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HomeMy WebLinkAbout5680AGENDA BILL CITY OF BREMERTON CITY COUNCIL SUBJECT: Contract Award to.Johansen ;_Excavating; Inc: for the Lebo Boulevard Roadway Improvement Project Study Session Date: COUNCIL MEETING Date: Department: Presenter: Phone: March 22, 2017 April 5, 2017 Public Works & Utilities Chal Martin (360) 473-5758 SUMMARY: This project: received seven bids. The lowest responsive, responsible bidder was Johansen Excavating, Inc., from Buckley, Washington with a bid of $4,934,570.06, including estimated sales tax. ATTACHMENTS: 1. Contract 2. Bid tabulation FISCAL IMPACTS (Include Budgeted Amount): The Lebo Boulevard Road Improvement Project is funded with a Transportation Improvement Board grant of $4,94:2,722; City Stormwater Utility funding of $913,514, and City Water Utility funding of approximately $113,000. STUDY SESSION AGENDA: px No Presentation ❑ Full Presentation STUDY SESSION ACTION: ❑ Consent Agenda 21 General Business ❑ Public Hearing RECOMMENDED MOTION: Move to approve a contract with Johansen Excavating, Inc. for the Lebo Boulevard Roadway Improvement Project in the amount of $4,934,570.06 including Washington State sales tax; and authorize the Mayor to finalize and execute the agreement with substantially the same terms and conditions as presented. COUNCIL ACTION: EO Approve ❑ Deny ❑ Table ❑ Continue ❑ No Action Form Updated 01/07/15 City of Bremerton 100 Oyster Bey Ave. N. Local Agency Contract THIS AGREEMENT, made and entered into this 10th day of .April, 2017 betweenathe B=m=, and the Johansen Excavating Inc., Company under and by virtue of Title 47 RCW, as amended and hereinafter called the Contractor. WITNESSETH: That in consideration of the terms and conditions contained herein and attached and made a part of this agreement, the parties hereto covenant and agree as follows: I. The Contractor shall do all work and furnish all tools„ materials, and equipment for: Lebo Boulevard Roadway Improvement Project I TIB NO. 8-0-152(026)-1 in accordance with and as described in the attached plans and specifications, and the standard specifications; of the Cjly of Bremerton which are by this reference incorporated herein and made part hereof and, shall perform any changes in the work in accord with the Contract Documents. The Contractor shall provide and bear the expense of all equipment, work and labor, of any sort whatsoever that may be required for the transfer of materials and for constructing and completing the work provided for in these Contract Documents except those items mentioned therein to be fumished by City of Brern=g& II. Ciy of Bremerton hereby promises and agrees with the Contractor to employ, and does employ the Contractor to provide the materials and to do and cause to be done the above described work and to complete and finish the same in accord with the attached plans and specifications and the terms and conditions herein contained and hereby contracts to pay for the same according to the attached specifications and the schedule of unit or itemized prices at the time and in the manner and upon the conditions provided for in this contract. Lebo Boulevard Lebo Boulevard Roadway Improvement Project DOT Forth 272-006A EF 07=11 III. The Contractor for himself/herself, and for his/her heirs, executors, administrators, successors, and assigns, does hereby agree to full performance of all convenants required of the Contractor in the contract. IV. It is further provided that