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13-151.00 Big Sky Development: 14th Ave Stormwater UpgradeContract THIS AGREEMENT, made and entered into this day of 2013, between the City of Spokane Valley under and by virtue of Title 35 RCW, Qs amended and Big Sky Development, 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: The Contractor shall do all work and furnish all tools, materials, and equipment for: 14th Avenue Stormwater Upgrade SVPW Contract #13 -034 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 Bid Proposal Documents 14th Avenue Stormwater Upgrade 11 Bid #13-034 013-151 V. The project was awarded for the bid amount of $297,154.00. 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 12013. Date Printed Name City of Printed Name City of Spokane Valley Bid Proposal Documents 14th Avenue Stormwater Upgrade 12 Bid #13-034 « a P ,111111111;o0vailley BOND CONTRACTOR'S PERFORMANCE BOND to City of Spokane Valley, Washington 2164595 The City of Spokane Valley, Washington, in Spokane County, has awarded to,Big Sky Development, Inc. (Contractor), as Principal, . a contract for the construction of rile project designated as 14th AVENUE STORMWATER UPGRADE PROJECT Project No. j:ffl4 in. Spokane Valley, Washington, and said Principal is required under the terms ofthe Contract to fish a performance bond in accordance with chapter 39.08 Revised Code of Washington (RCW). The. Principal, and NORTH AMERICAN SPECIALTY INSURANCE COMPANY (surety), a corporation, organized under the laws of:. NEW HAMPSHIRE 8nd licensed to do business in the State Of Washington as surety and named in the current list Of "Surety Companies Acceptable in Federal Bonds" as published in the Federal. Register by the Audit .Staff Bureau ofAccounts, U.S. Treasury Dept,,; are jointly and severally held.' and (firmly bound to the City of Spokane Valley, as 0' bligee, in the sum of 8297:1 MAO total Contract mount (including Washington State sales tax), subject to 66 provisions.herein. This performance bond shall become null and. void, if and when the Principal,. its heirs, executors, administrators, successors, or assigns shall well and faithfully perform all of the Principal's.obligations under the Contract and fulfill all the terms and conditions of all duly authorized modifications, additions, and - changes to said Contract that may hereaiier be made, at the time and in the manner therein specified; shall warranty the wark;as provided in the Contract and:shall indemnify and hold harmless the Obligee from any defects in the workmanship and materials incorporated into the work for the period identified in the Contract; and if such performance obligations have not been. fulfilled; this bond "I remain in full force and effect; The Surety for value received agrees that no change, extension of time, alteration or addition to the terms of the Contract, the specifications accompanying the Contract,.or: to the work _to be performed under the Conrad shall in anyway affoct its. obligation on this bond, and waives notice of any change, extension of time, alteration or addition to the terms of the Contract or the work performed The Surety agrees that modifrcati.ons. and changes. to the terns and conditions of the Contract that .increase the total amount to be paid the Principal shall automatically increase the obligation of the Surety on. this bond and notice to Surety is not required for such increased obligation. This bond may, be. executed in two original counte , and shall be signed by the .parties' duly authorized officers: This bond will only be accepted if it is accompanied by a executed and original power of attorney for the officer executing on behalf of the surety. PRIIN CiPAL. C ©NTRACTC}R SURETY BIG SKY DE MENT, NOR ERIC S ECIALTY INSURANCE COMPANY 8/23/13 ' 8/23/13 Principal Signature Date Surety Signatu Date - CHRIS LARSON Ifinted Maine .Printed Name 1�Q ATTORNEY -IN -FACT Title Title Name, address, and telephone of local office/agent of Surety Company is: WELLS FARGO INSURANCE SERVICES USA, INC. 601 W. MAIN, SUITE 1400, SPOKANE, WA 99201 509 - 358 -3800 Cite of Spokane Valley Bid Proposal Documents 14th Avenue Stormwater Upgrade 14 Bid #13 -034 M BONDNO: 2164595 CONTRACTOR'S PAYMENT, BOND (NON-FEDERALLY FUNDED piiC1`.l!ECT) to City of Spokane Valley, Washington The City of Spokane Valley, Washington, in Spokane County, has awarded to Big Sky Development, Inc. (Contractor), as Principal, a contract for the constriction of the project designated as 14a' AVENUE_ STORMWA,TER UPGRADE. Project No. 13-034 in Spokane Valley; Washington, and said Principal is required tinder the terms of the Contract to furnish a payment bond; in accordance with chapter 39.08 Revised Code of Washington (RCW). The Principal, and NORTH AMERICAN SPECIALTY INSURANCE COMPANY (Stcre'ty ), a corporation organized tntder the laWS NEW HAMPSHIRE and licensed to do business in the State of Washington as surety and named in the CutTCnt list of "Surety Companies Acceptable in Federal Bonds" as published in the Federal Register by the Audit: Staff l3ureau of Accounts, U.S. Treasury Dept., are jointly and severally held and firmly bound to the City of Spokane. Valley, as Obligee, -in the sum of 154. total Contract amount (including Washington State sales tax), subject to the provisions herein. This payment bond shall become null and void, if and when the Principal, its hears, executors; administrators, successors, or assigns shall pay all persons in accordance with chapters 39.08 and 3.9.12 RCW, including all workers, laborers, mechanics, subcontractors, and materialmen, and all persons who. shall supply such contractor or subcontractor with provisions and supplies. for the carrying on of such work= and shall indemnify and hold harmless the Obligee from all Foss, cost or damage which Obligee may surer by reason of the failure. of Principal to make such .required. payments; and if such payment obligations have not been fulfilled, this bond shall remain ml frill force and effect. The Surety for value received agrees that no change, extension of-titne, alteration or addition to the terms of the. Contract, One specifications accompanying the Contract, or to the work to be performed under the Contract shall in any way affect its. obligation on this bond, except as provided herein, and waives notice of any change, extension of time, alteration or addition to the terms of the Contract or the work performed.. The Surety agrees that modifications and changes to the terms and conditions of the Contract that increase the total amount to be paid the Principal shall ; automatically increase the obligation of the Surety on this bond and notice to Surety is not required for such increased obligation. This bond may be executed in two original couritenxxts, and shall be signed by the parties' duly authorized officers. This bond will only be accepted if it is accompanied by a . executed and original power of attorney for the officer executing on behalf of the surety. 