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12-113.00 Spokane Rock Products: 2012 Street Preservation Ph 2 Contract THIS AGREEMENT, made and entered into this f 5� day of %1 , 2012, between the City of Spokane Valley under and by virtue of Title 35 RCW, a 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: 2012 Street Preservation Project—Phase 2 SVPW Contract 12-027 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. 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. City of Spokane Valley Agreement for Construction Services 2012 Street Preservation Project—Phase 2 SVPW Contract 12-027 &0111,--(i"))-. V. The project was awarded for the bid amount of$679,475.50. 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 i— 1 Z , 2012. Date ?,,_- � „_Q_-.,, Printed Name -Pry 1 Title Signs City of Spokane alley lLe- V Printed Name Title / Signature , City of Spokane Valley Agreement for Construction Services 2012 Street Preservation Project—Phase 2 SVPW Contract 12-027 Iu Z Slitikai‹.1%**' BOND NO: 105803966 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$679.475.50(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 27, 2 012 offered to enter into a Contract with the City of Spokane Valley for Contract No. 12-027 pursuant to the terms and conditions set forth in the Contract Documents dated 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. The 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 7th DAY OF August YEAR 2012. Travelers Casualty and Surety Company of America Spok- e rock Products, Inc.4./SURETY P' _ !' . Signatuje---/ / S!a.ature mss-.-p Ora t d Ha f �k ,-f NA'^— Typed Tame Typed N e Attorney-In-Fact V� Title (SEAL)! Title City of Spokane Valley Agreement for Construction Services 2012 Street Preservation Project—Phase 2 SVPW Contract 12-027 WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER s � 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. 0 04564512 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 Pasco ,State of Washington their true and lawful Attorneys)-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. 28th 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 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 u Company Isu . 1`l1!/. ;17 S S W IN ' ■IHSU ... N ,,YY O A� 4g�, OY�.....;TG9 J?+......'�9 GS �!'AD'4,4 \p4 ' 'w0 OR ; ns �Q Pi TED'� m ./ A) pPORq TE t^19 8 2 O' 1977 r I F i —._ n: FORDr 1896,tv NN. n�•., o. ,3 o 6 JD , . 4y ♦ .�`p a,y.....r a't/ o.'•.. .fdD > +a! f p�f ,�,+p�y. ).~ i 1` 4:f, .�� "n„ �„�' a; tN � r.......:a ,a , 'ry /i!'1 AMA°' */ State of Connecticut By: City of Hartford ss. 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. ierk In Witness Whereof,I hereunto set my hand and official seal. C` v My Commission expires the 30th day of June,2016. * Ammo * G K/"Marie C.Tetreault,Notary Public 58440-6-11 Printed in U.S.A. WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER WARNING:THIS POWER OF ATTORNEY 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,4Fidelily' 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 7 th day of Augus t ,20 12 Kevin E.Hughes,Assistant Sec tary n5U . 1'tly„y F\RE 6 RN -Nf t INSUq p�iY AN° 0p Rw.,y ...YtYI�- n @. •.•� c:` '4 a p. °�J tl 9 ftORPMR„,, W!OR70RAi:,,c 'T., F6R0. 3 4rt 98 P 0 1977 N�+rortAtro a—+m : 431 Nnr RO, < "c0�101m a 1951 ' '11lU4 � SEAL coNN. ° coNN. e h' 1896 '• SSAL: W o bey � `9 �nnu moms fh�..A.✓ 1g.. ...'A bt �1� `I'+ '•//Attt 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 Attorney-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 ,..=BATE IIBIOn�vwY! 14C+7fRD► CERTIFICATE OF LIABILITY INSURANCE 1 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 poiicy(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. PHONE...:. fAX .. Conover Insurance 1p�, a p n (509)545-3800 IIAIC_Not (509)547 7960 1804 West Lewis Street r3• a ADDRESS. .. INSURER(S)AFFORDING COVERAGE NAICIt Pasco WA 99301 INSURER A.Ameri,Can:-.Economy :Ins..Co . .: .: .. ....... ... .. INSURED *SURER 0..Am'erican,::States...Ins.;Company -. Spokane Rock Products Inc. INSuRER.c:Starr: Indemnity..& .Liability Co P.O. Box 3808 INsuRERD.Navigators Insurance Comapny INSURER E:Liberty Northwest Ins. Corps -. Spokane I \ :COVERAGES` CERTIFICATE`NUMBER 2012-2.013" 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 -. ' iiive': :POLICY EFF- POUCY EXP . .- .. - - ... LTR TYPE OF INSURANCE INSR two- POUCY..0 BER - J M/ODIYYYYI MMIDDIY .YY) LMITS GENERALUABIUTY 1,000,000 _ EA X GOMMERGIALGENERALLIABILITY PREMISES IEa occurrence). $ 00,000 1/1/2012 1/1/2013 A j CLAIMS-MADE. 7C I OCCUR 01CG68716480 MED EXP(Anyorre parson) $ 210,000 X: Constructual PERSONALSADV.INJURY. s_. ...1,000,000 Includes X C-, U GENERAL AGGREGATE ._ $ 2,000,000 GENT AGGREGATE LIMITAPPLIES PER : PRODUCTS-COMP/OP AGG $ ._ 2,0 ,000 r : ' POLICY x 1 JFcoT.; LOC 00 $ Bda i _,..LIMIT _0 AUTOmoBILE udBILITY --a0eidertt3 :; - 1 000 000 X' ANY AUTO BODILY INJURY(Per person) $ , B ALLOVdNED SCHEDULED 010254636510 ;1/1/2012 1/1/2013 AUTOS AUTOS BODILY INJURY(Per acCldenq S - NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS IPer-accident) Hired Auto uabaily 1,000,000 UMBRELLA LAB ' OCCUR EACH OCCURRENCE. - $ 4,000„00.0 C X EXCESSUAB ''CLAIMS-MADE SISIGCE50027812 AGGREGATE.. $ -._.._ 4,000,000 I EXCESS AUTO LIABILITY x /1/2012 1/1/2013 ' 1._..� ENTIONS RET .,.:_._.- _".- : _...:-. S _. .._ _.. -- i A- fA!QRKERS:COMPENl3ATION: �'�--- : -. �-- _ �.. -:-- - : ...:�:�� ..::..... .......__,.,: - - �WC STATU �OTH - AND EMPLOYERS'LIABILITY ' - I"TORY 1 DAITS I ..I.FR ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N . - - N/A" E.L.EACH ACCIDENT i S 1,000,000 OFFICER/MEMBER EXCLUDED? �D10668716480 1/1/2012 :1/1/2013 (Mandatory In NH) - - EL DISEASE-EA EMPLQY€E $ 1,000,000 It es';de91crYbeundef_, .._ . GAP qq .WA STOP OCSORIP710N.OF.OPERATIONS below E L.DISEASE-POUCY LIMIT: $ 2,000,000 A CONTRACTORS POLLUTION :01CG68716480 1/1/2012 1/1/2013 LIMIT 1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(Attach ACORD 101,Addltlonal Remarks Schedule B more space Is required) Company D: Excess Liability, Policy #SE12EXC7450301C, 2/1/2012 TO 1/1/2013, $9,000,000 Occurrence/Aggregate Limit. Company E: ID/MT Workers Compensation, Policy #WC41NC011995011, 10/1/2011 to 10/1/2012, $1,000,000 Limit. RE: 2012 Street Preservation Project-Phase 2, Spokane Valley Capital Improvement Project No. 0162, SVPW Contract 12-027. City of Spokane Valley and its officers, lected officials, employees, agents, and volunteers and Vera Water and Power Company 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 CERTIFICATE=HOLDEIR.:.. CANCELLATION .... . (509)921-1008 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILt BE DELIVERED IN City of Spokane Valley ACCORDANCE WITH THE POLICY PROVISIONS. 11707 E Sprague Ave Suite 106 Spokane Valley, WA 99206 AUTHORIZED REPRESENTATIVE Chuck Hudon/NATASH d �I° a-.-I. �5(2010%05) ©1988-2010 ACORD CORPORATION. All rights reserved. ,. -:. . : �.._ AC6Rl) g IMCd19,mn.mc,n+ 'ri.., w-rno.n.............e r:.....