no liability shall attach to the State by reason of entering into this contract, except as provided herein. IN WITNESS WHEREOF, the Contractor has executed this instrument, on the day and year first below written and; Cly of B emerton has caused this instrument to be executed by and in the name of Cily of Bremerton the day and year first above written. Executed by the Contractor —7JQ7i1hiJ 5CrJ _ EK•cA,/ VV t r,46- .. I NL • . RIL. 1:5 2017- (Contractor) Local Agency: City of Bremerton Title: Mayor By: - - Date: April 10,��17 Lebo Boulevard Lebo Boulevard Roadway Improvement Project DOT Form 272-006A EF 0712011 BID PROPOSAL LEBO BOULEVARD ROADWAY IMPROVEMENT PROJECT BID SCHEDULE Sales Tax — The bidder shall include sales tax in the Bid Item price per Section 1-07.2(1) for all items in the Bid Schedule. BID TABULATION Item No. Ref to Spec Description of Item Estimated Quantity Unit Unit Price Amount 1 1-09.7 MOBILIZATION 1 L.S. $�I1G,�•°p $a17La0o,°o 2 2-01.5 CLEARING AND GRUBBING 2 ACRE 3 2-02.5 REMOVING CEMENT CONC. SIDEWALK 5,790 SY $ •�5 $ �p �{ 4 2-02.5 REMOVING CEMENT CONC. CURB AND GUTTER 9,550 LF $ 5 2-02.5 REMOVING DRAINAGE STRUCTURE 49 EACH $ y� J•®fl $�3t "1tp 6 2-02.5 REMOVAL OF STRUCTURE 1 L.S. $750M.00 $-Y-W,00.00 AND OBSTRUCTION 7 2-03.5 ROADWAY EXCAVATION INCL. 3,220 C.Y. $3$.SO $%aS�970C HAUL 8 2-03.5 SELECT BORROW INCL. HAUL 7,600 TON $22. SO $ %I% , 060.c* 9 2-03.5 RUBBLIZATION 18,800 S.Y. $ -j , �0 $ iL41.006 °6 10 7-05.5 CATCH BASIN TYPE 1 L 9 EACH $1'6$0.00 $ %,L420.00 11 7-05.5 CATCH BASIN TYPE 1 53 EACH $1%0.°0 $72.060.00 12 7-05.5 ADJUST CATCH BASIN 1 EACH $ 290 00 $ 290• 00 13 7-05.5 CATCH BASIN TYPE 2 -48" 13 EACH $1"!40.°0 $3S(o?O DIAM 14 7-05.5 CATCH BASIN TYPE 2 - 72" 1 EACH $(x190 DO $ (0190,00 DIAM CATCH BASIN TYPE 2 60" 15 7-05.5 DIAM WITH FLOW 1 EACH $(WO.0O $(.M.00 RESTRICTOR 16 7-02.5 SCH. A STORM SEWER PIPE 12 IN. DIAM. 2,920 L.F. $44.82- $NSIA-114. 17 7-02.5 SCH. A STORM SEWER PIPE 1,110 L.F. $ 60.'00 $ (.6&k0 -00 18 IN. DIAM. City of Bremerton Lebo Boulevard Roadway Improvement Project LO -1 March 2017 Public Works Agreement 00 ,50 ®.00 3f00 Item No. Ref to Spec Description of Item Estimated:Unit Quantity Unit Price Amount 18 7-02.5 SCH. A STORM SEWER PIPE 290 L.F. $104.00 $ 30160.00 24 IN. DIAM. 19 2-09.5 SHORING OR EXTRA EXCAVATION CL. B 3,500 S.F. $ 3,1,5 $ c OZF� 20 7-01.5 UNDERDRAIN PIPE 6 IN. DIAM. 1,1811 L.F. $40.50 $54,1!'10 °o 21 7-05.5 MODULAR WETLAND 4X6 2 EACH $2.TOO 00 $ 5'I,WO•°p UNDERGROUND 22 7-05.5 MODULAR WETLAND 4X8 5 EACH $30SbO oo $162,500 b UNDERGROUND 23 7-05.5 MODULAR WETLAND 6X8 1 EACH $-45ft* PG $4g 9W.Cp 24 7-05.5 MODULAR WETLAND 8X12 1 EACH $S65bp 00 $56, 0.06 25 7-05.5 MODULAR WETLAND 8X12 1 EACH t0.*0 $100 $11,000• UNDERGROUND 6-13.5 STRUCTURAL' EARTH WALL 3,910 SF $ x•00 $ %%-j 300.00 F27 4-04.5 CRUSHED SURFACING BASE 7,690 TON $2.77.50 $U%'Lk IS.00 COURSE 28 5-04.5 HMA CL. 1/2 IN. PG 58-22 5,220 TON $St.610 $Lj%r'j 29 5-04.5 JOB MIX COMPLIANCE PRICE i 1 EST. $2,000 $2,000 ADJUSTMENT 30 5-04.5 COMPACTION PRICE 1 EST. -$1 -$1 ADJUSTMENT 31 5-04.5 ASPHALT COST PRICE 1 EST. $355 $355 ADJUSTMENT 32 8-01.5 ESC LEAD 45 DAYS $243.00 $ IIOSS• EROSION CONTROL AND 33 8-01.5 WATER POLLUTION 1 L.S. $Z13OG od $2.1$wbo.°O PREVENTION 34 8-01.5 SEEDING, FERTILIZING, AND 2 ACRE $Zt25.°O $4.-M.00 MULCHING 35 8-04.5 CEMENT CONC. PEDESTRIAN 200 L.F. $Z9 .00 $S,200.00 CURB 36 8-04.5 CECURB AND GUTAFMENT CONC. RIC 11,350 L.F. $ 19.� $21S,6'so. 37 8-11.5 BEAM GUARDRAIL TYPE 31 140 L.F. $S3.QO $'1,6126.60 38 8-22.5 PLASTIC LINE 7,470 L.F. $ I •gyp 4 $�.