'FluBt >lYAL 4UlY 1RAGTQR SURETY BIG SKY D MENT, NORT ER :AN P CIALTY INSURANCE COMPANY 8/23/13 8/23/13 Principal Signature Date Surety Signature Dates 7EREm r tei p p CHRIS LARSON Printed Name Printed Name APE-C, 0 r S.i 1 ATTORNEY-IN-FACT Title Title Name, address, and telephone of local officelagent of Surety Company is: WELLS FARGO INSURANCE SERVICES USA, INC. 601 W. MAIN, SUITE 1400, SPOKANE, WA 99201 509- 358 -3800 1 13 City of Spokane Valley Bid proposal Documents 14th Avenue Stormwater Upgrade 13 Bid # 13 -034 NAS SURETY GROUP NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY GENERAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, THAT North American Specialty Insurance Company, a corporation duly organized and existing under laws of the State of New Hampshire, and having its principal office in the City of Manchester, New Hampshire, and Washington International Insurance Company, a corporation organized and existing under the laws of State of New Hampshire and having its principal office in the City of Schaumburg, Illinois, each does hereby make, constitute and appoint: W.W. WELLER, GEORGE C. SCHROEDER, KATHY GURLEY, CHRIS LARSON, ERIN L. REPP, H. KEITH McNALLY. DIANA R. WILLIAMS and HEATHER ANDERSON JOINTLY OR SEVERALLY Its true and lawful Attomey(s) -in -Fact, to make, execute, seal and deliver, for and on its behalf and as its act and deed, bonds or other writings obligatory in the nature of a bond on behalf of each of said Companies, as surety, on contracts of suretyship as are or may be required or permitted by law, regulation, contract or otherwise, provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the amount of: FIFTY MILLION ($50,000,000.00) DOLLARS This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held on the 9ffi of May, 2012: "RESOLVED, that any two of the Presidents, any Managing Director, any Senior Vice President, any Vice President, any Assistant Vice President, the Secretary or any Assistant Secretary be, and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds, undertakings and all contracts of surety, and that each or any of them hereby is authorized to attest to the execution of any sucli Power of Attorney and to attach therein the seal of the Company,- and it is FURTHER RESOLVED, that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsnnile, and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be - binding upon the Company when so affixed and in the future with regard to any bond, undertaking or contract of surety to which it is attached." UW-TY1 1&1/ji gQ p4Qi'�IigTi9G� uWUmewu�41 ifo l�L .... By ^�? SEAL : [f = Steven P. Anderson, SeniorV ice President of Washing on International Insurance Company S'�! 3 2t n t¢sl i2� 1973 g n ` &Senior Vice President of Korth American Specially Insurance Company 50. tM = r: �a�o\ 5q/rSd r� ��S0 �IltftSt =a' -�- By %Wla�atet� David M. Layman, Vice President of Washington International Insurance Company & Vice President of North American Specialty Insurance Company IN WITNESS WHEREOF, North American Specialty Insurance Company and Washington International Insurance Company have caused their official seals to be hereunto affixed, and these presents to be signed by their authorized officers this26th day of June 2012 . North American Specialty Insurance Company Washington International Insurance Company State of Illinois County of Cook SS: On this 26th day of Jane , 2012, before me, a Notary Public personally appeared Steven P. Anderson , Senior Vice President of Washington International Insurance Company and Senior Vice President ofNorth American Specialty Insurance Company and David M. Layman , Vice President of Washington International Insurance Company and Vice President of North American Specialty Insurance Company, personally known to me, who being by me duly sworn, acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the voluntary act and deed of their respective companies. "OFFICIALSEAL, 1)ONNAD. SKLENS Notary Public, Slate of Minbis My Commission Expires 10IN2015 ;�Oww �O 0 Donna D. Sklens, Notary Public I, Jeffiev Goldberg . the duly elected Assistant Secretary of North American Specialty Insurance Company and Washington International Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney given by said North American Specialty Insurance Company and Washington International Insurance Company, which is still in full force and effect. IN WITNESS WHEREOF, I have set my hand and affixed the seals of the Companies this 2-3R&yyof AUGUST r 20 13• Jeffrey Goldberg Vice President & Assistant Seaetary of Washington International Insurance Company & North American Specialty Insurance Company 193667 1--- 1 ® A� v CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 9/4/2013 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 Commercial Lines - (509) 358 -3800 Wells Fargo Insurance Services USA, Inc. - CA Lic#: OD08408 601 West Main Street, Suite 1400 Spokane, WA 99201 -0635 CONTACT Danielle Carroll NAME: PHCN o ; (509) 358 -3979 aC No): (866) 510 -9558 ADDRESS: danielle.carroll @wellsfargo.