-_.....ss......e.....:I....e n rnon COMMENTS/REMARKS 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. • • • • • • • OE REMARK COPYRIGHT 2000, AMS SERVICES INC. . • 4 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: Under paragraph C. — CERTAIN TRAILERS, MO- (1) The Insured contract" must be in effect nder pars 9 P during the policy period shown in the Decla- 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 Cov- 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 IS AN INSURED provision is amended by the addition (4) Coverage for this person or organization 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 1p (6) The coverage provided will not exceed the PERSONAL EFFECTS COVERAGE lesser of: A. SECTION 11I — 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 111 — 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 111 —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 in- PHYSICAL DAMAGE — ADDITIONAL TRANS- you paid for your damaged vehicle, not in- PORTATION EXPENSE COVERAGE ceg any Insurance or warranties pur- chashased; The first sentence of paragraph A.4. of SECTION in 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 physlcal 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, Tight truck or medium lease that the damaged covered "auto" is truck type (20,000 ibs 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 Under SECTION 111 — PHYSICAL DAMAGE COV- "loss"' 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 b. If the applicable Business Auto deduct- with the loan or lease. ible is not the smaller (or smallest) de- (4) Transfer or rollover balances from ductible it will be reduced by the amount previous loans or leases. of the smaller (or smallest) deductible; ar (5) Final payment due under a "Balloon • Loan". c. If the loss Involves two or more Busi- (g) The dollar amount of any ness Auto coverage forms or policies un-repalred damage that occurred the smaller (or smallest) deductible will prior to the "total Toss" 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 c. General Insurance Company of America of a lease agreement or any war- 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 Till 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 I11 — 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 71 "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 area:corporation. SECTION 111 — 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 Toss. If you unintentionally fall to disclose any hazards ex- RENTAL REIMBURSEMENT COVERAGE isting 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 g p Payment applies in addition to the.otherwise ap- right of canoelietiori'or'nori=renewal: piicable amount of each coverage you have on a HIRED AUTO — LIMITED WORLD WIDE COVER- covered "auto". No deductibles apply to this coverage. 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. If hired "autos" are covered "autos" for Liability cov- 2. $50 per day. erage and if Comprehensive, Specified Causes of D. This coverage does not apply while there are t 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 lectibie insurance. Subject to the above limit, described or designated as a covered "auto" on Page 4 of 6 , ,1 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- A. Coverage SIJRANCE provision of PHYSICAL DAMAGE 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 properly 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 ` ufo". 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- ts 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 Cioili- B. Exclusions sion Coverage, then for each covered "auto" The exclusions that apply to PHYSICAL DAM- our obligation to pay for, repair, retum or re- AGE COVERAGE, except for the exclusion relat- place damaged or stolen property will be re- AGE to Audio, Visual and Data Electronic duced by the applicable deductible shown In Equipment, also apply to this coverage. In addi- the Declarations. Any Comprehensive Cov- Equipment, the following exclusions apply: erage deductible shown in the Declarations 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 tronic 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. to the event that there is more than one ap- Q. "Personal effects" means your tangible placable deductible, only the highest deduct- property that Is wom or carrled by you, ex- • lble 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 385 days past the purchase date. Page 6 of 6 La COMMERCIAL GENERAL LIABILITY `` Nort}nti CG 78000787 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY:CHANGES IL 1201 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 'ORGANI ZATI ON 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 REQUIRINGINSDRAN.CE" 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 I:NSURED 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 70 0007 87 Paps 1 of 2 EP • xiy. COMMERCIAL GENERAL LIABILITY 6'" North c t. CG 79 00 07 87 THIS ENDORSEMENT CHANGES THE POUCY. PLEASE READ IT CAREFULLY. POLICY CHANGES IL 12 01 11 86 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 RANGE ,ORDERS, OR THE PREPARING, APPROVING, OR FAILING TO ,PREPARE OR APPROVE, DRAWINGS AND SPECIFICATIONS; .AND 3 SUPERVISORY, INSPECTION, ARCHITECTURAL OR ENGINEERING ACTIVITT_ES. 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 UNLESS THE "WRITTEN CONTRACT REQUIRING INSURANCE" SPECIFICALLY REQUIRES YOU TO PROVIDE SUCH COVERAGE FOR THAT ADDITIONALL: ,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 TIME POLICY PERIOD, WHICHEVER IS EARLIER. 3. THE INSURANCE PROVIDED TO THE ADDITIONAL INSURED BY THIS ENDORSEMENT I5 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 OV ANY VALID AND COLLECTI- BLE "OTHER INSURANCE ", WHETHER PRIMARY, EXCESS:, CONTINGENT OR ON ANY OTHER BASIS, THAT IS AVAILABLE TO THE ADDITIONAL INSURED WHEN THAT PERSON OR :ORGANI ZATION IS AN Copyright, Insurance Services Office, Inc., 1983 00 79 00 07 87 Page 1 012 EP Ifttherty COMMERCIAL GENERAL LIABILITY I+Inrtlnnvest. CG 79 00 07 87 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES IL 12 01 11 '86 This endorsement modifies insurance provided under the.following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTOFIS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPE'RATIONS 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; i1. THE NAMES AND ADDRESSES OF ANY INJURED PERSONS AND WITNESSES; AND . THE NATURE AND LOCATION. OF ANY INJURY OR DAMAGE ARISING OUT OF THE "OCCURRENCE" OR OFFENSE. 8. IF A CLAIM I.S MADE OR "SUIT" IS BROUGHT AGAINST THE ADDITIONAL INSURED, THE ADDITIONAL INSURED MUST: 1. 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" 5, AS SOON AS PRACTICABLE. C. THE ADDITIONAL INSURED MUST IMMEDIATELY SEND US COPI ES 0? ALL LEGAL PAPERS RECEIVED IN CONNECTION WITH THE CLAIM OR '".SUIT'", COOPERATE WITH US IN THE INVESTIGATION OR SETTLEMENT OF THE CLAIM OR PEF'ENSE 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 CQVER 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 Copyright, Insurance Services Mice, Inc., 7983 03 79.00 07 87 Page 1 912 EP r 14 Liberty COMMERCIAL GENERAL LIABILITY r ' Nort}s�vtw;t. 