEMPORARY SUBSTITUTE AUTOS of SECTION 1 — COVERED AUTOS, the following is added: If Physical Damage coverage is provided by this Cov- erage Form, then you have coverage for: Any "auto" you do not own while used with the per- mission of its owner as a temporary substitute for a covered "auto" you own that is out of service be- cause of its breakdown, repair, servicing, "loss" or destruction. BROAD FORM NAMED iNSURED SECTION 11 — LIABILITY COVERAGE — A.1. WHO iS AN INSURED provision is amended by the addition of the following: d. Any business entity newly acquired or formed by you during the policy period provided you own 50% or more of the business entity and the business entity is not separately insured for Business Auto Coverage. Coverage is extended up to a maximum of 180 days following acquisi- tion or formation of the business entity. Coverage under this provision is afforded only until the end of the policy period. BLANKET ADDITIONAL INSURED SECTION It — UABiLITY COVERAGE — A.I. WHO IS AN INSURED provision is amended by the addition of the following: e. Any person or organization for whom you are re- quired by an `insured contract" to provide insur- ance is an °insured ", subject to the following additional provisions: (1) The "insured contract" must be in effect during the policy period shown in the Decla- rations, 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 em- ployees. (3) There Is no coverage provided to this person or organization for "bodily injury" to its em- ployees, nor for "property damage" to its property. (4) Coverage for this person or organization shall be limited to the extent of your negli- gence or fault according to the applicable principles of comparative negligence or fault. (5) 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 ". includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, insurance Services Office, Inc., 1997 QA 71 10 03 07 Page i of 6 EP (6) The coverage provided will not exceed the lesser of: (a) The coverage and /or limits of this policy; or (b) The coverage and /or limits required by the "insured contract ". (7) A person's or organization's status as an "insured" under this subparagraph d ends when your operations for that "Insured" are completed_ EMPLOYEE AS INSURED Under Paragraph A. of Section it — LIABILITY COV- ERAGE item I. is added as follows: Your "employee" while using his owned "auto ", or an "auto" owned by a member of his or her household, in your business or your personal affairs, provided you do not own, hire or borrow that "auto ". This coverage is excess to any other collectible insurance coverage. PERSONAL EFFECTS COVERAGE A. SECTION III — PHYSICAL DAMAGE COVER- AGE, AA, COVERAGE EXTENSIONS, is amended by adding the following: c. Personal Effects Coverage For any Owned "auto" that Is involved in a covered "Joss ", we will pay up to $500 for "personal effects" that are lost or damaged as a result of the covered "loss ", without applying a deductible. EXTRA EXPENSE —BROADENED COVERAGE Paragraph A. — COVERAGE of SECTION if[ — PHYSICAL DAMAGE COVERAGE is amended to add: 5, We will pay for the expense of returning a stolen covered ."auto" to you. AIRBAG COVERAGE FELLOW EMPLOYEE COVERAGE Under paragraph B. — EXCLUSIONS of SECTION III — PHYSICAL DAMAGE COVERAGE, the following is Exclusion 5. FELLOW EMPLOYEE of SECTION ll — added: LIABILITY COVERAGE — B. EXCLUSIONS is amended by the addition of the following: The exclusion relating to mechanical breakdown does not apply to the accidental discharge of an airbag. However, this exclusion does not apply if the "bodily injury" results from the use of a covered "auto" you NEW VEHICLE REPLACEMENT COST own or hire, and provided that any coverage under this provision only applies in excess over any other Under Paragraph C —LIMIT OF INSURANCE of collectible insurance. Section III — PHYSICAL DAMAGE COVERAGE sec- tion 2 is amended as follows: 13LANIKET WAIVER. OF SUBROGATION We waive the right of recovery we may have for pay- ments made for "bodily injury" or "property damage" on behalf of the persons or organizations added as "insureds" under Section it — LIABILITY COVERAGE — A.I.D. BROAD FORM NAMED INSURED and AA.e. BLANKET ADDITIONAL INSURED. PHYSICAL DAMAGE — ADDITIONAL TRANS- PORTATION EXPENSE COVERAGE The first sentence of paragraph AA. of SECTION III — PHYSICAL DAMAGE COVERAGE is amended as follows: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type. 2. An adjustment for depreciation and physical con- dition will be made in determining actual cash Page 2 of 6 value in the event of a total loss. However, in the event of a total loss to your new vehicle" to which this coverage applies, as shown in the declarations, we will pay at your option: a. The verifiable "new vehicle" purchase price you paid for your damaged vehicle, not in- cluding any insurance or warranties pur- chased; b. The purchase price, as negotiated by us, of a new vehicle of the same make, model and equipment, not including any furnishings, parts or equipment not installed by the manufacturer or manufacturer's dealership. if the same model is not available pay the purchase price of the most similar model available; c. The market value of your damaged vehicle, not including any furnishings, parts or equip- ment not installed by the manufacturer or manufacturer's dealership. This coverage applies only to a covered "auto" of the private passenger, light truck or medium truck type (20,000 lbs or less gross vehicle weight) and does not apply to initiation or set up costs associated with loans or leases. TWO OR MORE DEDUCTIBLES Under SECTION III _ PHYSICAL DAMAGE COV- ERAGE, if two or more "company" policies or cover- age forms apply to the same accident, the following applies to paragraph D. Deductible: a. If the applicable Business Auto deduct- ible is the smaller (or smallest) deduct- ible it will be waived; or b. If the applicable Business Auto deduct- ible is not the smaller (or smallest) de- ductible it will be reduced by the amount of the smaller (or smallest) deductible; or c. if the loss involves two or more Busi- ness Auto coverage forms or policies the smatter (or smallest) deductible will