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: American Fire and Casualty Company 24066 INSURED Big Sky Development, Inc 10063 N Navion Dr Hayden, ID 83835 INSURER B : Ohio Casualty Insurance Company 24074 INSURERC: Bi<a,54502754 INSURER D: 0$/01/14 INSURER E: $ 1,000,000 INSURER F: $ 100,000 COVERAGES CERTIFICATE NUMBER: 6549626 REVISION NUMBER: See below THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MM /DDY EFF MM DDI EXP LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY X Bi<a,54502754 06/01/13 0$/01/14 EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 10,000 CLAIMS -MADE FK OCCUR PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 $ POLICY X E O LOC A AUTOMOBILE LIABILITY BAA54502754 08/01/13 08/01/14 EO aBINdEO SINGLE LIMIT $ 1,000,000 BODILY INJURY (Par person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS P X PeOr s ee dentDAMAGE $ $ B X UMBRELLA LIAB X OCCUR US054502754 08/01/13 08/01/14 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 EXCESS LIAR CLAIMS -MADE DED I X I RETENTION$ 10,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE WC STATU- OTH- T RY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ OFFICERIMEMBER EXCLUDED? ❑ (Mandatory In NH) N/A E.L. DISEASE - POLICY LIMIT 1 $ If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) CG 85 83 10 09,CG8810_1009,CG 88 60 12 08 RE: 14th Avenue Stormwater Upgrade project City of Spokane Valley, its officers, elected officials, employees, agents, and volunteers, The State of Washington and its officers, elected officials, employees, agents, and volunteers are included as an additional insureds and insurance is primary performs attached as required by written contract. Per project aggregate applies per form attached. GEKIIFIGA It: MUL.UtK LIAMLICLLA I IVIY City of Spokane Valley Public Works Dept, Stormwater Utility ATTN: Ryan Brodwater 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 ACORD 25 (2010/05) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE The ACORD name and logo are registered marks of ACORD © 1988 -2010 AGUKD GUKPUKA I IUN. Ali rignts reserveo. (This certlficate replaces certificate# 6549616 Issued w 914/2013) COMMERCIAL GENERAL LIABILITY CG 85 8310 09 THiS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED CONTRACTORS - PRODUCTS /COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Paragraph 2. under Section Ii - Who is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured In a written contract or written J agreement. Such person or organization is an additional insured but only with respect to liability for "bodily injury" or "property damage ": 1. Caused by "your work" performed for that additional Insured that is the subject of the written contract orwrltten agreement; and 2. Included in the "products- completed operations hazard ". The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage ". We have no duty to defend an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured as required In Paragraph b. of Condition 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit under Section IV -Commercial General Liability Conditions. B. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section I - Coverage A - Bodily Injury And Property Damage Liability: This insurance does not apply to: 1. "Bodily Injury'. or "property damage" that occurs prior to you commencing operations at the location where such "bodily injury" or "property damage" occurs. 2. "Bodily injury" or "property-damage" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services inciuding: a. The preparing, approving' or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys,field order's, change orders or drawing and specifications; and b. Supervisory, inspection, architectural or engineering activities. 02010 Liberty Mutual Insurance Company. All rights reserved. CG 85 83 10 09 Includes copyrighted material of Insurance Services Office, Ina, with its permission. Page I of 2 C. With respect to the Insurance afforded by this endorsement, exclusion 1. Damage To Your Work of Paragraph 2. Exclusions under Section 1- Coverage A - Bodily Injury And Property Damage Liability Is replaced by the following: 1. Damage To Your Work "Property damage" to "your work" arising out of it or any part of it and included in the "products - completed operations hazard ". D. The limits of insurance applicable to the additional insured are those specified in a written contract or written agreement or the limits of insurance as stated In the Declarations of this policy and defined-in Section III - Limits Of insurance of this policy, whichever are less. These limits are inclusive of and not In addition to the limits of Insurance available under this policy. E. With respect to the insurance afforded by this endorsement, Section IV - Commercial General liability Conditions is amended as follows: 1. The following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claims Or Suit: An additional insured under this endorsement will as soon asp racticable: a. Give written notice of an "occurrence" or an offense that may result in a claim or "suit" under this insurance to us; b. Tender the defense. and indemnity of any claim or "suit" to all insurers whom also have Insurance available to the additional Insured; and c. Agree to make available any other Insurance which the additional Insured has for a loss we cover underthis Coverage Part. d. We have no duty to defend or indemnify an additional Insured under this endorsement until we receive written notice of a "suit" by the additional Insured. 2. Paragraph 4. of Section IV -Commercial General Liability Conditions is amended as follows: a. The following is added to Paragraph a. Primary Insurance: If an additional insured's policy has an Other Insurance provision making its policy excess, and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis,bls policy shall be primary and we will not seek contribution from the additional Insured's policy for damages we cover. b. The following is added to Paragraph b. Excess Insurance: When a written contractor written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit Issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non- contributory, this instrance Is excess over any other insurance for which the additional insured is designated as a Named Insured. Regardless of the written agreement between you and an additional insured, this insur- ance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional Insured has been added as an additional insured on other policies: 022010 Liberty Mutual Insurance Company. All rights reserved. CG 85 83 10 09 Includes copyrighted material of insurance Services office, Inc., with Its permission. Page 2 of 2 Ce"MIEP ICIAL GENERAL LIABILITY CG 88'10'10 09 THIS ENDORSEMENT GHA14PIES THE POUCY. PLEASE RF11!13 IT CARFFIJILLY. COMMERCIAL GENERAL LIABILITY MaENSION This endibtsement inddifles Insurance pr6vid - dd utider the following: COMMERCIAL GENERAL UABILiTY'COWRAGE PART SUBJECT PAGE "ON -OWNED AIRCRAFT 2 ]YON-OWNED, WATERCRAFT PROPERTY OArAAG9 LIABILITY - ELEVATORS 2 'WENDED DAMAGE TO'P9OPERTY' RENTED TO YOU (Tepant's Property DOrriage) MEOWALPAWENTS EXTENSION 'EXTEWE401114 OF SUPPLEMENTARY PAYMENTS , COVERAGEA A AND 9 A13bMoh!AL INSUREDS -;.BY CONTRACT, AG$19EMtNT OR: PIERMit .O.WWWANib MON-CONTRIBUTORY.