�'.Z.�. City of Bremerton Lebo Boulevard Roadway Improvement Project LD -2 Manch 2017 Public Works Agreement Item No. Ref to Spec Description of Item Estimated Quantity Unit Unit Price Amount 39 8-22.5 PLASTIC WIDE LANE LINE 5,440 L.F. $ a1 • J $ 40 8-22.5 PLASTIC CROSSWALK LINE 2,250 S.F. $ 5j,3'5 $ l2 b3"1 41 8-22.5 PLASTIC STOP LINE 158 L.F. $ '1.00 $ 1 jOIO A 42 8-22.5 PLASTIC TRAFFIC ARROW 1 EACH $ Oft•W $ q480.0t 43 8-22.5 PLASTIC BICYCLE LANE SYMBOL 19 EACH $p9 L _T $ Z ,033• 44 8-22.5 PLASTIC TRAFFIC LETTER 13 EACH $ (o •54 $ ci0 3• 45 8-21.5 PERMANENT SIGNING 1 L.S. $ 7 �'SQ°d $ 46 8-23.5 TEMPORARY PAVEMENT MARKING -SHORT DURATION 16,000 L.F. $ . VS $ `d•OO 47 1-10.5 TRAFFIC CONTROL 1 EST. $2,500 $2,500 SUPERVISOR 48 1-10.5 PEDESTRIAN TRAFFIC 1 EST. $2,500 $2,500 CONTROL 49 1-10.5 FLAGGERS 1 EST. $2,000 $2,000 50 1-10.5 OTHER TRAFFIC CONTROL 1 EST. $2,000 $2,000 LABOR 51 1-10.5 PROJECT TEMPORARY 1 L.S. $326,600.0 $126,40 .06 TRAFFIC CONTROL 52 1-08.3(5) TYPE B PROGRESS SCHEDULE 1 L.S. $ SJ $ 'S0000. 10 53 7-01.5 GRAVEL BACKFILL FOR 200 C.Y. $q -L.00 $ S L460.°0 DRAIN 54 7-08.5 ABANDON PIPE 35 EACH $512.90 $11937.5b 55 8-14.5 CEMENT CONC. SIDEWALK 9,390 S.Y. $146 $4131,46. 56 8-06.5 CEMENT CONC. DRIVEWAY 1,390 S.Y. $-is%CO $1&17.50 a° ENTRANCE TYPE 2 57 8-06.5 CEMENT CONC. DRIVEWAY 990 S.Y. $7s''.06 $7H 230°0 ENTRANCE TYPE 3 58 8-14.5 CEMENT CONC. CURB RAMP 59 EACH $1%6.00 $112.1400 59 + 7-13.5 REPLACE ANBDOA,DJUST VALVE 61 EACH $ 3,Z0 0° $a3 60 1-05.18 RECORD DRAWINGS 1 L.S. $ 7' PQ4- $ 2 ODO- 61 1-07.13 4 () REIMBURSEMENT FOR THIRD 1 EST. $5,000 $5,000 PARTY DAMAGE City of Bremerton Lebo Boulevard Roadway Improvement Project LD -3 March 2017 Public Works Agreement 00 ,5v [i -M Z: Item No. Ref to Spec Description of Item Estimated Quantity Unit Unit Price Amount 62 7-05.5 ADJUST MANHOLE 34 EACH $ SI® pp $ 63 8-13.5 MONUMENT, CASE, COVER, AND PIPE 4 EACH $11050.00$ . 64 1-07.15(1) SPCC PLAN 1 L.S. $ Z per, $ 65 8-18.5 MAILBOX SUPPORT TYPE 1 5 EACH $ (� ��� $ 66 7-05.5 CONNECTION TO DRAINAGE STRUCTURE 9 EACH $ •M. $��' ,a.� 67 1-05.4 ROADWAY SURVEYING 1 L.S. $30000 O $10,0w.40 68 1-05.4 LICENSED SURVEYING 1 EST. $15,000 $15,000 69 7-13.5 ADJUST METER BOX 47 EACH $ qll(3.00 $ J.a,p 70 8-20.5 ILLUMINATION SYSTEM 1 L.S. $42Sao0.66 $yLs6M -!6 71 8-12.5 COATED CHAIN LINK FENCE 800 L.F. $20 •'ra $ l6°W., TYPE 4 COATED END, GATE, 72 8-12.5 CORNER, PULLPOST FOR 82 EACH $2$Z 00 $2) It,4 CHAIN LINK FENCE 73 8-02.5 TOPSOIL TYPE A 1,049 S.Y. $ 8'.y 9, $ 5,111. as, 74 8-02.5 6" CONCRETE MOW STRIP 271 L.F. 75 8-04.5 SEEDING AND FERTILIZING 20,408 S.F. $0.0-1 $ 1473,'F6 76 8-02.5 BARK OR WOOD CHIP MULCH 143 S.Y. $ 5.41, $119.3s 77 8-02.5 PSIPE ACER GLABRUM 'ROCKY 11 EACH $ $ 51S 4( MT' .°p 78 8-02.5 PSIPE PRUNUS VIRGINIANA 'CANADA 5 EACH $ 5116 �s $Z133,11s RED' 79 8-02.5 PSIPE SYRINGA RETICULATA 'IVORY 14 EACH $60"? •'�O $ $s-657 06 SILK' 80 8-02.5 PSIPE ARBUTUS UNEDO 'ELFIN KING 23 EACH $1 10 81 8-02.5 PSIPE HEMEROCALLIS X 'STELLA 12 EACH $12.4 $ DE ORO' 82 8-02.5 PSIPE NANDINA DOMESTICA 'FIRE 49 EACH POWER' 83 B-02.5 PSIPE POTENTILLA 'ABBOTSW 190 EACH $36 Ms $ 6926%%16 FRUTICOSA OOD' City of Bremerton Lebo Boulevard Roadway Improvement Project LD -4 March 2017 Public Works Agreement I +L - v IP Item No, Ref to Spec Description of Item Estimated Quantity Unit Unit Price Amount 84 8-02.5 PSIPE RHUS AROMATICA 'GRO-LOW' 156 EACH $ 22.00 $3�13Z• 85 8-02.5 PSIPE VIBURNUM DAVIDII 97' EACH $yp,►S $3JJ4J,ss- 86 8-02.5 PSIPE COTONEASTER 'TOM 129 EACH $ it AD $2.36J. 16 APICULATUS THUMB' 87 8-02.5 PSIPE EUONYMUS FORTUNEI 'CANADALE 100 EACH $ 0! 