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 UAf3ILITY COVERAGE PART POLLUTION UABILJTY COVERAGE PART . . PRODUCTS/COMPLETED OPERATIONS LIABILITYiCOVERAGE PART RAILROAD PRQTECTIVE 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 ZNSURANCE" 'MEANS THAT PART OF ANY WRITTEN OR AGREE- MENT UNDER WHICH YOU ARE REQUIRED ;TO INCLUDE A PERSON_ ORGANIZATION AS AN ADDITIONAL INSURED ON THIS COVERAGE PART, PROVIDED. THAT THE "BODILY INJURY" AND "PROPERTY DAMAGE" OCCURS AND THE "PERSONAL INJURY" IS CAUSED RYAN 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, Copyright, Insurance Services Office, Inc., 1983 C0 79 00 07 87 Page 1 or 2 .. EP Iibe COMMERCIAL GENERAL LIABILITY r' Northwest. CG 25 03 05 09 POLICY NUMBER: O1—CG-687164-8 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 Info-matron 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 Umit for that designated construction project. occurrences* under Section 1 — Coverage A, Such payments shall not reduce the General and for all medical expenses caused by acct- 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 gte 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 Umit 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 1 — 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 1 — 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 rnedica! under the General Aggregate Limit or the expenses shall reduce the Designated Products-completed Operations Aggregate Limit,whichever is applicable:;and Insurance Services Office,Inc.,2008 &dete and the Selene lag"ere tegbtered trodemarhe of Mato Co,pctation CG 25 03 05 OS Page t 012 EP r too In aenoiree nin•r 2. Such payments shall not reduce any Desig- Aggregate Limit nor the Designated Construction nated Construction Project General .Aggro- 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's 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 01 — Limits of Insur- ance not otherwise modified by this endorsement shall continue to apply as stipulated. i� 1 . Page 2of2 C4N:13.PRIRI1)7I400&1115&e VLiberty COMMERCIAL GENERAL LIABILITY North wait. st. CG 24104 4509 11 6...1,/wh Wm.IAn. POLICY NUMBER: 01-CG-687164-8 WAIVER OF TRANSFER. OF RIGHTS OF RECOVERY AGAINST OTHERS TO US ;This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABIIJTY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: 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 4'your;work*;tlone under a contract with that person Section N — Conditions: or organization and included in the "products-completed operations hazard".This waiver We waive any Ohl of recovery we may have.against applies only to the person or organization shown in the person or organization shown in the Schedule the Schedule above. above because of payments,we make for injury or x ra Insurance Services Office,Inc.,2008 Soles*end the Sot000 Togo at regielemd trodemerlts et Satnco Corporation CG 2404 05 09 EP C41M•13•PNIN 100bOOOB.Otbt}8 Washington State Department of y sTA : Employer Liability �`. Labor and Industries y Certificate ry i .f Department of Labor and Industries Employer Liability Certificate Date: 08/08/2012 UBI#: 600 283 585 Legal Business Name: EUCON CORPORATION Account# 133,446-03 'Doing Business As'Name: EUCON CORPORATION Estimated Workers Reported: Quarter 2 of Year 2012 "7 to 10 Workers" (See Description Below) Workers' Comp Premium Status: Account is current. Firm has voluntarily reported and paid their premiums. Licensed Contractor? Yes License: EUCONC*088DJ Expire Date: 1/11/2014 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). ACOR° CERTIFICATE OF LIABILITY INSURANCE YYY) 8/8/2012 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 CONTACT Jacqueline Hernandez, ACSR NAME: Conover Insurance PHONE (509)545-3800 FAX (509)547-7960 (A/C.No.Extl: (A/C,No): 1804 West Lewis Street E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Pasco WA 99301 INsuRERA:American States Ins Company INSURED INSURER B: Union Pacific Corporation INSURERC: Union Pacific Railway Company INSURER D: 4315 E. Sprague Avenue INSURER E Spokane WA 99212 INSURER F: COVERAGES CERTIFICATE NUMBER:2012-2013 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. NOTVVITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP W LIMITS LTR INSR VD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 ✓ DAMAGE TO RENTED $ COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) A CLAIMS-MADE X OCCUR 01CI64329510 8/7/2012 8/7/2013 MED EXP(Any one person) $ X Railroad Protective Liab PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ 6,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. _PRODUCTS-COMP/OP AGG $ POLICY n TOT n LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS AUTOS PROPERTY DAMAGE (Per accident) LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E .EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E .DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Re: City of Spokane Valley, 2012 Street Preservation Project-Phase 2, Spokane Valley Captital Improvement Project No. 0162, SVPW Contract 12-027. Designated Contractor: Spokane Rock Products, Inc. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Union Pacific Corporation ACCORDANCE WITH THE POLICY PROVISIONS. Union Pacific Railway Company 4315 E. Sprague Avenue AUTHORIZED REPRESENTATIVE Spokane, WA 99212 Chuck Hudon/JACKS ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005).01 The ACORD name and logo are registered marks of ACORD ® .L c� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)8/8/2012 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 CONTACT Jacqueline Hernandez, ACSR NAME: Conover Insurance (A/2NNo.Extr (509)545-3800 (A/c.No): (509)597-7960 1804 West Lewis Street E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Pasco WA 99301 INSURERA:American Economy Ins Co INSURED INSURERB American States Ins Company Spokane Rock Products Inc. INsuRERc:Starr Indemnity & Liability Co. P.O. Box 3808 INSURERD:Navigators Insurance Comapny INSURER E:Liberty Northwest Ins Corp. Spokane WA 99220 INSURERF: COVERAGES CERTIFICATE NUMBER:2012-2013 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 ✓ DAMAGE TO RENTED 200,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ A CLAIMS-MADE X OCCUR 01CG68716480 1/1/2012 1/1/2013 MED EXP(Any one person) $ 10,000 X Constructual PERSONAL&ADV INJURY $ 1,000,000 Includes X, C, U GENERAL AGGREGATE $ 2,000,000 '' GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000 —I POLICY 17C 1 lira LOC $ AUTOMOBILE COMBINED SINGLE LIMIT UTOMOBILE LIABILITY 1,000,000 (Ea accident) $ X ANY AUTO BODILY INJURY(Per person) $ B ALLOVVNED SCHEDULED 01C154636510 1/1/2012 1/1/2013 BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS _ AUTOS PROPERTY)DAMAGE $ (Per accident Hired Auto Liability $ 1,000,000 UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 C x EXCESS LIAB CLAIMS-MADE SISIGCE50027812 AGGREGATE $ 4,000,000 DED RETENTION$ EXCESS AUTO LIABILITY 2/1/2012 1/1/2013 $ A WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE, N/A E.L.EACH ACCIDENT $ 1,000,000 V OFFICER/MEMBER EXCLUDED? 