- AbbITTONAL Iftuhto, EkTENMON 5 ADDITIONAL INSUREDS- EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" .5 WHIJ. I& AN INSURED-- INC. ID9NTAL MEDICAL ERROR SIMALPRACTICE AND WHO 15 AN INSURED -'Fl tkLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOVEF9 6 NEWLY FORMED 10.11 ADDITIONALLY ACQUIRED ENTITIES 6 FAILUR12•0 DISCLOSE HAZARDS�AND PRIOR OCCURRENCES 7 KNOWLEDGE OF OCCURRENCE, OFOENSIF, CLAIM Oil SUM 7 jamiAuzATiON CLAUSE 7 906ILY INJURY REDEFINED 7 EXTENDED PROPERTY DAMAGE 7'. WAIVER OrTRANSMER OF RIGHTS OFRECOVERY AGAINST OTHE09, TO US - 7 WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU, 02010 'Liberty MUtual InsurstideCompanv. All rights tbsetved. CG as 10 10 09 Includes -bopyr-Lighted m9fterf8l of blaurtifice Servildet bffloe, Ind., With its peerMssicri. Page 1 of 7 With respect to coverage afforded by this endorsement, the provisions of the policy apply-unless modified by the endorsement. A. NON. -OWNED AIRCRAFT Under Paragraph 2; Exclu'sioas of Sdotiod I - C.overage A - Bodily injury And. Property Damage Liability, exclusion g:- Aircraft, Auto Or Watercraft does not apply to an aircraft.provided: 1. It is not oWned by any insured;' 2. It Is hired, chartered or loaned with a trained paid crew; 8. The pilgt,in corrtrriand ,holds a currigntly effectfVe cerCfflcg #e, Issued by the duly constituted authority of the United States of>'lrrierica ov-C nacta designating• heP6t.hfiln-a commercial or -airline pilot; and' 4, It is ndt being used to corry.persons or property for a charge. However,. the insurance afforded'oy this provision does not.apply if there is available to the. insured other valid a.nd co)le0ible Insurance, whether primary, excess (othet than i6surdAce written to apply specifically in excess .0f this policy), .coritingent or oji• any other.basis, that would also apply to the loss covered under th is provision. B: NON -OWNED INATCRCRAFT- - ._, Under Paragraph2 :Exciusi6b0Lof_Sectig)!t[1___ -0- rageA_.Bodilyinjury And Property: Damage Liability,: Subparagraph (2) of exclusion g. Aircraft, Auto prlfateroraf#is repiaced.bythe fo116wii5g: This exolu_slon does: not Apply to:' (2): Awatercraft you. do not oWn tfi.a't is (a) Less than 52feet:iong; and {bj Not being used to carry persons or properly for a ohatge, C. PROPI fR'f'Y DAMAGE LIABiLiTr ELEVATORS T, Under Paragraph 2. Ex4lusloris of Seetian I Coverage A - Bodily injury And Property Damage Liabil- ity, Subparagraphs (3), (4) and' (6) of exclusion j. Damage: Ta Property do not apply It Wch "property damage" resuh,tg from: #.he use.gf el.e%ra.jurs..For the purp.ovd of this provision ,.elevators do not' include vehlele Ifl)'rt, Vehicle Tifts are lifts or h..oi'sts used in a>;i oniobne seivide or repalroperatioha. 2, -`}1e folioWing is atfdod to So_ctiog IV.'- Cold norpisi General Liability Conditions;. Condition. 4. Other lnsUrofte, Parag raph la, Ekcess frr.$ul>ral►ce; The insursi?ce eff dreled by thus pro.Visibn of this endorse't arwt is excess over any property Insurance, whethbr-paihiary, excess , cont ingentolroriAriyoiherbasis. ' D. EXTENDIW 0A.i111AGE10 PROPIc"RTY RENTED 7'0 'YOU (7enant`s Property Damage) If Darrlago'r.o Prern.ises Pe.nted TQ You is not otherwise excluded f'romthis Coverage Pdrt: 1. Under. Paragraph 2, EXLriu$iohs of Section 11- Cay$rage A - Soddy Injury and Ptopelrty Damage l:iatiifitjr: a. The fourth frorn tbp last paragraph of oxclusicin j.. Damage To Property l$. replaced by "the follovir 4- ir1g: Paragraphs.(1), (3) and (4) of this exclusion do not apply to "praperty'damage" (other than damage by,fird,k lightning, eXpl6sibn, Smoke, or leakage from an automatic fire protectlori.system) to: (i Premises rented to you for. a period 017 or feirver consecutive days; or (ii) Qo.nteiifs-that'you rent or (ease as part of a preml$es: rental or Cease agree..rrlent for a period of chore than 7 days. Porrpprapht (1), (31 ;end (4) of this exclusion do nol apply ttx "property damage" to contents of premises renter! to you for 8 period,of 7 oefewer consecutive days. A s2para#e< limit of insurance applies to this coverage as described in Sectibri III - Limits of Insurance. ®2010 Liberty Mutual Insurance Company. All rights reserved. CG 89 10 10 09 Includes copyrighted material of Insurance Services Office, Inc:, with its permission. Pago 2 of 7 b. The last paragraph of sum section 2. Exclusions: is- replaced by the 1.nlowifig: Exclusiohs c. through m do not apply to damage by fire, lightning, explosion, smoke or leake'ge from'automatic fire protection systems to ptom seswhile rented to you qr temporarily occupied by yo4 With perrnissian of the owner. Asepafate limit of Insurance applies to Damage To Piernises R:ehted To You as described in Section Ill - Limits Of insurance. 2. Paragraph & under Sectiori•.ljil • Limits Of Iiisi aK ddeis replaced by the following: 6. Subject to Paragraph. C: above, the t)ahlage To Prerhises Rented To You Limit is the.most we will pay underCoirerage A for damages because of "property damage" to: a, Any () While rentecito you; oi• (2) While rented' t6 -VdL. or- tofrigorarily'oecupled by'Vou With permission of the dWiier for damage, by fire, lighth.ing, eXplosion, smoke or leakage from automatic protection sys- tems. or - " - - b. Contents that Vdu rerii or lhas€as �p5ft of_a premises rertial or lease agreement, 3. As regards coverage provided; by. this prpyision D. EitTENOED DAMAGE TO POOPEriTY REIIITED TO YQU (Tenant's P'rttperty Damage) , Pa ragf'aph 9.;a. of Defiiritions is replaced with tike following.° :__ -. - -,. _ .. 9.a. A tontrae for a tease 15�ernl$es, i- iowever,. ((jet pprt�ion of'the contract for a lease of premises that indlot i.ii9fles atly person or orghnization foil do.rnag[0 by fire, lightning, explosion, smoke, or leakage, from dutorinatic fire protection systeiris 'to premises while rented to you or temporarily, occupied by you with the permission. of the owner, or for damage to contents-of sgrb: prerplges that are: Include in your premi$estental or isrdse ogreer lent, is n6 tan " insurei; co tract' "r .1~ 'MEDICAL PAYMENTS EXTENSION if Coverage C' Medical Payments is.not otherwise expluded, the Medical Payments provided by this policy are amendedasfol.. W — _._..... Under Paragraph 1. Insuring Agreement of Section I - Coverage C - Medical payrfieft S, $.u�paragrepll (0). of Piu[agraph-a, is replaced by the following; (b) The expenses are incurred and reported Within iWeeyeairS of the dare of the t?iccideilt . 