be waived. For the purpose of this endorsement "company" means: a. Safeco insurance Company of America b. American States insurance Company c. General insurance Company of America d. American Economy Insurance Company e. First National Insurance Company of America f. American States Insurance Company of Texas g. American States Preferred Insurance Company h. Safeco Insurance Company of Illinois LOAN/LEASE GAP COVERAGE Under paragraph C — LIMIT OF INSURANCE of SECTION III — PHYSICAL DAMAGE COVERAGE, the following is added: a. Actual cash value of the damaged or stolen property as of the time of the "loss", less an adjustment for depreciation and physical condition; or b. Balance due under the terms of the loan or lease that the damaged covered "auto" is subject to at the time of the "loss ", less any one or all of the following adjustments: (1) Overdue payment and financial penalties associated with those payments as of the date of the "loss ". (2) Financial penalties imposed under a lease due to high mileage, exces- sive use or abnormal wear and tear. (3) Costs for extended warranties, Cre- dit Lite Insurance, Health, Accident or Disability Insurance purchased with the loan or leaser (4) Transfer or rollover balances from previous loans or leases - (5) Final payment due under a "Balloon Loan ". (6) The dollar amount of any un- repaired damage that occurred prior to the "total toss" of a covered "auto ". (7) Security deposits not refunded by a lessor. (S) Ali refunds payable or paid to you as a result of the early termination of a lease agreement or any war- ranty or extended service agree- ment on a covered "auto ". (9) Any amount representing taxes. (10) Loan or lease termination fees GLASS REPAIR — WAIVER OF DEDUCTIBLE Under paragraph D. — DEDUCTIBLE of SECTION III — PHYSICAL DAMAGE COVERAGE, the following is added: No deductible applies to glass damage if the glass is repaired rather than replaced. AMENDED DUTIES IN THE EVENT OF ACCI- DENT, CLAIM, SUIT OR LOSS 4. The most we will pay for a total "loss" in any one The requirement in LOSS CONDITION 2.a. — "accident" is the greater of the following, subject DUTIES IN THE EVENT OF ACCIDENT, CLAIM, to a $1,500 maximum limit: AUTO O ONDIT ONS othatE ` you must notify Page 3 of 6 EP CA 7t 10 03 07 "accident" applies only when the "accident" 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. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS SECTION IV — BUSINESS, . AUTO CONDITIONS — B2. is amended by the addition of the following: if you unintentionally fall to disclose any hazards ex- isting at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non- renewal: HIRED AUTO — LIMITED WORLD WIDE COVER- AGE Under Section IV — Business Conditions, Paragraph 13.7.b.e(1) is replaced by the following: (1) The "accident" or "loss" results from the use of an "auto" hired for 30 days or less. RESULTANT MENTAL ANGUISH COVERAGE SECTION V — DEFINITIONS — C. is replaced by the following: "Bodily injury" means bodily injury, sickness or dis- ease sustained by a person including mental anguish or death resulting from any of these. HIRED AUTO PHYSICAL DAMAGE COVERAGE If hired "autos" are covered "autos" for Liability cov- erage and if Comprehensive, Specified Causes of Loss or Collision coverages are provided under this Coverage Form for any "auto" you own, then the Physical Damage Coverages provided are extended to "autos" you hire or borrow. The most we will pay for loss to any hired "auto" is $50,000 or Actual Cash Value or Cost of Repair, whichever is smallest, minus a deductible. The de- ductible will be equal to the largest deductible appli- cable to any owned "auto" of the private passenger or light truck type for that coverage. Hired Auto Phy- sical Damage coverage is excess over any other col- lectible insurance. Subject to the above limit, deductible and excess provisions, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. HIRED AUTO PHYSICAL DAMAGE COVERAGE — LOSS OF USE SECTION III — PHYSICAL DAMAGE A.4.b. Form does not apply. Subject to a maximum of $1,000 per accident, we will cover loss of use of a hired "auto" if it results from an accident, you are legally liable and the lessor in- curs an actual financial loss. RENTAL REIMBURSEMENT COVERAGE A. We will pay for rental reimbursement expenses incurred by you for the rental of an "auto" be- cause of a covered "loss" to a covered "auto Payment applies, in addition to the otherwise. ap- pficabie 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 beginning 24 hours after the "foss" 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 fol- lowing 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 al- ready provided for under the PHYSICAL DAM- AGE COVERAGE Coverage Extension. F. The Rental Reimbursement Coverage described above does not apply to a covered "auto" that is described or designated as a covered "auto" on Page 4 of 6 Rental Reimbursement Coverage Form CA 99 23. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE A. Coverage 1. 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's" electrical system, in or upon the covered "auto 2. we will pay with respect to a covered "auto" for "loss" to any accessories used with the electronic equipment described in paragraph A.1. above. However, this does not include tapes, records or discs. 3. if Audio, Visual and Data Electronic Equip- ment Coverage form CA 99 60 or CA 99 94 is attached to this policy, then the Audio, Vi- suai and Data Electronic Equipment Cover- age described above does not apply. B. Exclusions The exclusions that apply to PHYSICAL DAM- AGE COVERAGE, except for the exclusion relat- ing to Audio, Visual and Data Electronic Equipment, also apply to this coverage. In addi- tion, the following exclusions apply: We will not pay for either any electronic equip- ment or accessories used with such electronic equipment that is: 1. Necessary for the normal operation of the covered "auto" for the monitoring of the covered "auto's" operating system; or the manufacturer for the installation of a radio. C. Limit of Insurance With respect to this coverage, the LIMIT OF IN- SURANCE provision of PHYSICAL DAMAGE COVERAGE is replaced by the following: 1. The most we will pay for "loss" to audio, vi- sual or data electronic equipment and any accessories used with this equipment as a result of any one "accident" is the lesser of: a. The actual cash value of the damaged or stolen property as of the tirne of the "loss "; or b. The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality. c. $1,000. 