1(0 $ 0Ita. c6 GOLD' 88 8-05.5 BENCHES 3 EACH $2.t*6.66 $ 636&,60 89 8-21.5 WEST MONUMENT SIGN 1 EACH $2fppd 00 $ioo 90 8-21.5 EAST MONUMENT SIGN 1 EACH $ 24,406.60 $ 2y066:,Qa 91 6-02.5 PIGMENTED SEALER FOR 1,874 S.F. $� TCy $ $g�;Cb 6 CONCRETE SURFACES 92 6-02.5 ANTI -GRAFFITI COATING 2,000 S.F. $ , (,S" $1u6 co 93 8-22.5 WHITE REFLECTIVE PAINT 84 L.F. $ 94 1-04.4 MINOR CHANGE 1 EST. $50,000 $50,000 95 1-07.17 FORCE ACCOUNT - POLE 1 EST. $20,000 $20,000 HOLDING 96 1-07.17(3) FORCE ACCOUNT - 1 EST. $7,500 $7,500 POTHOLING TOTAL: $4443y,970. °6 END OF BID PROPOSAL City of Bremerton Lebo Boulevard Roadway Improvement Project LD -5 Manch 2017 Public Works Agreement City of Bremerton 100 Oyster Bay Ave. N. (Local Agency Proposal Signature Page The bidder is hereby advised that by signature of this proposal he/she is deemed to have acknowledged all requirements and signed all certificates contained herein. A proposal guaranty in an amount of five percent (5%) of the total bid, based upon the approximate estimate of quantities at the above prices and in the form as indicated below is attached hereto: Cash ❑ In the Amount of Cashier's Check ❑ Dollars Certified Check ❑ (3 ) Payable to the Agency Proposal Bond 74 In the Amount of 5% of the Bid Receipt is hereby acknowledged of addendum(s) No.(s) I )? _ , Z & /Authorized Official(s) Proposal Must be Signed Firm Name <Zia -,,J Address w K - C(TT2, State of Washington Contractor's License No. -J cl �� y Federal ID No. \gyp Note: (1) This proposal form is not transferable and any alteration of the firm's name entered hereon without prior permission from the My of Bremerton will be cause for considering the proposal irregular and subsequent rejection of the bid. (2) Please refer to section 1-02.6 of the standard specifications, re: "Preparation of Proposal," or "Article 4" of the Instruction to Bidders for building construction jobs. Lebo Boulevard Lebo Boulevard Roadway Improvement Project A DOT Forth 272-036K EF 07/2011 No. BI -1220g POWER OF ATTORNEY BERKLEY INSURANCE COMPANY WH vIINGTON, DELAWARE NOTICE: The warning found elsewhere in this Power of Attorney affects the validity thereof. Please review carefully. KNOW ALL MEN BY THESE PRESENTS, that BERKLEY .INSURANCE COMPANY (the "Company"), a corporation duly organized and existing under the laws of the State,of Delaware, having its principal office in Greenwich, CT, has made, constituted and appointed, and does by these presents make, constitute and appoint: Karen C. Siwan son; Julie R. Truitt, Brent F_ Heilesen; Christopher Kinyon; Jamie Diemen, Carley Espiritu, Peter J. 'Comfort,• Annelies M. Richie; Kyle Joseph Howat; Mary. S. NorreU; or Heather L. Allen of Propel Insurance of Tacoma, WA_ its true and lawful Attorney -in -Fact, to sign its, name as surety only as delineated below and to execute; seal;`acknowledge and deliver any and allbonds'and undertakings, with the exception of Financial Guaranty Insurance, providing that no single obligation shall exceed Fifty Million and 00/100 U.S. Dollars (U.S.