01CG68716480 1/1/2012 1/1/2013 (Mandatory in NH) - E .DISEASE-EA EMPLOYEE $ 1,000,000 ✓ If yes,describe under DESCRIPTION OF OPERATIONS below WA STOP GAP E L DISEASE-POLICY LIMIT $ 2,000,0001/ A CONTRACTORS POLLUTION 01CG68716480 1/1/2012 1/1/2013 LIMIT 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Company D: Excess Liability, Policy #SE12EXC745030IC, 2/1/2012 TO 1/1/2013, $9,000,000 Occurrence/Aggregate Limit. Company E: ID/MT Workers Compensation, Policy #WC41NC011995011, 10/1/2011 to 10/1/2012, $1,000,000 Limit. RE: 2012 Street Preservation Project-Phase 2, Spokane Valley Capital Improvement Project No. 0162, SVPW Contract 12-027. Union Pacific Corporation and Union Pacific Railway Company 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. 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. Union Pacific Corporation Union Pacific Railway Company 4315 E. Sprague Avenue AUTHORIZED REPRESENTATIVE Spokane, WA 99212 / Chuck Hudon/NATASH �-- :-- „ Y ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005).01 The ACORD name and logo are registered marks of ACORD COMMENTS/REMARKS Waiver of Subrogation applies per attached blanket Form #CG 24 04 05 09.Per-Project Agg per Form #CG 25 03 05 09. OFREMARK COPYRIGHT 2000, AMS SERVICES INC. 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: Under paragraph C. — CERTAIN TRAILERS, MO- (1) The "insured contract" must be in effect during the policy period shown in the Decla- 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 Cov- 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 BROAD FORM NAMED INSURED or organization for "bodily injury" to its em- ployees, nor for "property damage" to its SECTION 11 — LIABILITY COVERAGE — A.1. WHO property. IS AN INSURED provision is amended by the addition (4) Coverage for this person or organization 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 " 50% or more of the business entity and the (5) The defense of any claim or suit" must be business entity is not separately insured for tendered by this person or organization as Business Auto Coverage. Coverage is extended soon as practicable to all other insurers up to a maximum of 180 days following acquisi- which potentially provide insurance for such tion or formation of the business entity. Coverage claim or "suit". 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 111 — 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 1I — 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 11 — 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- cluding any insurance or warranties pur- PORTATION EXPENSE COVERAGE chased; The first sentence of paragraph A.4. of SECTION 111 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 Under SECTION 111 — PHYSICAL DAMAGE COV- "loss". 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 b. If the applicable Business Auto deduct- with the loan or lease ible is not the smaller (or smallest) de- (4) Transfer or rollover balances from ductible 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- (6) 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 I11 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 1H — 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 .bn-renewal: plicable amount of each coverage you have on a HIRED AUTO — LIMITED WORLD WIDE COVER- covered "auto". No deductibles apply to this AGE coverage. 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 `foss" 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. If hired "autos" are covered "autos" for Liability cov 2. $50 per day. 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 sisal Damage coverage is excess over any other col- above does not apply to a covered "auto" that is iectible 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 Coverage SURANCE provision of PHYSICAL DAMAGE 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 receives or transmits audio, visual or data sual or data electronic equipment and any 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 be solely operated by use of the power from property of like kind and quality. 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 CoIli- 8. Exclusions sion Coverage, then for each covered "auto" The exclusions that apply to PHYSICAL DAM- our obligation to pay for, repair, return or re- AGE COVERAGE, except for the exclusion relat place damaged or stolen property will be re ing to Audio, Visual and Data Electronic duced by the applicable deductible shown in Equipment, also apply to this coverage. In addi- the Declarations. Any Comprehensive Cov tion, the following exclusions apply: erage deductible shown in the Declarations 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 meet or accessories used with such electronic lightning. equipment that is: 2. If "loss" to the audio, visual or data elec- t. Necessary for the normal operation of the tronic 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 1pfLiberty COMMERCIAL GENERAL LIABILITY Northwest. CG 24 04 05 09 POLICY NUMBER: 01-CG-687164-8 WAVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: 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 "products-completed operations hazard". This waiver We waive any right of recovery we may have against applies only to the person or organization shown in the person or organization shown in the Schedule the Schedule above. above because of payments we make for injury or e Insurance Services Office, Inc.,2008 Salted and the Safeco logo are tegirttered tradernad et SafeceCord°fatten CG2a0405o9 EP C.UR•13.PRINTtJi1 SCG3-0103 G _ i Liberty OMMERCIAL GENERAL LIABILITY f` � ` Northwest. CG 25 03 05 09 POLICY NUMBER: O1—CG-687164-8 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 1 —. Coverage A, Such payments shall not reduce the General and tor 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 gte designated construction project shown in the Limit for any other designated construction Schedule above: project shown in the Schedule above. •t. 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 2 The Designated Construction Project Gen shown in the Declarations, such limits will be era; Aggregate Limit is the most we will pay subject to the applicable Designated Con- for the sum of all damages under Coverage s#ruction project General Aggregate Limit. 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 1 — 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 1 — 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 e Insurance Services Office, Inc., 2008 Saco and the Snfeeo logo are m stored trademarks of Safeca Corparation CC 25 03 05 09 Page 1 of 2 EP r n",,na,amm nma mre r 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 to — Limits of Insur- ance not otherwise modified by this endorsement shall continue to apply as stipulated. MOM monwor —i mown MOM maim ~ Page 2 of 2 Liberty 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 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. 