8h F. EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND S 1. Uridee-Supplementary Payments -Coverages A and B, Paragraph 1.b. is replaced by the followings b. Up to $3,000 for cost of bail bonds required because of accidents of traffic lava vioiations a_ ,9tng out of the use. of any Vehicle to which the Bodily Injury Liability Coverage applied, We.do hot have tit famish thes ®bonds.. 2. Pamorap.h 1.d. is replaced by the following: d. All reasonable expenses incurred by the insured at o.Or request W assist us in the Chvestlgatibo or defense of the cialm or "suit ", including actual lost of,earnirtgs up to $500 a day because of time eff from work. G: ADDITIONAL AN811iAlEbS, BY CONTRACT, AGREEMENT ORIP18A 1 & 1. Paragraph 2.-"under Sec#loh II - Who is Art Insured is a.Mended to include as an. ii'isuted any person or organization Whim you have agreed to add as an additional insured In a written contract, written agreement or permit. Such person or organization is an $dditiopal insured but only vriith respect to liability for "bodily injury ", "property damage" or "persoTtai sold advertising injury" caused in whole or In part by: a. Your acts or orhisslons, oath° acts or oTnisslons of those acting on your behalf,. in the perforrinance of your oil goliig operations fof the additional jnsured that are the subject of tha written contract or written.agreement provided that the "bodily injury" or "property damage^ occurs, or the "per - .sonal and advertising injury" is committed, subsequent to the signing of such written contract or 'Written ag.reemght.' or 0'2010 liberty Mtnuai Insurance Company. All rights reserved. CG 88 10 10 09 Iricludes copyrighted material oflnsurance Services Offibe.'lrtc., with its perriiissiun. Page 3 of 7 b. Premises or facillt._j rented by you or used by you; or c. The maintenance, operation. or use by you of,equipment rented or leased to you by such person or organization; or d. Operations .performed by you or on your behalf for which the state or political subdivision has issued a permit subject to the following additional pr(?visitan$: .('1) This insurance.¢oeS.not apply to "bodily injury", "property damage ", or "personal .and ad- . vertisirig injery" arising opt of the operab ns per#orrited for the state or political subdivision; (2) This insurance does hot apply to "boti±iy injury" or " property damage" included within the 'c.9ropleted operatlons. hazeird'', . -• - • -- -.. _ _ ..__.._.... - -- • - =7. 13) ihsurance app[las tor.LreTrlfat'S ybu p*p.F rent, or.eohtrol but only with respect to the tilloVrring hazards: .. .._._._ ..._:... .:.. _: - -- (a) The dkistenc'e, fn ifhtenanca, repa.irt eahWti tion, drection; or removal of adv@rU$.ing - - -. - - - -- signs, awrnIn9s, ..cahoplesz cellar - 611tr6rices; Qoal hole §. dr)veways; matlhtiles� rilarOyees, hoist away. openings, sidewalk vaults, street banners, or decorations 'and similar expo- sures: or - :.. _.... (b) The construction, erection, or rem¢V141 of elevators; or c i he awhershi ; maintenance, or use of any elevators covered by this.!n's'uranee. With respect to Paragraph' 1.a. above, a person.'s or organization's status as an adc itionbl insured - - - -under this endorsamentendswhen _._...__.... _.. - - -• . -- - - -- .......... . (1) All work, including materials, parts or equipment furnished In conneption with such work, on the project (othet than servlce, lnaiintenarice or repairs) to be performed by or on behalf otthe additional insureds) at the location of the covered operations has been c - rnpleted; or (21 That portion of-J'your- work" obt of wbiph - the irijury or damage arises hi3s been put to its Intended use by any persah or tiryiirlization other than. another coritractor or subcontractoi engaged in performing operations fora principal as a partafthe same project. With respect to Paragraph 1.b. above, a person's or organization's status as an bdditional insured under this endorsement ends when their written contractor written agreement with you for such Premises orfacillties ends. With respects to Paragraph 1.c. above, this insurance doe$ not applyto.any "pgcurrence." which takes place after the equipment rental or lease agreeient lily exp)ritcj ZyF you hays returned such equipment to the lessor. The Insurance provided by this endorsernerit applies only if the. written contract. or wrtten-agreem.e.ht assigned prior to: the "bodily injury" or "property damage ". We have no duty to defend an addii.ronal insured under this endorsement until we receive• written notice of a "suit" by the additional rrisured as required in Paragraph b. of Condition 2. Duties In the veiit Of Occurrence, Offense, Claim Or Suit under Section. IV CotzCmercipl Qerferal Liability Condi- tibri5. 2. i11 0h respect to the Insurance ptavided by this endorsement; tfie folloviiIng are added to Parag.rapli 2. Exclusions underSection 1- Coverage A - Bodily Injury ✓end Property Damage Liability: This insurance does not apply to: a. " 9odily injury" or " properrty damage" arising from the sole. negligence of the additional insured.. b. "Bodily injury" or "property damage" that occurs prior to. you eprnmencing operations at the location where such "bodily'Injury" or "property damage" occurs; a "Bodily injury ", "property.darnage" or "personal and advertising Injury" arising out of the render- ing of, or the failure to render, any professional architectural, engineering or surveying services; Including: 02014 Liberty Mutual Insurance Company. All rights res&rV43d. CQ 88 1.0 10 69 includes• copyrighted material of Insurance Services office, Inc., with Its permisslgn. Page 4 of 7 (1) The preparing, ap, ving, or falling to prep6re or approve, .,ps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications, or (2) Supervisory, inspection, architectural orengineering activities. d. "Bodily injury" or "property damage" occurring after: ('{) All work, Including materials, parts or equipment furnished In connection with such Work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additioryfll iriSpred(s) at the location ofthe cflvered Qperations has been completed; or. (2) That portion of "your work" out of which the injury or damage arises .has been put- to its Intender] usO. by any person or organization other than arjother- ooriteactor or subeonfraetor