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HomeMy WebLinkAbout5467Contract Number: Vendor: Subj ect : Department: File Class: Begin Date: End Date: Review Date Vault Date: 5467 BELL PAINTINGS AND COATINGS GSA - Reservoir 10 North - Interior Coating Replacement Engineering LEG 12-1 3/13/2015 7/11/2015 7/31/2015 2016 Comments: GOODS AND SERVICES AGREEMENT THIS AGREEMENT, is entered into between the City of Bremerton, a �1�'ashington Municipal Corporation ("City"), and Bell Painting and Coatings ("Vendor"), whose mailing address is: 7205 No. 25` Street, Tacoma, WA 98406 The parties agree as follows: 1. VENDOR SERVICES. The Vendor shall provide the following goods and materials and/or perform the following services for the City: Scope: Inspection for surface preparation, coating application, and quality assurance testing for the interior coating replacement at Reservoir 10 North by a NACE Level 3 Inspector. See Exhibit A for further description of the scope of work. Exhibit A is incorporated by reference herein. 2. TIME OF COMPLETION. Vendor shall complete the work and provide all goods, materials and services within 120 calendar days from the date all parties have signed this Agreement. 3. COMPENSATION. The City shall pay the Vendor the total amount of $8483.50, which includes applicable Washington State Sales Tax, for the goods, materials and services contemplated in this Agreement. See attached Exhibit A for hourly rates, estimated mileage costs, and other miscellaneous costs. Work shall be invoiced based on actual hours worked but shall not exceed estimated hours in Exhibit A unless authorized by the City. 4. DEFECTIVE AND UNAUTHORIZED WORK. The City reserves its right to withhold payment from Vendor for any defective or unauthorized goods, materials or services. If Vendor is unable, for any reason, to complete any part of this Agreement, the City may obtain the goods, materials or services on its own or from a third party, and Vendor shall be liable to the City for any additional costs incurred by the City. "Additional costs" shall mean all reasonable costs, including legal costs and attorney fees, incurred by the City beyond the maximum Agreement price specified above. The City further reserves its right to deduct the cost to complete this Agreement, including any Additional Costs, from any and all amounts due or to become due the Vendor. 5. INDEPENDENT CONTRACTOR. Contractor is and shall be at all times acting as an independent contractor and not as an employee of the City. The Contractor shall secure at its expense, and shall be responsible for all payments of income tax, social security, state disability insurance compensation, unemployment compensation, and all other payroll deductions for the Contractor, officer, agents, employees and sub-contractors. The Contractor shall also secure all applicable business licenses, if required, in connection with the contract services, including all required licenses for Contractor's officers, agents, employees and sub-contractors. 6. TERMINATION. The City may terminate this Agreement for good cause. "Good cause" shall include, without limitation, any one or more of the following events: A. The Vendor's refusal or failure to supply a sufficient number of properly skilled workers or proper materials for completion of this Agreement. B. The Vendor's failure to complete this Agreement within the time specified in this Agreement. C. The Vendor's failure to make full and prompt payment to subcontractors or for material or labor. Goods and Services Agreement Page 1 March 2015 Bell Painting and Coatings D. The Vendor's failure to comply with federal, state or local laws, rules or regulations. E. The Vendor's filing for bankruptcy or becoming adjudged bankrupt. If the City terminates this Agreement for good cause, the Vendor shall not receive any further monies due under this Agreement until the goods, materials, and services required by this Agreement are completed and fully performed by the City or a third party of the City's choosing. 7. CHANGES. The City may issue a written change order for any change in the goods, materials or services to be provided during the performance of this Agreement. If the Vendor determines, for any reason, that a change order is necessary, Vendor must submit a written change order request to an authorized agent of the City within fourteen (14) calendar days of the date Vendor knew or should have known of the facts and events giving rise to the requested change. If the City determines that the change increases or decreases the Vendor's costs or time for performance, the City will make an equitable adjustment. The City will attempt, in good faith, to reach agreement with the Vendor on all equitable adjustments. However, if the parties are unable to agree, the City �vill determine the equitable adjustment as it deems appropriate. The Vendor shall proceed with the change order work upon receiving either a written change order from the City or an oral order from the City before actually receiving the written change order. If the Vendor fails to require a change order within the time allowed, the Vendor waives its right to make any claim or submit subsequent change order requests for that portion of the contract work. If the Vendor disagrees with the equitable adjustment the Vendor must complete the change order work; however, the Vendor may elect to protest the adjustment as provided below: A. Procedure and Protest bv the Vendor. If the Vendor disagrees with anything required by a change order, another written order, or an oral order from the City, includin� any direction, instruction, interpretation, or determination by the City, the Vendor shall: l. [mmediately give a signed written notice of protest to the City; 2. Supplement the written protest within fourteen (14) calendar days with a written statement that provides the following information: a. The date of the Vendor's protest. b. The nature and circumstances that caused the protest. c. The provisions in this Agreement that support the protest. d. The estimated dollar cost, if any, of the protested work and how that estimate was determined. e. An analysis of the progress schedule showing the schedule change or disruption if the Vendor is asserting a schedule change or disruption. L � 3. The Vendor shall keep complete records of extra costs and time incurred as a result of the protested work. The City shall have access to any of the Vendor's records needed for evaluating the protest. The City will evaluate all protests, provided the procedures in this section are followed. If the City determines that a protest is valid, the City will adjust payment for work or time by an equitable adjustment. No adjustment will be made for an invalid protest. Vendor's Dutv to Complete Protested Work. In spite of any protest, the Vendor shall proceed promptly to provide the goods, materials and services required by the City under this Agreement. Vendor's Acceptance of Chanees. The Vendor accepts all requirements of a change order by: ( I) endorsing it, (2) writing a separate acceptance, or (3) not protesting in the way this section provides. A change order that is accepted by Vendor as provided in this section shall constitute full payment and final settlement of all claims for contract time Goods and Services Agreement Page 2 March 2015 Bell Painting and Coatings and for direct, indirect and consequential costs, including costs of delays related to any work, either covered or affected by the change. D. Failure to Protest Constitutes Waiver. By not protesting as this section provides, the Vendor also waives any additional entitlement and accepts from the City any written or oral order (including directions, instructions, interpretations, and determination). E. Failure to Follow Procedures Constitutes Waiver. By failing to follow the procedures of this section, the Vendor completely waives any claims for protested work and accepts from the City any written or oral order (including directions, instructions, interpretations, and determination). 8. CLAIMS. The Vendor shall give written notice to the City of all claims other than change orders within fourteen (14) calendar days of the occurrence of the events giving rise to the claims. Any claim for damages, additional payment for any reason, or extension of time, whether under this Agreement or otherwise, shall be conclusively deemed to have been waived by the Vendor unless a timely written claim is made in strict accordance with the applicable provisions of this Agreement; or, if (and only i fl no such provision is applicable, unless that claim is set forth in detail in writing and received by the City within seven (7) calendar days from the date Vendor knew, or should have known, of the facts giving rise to the claim. At a minimum, a Vendor's written claim must include the information set forth regarding protests in Section 6(A)(2)(a)-(e). FAILURE TO PROVIDE A COMPLETE, WRITTEN NOTIFICATION OF CLAIM WITHIN THE TIME ALLOW�D SHALL BE AN ABSOLUTE WAIVER OF ANY CLA[MS ARISING IN ANY WAY FROM THE FACTS OR EVENTS SURROUNDING THAT CLAIM OR CAUSED BY THAT DELAY. Vendor must, in any event, file any claim or bring any suit arising from or connected with this Agreement within 120 calendar days from the date the contract work is complete. 9. WARRAIVTY. The Vendor shall correct all defects in workmanship and materials within one year from the date of the City's acceptance of the Contract work. When defects are corrected, the warranty for that portion of the work shall extend for one year from the date such correction is completed and accepted by the City. The Vendor shall begin to correct any defects within seven (7) calendar days of its receipt of notice from the City of the defect. If the Vendor does not accomplish the corrections within a reasonable time, the City may complete the corrections and the Vendor shall pay all costs incurred by the City in order to accomplish the correction. 10. INDEMNIFICATIOIV. Vendor shall defend, indemnify and hold the City, its officers, officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or suits, including all legal costs and attorney fees, arising out of or in connection with the performance of this Agreement. Vendor's obligation to indemnify shall not extend to that portion of damages caused by the City's sole negligence. The City's inspection or acceptance of any of Vendor's work when completed shall not be grounds to avoid any of these covenants of indemnification. Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.1 I5, then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the concurrent Goods and Services Agreement Page 3 March 2015 Bell Painting and Coatings negligence of the Vendor and the City, its officers, officials, employees, agents and volunteers, the Vendor's liability hereunder shall be only to the extent of the Vendor's negligence. IT IS FURTI-LER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THIS INDEMNIFICATION CONSTITUTES THE VENDOR'S WAIVER OF IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF TH1S INDEMNIFICATION. TH.E PARTIES ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER. The provisions of this section shall survive the expiration or termination of this Agreement. 11. INSURANCE. The Vendor shall procure and maintain for the duration of this Agreement, insurance against claims for injuries to persons or damage to property that may arise from or in connection with the performance of the Contract work by the Vendor, its agents, representatives, employees or subcontractors. Before beginning work on the project described in this Agreement, the Vendor shall provide a Certificate of Insurance evidencing: 1. Automobile Liabilitv insurance with limits no less than $I,000,000 combined single limit per accident for bodily injury and property damage; and 2. Commercial General Liabilitv insurance written on an occurrence basis with limits no less than $1,000,000 combined single limit per occurrence and $2,000,000 aggregate for personal injury, bodily injury and property damage. Coverage shall include but not be limited to: blanhet contractual; products/completed operations/broad form property damage; and employer's liability. 3. Professional Liabilitv: Insurance with limits no less than $1,000,000 per occurrence/claim. Any payment of deductible or self insured retention shall be the sole responsibility of the Vendor. All required policies shall be provided on an "occurrence" basis except professional liability insurance (if required), which shall be provided on a"claims-made" basis. The City shall be named as an additional insured on the Commercial General Liability insurance policy, as respects work performed by or on behalf of the Vendor and a copy of the endorsement naming the City as additional insured shall be attached to the Certificate of Insurance. The City reserves the right to receive a certified copy of all the required insurance policies. The Vendor's Commercial General Liability insurance shall contain a clause stating that coverage shall apply separately to each insured against whom claim is made or suit is brought, except with respects to the limits of the insurer's liability. The Vendor's insurance shall be primary insurance as respects the City and and it shall be an affirmative obligation upon Vendor to advise the City's Risk Manager by fax at (360) 473-5161, or by certified mail, return receipt requested to City of Bremerton, attn: Risk Management, 345 6` Street, Suite 600, Bremerton, WA 98337 within two days of the cancellation, suspension or substantive change of any insurance policy set out herein, and failure to do so shall be construed to be a breach of this Agreement. Goods and Services Agreement Page 4 March 2015 Bell Painting and Coatings The City also reserves its unqualified right to require at any time and for any reason, proof of coverage in the form of a duplicate of the insurance policy with all endorsements as evidence of coverage. 12. MISCELLANEOUS. A. Licenses and Taxes. Vendor shall possess a current Bremerton Business License and any regulatory license required to fulfill Vendor's obligations under this contract. B&O taxes shall be paid when due, and Vendor, by this agreement, assigns any payments due under this contract to the City Clerk for payment of such taxes which have been declared delinquent. B. Conflict and Precedence. ln the event of a conflict between the contract documents, the document which rates higher on the following list shall take precedence: 1. Addenda, if any, 2. Contract, 3. Specifications, 4. Terms and Conditions, 5. Contractor's proposal. C. Documents Incorporated bv Reference. The following documents are incorporated by reference, to include, but not be limited to: 1. Terms and Conditions, 2. Specifications, 3. Proposal, and 4. Non-Collusion Affidavit. D. Use of Photo�raphs and Ima� Vendor shall not use or distribute photographs or images depicting City officials, personnel, property, or equipment whether prepared by Vendor or provided by City without prior written consent of the City. The City will not unreasonably withhold its consent. E. Nondiscrimination. In the hiring of employees for the performance of work under this Agreement the Vendor, its subcontractors, or any person acting on behalf of Vendor shall not, by reason of race, religion, color, sex, sexual orientation, national origin, or the presence of any sensory, mental, or physical disability, discriminate against any person who is qualified and available to perform the work to which the employment relates. F. Complia�ce with Laws. Vendor shall comply with all federal, state and local laws, rules and regulations tliroughout every aspect in the performance of this Agreement. G. Work Performed at Vendor's Risk. Vendor shall take all precautions necessary and shall be responsible for the safety of its employees, agents, and subcontractors in the performance of this Agreement. All work shall be done at Vendor's own rish, and Vendor shall be responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with the work. H. Governin Law. This Agreement shall be governed and construed in accordance with the laws of the State of Washington. If any dispute arises between the City and Vendor under any of the provisions of this Agreement, resolution of that dispute shall be available exclusively under the jurisdiction, venue and rules of the Kitsap County Superior Court, Kitsap County, Washington. Goods and Services Agreement Page 5 March 2015 Bell Painting and Coatings Attorne, '�. In any claim or lawsuit for dama�es arising from the parties' performance of this Agreement, each party shall be responsible for payment of its own legal costs and attorney's fees incurred in defending or bringing such claim or lawsuit; however, nothing in this subsection shall limit the City's right to indemnification under Section 9 of this Agreement. K. L. M N. Written Notice. All communications regarding this Agreement shall be sent to the parties at the addresses listed below, unless otherwise notified. Any written notice shall become effective upon delivery, but in any event three (3) calendar days after the date of mailing by registered or certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this Agreement. Notices to be sent to: VENDOR: Attn:Autie Bell Bell Painting and Coatings 7205 N. 25` St Tacoma, WA 98406 Notices to be sent to: CITY: Attn: Bill Davis City of Bremerton 3027 Olympus Drive Bremerton, WA 98310 Assi n�. Any assignment of this Agreement by the Vendor without the written consent of the City shall be void. Modification. No waiver, alteration, or modification of any of the provisions of this Agreement shall be binding unless in writing and signed by a duly authorized representative of the City and Vendor. Severabilitv. If any one or more sections, sub-sections, or sentences of this Agreement are held to be unconstitutional or invalid, that decision shall not affect the validity of the remaining portion of this Agreement and the remainder shall remain in full force and effect. Entire A�reement. The written provisions and terms of this Agreement, together with any attached Exhibits, supersede all prior verbal statements by any representative of the City, and those statements shall not be construed as forming a part of or altering in any manner this Agreement. This Agreement and any attached Exhibits contain the entire Agreement between the parties. Should any language in any Exhibit to this Agreement conflict with any language contained in this Agreement, the terms ofthis Agreement shall prevail. Goods and Services Agreement Page 6 March 2015 Bell Painting and Coatings It�� �VITT'ESS Vt%HEREOF, the parties below fiave executed this Agreement. VENDOR: Bell Painting and Coatings By ', � (signature) Print Name: �C�r �C� /J Q / � C1TY: City of Bremerton sy' �Y� (signature) Print Name: (` �[�.,� �p..,r Eiv1 �ts: �_ Date: 3 • 9 - /S APPROVE AS Ta FOR�19• ay: i Breme on ity Att mey A S City Clerk its: ���ec_1 . PW � t�. � �a�e: 3-► 3- I s Goods and Serrices A�cement Pagc 7 March 2015 E3ell Painting and Cuatings � EXHIBITA ��; ; � � AL . , __�..... _ ...... ... . . .. _...._ ... ._. .. ._... .._ . . ._.....� ... .... Bcll Painting �nd Coatin Js ; 2�6 �: 2�t1: St T':;:�ma VV,=. 98.GS ' Phcre 20G 94' Gi,SG FAX 253 472 43:;1 � Autie:��;i�el�p�ir:'tyanticc��°. r,g; cx;rr� , :;1:� - :�it,i - R C;IT7 ;'!! izF?I '�Ti)�: .. � t t:±... ._ ... 2%15�2:3� ;'. , �.�i� ::....�.:.[;i�i't�3 ...,. °o�v;°�;.!s r_r •:-r "i� rr5i��. .:L i- �: ���rx=�; c�r . .=•s�;�x; .:.ra :%i;31 C ' v,^,Vc .':�� a -'3 2J ! 2 • r � �:_! �...�,,: . _. : T R�3[`: ':-i;. I. "J�:'%T�i i`�iEhi�;;F: �,�r� �..:>-::: . �.Jfi: B':. ��.;nNll(Y LE4,';RI(''IIUr� U�.I�� F'RICE :;r,-'�JUtd� .. . . . . . ........ . . . . THE COST OF COATINGS INSPECTION IS LARGELY DEPENDENT UPON THE PRODUCTION METHODS OF � THE PAINTING CONTRACTOR HERE IS A COST �„.. BREAKDOWN BASED ON THE CONTRACTOR .. . . ._ ....... ...... . . ...... . .. FOLIOWING THE PROCESS DESCRIBED BEIOW PRE-CON MEETING 4 HOURS AND 70 MILES TRAVEL ..... ... ............. . .... .......... . .. . ... 3 AMBIENT CONDITIOIVS CHECK INSPECTION PRIOR TO THE START OF SAND 4 HOURS 70 MILES .. , ;. .. . .. .. SP-10 INSPECTION OF FLOOR OF TANK 20 HOURS 70 MILES TRAVEL ' _... .. . .. _. ... �.. .. SP-10 INSPECTION OF WALLS AND CEILING OF TANK 32� � ', ..._. HOURS AND 70 MILES TRAVEL _, _.. PRIME COAT INSPECTION OF FLOOR OF TANK 4 HOURS AND 70 MILES TRAVEL � PRIMECOAT INSPECTION OF WALL AND CEILING OF _� TANK 8 HOURS,AND 70 MILES OF TRAVEL ._..... ......... � ..._ ... STRIPE COAT INSPECTION OF FLOOR OF TANK 4 � HOURS AND 70 MILES OF TRAVEL STRIPE COAT INSPECTION OF CEILING AND WALLS OF � ............ .... TANK 4 HOURS AND 70 MILES OF TRAVEL ... . . .. � INTERMEDIATE COAT INSPECTION OF FLOOR 4 HOURS ' ,, , . AND 70.MILES OF ;. . . .. . ...... INTERMEDIATE COP,T INSPECTION OF CEILING AND _ WALLS OF TANK 8 HOURS AND 70 MILES TRAVEL .. . . . . . TOP COAT INSPECTION OF FLOOR AND HOLIDAY TEST ?.,,.,.,,_...��..�.. . 8 HOURS AND,70,MILES_OF TRAVEL ...... . . ... ..... . ... . .�.....�. .. .. ; TOP COAT INSPECTION OF CEILING AND WALLS 8 � � HOURS AND 70 MILES OF TRAVEL � TOTAL FOR inspection of ceiling for TANK no 10 NORTH ....,.... . . .... . . ... . ....._...._ .. ... .. ... .. ... ... . . ... . . TOTAL COST HOURS 104 X 565 00 =$6.760 00 ? TOTAL MILEAGE COST 770 X 55 = S423 50 € ._... .. . ..... . ... . .. . ..... ....... .... .. .. .......... ... .. ... 