7. 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 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 o12 EP • 4—Liberty COMMERCIAL GENERAL LABILITY P 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- 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 OTHER BASIS, THAT IS AVAILABLE TO THE ADDITIONAL INSURED WHEN THAT PERSON OR ORGANIZATION IS AN Copyright, Insurance Services Office, Inc., 1983 C0 79 00 07 87 Page l of 2 EP VN-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 LIABIUTY 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 . 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 Copyright, Insurance Services Office, Inc., 1983 CG 79 00 07 87 Page 1 012 EP Liberty COMMERCIAL GENERAL LIABILITY North vc . 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 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. x Copyright, Insurance Services Office, Inc., 1983 CO 79 00 07 87 Pagel of 2 EP • Washington State Department of Employer Liability Labor and Industries Certificate Department of Labor and Industries Employer Liability Certificate Date: 08/08/2012 UBI #: 600 283 585 Legal Business Name: EUCON CORPORATION Account#: 133,446-03 Doing Business As' Name: EUCON CORPORATION Estimated Workers Reported: Quarter 2 of Year 2012 "7 to 10 Workers" (See Description Below) Workers' Comp Premium Status: Account is current. Firm has voluntarily reported and paid their premiums. Licensed Contractor? Yes License: EUCONC*088DJ Expire Date: 1/11/2014 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). / Y DATE(MM/DD/YYYY) A`o °® CERTIFICATE OF LIABILITY INSURANCE I 12/29/2012 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 CONTACt Jacqueline Hernandez, ACSR Conover Insurance (PATE HONFyn.FY • (509)545-3800 I FAX to/C Nol:(509)547-7960 . 1804 West Lewis Street E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Pasco WA 99301 INSURER American Economy Ins Co. INSURED INSURER B American States Ins Company. Spokane Rock Products Inc. INSURERC:Starr Indemnity & Liability Co. P.O. Box 3808 - INSURERD:Navigators Insurance Comapny INSURER E:Liberty Northwest Ins Corp. 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 LTR OF INSURANCE �, POLICY EFF POLICY EXP LTR ITh LIMITS POLICY NUMBER MM(.D uM/DD/YYYY I GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 200,000 COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ ICLAIMS-MADE © OCCUR 1CG6871649 /1/2013 /1/2014 MED EXP(Any one person) $ 10,000 Constructual PERSONAL&ADV INJURY $ 1,000,000 © Includes X, C, U GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 : PRODUCTS-COMP/OP AGG $ 2,000,000 ■ POLICY © PRO EM $ AUTOMOBILE LIABILITY *MB I L MIT (Ea accident) $ 1.000.000 © ANY AUTO BODILY INJURY(Per person) $ ■ AUTOVSMIED ■ SCHEDULED r1CI5463652 ./1/2013 1/1/2014 BODILYINJURY(Peraccident) $ ■ HIRED AUTOS ■ NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) ■ . $ ■ UMBRELLA LIAB © © OCCUR EACH OCCURRENCE $ 4,000,000 EXCESS LIAB ■ CLAIMS-MADE ISIGCE50027813 AGGREGATE $ 4,000,000 ■ DED 11. OCCUR XCESS AUTO LIABILITY x/1/2013 x/1/2014 $ I WORKERS COMPENSATION WC STATU- TORY EMPLOYERS'LIABILITY TORY I IMITS ER ANY PI�UPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? 1CSTOP GAP ./1/2013 ./1/2014 (Mandatory in NH) E.L.DISEASE-EA EMPLOYE: $ 1,000,000 If yes,describe under STOP GAP DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 2 000 000 IIICONTRACTORS POLLUTION •1CG6871649 '/1/2013 '/1/2014 LIMIT 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/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 #WC4 1NC011995012, 10/1/2012 to 10/1/2013, $1,000,000 Limit. RE: 2012 Street Preservation Project-Phase 2, Spokane Valley Capital Improvement Project No. 0162, SVPW Contract 12-027. City of Spokane Valley and its officers, lected officials, employees, agents, and volunteers and Vera Water and Power Company and its officers, elected officials, employees, agents and volunteers are additional insured. Certificate continuation attached: CERTIFICATE HOLDER CANCELLATION (509) 921-1008 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Spokane Valley ACCORDANCE WITH THE POLICY PROVISIONS. 11707 E Sprague Ave Suite 106 Spokane Valley, WA 99206 AUTHORIZED REPRESENTATIVE Chuck Hudon/JACKS ` ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INCD9S ion,nnal n, Tr.., w anon..............a r....................4,.....1......t....t w anon C,(>''2_. 1, {2 COMMENTS/REMARKS Certificate continuation: 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. OFREMARK COPYRIGHT 2000, AMS SERVICES INC. 'titfLiberty COMMERCIAL GENERAL LIABILITY Northwest. CG 79 00 07 87 THIS ENDORSEMENT CHANGES THE POUCY. PLEASE READ IT CAREFULLY. POLICY CHANGES IL 1201 1185 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. •. 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 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 • • � Labcrty COMMERCIAL GENERAL LIABILITY f, 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/COMPLE I ti) 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, ARCHI TECTURAL 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- 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 OTHER BASIS, THAT IS AVAILABLE TO THE ADDITIONAL INSURED WHEN THAT PERSON OR ORGANIZATION IS AN Copyright, Insurance Services Office, Inc., 1983 CG 79 DO 07 87 Page 1 of 2 EP Liberty COMMERCIAL GENERAL LIABILITY 10"`Nortinvest. 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: 1 . 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 Copyright, Insurance Services Office, Inc., 1983 CG 79 00 07 87 " Pags 1 of 2 EP Liberty COMMERCIAL GENERAL LIABILITY NorthwcK,t. 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 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. Copyright, insurance Services Office, Inc., 1983 CG 79 OD 07 87 Page l of 2 EP kl.t.{�crty COMMERCIAL GENERAL LIABILITY No rth rest. CG 24 04 05 09 POLICY NUMBER: 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 B. 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 "products-completed operations hazard". This waiver We waive any right of recovery we may have against applies only to the person or organization shown in the person or organization shown in the Schedule the Schedule above. above because of payments we make for injury or a insurance Services Office, Inc., 2008 Satecc and the Sateco logo are reoistered trademarks of Sateco Corporation CG 24 04 05 09 EP AFP-M"ETA2-23-PRINT0o-0679-0017-C 1. Liberty COMMERCIAL GENERAL LIABILITY � Northwest. CG 25 03 05 09 POLICY NUMBER: 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 1 — 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 1 —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 2. The Designated Construction Project Gen- shown in the Declarations, such limits will be eral Aggregate Limit is the most we will pay subject to the applicable Designated Con for the sum of all damages under Coverage struction Project General Aggregate Limit. 