2. An adjustment for depreciation and physical condition will be made In determining actual cash value at the time of the 'loss ". 3. If a repair or replacement results in better than like kind or quality, we will not pay for the amount of the betterment. D. Deductible 0 2. Both: a. an integral part of the same unit housing any sound reproducing equipment de- signed solely for the reproduction of sound if the sound reproducing 3 equipment is permanently installed in the covered "auto "; and b. permanently installed in the opening of the dash or console normally used by If "loss" to the audio, visual or data elec- tronic equipment or accessories used with this equipment is the result of a 'loss" to the covered "auto" under the Business Auto Coverage Form's Comprehensive or Colli- sion Coverage, then for each covered "auto" our obligation to pay for, repair, return or re- place damaged or stolen property will be re- duced by the applicable deductible shown in the Declarations. Any Comprehensive Cov- erage deductible shown in the Declarations does not apply to "loss" to audio, visual or data electronic equipment caused by fire or lightning. If "loss" to the audio, visual or data elec- tronic equipment or accessories used with this equipment is the result of a "loss" to the covered "auto" under the Business Auto Coverage Form's Specified Causes of Loss Coverage, then for each covered "auto" our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by a $100 deductible. If "toss" occurs solely to the audio, visual or data electronic equipment or accessories used with this equipment, then for each cov- ered "auto" our obligation to pay for, repair, CA 71 10 03 07 Page 5 of 6 EP return or replace damaged or stolen property will be reduced by a $100 deductible. 4. in the event that there is more than one ap- plicable deductible, only the highest deduct- ible will apply. In no event will more than one deductible apply. SECTION V — DEFINITIONS is amended by adding the following: Q, "Personal effects" means your tangible property that is worn or carried by you, ex- cept for tools, jewelry, money, or securities. R. "New vehicle" means any "auto" of which you are the original owner and the "auto" has not been previously titled and is less than 365 days past the purchase date. Page 6 of 6 Washington State Department of Labor and Industries Department of Labor and Industries Employer Liability Certificate Date: 07/24/2012 UBI #: 602 082 495 Employer Liability Certificate Business Name: SPOKANE ROCK PRODUCTS INC Legal Business Name: SPOKANE ROCK PRODUCTS INC Account #: 133,446 -07 'Doing Business As' Name: SPOKANE ROCK PRODUCTS INC Estimated Workers Reported: Quarter 1 of Year 2012 "51 to 75 Workers" (See Description Below) Workers' Comp Premium Status: Account is current. Firm has voluntarily reported and paid their premiums. Licensed Contractor? License: Expire Date: Yes SPOKARP990BH 2/1/2014 Account Representative: T8 / DALE MCMASTER (360)902 -5617 - Email: MCMS235 @lni.wa.gov 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 51.16.190). ® �' ° DATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE I 10/1/2013 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 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 Jacqueline Hernandez, ACSR NAME: Conover Insurance fAHONN F:tl• (509)545-3800 FAX _(509)567-7960 fA/C 1804 West Lewis Street E-MAIL INSURER(S)AFFORDING COVERAGE NAIC# Pasco WA 99301 INSURERAAmerican Economy Ins Co. 19690 INSURED INSURER B:American States Ins Company 19704 Spokane' Rock-Products Inc. ° INSURERC:Starr Indemnity & Liability Co. 38318 P.O. Box 3808 INSURER D:Navigators Insurance Company 42307 INSURER E:Zurich American Insurance Co. 16535 Spokane WA 99220 INSURERF: COVERAGES CERTIFICATE NUMBER:2013-2014 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYYI IMM/DD/YYYYI GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 200,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ A I CLAIMS-MADE © OCCUR 01CG6871649 1/1/2013 1/1/2014 MED EXP(Any one person) $ 10,000 X Contractual PERSONAL BADVINJURY $ 1,000,000 X Includes X, C, U GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 7 POLICY IXIJF(:OT T1 LOC $ AUTOMOBILE LIABILITY Ea accciden SINGLE LIMIT $ 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ B ALL OWNED SCHEDULED 01CI5463652 1/1/2013 1/1/2014 BODILY INJURY(Per accident) $ AUTOS _ AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS — AUTOS (Per accident) $ UMBRELLA LIAB /X OCCUR EACH OCCURRENCE $ 4,000,000 C x EXCESS LIAB CLAIMS-MADE SISIGCE50027813 _AGGREGATE $ 4,000,000 DED I I RETENTION$ EXCESS AUTO LIABILITY 1/1/2013 1/1/2014 $ A WORKERS COMPENSATION X I TORY I IAM- I IOFR AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE❑ E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A 01CG6871649 1/1/2013 1/1/2014 (Mandatory in NH) E .DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below WA STOP GAP E .DISEASE-POLICY LIMIT $ 2,000,000 A CONTRACTORS POLLUTION 01CG6871649 1/1/2013 1/1/2014 LIMIT 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) Company D: Excess Liability, Policy #SISIGCE50027813, 1/1/13 TO 1/1/2014, $9,000,000 Occurrence/Aggregate Limit. Company E: ID/MT Workers Compensation, Policy ##WC-9327180-00 10/1/2013 to 1/1/2014, $1,000,000 Limit.:Project #0162 University Overlay SVPW Contract 12-028. )City of Spokane Valley and its officers, elected officials, employees, agents, and volunteers are additional insured. Business Auto additional insured applies per attached blanket Form #CA 71 10 03 07. Additonal Insured/Primary Additional Insured apply per attached blanket Form #CG 79 00 07 87. Waiver of Subrogation applies per attached blanket Form #CG 24 04 05 09.Per-Project Agg per Form #CG 25 03 05 09. AMENDED: Cancels and replaces prior CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Spokane Valley 11707 E. Sprague Ave Suite 106 Spokane Valley, WA 99206 AUTHORIZED REPRESENTATIVE J Hernandez, ACSR/JAC ,S u -7'71-,x. ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. IkICf17C,ten,nncsn, TI... Af't I'1.....„.......I r...-�.....�........4..�...J......�I,....s Annon aAl2-o 9 COMMENTS/REMARKS Certificate. OFREMARK COPYRIGHT 2000, AMS SERVICES INC. Washington State Department of s4.7,x: Employer Liability Certificate Labor and Industries ',4_; .� is t „. ..H 11 .. Department of Labor and Industries Employer Liability Certificate Date: 10/01/2013 UBI #: 602 082 495 Legal Business Name: SPOKANE ROCK PRODUCTS INC Account#: 133,446-07 'Doing Business As'Name: SPOKANE ROCK PRODUCTS INC Estimated Workers Reported: Quarter 2 of Year 2013 "Greater than 100 Workers" (See Description Below) Workers' Comp Premium Status: Account is current. Firm has voluntarily reported and paid their premiums. Licensed Contractor? Yes License: SPOKARP990BH Expire Date: 2/1/2014 Account Representative: T8 /DALE MCMASTER(360)902-5617 - Email: MCMS235 @lni.wa.gov 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 51.16.190). � Liberty COMMERCIAL GENERAL LIABILITY f• ' Northwest. CG 79 00 07 87 Lef.td,h,w,w+daI'O THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES IL 12 01 11 85 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART PHYSICIANS, SURGEONS AND DENTISTS PROFESSIONAL LIABILITY INSURANCE BLANKET ADDITIONAL INSURED (CONTRACTORS) 1. WHO IS AN INSURED — (SECTION 1) IS AMENDED TO INCLUDE ANY PERSON OR ORGANIZATION THAT YOU AGREE IN A "WRITTEN CONTRACT REQUIRING INSURANCE" TO INCLUDE AS AN ADDITIONAL INSURED ON THIS COVERAGE PART, BUT: A. ONLY WITH RESPECT TO LIABILITY FOR "BODILY INJURY" , "PROPERTY DAMAGE" OR "PERSONAL INJURY"; AND B. IF, AND ONLY TO THE EXTENT THAT, THE INJURY OR DAMAGE IS CAUSED BY ACTS OR OMISSIONS OF YOU OR YOUR SUBCONTRACTOR IN THE PERFORMANCE OF "YOUR WORK" TO WHICH THE "WRITTEN CONTRACT REQUIRING INSURANCE" APPLIES. THE PERSON OR ORGANIZATION DOES NOT QUALIFY AS AN ADDITIONAL INSURED WITH RESPECT TO THE INDEPENDENT ACTS OR OMISSIONS OF SUCH PERSON OR ORGANIZATION. 2. THE INSURANCE PROVIDED TO THE ADDITIONAL INSURED BY THIS ENDORSEMENT IS LIMITED AS FOLLOWS: A. IN THE EVENT THAT THE LIMITS OF INSURANCE OF THIS COVERAGE PART SHOWN IN THE DECLARATIONS EXCEED THE LIMITS OF LIABILITY REQUIRED BY THE "WRITTEN CONTRACT REQUIRING INSURANCE" , THE INSURANCE PROVIDED TO THE ADDITIONAL INSURED SHALL BE LIMITED TO THE LIMITS OF LIABILITY REQUIRED BY THAT "WRITTEN CONTRACT REQUIRING INSURANCE" . THIS ENDORSE- MENT SHALL NOT INCREASE THE LIMITS OF INSUR- ANCE DESCRIBED IN SECTION III — LIMITS OF INSURANCE. B. THE INSURANCE PROVIDED TO THE ADDITIONAL EEE INSURED DOES NOT APPLY TO "BODILY INJURY" , , ,,, "PROPERTY DAMAGE" OR "PERSONAL INJURY" ARISING OUT OF THE RENDERING OF, OR FAILURE TO RENDER, ANY PROFESSIONAL ARCHITECTURAL, ENGINEERING OR SURVEYING SERVICES, INCLUDING: i . THE PREPARING, APPROVING, OR FAILING TO = PREPARE OR APPROVE, MAPS, SHOP DRAWINGS, Copyright, Insurance Services Office, Inc., 1983 CG 79 00 07 87 Page 1 of 2 EP C-AG-31-PRIN7001.19O4.W1-Y • Page 2 of 2 C-AG3I-P RI NT001.1904-0092N Ltibert7 COMMERCIAL GENERAL LIABILITY r Northwest. CG 79 00 07 87 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES IL 12 01 11 85 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART PHYSICIANS, SURGEONS AND DENTISTS PROFESSIONAL LIABILITY INSURANCE OPINIONS, REPORTS, SURVEYS, FIELD ORDERS OR CHANGE ORDERS, OR THE PREPARING, APPROVING, OR FAILING TO PREPARE OR APPROVE, DRAWINGS AND SPECIFICATIONS; AND ii . SUPERVISORY, INSPECTION, ARCHITECTURAL OR ENGINEERING ACTIVITIES. C. THE INSURANCE PROVIDED TO THE ADDITIONAL INSURED DOES NOT APPLY TO "BODILY INJURY" OR "PROPERTY DAMAGE" CAUSED BY "YOUR WORK" AND INCLUDED IN THE "PRODUCTS-COMPLETED OPERA- TIONS HAZARD" UNLESS THE "WRITTEN CONTRACT REQUIRING INSURANCE" SPECIFICALLY REQUIRES YOU TO PROVIDE SUCH COVERAGE FOR THAT ADDITIONAL INSURED, AND THEN THE INSURANCE PROVIDED TO THE ADDITIONAL INSURED APPLIES ONLY TO SUCH "BODILY INJURY" OR "PROPERTY DAMAGE" THAT OCCURS BEFORE THE END OF THE PERIOD OF TIME FOR WHICH THE "WRITTEN CONTRACT REQUIRING INSURANCE" REQUIRES YOU TO PROVIDE SUCH COVERAGE OR THE END OF THE POLICY PERIOD, WHICHEVER IS EARLIER. 3. THE INSURANCE PROVIDED TO THE ADDITIONAL INSURED BY THIS ENDORSEMENT IS EXCESS OVER ANY VALID AND COLLECTIBLE "OTHER INSURANCE" , WHETHER PRIMARY, EXCESS, CONTINGENT OR ON ANY OTHER BASIS, THAT IS AVAILABLE TO THE ADDITIONAL INSURED FOR A LOSS WE COVER UNDER THIS ENDORSEMENT. HOWEVER, IF THE "WRITTEN CONTRACT REQUIRING INSURANCE" SPECIFICALLY REQUIRES THAT THIS INSURANCE APPLY ON A • PRIMARY BASIS OR A PRIMARY AND NON-CONTRIBU- . ,I TORY BASIS, THIS INSURANCE IS PRIMARY TO "OTHER INSURANCE" AVAILABLE TO THE ADDITIONAL meg INSURED WHICH COVERS THAT PERSON OR ORGANIZA- TION AS A NAMED INSURED FOR SUCH LOSS, AND SEE WE WILL NOT SHARE WITH THAT "OTHER = INSURANCE" BUT THE INSURANCE PROVIDED TO .a THE ADDITIONAL INSURED BY THIS ENDORSEMENT STILL IS EXCESS OVER ANY VALID AND COLLECTI- BLE "OTHER INSURANCE", WHETHER PRIMARY, EEE= EXCESS, CONTINGENT OR ON ANY OTHER BASIS, LTEM THAT IS AVAILABLE TO THE ADDITIONAL INSURED = WHEN THAT PERSON OR ORGANIZATION IS AN Copyright, Insurance Services Office, Inc., 1983 CG79000787 Pagel oft EP C-AS31.PRINT .S91440934 Page 2 of 2 C-AG31-PRINTOQl$ }44)4-Y Vi Liberty COMMERCIAL GENERAL LIABILITY Northwest. CG 79 00 07 87 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES IL 12 01 11 85 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART PHYSICIANS, SURGEONS AND DENTISTS PROFESSIONAL LIABILITY INSURANCE ADDITIONAL INSURED UNDER SUCH "OTHER INSURANCE" . 