engaged..in performing operations for a.prihcipal as a part of the same project. e. Ariy person of organization specificallyr designated as am additional irisured for 6iio.oing operatioiis by a separate ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTQRS 0:m6ft6hierit Is- sued by us and made apart of this policy. H. PRIMARY AND NON - CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applids to any person or or6aniz6ti6ft who quill at es an-additional insured under any form or,endorsement.under this policy.. __ .. .... _. Condition 4. Other Insurance of SECT16N IV - C.OMMERCIAL GENERAL. LIABILITY CONDITIONS is amend. ed as follows: a.. Thefollowing is addedto Paragraph a..Primary:insurance: If an additional Insured's policy has an Other insurance provision making its policy excess, and'you have;tgreed in a Written contract or yVritt'er< agreeritient to proKide tiie additional iitsu.'red coverage on a lir�mary and. noncontributory basis, this: polieV shall be prirnarV antl'vVe will not seek co6tribution from. ... -- - - - -`— tjid.aciditional insured'•s pollcyfor damages inie cover; b, Tha following is added to Paragraph b. Exeess - IhsWraned: 1Nheh.0 Written' contract or written agreemerit, other than a pie1ni$es iea$e, facilities rental contract or agreelileritr ph equipment rental or lease coritract or agreement;. or permit issued by a state or yioliticai subdivision between you and an additional insured does not require this• insurance to be primary or primary and non - contributory, this ingu:rance is OXcess over any other insurance for which the pddi- 6bhol %iYsurod is designated as a Named insured: Regardless- of the written. tigreelileht between yoq and an additional irl.50redi this insurance is oi(cess dyer shy other insurance Whether primary, excess„ conflrigeiit br o.h Ady other basis for which the additional insured has been added as anadditional insured on other policies. L ADDITIONAL INSI.PIRED6. EXTENDED PROTECTION OF YOUR "LIMITS OF IN$URANCE" This provision applies to any person or organization who qualifies as an- additional insured under any form or endgrsementunder this policy. 1. The following Is added to Condition 2. Durties In The Event. Of Oceurreace, Offense, Claim or Suit, An additional insured under this endorsement will as soon as practicable: ar Give written notice of an "occurrence!' or an offense: that may result in a claim or. "suit" under this insurance to us; b Tender the defense and indemnity of any claim or ",suit" to pll insurers whom also have Insurance available to the additional. insured; and c. Agree to make available any other insurance which the additional in$Qred has for a loss we cover under this Coverage Paris. 02010 Liberty Mutual Insurance Companyti All rights reserved. CG 88 lo lo o9 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 7 d. We have no . .y.'to defend or indemnify ah addttfona. cured under this endorsement until we recdlVp written notice of a "suit'•' by the additional Insured. 2. The limits of lnsurainjie 6ppiicable to the additioral Insured are those specified in a written contract of written agreerher`It or the limits of. insurance as stated in the beclaration$ of this policy and defined in Section 111 - Limits- of Insurance of 16is polic,?, Whlchever are. less. These limits are inclusive of and not in additfoh to the lirnits.of insurance available under this policy. J. ..WHO 1S All INSURED- INCIDENTAL MEDICAL ERRORS I MALPRACTICSI WHO IS AN INSURED - FELLOW EMPLOYEE FXTE.'NMON, MANAGEMENT EMPLOYEES Paragraph 2.a.(1):of'Seci1on It - Who is An Insured is replaced with the following: y uy" or a Injury"- - Bodnj (a) To your to your partners-dr=niembers (if you area partnership or joint ventore) f to your nle.Mbers: {ft you ara.a limited liability corrlpbny), to a co- "employee" while in the course of his or her employ- fnent or 'perforrrifrlg duties related to the conduct of your business, or to your other "volunteer Wo.rkers^' while pdtforming duties relatedtothe conduct ofyourbusiness; (b T.b the spouse, cbild" _parent, brother or sister of that co- "erployee" or "volunteer worker" as a. consequence of Paragraph'(1) (al above, (c) For.Which..thera ft_ an)Lobjigation -to -share dam'agas -with or f0pay. sohieone else who must pay damages because of'th6 injury described- ln'Paragrpp'lis.(1j (a) or (h) abgve; or (d) Arising out of his or her providing orfailing to provide professional Health eare.servlces. However, if you are not.in- the. bu$iness.Of providing professional health care services or providing profes- slonal health care personnof tO others, br if govefage for providing professional health care ser- vicWrTs not othotWlse eXokided by separate endorsement, this provision (Paragraph (d)) does not apply. Paragraphs (aj and (b) ab6ve do.hot applyto- "bodily Injury "' or "'personal and advertising Injury" caused by an "employee's who is actfng in a supervisory capacity for you. •S1Upervisorjr capacity as used herein means the "employee's" job respbnsibilWes assigned by-you, includes the direct supervision of other "employ- ees" of yowsii, Howevo'r„ n6n6 of these. "employees." are insureds for "bodily Injury" or "personal and advertising Injilry" arising but of their willful conduct, which is defined as the purposeful or willful fntent<to cause "bodily, Injury" or "personal and advertising injury", or caused in whole or in part by their intoxica- tion by liquor or controlled substances: The coverage provided by prgvlslon J, is excess over any other valid and collectable insurance available to your "employee'': K. NEWLY FORMED OR 4001TI.DNALLY ,j-IWWRED ENTiTI)`S Paragraph 1 of Section li - Whoa Is An los.ured is replaced by this following: 3. Any organization you newly acquire or foi'fn arid over which yciL maintain owtiershfp or majority interest, will qualify as- a Named Insured If fFiere is no other similar insurance available to that organization. However; a. .Coverage tinder this provision is afforded only until the expiration of the policy period In Whic.11 the entity was acquired or•formed by you; b. Coverage °A does hot apply to "bodily ifijury" or "property damage" that occurred before you acquired. or formed the organization; and c. Coverage B does not apply to "persoh4l and advertising, injury" arising out of an offense committed before you acquired or formed the organlzation, d. Raddrds. Arid descriptions of operations must be maintained by the first Named Insured. No person or organization is ah insured with tespect to the conduct of any current or past partnership, joint venture or limited IlabilRy company that is not shown as a Named Insured in the Declarations or qualif ?es as-an insured under this provision. 