1 MISCELLANEOUS EQUIPMENT COST = 5300 00 CONTINGENCY (USED IONLY UPON APPROVAL) = 51000 .. TOTAL COST FOR TANK #10 NORTH =$8,483 50 ......... ... _..... _................. ....,... ................... ..... . ' i i � ONCE AGAIN THIS ESTIMATE IS BASED ON THE � . ...... .... .. . CONTRACTOR FOLLOWING THIS ., „ .. .... ...... ... . ..... BELL PAINTING AIVD COATINGS DOES NOT CONTROL THE WAYS, MEANS AND METHODS OF THE PAINTING CONTRACTOR MORE SITE VISITS WILL y . INCURE_COSTS THE_ABOVE MENTIONED . . . .. ... ......._ .... ... ... .. .... .. � MANHOUR RATE AND TRAVEL COST t SUBTOTAL y8,483.50 TAX RATE N1A SALES TAX NIA OTHER TOTAL S8,483.50 ` ACORU CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/WW) �� 3/9/2015 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 NAMEACT �exdIIdT3 Copeland Rice Insurance LLC PHONE .(360) 734-1161 Fax C o:�360)734-1173 1400 Broadway E-MAIL ADDRESS: P. O. BOX 63 9 INSURER S AFFORDING COVERAGE NAIC f! Bellingham WA 98227 INSURERA.Ot110 Casualt Insurance Co. 4074 INSURED INSURERB:Ot110 $2CL1Tlt Insurance CO. Autie Bell dba: Bell Painting and Coatings iNSUReRCAlaska National Insurance Co. 7206 North 25th Street INSURERD: INSURER E : Tacoma WA 98406 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1451223699 ` 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 NOTIMTHSTANDING 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 7ypE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP L7R POLICY NUMBER MMIDD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE g 1� 000 , OOO X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 1, 000 , 000 A CLAIMS-MADE � OCCUR L055188935 6/21/2014 6/21/2015 MED EXP (Any one person) $ 15 , 00� PERSONAL 8 ADV INJURY S 1, 000 , OOO GENERAL AGGREGATE $ 2, OOO � O00 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG 5 Z� 000 , OOO X POLICY PR � LOC $ AUTOMOBILELIABILITY EaaBcdeDSINGLELIMIT $ 1 000 OOO B ANY AUTO BODILY INJURY (Perperson) $ ALLOWNED X SCHEDULED AS55188935 /21/2014 /21/2015 BODILYINJURY Peraccident 5 AUTOS AUTOS ( 1 X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS Peracadent $ PIP g lO OOO UMBRELLALIAB OCCUR EACH OCCURRENCE 6 EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTIONS � C WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACHACCIDENT $ 1 OOO OOO OFFICER/MEMBER EXCLUDED? � N � A (Mandatory In NH) 14HWU09631 6/1/2014 6/1/2015 E L DISEASE -EA EMPLOVE $ 1 D00 00� If yes, descnbe under E L DISEASE - POLICY LIMIT $ 1 ��� 00� DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additlonal Remarks Schedule, If more space Is requlred) City of Bremerton is Additional Insured per attached form as required by written contract. Coverage is Primary and Non Contributory and the Waiver of Subrogation applies. CERTIFICATE HOLDER CANCELLATION City of Bremerton Attn: Bill Davis 3027 Olympus Drive Bremerton, WA 98310 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 Troy Haskell/AICC �— �� � �1 ACORD 25 (2010/05) INS025 r�mnn5i m O 1988-2010 ACORD CORPORATION. All rights reserved. Thc A(:f1Rll namo anrl Innn a►o ronic4o�orl mar4c nf A�:(1RI1 ADDITIONAL COVERAGES Ref # Description Coverage Code Form No. Edition Date Underinsured motorist BI single limit UNDSG Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 1, 000, 000 Ref # Description Coverage Code Form No. Edition Date U.S. longshore & harbor WC act USLH Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 1, 000,000 Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 7 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium OFADTLCV Copyright 2001, AMS Services, Inc. COMMERCIAL GENERAL LIABILITY CG88100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX 0 � SUBJECT NON-OWNED AIRCRAFT NON-OWNED WATERCRAFT PROPERTY DAMAGE LIABILITY - ELEVATORS EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (TenanYs Property Damage) MEDICAL PAYMENTS EXTENSION EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B ADDITIONAL INSUREDS - BY CONTRACT, AGREEMENT OR PERMIT PRIMARY AND NON-CONTRIBUTORY- ADDITIONAL INSURED EXTENSION ADDITIONAL INSUREDS - EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORS/MALPRACTICE AND WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT LIBERALlZATION CLAUSE BODILY INJURY REDEFINED EXTENDED PROPERTY DAMAGE WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU � 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission PAGE 2 2 2 2 3 3 3 5 6 6 7 7 7 7 7 8 8 Page 1 of 8 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. Exclusions of Section I- Coverage 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; 3. The pilot in command holds a currently effective certificate, issued by the duly constituted authority of the United States of America or Canada, designating her or him a commercial or airline pilot; and 4. It is not being used to carry persons or property for a charge. B. If Damage To Premises Rented To You is not otherwise excluded from this Coverage Part: 1. Under Paragraph 2. Exclusions of Section I- Coverage A- Bodily Injury and Property Damage Liability: a. The fourth from the last paragraph of exclusion j. Damage To Property is replaced by the follow- ing: Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire, lightning, explosion, smoke, or leakage from an automatic fire protection system) to: (i) Premises rented to you for a period of 7 or fewer consecutive days; or (ii) Contents that you rent or lease as part of a premises rental or lease agreement for a period of more than 7 days. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described in Section III - Limits of Insurance. 0 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 8 However, the insurance afforded by this provision does not apply if there is available to the insured other valid and collectible insurance, whether primary, excess (other than insurance written to apply specifically in excess of this policy), contingent or on any other basis, that would also apply to the loss covered under this provision. NON-OWNED WATERCRAFT Under Paragraph 2. Exclusions of Section I- Coverage A- Bodily Injury And Property Damage Liability, Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by the following: This exclusion does not apply to: (2) A watercraft you do not own that is: (a) Less than 52 feet long; and (b) Not being used to carry persons or property for a charge. C. PROPERTY DAMAGE LIABILITY - ELEVATORS 1. Under Paragraph 2. Exclusions of Section I- Coverage A- Bodily Injury And Property Damage Liabil- ity, Subparagraphs (3), (4) and (6) of exclusion j. Damage To Property do not apply if such "property damage" results from the use of elevators. For the purpose of this provision, elevators do not include vehicle lifts. Vehicle lifts are lifts or hoists used in automobile service or repair operations. 2. The following is added to Section IV - Commercial General Liability Conditions, Condition 4. Other Insurance, Paragraph b. Excess Insurance: The insurance afforded by this provision of this endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis. D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) b. The last paragraph of subsection 2. Exclusions is replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III - Limits Of Insurance. 2. Paragraph 6. under Section III - Limits Of Insurance is replaced by the following: 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to: a. Any one premise: (1) While rented to you; or (2) While rented to you or temporarily occupied by you with permission of the owner for damage by fire, lightning, explosion, smoke or leakage from automatic protection sys- tems; or b. Contents that you rent or lease as part of a premises rental or lease agreement. 3. As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY REN7ED TO YOU (Tenant's Property Damage) - Paragraph 9.a. of Definitions is replaced with the following: 9.a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such premises that are included in your premises rental or lease agreement, is not an "insured contracY'. E. MEDICAL PAYMENTS EXTENSION If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this policy are amended as follows: Under Paragraph 1. Insuring Agreement of Section I- Coverage C- Medical Payments, Subparagraph (b) of Paragraph a. is replaced by the following: (b) The expenses are incurred and reported within three years of the date of the accident; and F. EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B 1. Under Supplementary Payments - Coverages A and B, Paragraph 1.b. is replaced by the following: b. Up to $3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2. Paragraph 1.d. is replaced by the following: ° d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suiY', including actual loss of earnings up to $500 a day because of time off from work. " G. ADDITIONAL INSUREDS - BY CONTRACT, AGREEMENT OR PERMIT 1. 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, written agreement or permit. Such person or organization is an additional insured but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by: a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your on going operations for the additional insured that are the subject of the 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 agreement; or � 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of lnsurance Services O�ce, Inc., with its permission. Page 3 of 8 b. Premises or facilities 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 provisions: � (1) This insurance does not apply to "bodily injury", "property damage", or "personal and ad- vertising injury" arising out of the operations performed for the state or political subdivision; (2) This insurance does not apply to "bodily injury" or "property damage" included within the "completed operations hazard". (3) Insurance applies to premises you own, rent, or control but only with respect to the following hazards: (a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar expo- sures; or (b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elevators covered by this insurance. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insur- ance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. With respect to Paragraph 1.a. above, a person's or organization's status as an additional insured under this endorsement ends when: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. With respect to Paragraph 1.b. above, a person's or organization's status as an additional insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends. 0 With respects to Paragraph 1.c. above, this insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. 