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 1 — 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 1 — 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 Insurance Services Office, Inc., 2008 Sateco and the Sateco Ingo are registered trademarks of Sateco Corporatian CG 25 03 05 09 Page 1 of 2 EP r fits r2 oofumm fmna mra r 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 III — Limits of Insur- ance not otherwise modified by this endorsement shall continue to apply as stipulated. i -w Page 2 of 2 Cd1H.f 3PHIHTOM LL'116111654 COMMERCIAL AUTO CA71100307 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 fI — 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: Under paragraph C. — CERTAIN TRAILERS, MO- (1) The insured contract" must be in effect BILE EQUIPMENT AND TEMPORARY SUBSTITUTE during the policy period shown in the Decia AUTOS of SECTION 1 — COVERED AUTOS, the rations, and must have been executed prior following is added: to the "bodily injury" or "property damage". (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 BROAD FORM NAMED INSURED or organization for "bodily injury" to its em- ployees, nor for "property damage" to its SECTION II — LIABILITY COVERAGE — A.1. WHO property. IS AN INSURED provision is amended by the addition (4) Coverage for this person or organization 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 any(5) The defense of an claim or "suit" must be 50% or more of the business entity and the business entity is not separately insured for tendered by this person or organization as Business Auto Coverage. Coverage is extended soon as practicable to all other insurers up to a maximum of 180 days following acquisi- which potentially provide'insurance for such tion or formation of the business entity. Coverage claim or "suit". 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 8 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". (7) A person's or organization's status as an For any Owned "auto" that is involved in a 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 PHYSICAL DAMAGE — ADDITIONAL TRANS- you paid for your damaged vehicle, not in- PHYSICAL EXPENSE COVERAGE ceg any insurance or warranties pur- chashased; 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 Under SECTION III — PHYSICAL DAMAGE COV- loss". 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 b. If the applicable Business Auto deduct—with the loan or lease: ible is not the smaller (or smallest) de- (4) Transfer or rollover balances from ductible 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. p "auto". For the purpose of this endorsement (7) Security deposits not refunded by a "company" means: lessor. a. Safeco Insurance Company of America (8) Al! refunds payable or paid to you b. American States Insurance Company as a result of the early termination c. General Insurance Company of America of a lease agreement or any war 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; HIRED AUTO PHYSICAL DAMAGE COVERAGE — (2) A partner, if you are a partnership;or 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 fall to disclose any hazards ex- RENTAL REIMBURSEMENT COVERAGE isting 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 such failure. However, this provision does not affect incurred by you for the..rental of an "auto" be our right to collect additional premium or exercise our cause of a covered gloss" to a covered "auto". right of cancellation or non renewal. Payment applies in addition to the otherwise ap- plicable amount of each coverage you have on a HIRED AUTO — LIMITED WORLD WIDE COVER- covered "auto". No deductibles apply to this AGE coverage. rah B. We will pay only for those expenses incurred Under Section IV — Business Conditions, Paragraph p 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. If hired "autos" are covered "autos" for Liability coy- 2 $50 per day. 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- A. Coverage SURANCE provision of PHYSICAL DAMAGE 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 receives or transmits audio, visual or data sual or data electronic equipment and any signals and that is not designed solely for the accessories used with this equipment as a reproduction of sound.This coverage applies result of any one "accident" is the lesser of: 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 replacing the in the covered "auto" at the time of the p g or P 9 loss", and such equipment is designed to damaged or stolen property with other be solely operated by use of the power from property of like kind and quality. 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 Coili- B. Exclusions sion Coverage, then for each covered "auto" The exclusions that apply to PHYSICAL DAM- our obligation to pay for, repair, return or re AGE COVERAGE, except for the exclusion relat place damaged or stolen property will be re- ing to Audio, Visual and Data Electronic duced by the applicable deductible shown in Equipment, also apply to this coverage. In addi- tion, the following exclusions apply: erage deductible shown in the Declarations 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 tronic 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 solel y to the audio, visual or equipment is permanently installed in data electronic equipment or accessories the covered "auto"; and q P 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 . - . . Washington State Department of -,L-, . Employer Liability Labor and Industries ,; x ' , Certificate ...} Department of Labor and Industries Employer Liability Certificate Date: 12/31/2012 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 3 of Year 2012 "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). l ® A`�° DATE(MM/DD/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 /PwHONN Frtl• (509)545-3800 I FAX Not: (509)547-7960 /A/C 1804 West Lewis Street ADORFSS• INSURER(S)AFFORDING COVERAGE NAIC# Pasco WA 99301 INsURERAAmerican Economy Ins Co. 19690 INSURED INSURERBAmerican States Ins Company 19704 ' Spokane Rock Products Inc. i INSURERC:Starr Indemnity & Liability Co. 38318 - P.O. Box 3808 INSURERD:Navigators Insurance Company 42307 INSURER E:Zurich American Insurance Co. 16535 Spokane WA 99220 INSURER F: , 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 TYPE OF INSURANCE LTR INSR WVD POLICY NUMBER /MM/DD/YYYYI IMM/DDIYYYY1 LIMITS 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&ADV INJURY $ 1,000,000 X Includes X, C, U GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREG�A'T�E LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000 —I POLICYIXIjEt° 1 ILOC $ AUTOMOBILE LIABILITY Ea