02010 Liberty Mutual Insurance Cc'mpany. All rights reserved. CG 88 10.10 09 In eludes copyrighted material of Nisu ran cd Service's Office,. In a., with. Its permission. Page 6 of 7 .L. FAILURE TO DISCLO$E HAZAR_ . AND PRIOR OCCURRENCES Under Section IV - Commercial General Liability Conditions, the following iS added to Condition 6. Repro;, sentatians: Your foiluro to disclose all hazardg or prior "Occurrences" existing as of the inception date of the policy shall not pCejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior "Occurrences" is not intentional. Mi KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT Urider Sedtlon 11V � Commercial deneral Liability Conditions, we following is Wed to Cohdition 2,. Duties In The Event of Occurrence, Offense;. Claim Or Suit: Knowledge of an• "occurregce "; offerise, cairn or "suit" by an Agent, servant of "employee" of a.ny insured•shall not in lt$i lfconstitute knowledge ofthe fnsuretl unless a:ri. ifisuted liatod under Paragraph 1. of Sectidii Il': Who 1s Ah Insured ore. pe'rsOn who has been designated bythem to receive reports of "oddU.rt6nce$ ",. -offenses,. claims. or "suits" she]] have received such -ngtic.s ft'ohn the agent, servant or "employee ". N. LIBERALIZATION CLAUSE rare revrse'tfiis commercial Gefieral Liability Faifeinsio'r indorsement fo prQVfde•r'rloro coverage v+iithobt*"'*• additional premium charge, yourpolicy v�iil automatically provide the coverage as of'th6 dtythe revision is- effective In your state. Q. BODILY'INJURV FtEbEFJNED Under Section- V - Definitions, Definition 3. is replaced by the following: 3. "bodily Injuxkr" means physical injury, sickness or disease sustained by a personr This Incritdes _ __..... Toetital. anguish, mental injury, shock, fright or death that results from such physical Injury; sick- ness or disease. P. WENDED PROPERTY DAMAGE Exclus-joK a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the fol:lowLnv a. Expected'Or Intended injury "Bodily if►jury" or °property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or'rproperty damage" rasufting from the use of reasonably force to protect persons onproperty, Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTEiERS TO QS �6 WHEN REQUIRED IN A CONTRACT OFtACaRI;EMENT WITH YOU Under $action .W - Commercial General Liability Conditions, 'the following Is add6d'to Condition 8. Yeans- fes Of Rightts Of Recovery Against OtherS Y9 Us: We Walvis any right of'recdvery wo rinayhave againsta person or brgenizatlon because of payments we make- for Injury or damage arising out of your ongoing operations or "your work" done under a .contract with that person or organization and Included in the "products- corrlpjeted operations hazard" provided-,. t. Ybu and. that person or organization have agreprl in wrltlngr in a contrlct or agreement that you waIva sock rights against that person or organization; and 2: The.ihjury or damage occurs subsequent to the eXecation of the written contract or writteh agree- ment. 62010 Liberty Mutual Insurance Company. All rights reserved. CG 88 10 1609 16ciudes copyrighted inat6r7al of In'sursnce Services Of oe, Inc., with its permis.$ion. Page 7 of 7 COMMERCIAL GENERAL LIABILITY CG 88 60 12 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EACH LOCATION GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. For all sums which the insured becomes legally obligated to pay as damages caused by 'occurrences" under Section I - Coverage A - Bodily Injury And Property Damage Liability, and for all medical ex- penses caused by accidents under Section 1 - Coverage C Medical Payments, which can be attributed only to operations at a single "location" owned by or rented to you: 1. A separate Each Location General Aggregate Limit applies to each "location ", and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Each Location General Aggregate Limit is the most we will pay for the sum of all damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products- completed operations hazard ", and for medical expenses under Coverage C regard- less of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits ". 3. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Each Location General Aggregate Limit for that "location ". Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Each Location General Aggregate Limit for any other "location ". 4. The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Each Location General Aggregate Limit. B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I - Coverage A - Bodily Injury And Property Damage Liability, and for all medical ex- penses caused by accidents under Section I - Coverage C Medical Payments, which cannot be attrib- uted only to operations at a single "location" owned by or rented to you: 1. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products - Completed 9 Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Each Location General Aggregate Limit. C. When coverage for liability arising out of the "products- completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" included in the "products - completed operations hazard" will reduce the Products - Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Each Location General Aggregate Limit. D. For the purposes of this endorsement, the following definition is added to Sectio n V - Definitions: "Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right -of -way of a railroad. E. The provisions of Section III - Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated. CG 88 60 12 08 Includes copyrighted material of ISO Properties, Inc., with its permission. Page 1 of 1 BIGSK -1 OP ID: CM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 08/23/2013 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 statementon this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Phone: 208-336-7733 Associated Insurance Svcs LLC Fax: 208- 336 -0376 P 0 Box 16410 Boise, ID 83716 Clint Paskewitz NAME; GOON o EtI FAX No NAP ADDRESS: INSURERS, AFFORDING COVERAGE NAICA INSURER A: Associated Loggers Exchange 37370 INSURED Big Sky Development, Inc. 10063 Navion Drive Hayden, ID 83835 INSURER E: INSURERC: $ INSURER O: $ INSURER E COMMERCIAL GENERAL LIABILITY INSURER F : CAVFPAnFA CFRTIFICOTF NIIMRFR! 