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"suiY' 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 Condi- tions. � 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 8 2. 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: a. "Bodily injury" or "property damage" arising from the sole negligence of the additional insured. b. "Bodily injury" or "property damage" that occurs prior to you commencing operations at the location where such "bodily injury" or "property damage" occurs. c. "Bodily injury", "property damage" 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: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occur- rence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. d. "Bodily injury" or "property damage" occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. e. Any person or organization specifically designated as an additional insured for ongoing operations by a separate ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS endorsement is- sued by us and made a part of this policy. 3. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: a. Required by the contract or agreement; or b. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. o This endorsement shall not increase the applicable Limits of Insurance shown in the Declaratio ns. H. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional insured under any form " or endorsement under this policy. Condition 4. Other Insurance of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is amend- ed 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, this policy shall be primary and we will not seek contribution from the additional insured's policy for damages we cover. � 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 8 b. The following is added to Paragraph b. Excess Insurance: I. When a written contract or 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 insurance is excess over any other insurance for which the addi- tional insured is designated as a Named Insured. Regardless of the written agreement between you and an additional insured, this insurance 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. ADDITIONAL INSUREDS - EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. 1. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim or Suit: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence" or an offense that may result in a claim or "suiY' under this insurance to us; b. Tender the defense and indemnity of any claim or "suiY' 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 under this Coverage Part. d. We have no duty to defend or indemnify an additional insured under this endorsement until „ we receive written notice of a"suiY' by the additional insured. 2. 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. J. WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORS / MALPRACTICE WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES Paragraph 2.a.(1) of Section II - Who Is An Insured is replaced with the following: (1) "Bodily injury" or "personal and advertising injury": (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co-"employee" while in the course of his or her employ- - ment or pertorming duties related to the conduct of your business, or to your other "volunteer ° workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co-"employee" or "volunteer worker" as a consequence of Paragraph (1) (a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1) (a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. However, if you are not in the business of providing professional health care services or providing profes- sional health care personnel to others, or if coverage for providing professional health care ser- vices is not otherwise excluded by separate endorsement, this provision (Paragraph (d) ) does not apply. Paragraphs (a) and (b) above do not apply to "bodily injury" or "personal and advertising injury" caused by an "employee" who is acting in a supervisory capacity for you. Supervisory capacity as used herein means the "employee's" job responsibilities assigned by you, includes the direct supervision of other "employ- ees" of yours. However, none of these "employees" are insureds for "bodily injury" or "personal and � 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 8 advertising injury" arising out of their willful conduct, which is defined as the purposeful or willful intent 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 provision J. is excess over any other valid and collectable insurance available to your "employee". K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES Paragraph 3. of Section II - Who Is An Insured is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. d. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations or qualifies as an insured under this provision. L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES Under Section IV - Commercial General Liability Conditions, the following is added to Condition 6. Repre- sentations: Your failure to disclose all hazards or prior "occurrences" existing as of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior "occurrences" is not intentional. M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT Under Section IV - Commercial General Liability Conditions, the following is added to Condition 2. Duties In The Event of Occurrence, Offense, Claim Or Suit: Knowledge of an "occurrence", offense, claim or "suiY' by an agent, servant or "employee" of any insured shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph 1. of Section II - Who Is An Insured or a person who has been designated by them to receive reports of "occurrences", offenses, claims or "suits" shall have received such notice from the agent, servant or "employee". � N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the day the revision is " effective in your state. O. BODILY INJURY REDEFINED Under Section V- Definitions, Definition 3. is replaced by the following: 3. "Bodily Injury" means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physical injury, sick- ness or disease. � 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Senrices Office, Inc., with its permission. Page 7 of 8 P. EXTENDED PROPERTY DAMAGE Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. Q. 0 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU Under Section IV - Commercial General Liability Conditions, the following is added to Condition 8. Trans- fer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against a person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard" provided: 1. You and that person or organization have agreed in writing in a contract or agreement that you waive such rights against that person or organization; and 2. The injury or damage occurs subsequent to the execution of the written contract or written agree- ment. � 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services O�ce, Inc., with its permission. Page 8 of 8 COMMERCIAL AUTO CA 88 10 01 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. COVERAGEINDEX SUBJECT ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT ACCIDENTAL AIRBAG DEPLOYMENT AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS AMENDED FELLOW EMPLOYEE EXCLUSION AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE BROAD FORM INSURED BODILY INJURY REDEFINED EMPLOYEES AS INSUREDS (including employee hired auto) EXTENDED CANCELLATION CONDITION EXTRA EXPENSE — BROADENED COVERAGE GLASS REPAIR — WAIVER OF DEDUCTIBLE HIRED AUTO PHYSICAL DAMAGE(including employee hired auto) HIRED AUTO COVERAGE TERRITORY LOAN / LEASE GAP PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) PERSONAL EFFECTS COVERAGE PHYSICAL DAMAGE — ADDITIONAL TRANSPORTATION EXPENSE COVERAGE RENTAL REIMBURSEMENT SUPPLEMENTARY PAYMENTS TOWING AND LABOR UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US SECTION II — LIABILITY COVERAGE is amended as follows: 1. BROAD FORM INSURED PROVISION NUMBER 3 12 18 5 13 1 21 2 22 10 15 6 20 14 16 11 8 9 4 7 17 19 SECTION II — LIABILITY COVERAGE, paragraph A.1. —WHO IS AN INSURED is amended to include the following as an insured: d. Any legally incorporated entity of which you own more than 50 percent of the voting stock during the policy period. However, "insured" does not include any organization that: (1) Is a partnership orjoint venture; or (2) Is an insured under any other automobile policy; or (3) Has exhausted its Limit of Insurance under any other automobile policy. Paragraph d. (2) of this provision does not apply to a policy written to apply specifically in excess of this policy. e. Any organization you newly acquire or form, other than a partnership or joint venture, of which you own more than 50 percent of the voting stock. This automatic coverage is afforded only for 180 days from the date of acquisition or formation. However, coverage under this provision does not apply: (1) If there is similar insurance or a self-insured retention plan available to that organization; 02010 Liberty Mutual Insurance Company. All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Seroices Office, with its permission. Page 1 of 7 (2) If the Limits of Insurance of any other insurance policy have been exhausted; or (3) To "bodily injury" or "property damage" that occurred before you acquired or formed the organization. 2. EMPLOYEES AS INSUREDS SECTION II — LIABILITY COVERAGE, paragraph A.1. —WHO IS AN INSURED is amended to include the following as an insured: f. Any "employee" of yours while using a covered "auto" you do not own, hire or borrow but only for acts within the scope of their employment by you. Insurance provided by this endorsement is excess over any other insurance available to any "employee". g. An "employee" of yours while operating an "auto" hired or borrowed under a written contract or agreement in that "employee's" name, with your permission, while perForming duties related to the conduct of your business and within the scope of their employment. Insurance provided by this endorsement is excess over any other insurance available to the "employee". 3. ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT SECTION II — LIABILITY COVERAGE, paragraph A.1. —WHO IS AN INSURED is amended to include the following as an insured: h. Any person or organization with respect to the operation, maintenance or use of a covered "auto", provided that you and such person or organization have agreed in a written contract, agreement, or permit issued to you by governmental or public authority, to add such person, or organization, or governmental or public authority to this policy as an "insured". However, such person or organization is an "insured": (1) Only with respect to the operation, maintenance or use of a covered "auto"; (2) Only for "bodily injury" or "property damage" caused by an "accident" which takes place after you executed the written contract or agreement, or the permit has been issued to you; and (3) Only for the duration of that contract, agreement or permit 4. SUPPLEMENTARY PAYMENTS SECTION II — LIABILITY COVERAGE, Coverage Extensions, 2.a. Supplementary Payments, paragraphs (2) and (4) are replaced by the following: (2) Up to $3,000 for cost of bail bonds (including bonds for related traffic violations) required because of an "accidenY' we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the insured at our request, including actual loss of earnings up to $500 a day because of time off from work. 5. AMENDED FELLOW EMPLOYEE EXCLUSION In those jurisdictions where, by law, fellow employees are not entitled to the protection afforded to the employer by the workers compensation exclusivity rule, or similar protection, the following provision is added: SECTION II — LIABILITY, exclusion B.5. FELLOW EMPLOYEE does not apply if the "bodily injury" results from the use of a covered "auto" you own or hire. SECTION III — PHYSICAL DAMAGE COVERAGE is amended as follows: 6. HIRED AUTO PHYSICAL DAMAGE Paragraph A.4. Coverage Extensions of SECTION III — PHYSICAL DAMAGE COVERAGE, is amended by adding the following: If hired "autos" are covered "autos" for Liability Coverage, and if Comprehensive, Specified Causes of Loss or Collision coverage'are provided under the Business Auto Coverage Form for any "auto" you own, then the Physical Damage coverages provided are extended to "autos": a. You hire, rent or borrow; or 02010 Liberty Mutual Insurance Company. All rights reserved. CA 8810 01 10 Includes copyrighted material of Insurance Services Office, with its permission. Page 2 of 7 b. Your "employee" hires or rents under a written contract or agreement in that "employee's" name, but only if the damage occurs while the vehicle is being used in the conduct of your business, subject to the following limit and deductible: A. The most we will pay for "loss" in any one "accident" or "loss" is the smallest of: (1) $50,000; or (2) The actual cash value of the damaged or stolen property as of the time of the "loss"; or (3) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality, minus a deductible. B. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. C. Subject to the limit, deductible and excess provisions described in this provision, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. D. Subject to a maximum of $750 per "accidenY', we will also cover the actual loss of use of the hired "auto" if it results from an "accident", you are legally liable and the lessor incurs an actual financial loss. E. This coverage extension does not apply to: (1) Any "auto" that is hired, rented or borrowed with a driver; or (2) Any "auto" that is hired, rented or borrowed from your "employee". For the purposes of this provision, SECTION V— DEFINITIONS is amended by adding the following: "Total loss" means a"loss" in which the cost of repairs plus the salvage value exceeds the actual cash value. 7. TOWING AND LABOR SECTION III — PHYSICAL DAMAGE COVERAGE, paragraph A.2. Towing, is amended by the addition of the following: We will pay towing and labor costs incurred, up to the limits shown below, each time a covered "auto" classified and rated as a private passenger type, "light truck" or "medium truck" is disabled: a. For private passenger type vehicles, we will pay up to $50 per disablement. b. For "light trucks", we will pay up to $50 per disablement. "Light trucks" are trucks that have a gross vehicle weight (GVW) of 10,000 pounds or less. c. For "medium trucks" , we will pay up to $150 per disablement. "Medium trucks" are trucks that have a gross vehicle weight (GV111� of 10,001 — 20,000 pounds. However, the labor must be performed at the place of disablement. 8. PHYSICAL DAMAGE- ADDITIONAL TRANSPORTATION EXPENSE COVERAGE Paragraph A.4.a., Coverage Extension of SECTION III — PHYSICAL DAMAGE COVERAGE, is amended to provide a limit of $50 per day and a maximum limit of $1,500 02010 Liberty Mutual Insurance Company. All rights reserved. CA 88 10 01 10 Includes copyrighted matenal of Insurance Services Office with its permission. Page 3 of 7 9. RENTAL REIMBURSEMENT SECTION III — PHYSICAL DAMAGE COVERAGE, A. COVERAGE, is amended by adding the following: a. We will pay up to $75 per day for rental reimbursement expenses incurred by you for the rental of an "auto" because of "accident" or "loss", to an "auto° for which we also pay a"loss" under Comprehensive, Specified Causes of Loss or Collision Coverages. We will pay only for those expenses incurred after the first 24 hours following the "accidenY' or "loss" to the covered "auto." b. Rental Reimbursement will be based on the rental of a comparable vehicle, which in many cases may be substantially less than $75 per day, and will only be allowed for the period of time it should take to repair or replace the vehicle with reasonable speed and similar quality, up to a maximum of 30 days. c. We will also pay up to $500 for reasonable and necessary expenses incurred by you to remove and replace your tools and equipment from the covered "auto". d. This coverage does not apply unless you have a business necessity that other "autos" available for your use and operation cannot fill. e. If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided under Paragraph 4. Coverage Extension. f. No deductible applies to this coverage. For the purposes of this endorsement provision, materials and equipment do not include "personal effects" as defined in provision 11. 10. EXTRA EXPENSE - BROADENED COVERAGE Under SECTION III — PHYSICAL DAMAGE COVERAGE, A. COVERAGE, we will pay for the expense of returning a stolen covered "auto" to you. The maximum amount we will pay is $1,000. 11. PERSONAL EFFECTS COVERAGE A. SECTION III — PHYSICAL DAMAGE COVERAGE, A. COVERAGE, is amended by adding the following: If you have purchased Comprehensive Coverage on this policy for an "auto" you own and that "auto" is stolen, we will pay, without application of a deductible, up to $600 for "personal effects" stolen with the "auto." The insurance provided under this provision is excess over any other collectible insurance. B. SECTION V— DEFINITIONS is amended by adding the following: For the purposes of this provision, "personal effects" mean tangible property that is worn or carried by an insured." "Personal effects" does not include tools, equipment, jewelry, money or securities. 12. ACCIDENTAL AIRBAG DEPLOYMENT SECTION III — PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS is amended by adding the following: If you have purchased Comprehensive or Collision Coverage under this policy, the exclusion for "loss" relating to mechanical breakdown does not apply to the accidental discharge of an airbag. Any insurance we provide shall be excess over any other collectible insurance or reimbursement by manufacturer's warranty. However, we agree to pay any deductible applicable to the other coverage or warranty. 13. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE SECTION III — PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS, exception paragraph a. to exclusions 4.c. and 4.d. is deleted and repiaced with the following: 02010 Liberty Mutual Insurance Company. All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office, with its permission. Page 4 Of 7 Exclusion 4.c. and 4.d. do not apply to: a. Electronic equipment that receives or transmits audio, visual or data signals, whether or not designed solely for the reproduction of sound, if the equipment is permanently installed in the covered "auto" at the time of the "loss" and such equipment is designed to be solely operated by use of the power from the "auto's" electrical system, in or upon the covered "auto" and physical damage coverages are provided for the covered "auto"; or If the "loss" occurs solely to audio, visual or dat equipment, then our obligation to pay for, repair, reduced by a $100 deductible. a electronic equipment or accessories used with this return or replace damaged or stolen property will be 14. LOAN / LEASE GAP COVERAGE A. Paragraph C., LIMIT OF INSURANCE of SECTION III — PHYSICAL DAMAGE COVERAGE is amended by adding the following: The most we will pay for a"total loss" to a covered "auto" owned by or leased to you in any one "accident" is the greater of the: Balance due under the terms of the loan or lease to which the damaged covered "auto" is subject at the time of the "loss" less the amount of: a. Overdue payments and financial penalties associated with those payments as of the date of the "loss", b. Financial penalties imposed under a lease due to high mileage, excessive use or abnormal wear and tear, c. Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease, d. Transfer or rollover balances from previous loans or leases, e. Final payment due under a"Balloon Loan", f. The dollar amount of any unrepaired damage which occurred prior to the "total loss" of a covered "auto", g. Security deposits not refunded by a lessor, h. All refunds payable or paid to you as a result of the early termination of a lease agreement or as a result of the early termination of any warranty or extended service agreement on a covered "auto", i. Any amount representing taxes, j. Loan or lease termination fees; or 2. The actual cash value of the damage or stolen property as of the time of the "loss". An adjustment for depreciation and physical condition will be made in determining the actual cash value at the time of the "loss". This adjustment is not applicable in Texas. B. ADDITIONAL CONDITIONS This coverage applies only to the original loan for which the covered "auto" that incurred the loss serves as collateral, or lease written on the covered "auto" that incurred the loss. C. SECTION V— DEFINTIONS is changed by adding the following: As used in this endorsement provision, the following definitions apply: "Total loss" means a"loss" in which the cost of repairs plus the salvage value exceeds the actual cash value. A"balloon loan" is one with periodic payments that are insufficient to repay the balance over the term of the loan, thereby requiring a large final payment. 02010 Liberty Mutual Insurance Company. All rights reserved CA 88 10 01 10 Includes copyrighted material of Insurance Services Office, with its permission. Page 5 Of 7 15. GLASS REPAIR - WAIVER OF DEDUCTIBLE Paragraph D. Deductible of SECTION III — PHYSICAL DAMAGE COVERAGE is amended by the addition of the following: No deductible applies to glass damage if the glass is repaired rather than replaced. 16. PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) Paragraph D. Deductible of SECTION III — PHYSICAL DAMAGE COVERAGE is amended by the addition of the following: The deductible does not apply to "loss" caused by collision to such covered "auto" of the private passenger type or light weight truck with a gross vehicle weight of 10,000 Ibs. or less as defined by the manufacturer as maximum loaded weight the "auto" is designed to carry while it is: a. In the charge of an "insured"; b. Legally parked; and c. Unoccupied. The "loss" must be reported to the police authorities within 24 hours of known damage. The total amount of the damage to the covered "auto" must exceed the deductible shown in the Declarations. This provision does not apply to any "loss" if the covered "auto" is in the charge of any person or organization engaged in the automobile business. SECTION IV — BUSINESS AUTO CONDITIONS is amended as follows: 17. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS SECTION IV- BUSINESS AUTO CONDITIONS, Paragraph B.2. is amended by adding the following: If you unintentionally fail to disclose any hazards, exposures or material facts existing as of the inception date or renewal date of the Business Auto Coverage Form, the coverage afforded by this policy will not be prejudiced. However, you must report the undisclosed hazard of exposure as soon as practicable after its discovery, and we have the right to collect additional premium for any such hazard or exposure. 18. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT, OR LOSS SECTION IV — BUSINESS AUTO CONDITIONS, paragraph A.2.a. is replaced in its entirety by the following: a. In the event of "accident", claim, "suit" or "loss", you must promptly notify us when it is known to: 1. You, if you are an individual; 2. A partner, if you are a partnership; 3. Member, if you are a limited liability company; 4. An executive officer or the "employee" designated by the Named Insured to give such notice, if you are a corporation. To the extent possible, notice to us should include: (1) How, when and where the "accident" or "loss" took place; (2) The "insureds" name and address; and (3) The names and addresses of any injured persons and witnesses. 19. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US SECTION IV — BUSINESS AUTO CONDITIONS, paragraph A.5., Transfer of Rights of Recovery Against Others to Us, is amended by the addition of the following: If the person or organization has waived those rights before an "accident" or "loss", our rights are waived also. 002010 �iberty Mutual Insurance Company. All rights reserved. CA 8810 01 10 Includes copyrighted material of Insurance Services O�ce with its permission. Page 6 of 7 20. HIRED AUTO COVERAGE TERRITORY SECTION IV — BUSINESS AUTO CONDITIONS, paragraph B.7., Policy Period, Coverage Territory, is amended by the addition of the following: f. For "autos" hired 30 days or less, the coverage territory is anywhere in the world, provided that the insured's responsibility to pay for damages is determined in a"suit", on the merits, in the United States, the territories and possessions of the United States of America, Puerto Rico or Canada or in a settlement we agree to. This extension of coverage does not apply to an "auto" hired, leased, rented or borrowed with a driver. SECTION V— DEFINITIONS is amended as follows: 21. BODILY INJURY REDEFINED Under SECTION V— DEFINTIONS, definition C. is replaced by the following: "Bodily injury" means physical injury, sickness or disease sustained by a person, including mental anguish, mental injury, shock, fright or death resulting from any of these at any time. . COMMMON POLICY CONDITIONS 22. EXTENDED CANCELLATION CONDITION COMMON POLICY CONDITIONS, paragraph A.— CANCELLATION condition applies except as follows: If we cancel for any reason other than nonpayment of premium, we will mail to the first Named Insured written notice of cancellation at least 60 days before the effective date of cancellation. This provision does not apply in those states which require more than 60 days prior notice of cancellation. 02010 Liberty Mutual Insurance Company. All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office, with its permission. Page 7 of 7 ' 4C° � � TIFICAT OF LIA ILITY �NS ANC DATE(MMlDOlYYri) �+� 3/9/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTfFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIYELY AMEND, EXTEND OR AITER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER{S), AIJTHQRIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(iesj must be endorsed. If SUBROGATION IS WAIVEO, subJect to the terms and conditions of the policy, certain policies may requirs an endorsement. A statement on this certificate does noY confer rights to the certifica4e holder in lieu of such endorsement(s). RRODUCER HTyco£f Insurance Ageacy Inc. 501 South 2nd Street P. 0. Box 1Q10 Mount Vernon WA 98273 INSURE� l+Torthwest Corroaion Engiaeering LLC 10995 warfield Road Sedro- HIA 98284 c: lly Saben (3fi0)33fi-2112 F � No (3601 336-529 1 L1vSi�wvcoffinsurance.com GOVERAGES CERTIFICATE NUMBER:14-15 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LlSTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITMSTANDtNG ANY REQUIREMENT, TERM OR CONOITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFpRDED 8Y 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. f LTR TYPE OF INSURANCE A9DL S 6 pOIICY NUMBER pOEInY E� M PO� p�Y EXP LIMIiS GENERAL LIAHILITY EACH OCCURRENCE $ DAMAGE TO RENTED CpMMERCIAL GENFRAI.. LIABILITY PREMI F F ccunen -t : CLAIM&MADE � OCCUR MED EXP fAry one pe�on) $ � PERSONAL 8 ADV INJURY $ GENERIIL AGGREGA7E 5 G[ML AGGREGATE LIh117 APPLIE5 PER• PRO�UCTS - COM1��PiOP AGG F POLIGY PR � LOC "� AUTOMOBILE IIABILITY COMBINED SINGLE LIMI7 �Ea acc�dent' ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY tNJURY (Per accidon±) $ AUTOS AUTOS HIRED AUTOS NON-0WNED PROPERTY DAMAGE � AUTOS lPer accident 8 UMBRELIA LIAB pCCUR EACH OCCURRENCE $ E%CESS LIRB CLAIMS-Fa.ADE AGGRE-GATE y DED RETENTION $ $ WORKERS COAIPENSATION WC STATU- O7H- AND EMPLOYERS' LIA8ILITY Y! N ANY PROPRIETORIPARTNERfEXECUTIVE pFFIGEWMEMeER F%CLUDEQ? � N! A E.l. EACH ACCIDENT $ (Mandalory in NH) E.L. DISL45[ - EA EMPLUYE $ liyes.descnbe under DESCRIPTION OF OPERATIONS be'c�v E.L �ISEASE • POLICY LIMIT y A PROFSSSIONAL LIABILITY cci4zi299 12/15/20141a/15/2015 LIMITPcRCLA1M $2,000,000 ANNUALAGGREGATE $2, 000, 000 DESCRIPTION OF OPERATIONS f LOCATiONS ! VEHICLES (Attaeh ACORD 101, Addltlonal Remarke Schedute, It more space ia required) THE PROFESSIONAL LIABILITY LIMIT INCRBASE FROM $1,000,000 TO $2,000,000 HAS A RETROACTIVE DATE OF 7-7-14. ELLATION CITY OF BREMERTON 345 6TH ST BREIKFRTON, WA 98337 SHOULD ANY OF THE ABOYE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WI7H THE P�LICY PROVISIONS. Al1THOR17E0 REPRESENTATiVE � '�.�� �- ��.�,��-�.M.�.----- ACORD 25 (2010J05) O 798&2010 ACORD CORPORATiON. All rights reserved. iN5o25 �zo�oos> e� The ACORD name and logo are registered marks of ACORD 5ct( 2 ACoRIJ CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 6/8/2015 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 RECEIVED NAME:ACT Stan Rice Rice Insurance LLC AHCNNo,Extl: (360)734-1161 A/C,No):(360)734-1173 1400 Broadway JUN 2 9 2015 ADDRESS: P.O. Box 639 INSURER(S)AFFORDING COVERAGE NAIC# Bellingham WA 98227 INSURERA:Ohio CasualtyInsurance Co. 24074 City of Bremerton INSURED INSURERB:Ohio SecurityInsurance Co. 24082 Autie Bell dba: Bell Paintingand Coatingsig Management INsuRER c Alaska National Insurance Co'. 7206 North 25th Street INSURERD:Hi3COX INSURER E: \1f\ 0 //> Tacoma WA 98406 INSURERF: �) / COVERAGES CERTIFICATE NUMBER:CL156829629 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 INSD WVD POLICY NUMBER (MM/DD/YYYY) IMM/DDIYYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 / DAMAGE TE A CLAIMS-MADE X OCCUR PREM SESO(Ea olccur ence) $ 1,000,000 X Y BL055188935 6/21/2015 6/21/2016 MED EXP(Any one person) _ $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 / GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 - X , POLICY PR0JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER. $ / AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 V/ (Ea accident) B ANY AUTO BODILY INJURY(Per person) $ ALL OWNEDX SCHEDULED BAS55188935 5/21/2015 5/21/2016 BODILY INJURY(Per accident) $ AUTOS AUTOS X X NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) pip $ 10,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE US L&H E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A C (Mandatory in NH) 15FWU09631 6/5/2015 6/5/2016 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 D Professional Liability MPL155704715 4/1/2015 4/1/2016 Per Claim 1,000,000 *4/1/2015 Retro Date Aggregate 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Bremerton is Additional Insured per CG8810 0413 attached. Coverage is Primary and Non Contributory and the Waiver of Subrogation applies. CERTIFICATE HOLDER CANCELLATION (360) 473-5161 William.Davis@ci.bremerton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Bremerton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Risk Management ACCORDANCE WITH THE POLICY PROVISIONS. 