acccidentSINGLE LIMIT $ 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ B ALL OWNED SCHEDULED 01C15463652 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 TWAT I IOT AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE 0 E .EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED', 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/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, $1,000,000 Limit. RE: 2012 Street Preservation Project-Phase 2, Spokane Valley Capital Improvement Project No. 0162, SVPW Contract 12-027. City of Spokane Valley and its officers, lected officials, employees, agents, and volunteers and Vera Water and Power Company and its officers, elected officials, employees, agents and volunteers are additional insured. Certificate continuation: Business Auto additional insured applies per attached blanket Form #CA 71 10 03 07. Additonal Insured/Primary Additional Insured apply per CERTIFICATE HOLDER CANCELLATION (509) 921-1008 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Spokane Valley ACCORDANCE WITH THE POLICY PROVISIONS. 11707 E Sprague Ave Suite 106 Spokane Valley, WA 99206 AUTHORIZED REPRESENTATIVE J Hernandez, ACSR/JAC Q-e$L`-#--1-" '4-VI' ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. mmillG,nn.nncsn. �. LiIJ I L-I l� J COMMENTS/REMARKS 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 12/29/2012 Certificate. OFREMARK COPYRIGHT 2000, AMS SERVICES INC. , • Washington State Department of sT,Vre Employer Liability Labor and Industries _ certificate 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). Sic Liberty COMMERCIAL GENERAL LIABILITY o. ' Northwest. CG 79 00 07 87 !La1M d,A.w}u.wl imgr 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 P. 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 EEE INSURANCE. "—' B. THE INSURANCE PROVIDED TO THE ADDITIONAL EEE INSURED DOES NOT APPLY TO "BODILY INJURY" , asi "PROPERTY DAMAGE" OR "PERSONAL INJURY" ARISING OUT OF THE RENDERING OF, OR FAILURE EZE 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-PRINT001.1904. 91-Y Page 2of2 C-AG31-PRINT001490447.092.Y Liberty COMMERCIAL GENERAL LIABILITY Northwest. CG 7900 07 87 }..Mfd1MC.W..1rsy 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- = TORY BASIS, THIS INSURANCE IS PRIMARY TO "OTHER INSURANCE" AVAILABLE TO THE ADDITIONAL EMe INSURED WHICH COVERS THAT PERSON OR ORGANIZA- TION AS A NAMED INSURED FOR SUCH LOSS, AND EEE WE WILL NOT SHARE WITH THAT "OTHER INSURANCE" . BUT THE INSURANCE PROVIDED TO ma THE ADDITIONAL INSURED BY THIS ENDORSEMENT STILL IS EXCESS OVER ANY VALID AND COLLECTI- BLE "OTHER INSURANCE" , WHETHER PRIMARY, = EXCESS, CONTINGENT OR ON ANY OTHER BASIS, EaE ,_ 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 Page 1 of 2 EP C-AG-31-PR I N 5001.1904-00934 • Page 2 of 2 C-AG-31-PRIMT001-19044094.Y 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 EME DEFENSE AND INDEMNITY OF ANY CLAIM OR "SUIT" TO ANY PROVIDER OF "OTHER INSURANCE" WHICH = WOULD COVER THE ADDITIONAL INSURED FOR A LOSS EEE WE COVER UNDER THIS ENDORSEMENT. HOWEVER, .ai 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 Copyright, Insurance Services Office, Inc., 1983 CG 79 00 07 87 Page 1 of 2 EP c-AG31-PRI"Tan 4 934.009%.r X Page 2 of 2 GA631-PR'NW-19040096-Y .'\', Liberty COMMERCIAL GENERAL LIABILITY A 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 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. = Copyright, Insurance Services Office, Inc., 1983 CG 79 00 07 87 Page t of 2 EP C-AG-31-PRINT001.1904-0097-Y • x Page 2 of 2 C-AG-3I-PRINT001.1904-009&Y 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 Decla- 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 (4) Coverage for this person or organization IS AN INSURED provision is amended by the addition ( ) g p g 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". lion 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- cluding 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 HI — 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 ductible 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 ACCT- 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; HIRED AUTO PHYSICAL DAMAGE COVERAGE — (2) A partner, if you are a partnership;or 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 isting 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 coverage. 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. If hired "autos" are covered "autos" for Liability cov 2. $50 per day. 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 F. The Rental Reimbursement Coverage described or light truck type for that coverage. Hired Auto Phy- . above does not apply to a covered "auto" that is sical Damage coverage is excess over any other col- lectible insurance. Subject to the above limit, 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 Coy- Equipment, also apply to this coverage. In addi- erage deductible shown in the Declarations tion, 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 meni 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 tronic 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 coy- 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 �k Liberty COMMERCIAL GENERAL LIABILITY ` Northwest. CG 25 03 05 09 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 1 — 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 cannot be attributed only to ongoing operations a. Insureds; 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 pm. 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 m Insurance Services Office,Inc., 2008 Sateco and the Safeco logo are registered trademarks of Sale=Corporation �.. CG 25 03 05 09 Page 1 of 2 EP C-AG31-P N I N T1 01-19 W-o ps-r 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 III — Limits of Insur- ance not otherwise modified by this endorsement shall continue to apply as stipulated. x Page 2 of 2 C4G,31.PRINTWI-1934-Q0?O-Y • • Liberty COMMERCIAL GENERAL LIABILITY f• ' Northwest. CG 24 04 05 09 !cr A.rd 1l.,,}Yeutl.sear POLICY NUMBER: O1-CG-687164-9 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. IMMO ®Insurance Services Office, Inc.,2008 Salao and the Sateco logo are registered trademarks of Sateco Corporation CG 24 04 05 09 EP C-AGJI-PRISM-1904-0011-Y SUPERIOR COURT OF WASHINGTON FOR SPOKANE COUNTY In the Matter of: ADVERTISEMENT FOR BIDS No. City of Spokane Valley Public Works Department Bid # 12 -027 ) 2012 Street Preservation Project - Phase 2� AFFIDAVIT OF PUBLISHING NOTICE STATE OF WASHINGTON ) )SS. County of Spokane ) MICHAEL HUFFMAN . being first duly sworn on oath deposes and says that he is the ED IQJ , of The Spokane ValleyNewsHerald, aweekly newspaper. Thatsaid newspaper is a legalnew5paper and itisnow andhasbeenfor more than six months prior to the date of the publication hereinafter referred to, published in the English language continually as a weekly newspaper in Spokane County, Washington, and it is now and during all of said time was