4. AS A CONDITION OF COVERAGE TO THE ADDITIONAL INSURED BY THIS ENDORSEMENT: A. THE ADDITIONAL INSURED MUST GIVE US WRITTEN NOTICE AS SOON AS PRACTICABLE OF A "OCCURRENCE" OR AN OFFENSE WHICH MAY RESUL IN A CLAIM. TO THE EXTENT POSSIBLE, SUCH NOTICE SHOULD INCLUDE: i . HOW, WHEN AND WHERE THE "OCCURRENCE" OR OFFENSE TOOK PLACE; ii . THE NAMES AND ADDRESSES OF ANY INJURED PERSONS AND WITNESSES; AND iii . THE NATURE AND LOCATION OF ANY INJURY OR DAMAGE ARISING OUT OF THE "OCCURRENCE" OR OFFENSE. B. IF A CLAIM IS MADE OR "SUIT" IS BROUGHT AGAINST THE ADDITIONAL INSURED, THE ADDITIONAL INSURED MUST: i . IMMEDIATELY RECORD THE SPECIFICS OF THE CLAIM OR "SUIT" AND THE DATE RECEIVED; AND ii. NOTIFY US AS SOON AS PRACTICABLE. THE ADDITIONAL INSURED MUST SEE TO IT THAT WE RECEIVE WRITTEN NOTICE OF THE CLAIM OR "SUIT" AS SOON AS PRACTICABLE. C. THE ADDITIONAL INSURED MUST IMMEDIATELY SEND US COPIES OF ALL LEGAL PAPERS RECEIVED IN CONNECTION WITH THE CLAIM OR "SUIT", COOPERATE WITH US IN THE INVESTIGATION OR SETTLEMENT OF THE CLAIM OR DEFENSE AGAINST THE "SUIT" , AND OTHERWISE COMPLY WIH ALL POLICY CONDITIONS. D. THE ADDITIONAL INSURED MUST TENDER THE EEM DEFENSE AND INDEMNITY OF ANY CLAIM OR "SUIT" TO ANY PROVIDER OF "OTHER INSURANCE" WHICH = WOULD COVER THE ADDITIONAL INSURED FOR A LOSS = WE COVER UNDER THIS ENDORSEMENT. HOWEVER, EMS THIS CONDITION DOES NOT AFFECT WHETHER THE INSURANCE PROVIDED TO THE ADDITIONAL INSURED BY THIS ENDORSEMENT IS PRIMARY TO "OTHER INSURANCE" AVAILABLE TO THE ADDITIONAL ,== INSURED WHICH COVERS THAT PERSON OR ORGAN' 2A- TION AS A NAMED INSURED AS DESCRIBED IN Copyright, Insurance Services Office, Inc., 1983 CO 79 00 07 87 Page 1 of 2 EP x Page 2 of 2 C•AG• 1-PR IRT001-1904-cO -V liberty COMMERCIAL GENERAL LIABILITY pt Northwest. CG 79 00 07 87 Mr.a..dttb.,Ms.tl taT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES IL 12 01 11 85 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART PHYSICIANS, SURGEONS AND DENTISTS PROFESSIONAL LIABILITY INSURANCE PARAGRAPH 3. ABOVE. 5. THE FOLLOWING DEFINITION IS ADDED TO SECTION V — DEFINITIONS: "WRITTEN CONTRACT REQUIRING INSURANCE" MEANS THAT PART OF ANY WRITTEN CONTRACT OR AGREE- MENT UNDER WHICH YOU ARE REQUIRED TO INCLUDE A PERSON OR ORGANIZATION AS AN ADDITIONAL INSURED ON THIS COVERAGE PART, PROVIDED THAT THE "BODILY INJURY" AND "PROPERTY DAMAGE" OCCURS AND THE "PERSONAL INJURY" IS CAUSED BY AN OFFENSE COMMITTED: A. AFTER THE SIGNING AND EXECUTION OF THE CONTRACT OR AGREEMENT BY YOU; B. WHILE THAT PART OF THE CONTRACT OR AGREEMENT IS IN EFFECT; AND C. BEFORE THE END OF THE POLICY PERIOD. 0 Copyright, Insurance Services Office, Inc., 1983 CG 79 00 07 87 Page 1 o12 EP C-AG31-PRIN1001.1904-0097-Y Page 2 of 2 C-AG-31•PRINTW7.1904009&V COMMERCIAL AUTO CA 71 10 03 07 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. EXTENDED CANCELLATION CONDITION BLANKET ADDITIONAL INSURED Paragraph 2.b. of the CANCELLATION Common SECTION II — LIABILITY COVERAGE — A.1. WHO Policy Condition is replaced by the following: IS AN INSURED provision is amended by the addition of the following: b. 60 days before the effective date of cancellation if we cancel for any other reason. e. Any person or organization for whom you are re- quired by an 'Insured contract" to provide insur- TEMPORARY SUBSTITUTE AUTO — PHYSICAL ance is an "insured", subject to the following DAMAGE COVERAGE additional provisions: (1) The Insured contract" must be in effect Under paragraph C. — CERTAIN TRAILERS, MO- during the policy period shown in the Dec1a- BILE EQUIPMENT AND TEMPORARY SUBSTITUTE rations, and must have been executed prior AUTOS of SECTION 1 — COVERED AUTOS, the to the "bodily injury" or "property damage". following is added: (2) This person or organization is an Insured" If Physical Damage coverage is provided by this Coy- only to the extent you are liable due to your erage Form, then you have coverage for: ongoing operations for that insured, whether the work is performed by you or for you, and Any "auto" you do not own while used with the per- only to the extent you are held liable for an mission of its owner as a temporary substitute for a "accident" occurring while a covered "auto" covered "auto" you own that is out of service be- is being driven by you or one of your em- cause of its breakdown, repair, servicing, "loss" or ployees. destruction. (3) There is no coverage provided to this person or organization for "bodily injury" to its em- BROAD FORM NAMED INSURED ployees, nor for "property damage" to its property. SECTION II — LIABILITY COVERAGE — A.1. WHO Coverage for this person or organization IS AN INSURED provision is amended by the addition (4) of the following: shall be limited to the extent of your negli- gence or fault according to the applicable d. Any business entity newly acquired or formed by principles of comparative negligence or fault. you during the policy period provided you own (5) The defense of any claim or "suit" must be 50% or more of the business entity and the tendered by this person or organization as business entity is not separately insured for soon as practicable to all other insurers Business Auto Coverage. Coverage is extended which potentially provide insurance for such up to a maximum of 180 days following acquisi- claim or "suit". tion or formation of the business entity. Coverage under this provision is afforded only until the end of the policy period. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1997 CA 71 10 03 07 Page 1 of 6 EP (6) The coverage provided will not exceed the PERSONAL EFFECTS COVERAGE lesser of: A. SECTION III — PHYSICAL DAMAGE COVER- (a) The coverage and/or limits of this policy; AGE, A.4. COVERAGE EXTENSIONS, is or amended by adding the following: (b) The coverage and/or limits required by c. Personal Effects Coverage the "insured contract". For any Owned "auto" that is involved in a (7) A person's or organization's status as an covered "loss", we will pay up to $500 for "insured" under this subparagraph d ends "personal effects" that are lost or damaged when your operations for that "insured" are as a result of the covered "loss", without completed. applying a deductible. EMPLOYEE AS INSURED EXTRA EXPENSE — BROADENED COVERAGE Under Paragraph A. of Section II — LIABILITY COV- Paragraph A. — COVERAGE of SECTION III — ERAGE item f. is added as follows: PHYSICAL DAMAGE COVERAGE is amended to add: Your "employee" while using his owned "auto", or an "auto" owned by a member of his or her household, 5. We will pay for the expense of returning a stolen in your business or your personal affairs,provided you covered "auto"to you. do not own, hire or borrow that "auto". This coverage is excess to any other collectible insurance coverage. AIRBAG COVERAGE FELLOW EMPLOYEE COVERAGE Under paragraph B. — EXCLUSIONS of SECTION III — PHYSICAL DAMAGE COVERAGE, the following is Exclusion 5. FELLOW EMPLOYEE of SECTION II — added: LIABILITY COVERAGE — B. EXCLUSIONS is amended by the addition of the following: The exclusion relating to mechanical breakdown does not apply to the accidental discharge of an airbag. However, this exclusion does not apply if the "bodily injury" results from the use of a covered "auto" you NEW VEHICLE REPLACEMENT COST own or hire, and provided that any coverage under this provision only applies in excess over any other Under Paragraph C — LIMIT OF INSURANCE of collectible insurance. Section III —PHYSICAL DAMAGE COVERAGE sec- tion 2 is amended as follows: BLANKET WAIVER OF SUBROGATION 2. An adjustment for depreciation and physical con- We waive the right of recovery we may have for pay- dition will be made in determining actual cash ments made for "bodily injury" or "property damage" value in the event of a total loss. However, in the on behalf of the persons or organizations added as event of a total loss to your "new vehicle" to "insureds" under Section II —LIABILITY COVERAGE which this coverage applies, as shown in the — A.1.D. BROAD FORM NAMED INSURED and declarations,we will pay at your option: A.1.e. BLANKET ADDITIONAL INSURED. a. The verifiable "new vehicle" purchase price you paid for your damaged vehicle, not in- PHYSICAL DAMAGE — ADDITIONAL TRANS- chiding any insurance or warranties pur- PORTATION EXPENSE COVERAGE chased; The first sentence of paragraph A.4. of SECTION III b. The purchase price, as negotiated by us, of — PHYSICAL DAMAGE COVERAGE is amended as a new vehicle of the same make, model and follows: equipment, not including any furnishings, parts or equipment not installed by the We will pay up to $50 per day to a maximum of manufacturer or manufacturer's dealership. $1,500 for temporary transportation expense incurred If the same model is not available pay the by you because of the total theft of a covered "auto" purchase price of the most similar model of the private passenger type. available; Page 2 of 6 c. The market value of your damaged vehicle, a. Actual cash value of the damaged or stolen not including any furnishings, parts or equip- property as of the time of the loss", less an ment not installed by the manufacturer or adjustment for depreciation and physical manufacturer's dealership. condition; or This coverage applies only to a covered "auto" b. Balance due under the terms of the loan or of the private passenger, light truck or medium lease that the damaged covered "auto" is truck type (20,000 lbs or less gross vehicle subject to at the time of the "loss", less any weight) and does not apply to initiation or set up one or all of the following adjustments: costs associated with loans or leases. (1) Overdue payment and financial TWO OR MORE DEDUCTIBLES penalties associated with those payments as of the date of the "loss". Under SECTION III — PHYSICAL DAMAGE COV- ERAGE, if two or more "company" policies or cover- (2) Financial penalties imposed under a age forms apply to the same accident, the following lease due to high mileage, exces- applies to paragraph D. Deductible: sive use or abnormal wear and tear. a. If the applicable Business Auto deduct- (3) Costs for extended warranties, Cre- ible is the smaller (or smallest) deduct- dit Life Insurance, Health, Accident ible it will be waived; or or Disability Insurance purchased with the loan or lease: b. if the applicable Business Auto deduct- ible is not the smaller (or smallest) de- (4) Transfer or rollover balances from ductibie it will be reduced by the amount previous loans or leases. of the smaller (or smallest) deductible; (5) Final payment due under a `Balloon or Loan". c. If the loss involves two or more Busi- (g) The dollar amount of any ness Auto coverage forms or policies un-repaired damage that occurred the smaller (or smallest) deductible will prior to the "total loss"of a covered be waived. "auto". For the purpose of this endorsement (7) Security deposits not refunded by a "company" means: lessor. a. Safeco Insurance Company of America (8) All refunds payable or paid to you b. American States Insurance Company as a result of the early termination of a lease agreement or any war- c. General Insurance Company of America ranty or extended service agree- d. American Economy Insurance Company ment on a covered "auto". e. First National Insurance Company of (9) Any amount representing taxes. America (10) Loan or lease termination fees f. American States Insurance Company of Texas GLASS REPAIR —WAIVER OF DEDUCTIBLE g. American States Preferred Insurance Under paragraph D. — DEDUCTIBLE of SECTION III Company — PHYSICAL DAMAGE COVERAGE, the following is h. Safeco Insurance Company of Illinois added: LOAN/LEASE GAP COVERAGE No deductible applies to glass damage if the glass is repaired rather than replaced. Under paragraph C — LIMIT OF INSURANCE of SECTION III — PHYSICAL DAMAGE COVERAGE, AMENDED DUTIES IN THE EVENT OF ACCI- the following is added: DENT, CLAIM, SUIT OR LOSS 4. The most we will pay for a total "loss" in any one The requirement in LOSS CONDITION 2.a. — "accident" is the greater of the following,subject DUTIES IN THE EVENT OF ACCIDENT, CLAIM, to a$1,500 maximum limit: SUIT OR LOSS — of SECTION IV — BUSINESS AUTO CONDITIONS that you must notify us of an CA 71 10 03 07 Page 3 of 6 EP "accident"applies only when the "accident" is known deductible and excess provisions, we will provide to: coverage equal to the broadest coverage applicable to any covered "auto" you own. (1) You, if you are an individual; (2) A partner, if you are a partnership;or HIRED AUTO PHYSICAL DAMAGE COVERAGE — LOSS OF USE (3) An executive officer or insurance manager,if you are a corporation. SECTION III — PHYSICAL DAMAGE A.4.b. Form does not apply. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS Subject to a maximum of$1,000 per accident, we will cover loss of use of a hired "auto" if it results from SECTION IV — BUSINESS AUTO CONDITIONS — an accident, you are legally liable and the lessor in- B.2. is amended by the addition of the following: curs an actual financial loss. If you unintentionally fail to disclose any hazards ex- RENTAL REIMBURSEMENT COVERAGE fisting at the inception date of your policy, we will not A. We will pay for rental reimbursement expenses deny coverage under this Coverage Form because of incurred by you for the rental of an "auto" be- such failure. However, this provision does not affect cause of a covered loss" to a covered "auto". our right to collect additional premium or exercise our Payment applies in addition to the otherwise ap- right of cancellation or non-renewal: plicable amount of each coverage you have on a HIRED AUTO — LIMITED WORLD WIDE COVER- covered "auto". No deductibles apply to this cove rage. AGE B. We will pay only for those expenses incurred Under Section IV — Business Conditions, Paragraph during the policy period beginning 24 hours after B.7.b.e(1) is replaced by the following: the "loss" and ending, regardless of the policy's (1) The "accident" or "loss" results expiration,with the lesser of the following number from the use of an "auto" hired for of days: 30 days or less. 1. The number of days reasonably required to repair or replace the covered "auto". If RESULTANT MENTAL ANGUISH COVERAGE loss" is caused by theft, this number of days is added to the number of days it takes SECTION V — DEFINITIONS —C. is replaced by the to locate the covered "auto" and return it to following: you. "Bodily injury" means bodily injury, sickness or dis- 2. 30 days. ease sustained by a person including mental anguish C. Our payment is limited to the lesser of the fol- or death resulting from any of these. lowing amounts: HIRED AUTO PHYSICAL DAMAGE COVERAGE 1. Necessary and actual expenses incurred. 2. $50 per day. If hired "autos" are covered "autos" for Liability cov- erage and if Comprehensive, Specified Causes of D. This coverage does not apply while there are Loss or Collision coverages are provided under this spare or reserve "autos"available to you for your Coverage Form for any "auto" you own, then the operations. Physical Damage Coverages provided are extended to "autos" you hire or borrow. E. If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay The most we will pay for loss to any hired "auto" is under this coverage only that amount of your $50,000 or Actual Cash Value or Cost of Repair, rental reimbursement expenses which is not al- whichever is smallest, minus a deductible. The de- ready provided for under the PHYSICAL DAM- ductible will be equal to the largest deductible appli- AGE COVERAGE Coverage Extension. cable to any owned "auto" of the private passenger or light truck type for that coverage. Hired Auto Phy- F. The Rental Reimbursement Coverage described sical Damage coverage is excess over any other col—above does not apply to a covered "auto" that is lectible insurance. Subject to the above limit, described or designated as a covered "auto" on Page 4 of 6 Rental Reimbursement Coverage Form the manufacturer for the installation of a CA 99 23. radio. AUDIO, VISUAL AND DATA ELECTRONIC C. Limit of Insurance EQUIPMENT COVERAGE With respect to this coverage, the LIMIT OF IN- SURANCE provision of PHYSICAL DAMAGE A. Coverage COVERAGE is replaced by the following: 1. We will pay with respect to a covered "auto" 1. The most we will pay for "loss" to audio,vi- for loss" to any electronic equipment that sual or data electronic equipment and any receives or transmits audio, visual or data accessories used with this equipment as a signals and that is not designed solely for the result of any one "accident" is the lesser of: reproduction of sound.This coverage applies only if the equipment is permanently installed a. The actual cash value of the damaged in the covered "auto" at the time of the or stolen property as of the time of the "loss" or the equipment is removable from a "loss"; or housing unit which is permanently installed b. The cost of repairing or replacing the in the covered "auto" at the time of the damaged or stolen property with other "loss", and such equipment is designed to property of like kind and quality. be solely operated by use of the power from the "auto's" electrical system, in or upon the c. $1,000. covered "auto 2. An adjustment for depreciation and physical 2. We will pay with respect to a covered "auto" condition will be made in determining actual for "loss" to any accessories used with the cash value at the time of the loss". electronic equipment described in paragraph 3. If a repair or replacement results in better A.1. above. than like kind or quality, we will not pay for However, this does not include tapes, the amount of the betterment. records or discs. D. Deductible 3, If Audio, Visual and Data Electronic Equip- ment Coverage form CA 99 60 or CA 99 94 1. If "loss" to the audio, visual or data elec- is attached to this policy, then the Audio, Vi- tronic equipment or accessories used with sual and Data Electronic Equipment Cover- this equipment is the result of a "loss" to the age described above does not apply. covered "auto" under the Business Auto Coverage Form's Comprehensive or Colli- B. Exclusions sion Coverage, then for each covered "auto" our obligation to pay for, repair, return or re- The exclusions that apply to PHYSICAL DAM- place damaged or stolen property will be re- AGE COVERAGE, except for the exclusion relat- duced by the applicable deductible shown in ing to Audio, Visual and Data Electronic the Declarations. Any Comprehensive Cov- Equipment, also apply to this coverage. In addi- erage deductible shown in the Declarations Sion, the following exclusions apply: does not apply to "loss" to audio, visual or We will not pay for either any electronic equip- data electronic equipment caused by fire or ment or accessories used with such electronic lightning. equipment that is: 2. If loss" to the audio, visual or data elec- 1, Necessary for the normal operation of the Ironic equipment or accessories used with covered "auto" for the monitoring of the this equipment is the result of a "loss" to the