345 6th Street Ste 600 Bremerton, WA 98337 AUTHORIZED REPRESENTATIVE Troy Haskell/SJR A _ -- "set ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) COMMERCIAL GENERAL LIABILITY CG 88 10 04 13 With res to coverage afforded bythis endorsement, the respect g provisions of the policy apply unless modified by THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. the endorsement. A. NON-OWNED AIRCRAFT COMMERCIAL GENERAL LIABILITY EXTENSION Under Paragraph 2.Exclusions of Section I-Coverage A-Bodily Injury And Property Damage Liability, This endorsement modifies insurance exclusion g.Aircraft,Auto Or Watercraft does not apply to an aircraft provided: provided under the following: 1. It is not owned by any insured; COMMERCIAL GENERAL LIABILITY COVERAGE PART 2. It is hired,chartered or loaned with a trained paid crew; 3. The pilot in command holds a currently effective certificate, issued by the duly constituted authority of INDEX the United States of America or Canada,designating her or him a commercial or airline pilot; and 4, It is not being used to carry persons or property for a charge. $OBJECT PAGE __ However, the insurance afforded by this provision does not apply if there is available to the insured other NON-OWNED AIRCRAFT 2 valid and collectible insurance, whether primary, excess(other than insurance written to apply specifically in excess of this policy), contingent or on any other basis,that would also apply to the loss covered under NON-OWNED WATERCRAFT 2 this provision. e B. NON-OWNED WATERCRAFT PROPERTY DAMAGE LIABILITY-ELEVATORS 2 Under Paragraph 2.Exclusions of Section I"Coverage A-Bodily Injury And Property Damage Liability, EXTENDED DAMAGE TO PROPERTY RENTED TO YOU(tenant's Property Damage) 2 e Subparagraph (21 of exclusion g.Aircraft,Auto Or Watercraft is replaced by the following. - This exclusion does not apply to MEDICAL PAYMENTS EXTENSION 3 (2) A watercraft you do not own that is: EXTENSION OF SUPPLEMENTARY PAYMENTS-COVERAGES AAND B 3 (a) Less than 52 feet long;and ADDITIONAL INSUREDS-BY CONTRACT,AGREEMENT OR PERMIT 3 (b) Not being used to carry persons or property for a charge. C. PROPERTY DAMAGE LIABILITY-ELEVATORS PRIMARY AND NON-CONTRIBUTORY- ADDITIONAL INSURED EXTENSION 5 1. Under Paragraph 2.Exclusions of Section I-Coverage A-Bodily Injury And Property Damage Liabil- ity,Subpaagraphs (3),(4)and(6)of exclusion J.Damage To Property do not apply if such"property damage" results from the use of elevators. For the purpose of this provision, elevators do not include vehicle lifts.Vehicle lifts em lifts or hoists used in automobile service or repair operations. WHO IS AN INSURED-INCIDENTAL MEDICAL ERRORS/MALPRACTICE AND WHO IS AN INSURED-FELLOW EMPLOYEE EXTENSION-MANAGEMENT EMPLOYEES 6 2. The following is added to Section IV-Commercial General Liability Conditions,Condition 4.Other Insurance,Paragraph b.Excess Insurance: NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES 7 The Insurance afforded by this provision of this endorsement is excess over any property insurance, whether primary, excess,contingent or on any other basis. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES 7 D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU(Tenant's Property Damage) • KNOWLEDGE OF OCCURRENCE,OFFENSE,CLAIM OR SUIT 7 i If Damage To Premises Rented To You is not otherwise excluded from this Coverage Part: LIBERALIZATION CLAUSE 7 1. Under Paragraph 2.Exclusions of Section I-Coverage A-Bodily Injury and Property Damage Liability: s. BODILY INJURY REDEFINED 7 a. The fourth from the last paragraph of exclusion j.Damage To Property Is replaced by the follow- Ing: EXTENDED PROPERTY DAMAGE g Paragraphs(1),(3)and(4)of this exclusion do not apply to"property damage' (other than damage by fire,lightning, explosion, smoke,or leakage from an automatic fire protection system)to: WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US- 8 (I) Premises rented to you for a period of 7 or fewer consecutive days;or WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU (II) Contents that you rent or lease as part of a premises rental or lease agreement for a period of more than 7 days. Paragraphs (1),(3)and(4)of this exclusion do not apply to"property damage" to contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described in Section DI"Limns of Insurance. ®2013 Liberty Mutual Insurance ®2013Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 1 of 8 CG 88 10 04 13 Includes copyrighted material of Insurance Serves Once,Inc.,wkh its permission. Page 2 of 8 b. The last paragraph of subsection 2.Exclusions is replaced by the following: b. Premises or facilities rented by you or used by you;or Exclusions c,through n.do not apply to damage by fire,lightning, explosion, smoke or leakage e. The maintenance, operation or use by you of equipment rented or leased to you by such person or from automatic fire protection systems to premises while rented to you or temporarily occupied by organization; or you with permission of the owner. A separate limit of insurance applies to Damage To Premises d. Operations performed by you or on your behalf for which the state or political subdivision has Rented To You as described in Section III-Limns Of Insurance. issued a permit subject to the following additional provisions' 2. Paragraph 8.under Section III"Limits Of Insurance is replaced by the following: (1) This insurance does not apply to"bodily Injury', "property damage", or'personal and ad- 6. Subject to Paragraph 5.above,the Damage To Premises Rented To You Limit is the most we will vertising Injury" arising out of the operations performed for the state or political subdivision; pay under Coverage A for damages because of'property damage" to: (2) This insurance does not apply to'bodily injury' or"property damage" induded within the a. Any one premise: "completed operations hazard". (1) While rented to you;or (3) Insurance applies to premises you own,rent,or control but only with respect to the following (2) While rented to you or temporarily occupied by you with permission of the owner for hazards: damage by fire,lightning, explosion, smoke or leakage from automatic protection sys- tems;or (a) The existence, maintenance, repair, construction, erection, or removal of advertising b. Contents that you rent or lease as part of a premises rental or lease agreement. signs,awnings, canopies, cellar entrances, coal holes,driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and si!milar expo- 3. As regards coverage provided by this provision D.EXTENDED DAMAGE TO PROPERTY RENTED TO Sures;or YOU(Tenant's Property Damage)-Paragraph Na,. of Definitions is replaced with the following: (b) The construction, erection,or removal of elevators; or 9.a.A contract for a lease of premises. However, that portion of the contract for a lease of premises _ (0) The ownership, maintenance, or use of any elevators covered by this insurance. that indemnifies any person or organization for damage by fire,lightning, explosion, smoke,or s j= leakage from automatic fire protection systems to premises while rented to you or temporarily However: occupied by you with the permission of the owner, or for damage to contents of such premises 1. The insurance afforded to such additional insured only applies to the extent permitted by law,and that are included in your premises rental or lease agreement, is not an"insured contract". E. MEDICAL PAYMENTS EXTENSION 2. If coverage provided to the additional insured Is required by a contract or agreement, the Insur- ance afforded to such additional insured will not be broader than that which you am required by If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this policy the contract or agreement to provide for such additional insured. are amended as follows: With respect to Paragraph 1.a.above, a person's or organization's status as an additional insured Under Paragraph 1.Insuring Agreement of Section I-Coverage C-Medical Payments,Subparagraph under this endorsement ends when: (h)of Paragraph e.is replaced by the following: (1) All work,including materials, parts or equipment furnished in connection with such work,on (b) The expenses are incurred and reported within three years of the date of the accident; and the project(other than service,maintenance or repairs)to be performed by or on behalf of the F. EXTENSION OF SUPPLEMENTARY PAYMENTS"COVERAGES A AND B additional insured(s)at the location of the covered operations has been completed; or 1. Under Supplementary Payments-Coverages A and B,Paragraph 1.b.is replaced by the following: (2) That portion of'your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor b. Up to$3,000 for cost of bail bonds required because of accidents or traffic law violations arising nsing engaged in pedonning operations for a principal as a pan of the same project. out of the use of any vehicle to which the Bodily Injury Liability Coverage applies.We do not have With respect to Paragraph l.b.above, a person's or organization's status as en additional insured to fumish these bonds. under this endorsement ends when their written contract or written agreement with you for such 2. Paragraph 1.d.is replaced by the following: premises or facilities ends. d. All reasonable expenses Inured by the insured at our request to assist us in the investigation or = With respects to Paragraph 1.c.above,this insurance does not apply to any'occurrence" which takes defense of the claim or'suit", including actual loss of eamings up to$500 a day because of time place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. off from work. G. ADDITIONAL INSUREDS-BY CONTRACT,AGREEMENT OR PERMIT 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". 1. Paragraph 2,under Section II-Who Is An Insured is amended to include as an insured any person or We have no duty to defend an additional insured under this endorsement until we receive written organization whom you have agreed to add as an additional insured in a written contract, written notice of a"suit" by the additional Insured as required in Paragraph b.of Condition 2-Duties In the agreement or permit. Such person or organization is an additional insured but only with respect to Event Of Occurrence,Offense,Claim Or Suit under Section IV"Commercial General Liability Condi" liability for'bodily injury, 'property damage" or'personal and advertising injury caused in whole liens. or in part by a. Your acts or omissions, or the acts or omissions of those acting on your behalf,in the performance of your on going operation for the additional insured That are the subject of the written contract or written agreement provided that the"bodily injury" or'property damage" occurs,or the-per- nal and advertising injury' is committed, subsequent to the signing of such written contract or written agreement; or ®2013 Liberty Mutual Insurance ®2013 Liberty Mutual Insurance CG 88 10 04 13 Indudes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 3 of 8 CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page a of 8 • • ' B tot 2. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. b. The following is added to Paragraph b.Excess Insurance: Exclusions under Section 1•Coverage A-Bodily Injury And Property Damage Liability: When a written contract or written agreement, other than a premises lease,facilities rental contract or This Insurance does not apply to: agreement, an equipment rental or lease contract or agreement, or permit issued by a state or political a. "Bodily Injury or"property damage arising from the sole negligence of the additional insured, subdivision between you and an additional insured does not require this insurance to be primary or primary and noncontributory, this insurance is excess over any other insurance lar which the addl- b. 'Bodily injury or"property damage" that occurs prior to you commencing operations at the clonal insured is designated as a Named Insured. location where such'bodily injury' or"property damage'occurs. Regardless of the wnden agreement between you and en additional insured.this insurance is excess c. 