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 TYPE OF INSURANCE POLICY NUMBER MM/DDn Y MWDWYYYI' LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RFNTLIT PREMISES Ea occurrence $ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F-1 OCCUR MOD EXP (Anyone person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ $ POLICY PRO- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ H REDAU70S NON -OWNED AUTOS UMBRELLALIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS UAB DEB I I RETENTION$ S A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA ALE6028 -13 07!01/2013 0710112014 X WC STATU OTH- E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE -EA EMPLOYE- S 1,000,00 If yyees desor�e under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace Is required) State of Idaho Benefits Elective Coverage: None Re: 14th Avenue Stormwater Upgrade Project CITYSP2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF SPOKANE VALLEY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PUBLIC WORKS DEPARTMENT STORMWATER UTILITY AUTHORIZED REPRESENTATIVE 11707 E SPRAGUE AVE, STE 106 SPOKANE VALLEY, WA 99206 ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD SUPERIOR COURT OF WASHINGTON FOR SPOKANE COUNTY In the Matter of: ADVERTISEMENT FOR BIDS City of Spokane Valley Public Works Department Bid # 13 -034 14th Avenue Stormwater Upgrade STATE OF WASHINGTON )SS. County of Spokane ) Im AFFIDAVIT OF PUBLISHING NOTICE MICHAEL HUFFMAN , being first duly sworn on oath deposes and says that he is the EDITOR of The Spokane ValleyNewsHerald, a weekly newspaper. Thatsaidnewspaperis a legalnewspaperand itis now and hasbeenfor 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 2nd day of August, 2013 and ending the 9th of t 1 all kes ' usive, and that such newspaper was regularly distributed to its subscribers during all of said perio �_ ADVERTISEMENT FOR BIDS CrLI VALLEY PUBLIC WORKS DEPARTMENT SOKC-911BED and RN to before me BID # 13-M 14th AVENUE STORMWATER this 9th day of August. 2013. UPGRADE Notice is hereby given that the City of Spa- 0.1111 t i l l State of Washingtton kane Valley, Spokane County, Washington, %% b` will accept sealed bids forth. 14th AVENUE ��` n AE Syl/ /// County of Spokane STORMWATER UPGRADE. The proj" consists of installation of an underground 'II piped stormwater conveyance system and • c� \ON EXp j�•., I certify that I know or have satisfactory evidence that street improvements for. 14M Avenue be- _c` Fs °; °v Michael Huffman is the ersonwho appeared before tweed Custer Road and Carnahan Road. /•� ® p lip Copies of the bid packet including specig- A P :;me, and said person acknowledged that he signed cations and plans maybe obtained in one '� ; Z :{his instrument and acknowledged it to be his free format by downloading from the Spokane 7 • N® g Valley FfP site. To obtain the FTP site Q��`1G d ;and voluntary act for the uses and purposes men - passwodiand stcontitabidfortMsprojpo_ °% �, �tioneq m the instrument. Con VartosmustcontactDade Arnold, S i or by Valley Public WOrks ,at509.7205003 �'1 6/ °� '► /7� or by email at damold ®5pokarrevapey -org, %x•O•.� `�1��•° �` - C(Y/ J`.� \ \r Monday through Friday from 8:00 a.m. to 9 • . $� • ��� 5:00 p.m. Contractors will then be placed // �F c on the City's Plan. 1.1 list. Any addenda // OF ort toth Jolene Rae Wentz iamjaidw'Ilbe Rae ntonlytothose listed list, //0/1111f1���` I All bids must be accompanied by a bid All Notary Public deposit in the form of a surety bond, postal My appointment expires: 5 -16 -15 money order, cash, cashierb check, orcerti- tiied check in an amount equal to five percent (5 %) of the amount of the bid proposed. Failure to fumish a bid bond in compliance with the City's bid deposit surety bond fond 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 108, Spokane Valley, Washington, 99206, and received not later than 10:30 a.m. PSOT, Friday, August 16, 2013. The bids will be opened immediately thereafter and read aloud in the City Council Cham- bers, Suite 101. Bid results will be posted that afternoon on the City's website. The City of Spokane Valley reserves the right to waive any irregularities or infor- malities and to reject any or all bids. No bidder may withdraw his bid after the time announced forthe bid opening, or before the award and execution of the contract, unless the award is delayed for a period exceeding sixty (60) days. PUBLISH: Spokane August 2 and August 9,2013 Chdslin. Balnbddge, MMC Spokane Valley City Clerk 812, 819 ADVERTISEMENT FOR BIDS CITY OF SPOKANE VALLEY PUBLIC WORKS DEPARTMENT BID # 13 -034 14th AVENUE STORMWATER UPGRADE Notice is hereby given that the City of Spokane Valley, Spokane County, Washington, will accept sealed bids for the 14th AVENUE STORMWATER UPGRADE. The project consists of installation of an underground piped stormwater conveyance system and street improvements for 14th Avenue between Custer Road and Carnahan Road. Copies of the bid packet including specifications and plans may be obtained in PDF format by downloading from the Spokane Valley FTP site. To obtain the FTP site password and to submit a bid for this project, Contractors must contact Darla Arnold, Spokane i Valley Public Works, at 509 - 720 -5003 or by email at da rnold @s ookanevallev.ore, Monday through Friday from 8:00 a.m. to 5:00 p.m. Contractors will then be placed on the City's Planholder's list. Any addenda to this project will be sent only to those listed on the Planholder's list. 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 10:30 a.m. PSOT, Friday, August 16, 2013. The bids will be opened immediately thereafter and read aloud in the City Council Chambers, Suite 101. Bid results will be posted that afternoon on the City's website. 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. PUBLISH: Spokane, August 2, and August 9, 2013 Christine Bainbridge, MMC Spokane Valley City Clerk SR26501 "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. SR26501 No. Lines: 42365 81 Total Cost: $691.02 1 Order No. 132433 I, Jean Robinson 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: August 2 & 9, 2013 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 9th day of August , 2013. r07\ssso L VIN ta- Public in and for the State of Washington, residing at Spokane County, Washington Notary Stamp VC;l4 -(i Paper Affidavits