printed in an office maintained at the aforesaid place of publication of said newspaper, which said newspaper had been approved as a legal newspaper by order of the Superior Court of the State of Washington in and for Spokane County. That the following is a true copy of a public notice as it was published in regular issues commencing on the 13th day of Iuly, 2012 and ending the 20th day of My. 2942, all e ' cl 4 dthat such newspaper was regularly distributed to its subscribers during all of said period. ADVERTISEMENT FOR BIDS OF SPOKANE VALLEY PUBLILIC WORK DEPARTMENT B �RIBE d SWORN to before me BID 2012 STREET PRESERVATION this 20th ay of July, 2012. PROJECT— PHASE 2 Notice is hereby given that the City of Spokane on State of Washington Valley, Spokane County, Washington will accept ���� /// gt sealed bids for the 2012 Street Preaervenan 1�G RA �+ _ /,', County of Spokane Pmlect — Phase 2. The project consists of bt 4 ` / luminous planning; hot mix asphalt overlaying; hot mix asphalt patching; sidewalk and curb �••�g$ION F,'- ••�2� -i I certify that I know or have satisfactory evidence that work; replacement o(vehicle detection loops and A•� miscellaneous road renovation work. tp� ��F Michael Huffman is the person who appeared before Copies of the bid packet including specifications J tn• r4 Mlle, and said person acknowledged that he signed of Spokane a Vale obtained orkso Depart iheCry NOTARY ' =his instrument and acknowledged it to be his free of Spokane Valley Public Works Department, at � 11707E Sprague Avenue, Suite 304, Spokane PUBLIC and voluntary act for the uses and purposes men - Valley, WA 992068124, Monday through Friday from 8:00 a.m. to 5:00 p.m. A non-ref mdable �: �Z �ioned in the irtstrtllnent. amount of $50.00 is required. Copies of the bid t� packet including specifications and plans may \ - bae^ obtained in POP format on a compact disc 1 • 5.16.15 ••• YN \\ All bids must be accompanied by a bid deposit OF••• • %% in Olen e W tZ in the form of a surety bond, postal money order, / 1'Y A�+ I cash, cashier's check, or certified check in an / / //I j j 11�1�` Title: Otar Public amount equal to five percent (5 %) of the amount y ofthe bid proposed. Failure to furnish a bid bond My app lment expires: 5 -16-15 in compliance with the City's bid deposit surety bond form shall make the bid non - responsive and cause the bid to be rejected. Bids must be submitted in sealed envelopes addressed to the City Clerk of the City of Spo- kane Valley, 11707 E. Spragde Avenue, Suite ((�� 106, Spokane Valley, Washington, 99206, and lip received not 1. than 2:gg -am. PSDT. Friday VV JWy 27. 2012. Bid openings will be held im- mediately thereafter and mad aloud in the City Council Chambers, Suite 101. The City of Spokane Valley reserves the right to waive any irregularities or informalities and to reject any or all bids. No bidder may withdraw his bid after the time announced for the bid opening, or before the award and execution of the contract, unless the award is delayed for a period exceeding sixty (60) days. Christine Bainbndge, MMC Spokane Valley City Clerk 7/13,7/20 ADVERTISEMENT FOR BIDS CITY OF SPOKANE VALLEY PUBLIC WORKS DEPARTMENT BID # 12 -027 2012 STREET PRESERVATION PROJECT - PHASE 2 Notice is hereby given that the City of Spokane Valley, Spokane County, Washington will accept sealed bids for the 2012 Street Preservation Project - Phase 2. The project consists of bituminous planning; hot mix asphalt overlaying; hot mix asphalt patching; sidewalk and curb work; replacement of vehicle detection loops and miscellaneous road renovation work. Copies of the bid packet including specifications and plans can be obtained at the office of the City of Spokane Valley Public Works Department, at 11707 E. Sprague Avenue, Suite 304, Spokane Valley, WA 99206 -6124, Monday through Friday from 8:00 a.m. to 5:00 p.m. A non - refundable amount of $50.00 is required. Copies of the bid packet including specifications and plans may be obtained in PDF format on a compact disc at no charge. All bids must be accompanied by a bid deposit in the form of a surety bond, postal money order, cash, cashier's check, or certified check in an amount equal to five percent (5%) of the amount of the bid proposed. Failure to furnish a bid bond in compliance with the City's bid deposit surety bond form shall make the bid non- responsive and cause the bid to be rejected. Bids must be submitted in sealed envelopes addressed to the City Clerk of the City of Spokane Valley, 11707 E. Sprague Avenue, Suite 106, Spokane Valley, Washington, 99206, and received not later than 2:00-o.m. PSDT, Friday, July 27, 2012. Bid openings will be held immediately thereafter and read aloud in the City Council Chambers, Suite 101. The City of Spokane Valley reserves the right to waive any irregularities or informalities and to reject any or all bids. No bidder may withdraw his bid after the time announced for the bid opening, or before the award and execution of the contract, unless the award is delayed for a period exceeding sixty (60) days. Christine Bainbridge, MMC Spokane Valley City Clerk PUBLISH: Spokane July 13 and July 20, 2012 SR24741 *Federal Tax ID No. 68- 0617327 AFFIDAVIT OF PUBLICATION STATE OF WASHINGTON County of Spokane} ss Name: City of Spokane Valley Client ID PO No. SR24741 42365 No. Lines: 75 Total Cost: $640.50 Order No. 92552 I, Kristina Hummer do solemnly swear that I am the Principal Clerk of The Spokesman- Review, a newspaper established and regularly published, once each day in the English language, in and of general circulation in the City of Spokane County, Washington; and in the City of Coeur d'Alene, Kootenai County, Idaho; that said newspaper has been so established and regularly published and has had said general circulation continuously for more than six (6) months prior to the 23rd day of July, 1941; that said newspaper is printed in an office maintained at its place of publication in the City of Spokane, Washington; that said newspaper was approved and designated as a legal newspaper by order of the Superior Court of the State of Washington for Spokane County on the 23rd day of July, 1941, and that said order has not been revoked and is in full force and effect; that the notice attached hereto and which is a part of the proof of publication, was published in said newspaper two time(s), the publication having been made once each time on the following dates: July 13 & 20, 2012 That said notice was published in the regular and entire issue of every number of the paper during the period of time of publication, and that the notice was published in the newspaper proper and not in a supplement. Subscribed and sworn to before me at the City of Spokane, this 20th day of July , 2012. �\ L VIN �O �OSSiON FCF2 A v J �i0TAky 9rn s D • N , Pt]8LIC �a Notackblic in and for the State of Washington, 7��QER `1 residing at Spokane County, Washington �FM/AC \� Notary Stamp Paper Affidavits