'Bodily injury", 'property damage' or"personal and advertising injury" arising out of the render- over anyother in ce whether primary, excess,contingent oron any other basis for which the ing of,or the failure to render,any professional architectural, engineering or surveying services, additional insured Shasnbeen added as an additional insured on other policies. including: _ (1) The preparing, approving, or failing to prepare Sr approve, maps,shop drawings, opinions, _I. ADDITIONAL INSUREDS•EXTENDED PROTECTION OF YOUR"LIMITS OF INSURANCE" reports,surveys,field orders,change orders or drawings and specifications: or This provision applies to any person or organization who qualifies as an additional insured under any form (2) Supervisory, inspection, architectural or engineering activities. or endorsement under this policy. This exclusion applies even it the claims against any insured allege negligence or other wrongdoing in 1. The following is added to Condition 2.Duties In The Event Of Occurrence,Offense,Claim or Suit the supervision, hiring, employment, training or monitoring of others by that insured, if the"occur- ence which cased the'bodily injury' or'property damage, or the offense which caused the An additional insured under this endorsement will as soon as practicable: 'personal and advertising injury. involved the rendering of,or the failure to render,any professional a. Give written notice of an'occurrence' or an offense that mayresult in a claim or"suit' under architectural, engineering or surveying services. a this Insurance to us; d. "Bodily injury' or'properly damage" occurring after: b. Tender the defense and indemnity of any claim or"suit" to all insurers whom also have (1) All work,including materials, parts or equipment fumished in connection with such work.on Insurance available to the additional insured; and the project(other than service,maintenance or repairs)to be performed by or on behalf of the c. Agree to make available any other insurance which the additional insured has for a loss we additional insured(s)et the location of the covered operations has been completed; or cover under this Coverage Part. (2) That portion of'your work" out of which the injury or damage arises has been put to its d. We have no duly to defend or indemnify an additional insured under this endorsement until intended use by any person or organization other than another contractor or subcontractor we receive whiten notice of a'suit" by the additional insured. engaged in performing operations for a principal as a part of the same project. 2. The limits of insurance applicable to the additional insured are those specified in a written contract e. Any person or organization specifically designated as an additional insured for ongoing operations or written agreement or the limits of insurance as slated in the Declarations of this policy and by a separate ADDITIONAL INSURED-OWNERS,LESSEES OR CONTRACTORS endorsement is- defined in Section 111-Limits of Insurance of this policy, whichever are less.These limits are sued by us and made a part of this policy. inclusive of and not in addition M the limits of insurance available under this policy. 3. With respect to the insurance afforded to these additional insureds,the following is added to Section 111 J. WHO IS AN INSURED-INCIDENTAL MEDICAL ERRORS I MALPRACTICE -Limits Of Insurance: WHO IS AN INSURED-FELLOW EMPLOYEE EXTENSION-MANAGEMENT EMPLOYEES If coverage provided to the additional insured is required by a contract or agreement, the most we will Paragraph 2.a.(1)of Section II•Who Is An Insured is replaced with the following: pay on behalf of the additional insured is the amount of insurance: a. Required by the contract or agreement; or (1) 'Bodily injury' or-personal and advertising injury'. b. Available under the applicable Limits of Insurance shown in the Declarations; (a) To you,to your partners or members(if you are a partnership or joint venture),to your members(if whichever is less. you are a limited liability company), to a co-"employee- while in the course of his or her ment or performing duties related to the conduct of your business, or to your other"volunteer This endorsement shall not increase the applicable Limits of Insurance shown in the Declaratio ns. r workers' while performing duties related to the conduct of your business, H. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION (b) To the spouse,child, parent,brother or sister of that co-"employee" or"volunteer worker' as a This provision applies to any person or organization who qualifies as an additional insured under any form consequence of Paragraph(1)(a)above; or endorsement under this policy. (c) For which there is any obligation to share damages with or repay someone else who must pay Condition 4.Other Insurance of SECTION IV-COMMERCIAL GENERAL LIABILITY CONDITIONS is amend- damages because of the injury described in Paragraphs(1)(a)or(b)above;or ed as follows: (d) Arising out of his or her providing or failing to provide professional health Care services.However, if you are not in the business of providing professional health care services or providing proles- a. The following is added to Paragraph a.Primary Insurance: sional health care personnel to others, or if coverage for providing professional health care ser- vicesif an additional insured'shas an Other Insurance - makingits tic and not otherwise excluded by separate endorsement, this provision (Paragraph(d))does not policy provisionpolicy excess, n you ly is have agreed in a written contract orwritten agreement to provide the additional insuredcoverageon a primary and noncontributory basisthis policy shall be primary and we will not seek contribution from Paragraphs(a)and(b)above do not apply to"bodily injury' or"personal and advertising injury' caused by the additional insured's policy for damages we cover. an employee who is acting in a supervisory capacity for you.Supervisory capacity as used herein means the"employee's' job responsibilities assigned by you,Includes the direct supervision of other"employ- ees of yours. However, none of these"employees" are insureds for"bodily injury" or'personal and ®2013 Liberty Mutual Insurance w 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc„weh its permission. Page 5 of 8 CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 6 of 8 advertising injury” arising out of their willful conduct,which is defined as the purposeful or willful intent to P. EXTENDED PROPERTY DAMAGE cause"bodily injury" Or'personal and advertising injury", or caused in whole or in part by their intozica- Exclusion a.of COVERAGE A.BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the tion by liquor or controlled substances. following. The coverage provided by provision J.is excess over any other valid and collectable insurance available to Expected Or Intended In' your"employee". a. jury K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES 'Bodily injury or"properly damage' expected or intended from the standpoint of the insured. Paragraph 3.of Section II-Who Is An Insured is replaced by the following: This exclusion does not apply to"bodily injury' or"property damage" resulting from the use of reasonable force to protect persons or property. 3. Any organization you newly acquire or form and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other Similar Insurance available to that Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US•WHEN REQUIRED IN A organization, However CONTRACT OR AGREEMENT WITH YOU a. Coverage under this provision is afforded only until the expiration of the policy period in = Under Section IV"Commercial General Liability Conditions,the following is added to Condition 8,Trans- which the entity was acquired or formed by you', ter Of Rights Of Recovery Against Others To Us: b. Coverage A does not apply to'bodily injury or'property damage- that occurred before you We waive any right of recovery we may have against a personor organization because of payments we acquired or formed the organisation; and make for injury or damage arising nut of your ongoing operations or'your work" done under a c. Coverage B does not apply to'personal and advertising injury" arising out of an offensecontract with that person or organization and included in the"products-completed operations hazard" committed before you acquired or formed the organization. provided. d. Records and descriptions of operations must be maintained by the first Named Insured. 1. You and that person or organization have agreed In writing in a contract or agreement that you No person or organization is sured with respect to the conduct of any current or past partnership, joint waive such rights against that person or organization; and venture or limited liability company that is not shown as a Named Insured in the Declarations or qualifies 2. The injury or damage occurs subsequent to the execution of the written contract or written agree- as an insured under Ihis provision. merit. L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES Under Section IV-Commercial General Liability Conditions,the following is added to Condition 6.Repre- sentations: Your failure to disclose at hazards or prior"occurrences" existing as of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or poor"occurrences" is not intentional. M. KNOWLEDGE OF OCCURRENCE,OFFENSE,CLAIM OR SUIT Under Section IV-Commercial General Liability Conditions,the following is added to Condition 2.Duties In The Event of Occurrence,Offense,Claim Or Suit: Knowledge of an-occurrence", offense, claim or'suit" by an agent,servant or"employee' of any insured shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph 1.of Section II-Who Is An Insured or a person who has been designated by them to receive reports of "occurrences', offenses, claims or suits' shall have received such notice from the agent,servant or "employee". x N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge,your policy will automatically provide the coverage as of the day the revision is effective in your state. a 0, BODILY INJURY REDEFINED Under Section V-Definitions,Definition 3.is replaced by theng: 1"J E D 3. "Bodily Injury' means physical injury, sickness or disease sustained by a person.This includes mental anguish, mental injury, shock,fright or death that results from such physical Injury, sick- ness or disease. 0 2013 Liberty Mutual Insurance •2013 Liberty Mutual Insurance CC 88 10 04 13 Includes copyrighted material or Insurance Services Office,Inc.,with its permission. Page 7 of B CG 88 10 04 13 Irvl•,tles rmmnighted material,n Insurance Services Mace,Inc with its permission. Page d of 8