covered "auto's" operating system; or covered "auto" under the Business Auto 2. Both: Coverage Form's Specified Causes of Loss Coverage, then for each covered "auto" our a. an integral part of the same unit housing obligation to pay for, repair, return or replace any sound reproducing equipment de- damaged or stolen property will be reduced signed solely for the reproduction of by a$100 deductible. sound if the sound reproducing 3. If "loss" occurs solely to the audio, visual or equipment is permanently installed in data electronic equipment or accessories the covered "auto"; and used with this equipment,then for each cov- b. permanently installed in the opening of ered "auto" our obligation to pay for, repair, the dash or console normally used by CA 71 10 03 07 Page 5 of 6 EP return or replace damaged or stolen property SECTION V — DEFINITIONS is amended by adding will be reduced by a$100 deductible. the following: 4. In the event that there is more than one ap- Q. "Personal effects" means your tangible plicable deductible, only the highest deduct- property that is worn or carried by you, ex- ible will apply. In no event will more than one cept for tools, jewelry, money, or securities. deductible apply. R. "New vehicle" means any "auto" of which you are the original owner and the "auto" has not been previously titled and is less than 365 days past the purchase date. Page 6 of 6 . a 1'i; liberty COMMERCIAL GENERAL LIABILITY G ` Northwest. CG 25 03 05 09 alb.n;fowl .Mw. POLICY NUMBER: 01-CG-687164-9 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): ALL PROJECTS OF THE NAMED INSURED UNLESS SPECIFICALLY EXCLUDED Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. For all sums which the insured becomes legally Construction Project General Aggregate obligated to pay as damages caused by Limit for that designated construction project. "occurrences" under Section I — Coverage A, Such payments shall not reduce the General and for all medical expenses caused by acci- Aggregate Limit shown in the Declarations dents under Section I —Coverage C, which can nor shall they reduce any other Designated be attributed only to ongoing operations at a sin- Construction Project General Aggregate gle designated construction project shown in the Limit for any other designated construction Schedule above: project shown in the Schedule above. 1. A separate Designated Construction Project 4. The limits shown in the Declarations for General Aggregate Limit applies to each Each Occurrence, Damage To Premises designated construction project, and that Rented To You and Medical Expense con- limit is equal to the amount of the General tinue to apply. However, instead of being Aggregate Limit shown in the Declarations. subject to the General Aggregate Limit shown in the Declarations, such limits will be 2. The Designated Construction Project Gen- -- subject to the applicable Designated Con eral Aggregate Limit is the most we will pay struction Project General Aggregate Limit. for the sum of all damages under Coverage A, except damages because of "bodily B. For all sums which the insured becomes legally injury" or "property damage" included in the obligated to pay as damages caused by "products-completed operations hazard", "occurrences" under Section I — Coverage A and for medical expenses under Coverage and for all medical expenses caused by acci- C regardless of the number of: dents under Section I — Coverage C, which a. Insureds; cannot be attributed only to ongoing operations at a single designated construction project shown ':: b. Claims made or "suits" brought; or in the Schedule above: c. Persons or organizations making claims 1. Any payments made under Coverage A for or bringing "suits". damages or under Coverage C for medical 3. Any payments made under Coverage A for expenses shall reduce the amount available damages or under Coverage C for medical under the General Aggregate Limit or the expenses shall reduce the Designated Products-completed Operations Aggregate Limit, whichever is applicable; and o Insurance Services Office,Inc., 2008 Safeeo and the Safeeo logo are registered trademark of Safeeo Corporation CG 25 03 05 09 Page 1 of 2 EP C-AG31-Pit1NT0g1-1904lXTSr • 2. Such payments shall not reduce any Desig- Aggregate Limit nor the Designated Construction nated Construction Project General Aggre- Project General Aggregate Limit. gate Limit. D. If the applicable designated construction project C. When coverage for liability arising out of the has been abandoned, delayed,or abandoned and "products-completed operations hazard" is pro- then restarted, or if the authorized contracting vided, any payments for damages because of parties deviate from plans, blueprints, designs, "bodily injury" or "propery damage" included in specifications or timetables, the project will still the "products-completed operations hazard" will be deemed to be the same construction project. reduce the Products-completed Operations Aggregate Limit, and not reduce the General E. The provisions of Section Iff — Limits of Insur- ance not otherwise modified by this endorsement shall continue to apply as stipulated. x Page 2O12 C4G-31-PRINTOD1.1904407G-Y is Liberty COMMERCIAL GENERAL LIABILITY Northwest. CG 24 04 05 09 Vr.MA 1!m}"eew.YVT POLICY NUMBER: O 1-CG-68 7164-9 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: ANY PERSON OR ORGANIZATION FOR WHOM YOU ARE REQUIRED BY WRITTEN CONTRACT, AGREEMENT OR PERMIT TO WAIVE RIGHTS OF RECOVERY. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of damage arising out of your ongoing operations or Rights Of Recovery Against Others To Us of "your work" done under a contract with that person Section IV — Conditions: or organization and included in the We waive any right of recovery we may have against "Products completed operations hazard". This waiver the person or organization shown in the Schedule applies only to the person or organization shown in above because of payments we make for injury or the Schedule above. • MOM _ e Insurance Services Office, Inc.,2008 Salao and the Saleao logo are registered trademarks or SateooCorporatlon CG24040509 EP C-AG31-P RI NT W 1-191140071-Y