$50,000,000.00), to the same extent as if such bonds had been duly executed. and acknowledged by the regularly elected officers of the Company at its principal office in their own proper persons. This Power of Attorney shall be construed and enforced in accordance with, and governed by, the laws of the State of Delaware, without giving effect to the principles of conflicts of laws thereof, This Power of Attorney is granted pursuant to the following resolutions which were duly and validly adopted at a meeting of the Board of Directors of the Company held on January 25, 2010: RESOLVED, that, with respect to the Surety business written by Berkley, Surety Group, the Chairman of the..Board, Chief Executive Officer, President or any Vice President of the Company, in conjunction with the Secretary or any Assistant Secretary are hereby authorized to execute powers of attorney authorizing and qualifying the attorney-in-fact named therein to execute bonds, undertakings, recognizances, or other suretyship obligations on behalf of the Company, and to affix the corporate seal of.the Company to powers of attorney executed pursuant hereto; -and said officers may remove any such attorney-in-fact and revoke any power of attorney previously granted; and fiiither RESOLVED, .that such power of attorney limits the acts of those named therein to the bonds, undertakings, recognizances, or other suretyship obligations specifically named therein, and they have no authority to bind the Company except in the manner and to the extent therein stated; and further RESOLVED, that such power of attorney revokes all previous powers issued on behalf of the attorney-in-fact named; and further RESOLVED, that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any power of attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligation of the Company; and such signature and seal when so used shall have the same force and effect as though manually affixed. The Company may continue to use for the.purposes herein stated the facsimile signature of any person or persons who shall have been such officer or officers of the Company, notwithstanding the fact that they may have ceased to be such at the time when such instruments shall be issued: IN WITNESS WHEREOF, the Company has ca sed these presents to be signed and attested by its appropriate officers and its corporate seal hereunto affixed thiisday of 2016. Attest: (seal) By Berkley insurance Ira S. Lederman je afleQExecutive Vice President & Secretary forVleb President WARNING: THIS POWER INVALID IF NOT PRINTED ON BLUE "BERKLEY" SECURITY PAPER. STATE OF CONNECTICUT) ) ss: COUNTY OF FAIRFIELD ) Sworn to before me, a Notary Public in the State of Connecticut, this' iay of 2016, by Ira S. Lederman and Jeffrey M. Halter who are sworn to me to be the Executive Vice President an err ;ande Senior Vice President, respectively, of Berkley Insurance Company.MARIA C. RUNDBAKEN NOTARY PUBLIC MY COMMISSION EXPIRES Notary Public, State of Connecticut APRIL 30, 2019 CERTIFICATE I, the undersigned, Assistant Secretary of BERKLEY INSURANCE COMPANY, DO HEREBY CERTIFY that the foregoing is a true, correct and complete copy of the original Power of Attorney; that said Power of Attorney has not been revoked or rescinded and that the authority of the Attorney -in -Fact setforth therein, who executed the bond or undertaking to which this Power of Attorney is attached, is in full force and effect as of this date. Given under my hand and seal of the Company, this, day of _ (Seal) Vincent P. Forte Local Agency Name Local Agency Address 3y s 64 si . � error, WA 1I 331 Local Agency Subcontractor List Prepared in compliance with RCW 39.30.060 as amended To Be Submitted with the Bid Proposal Project Name Lt�O'_._ O�,I'rV"J 4Zcodi. , •T Failure to list subcontractors with whom the bidder, if awarded the contract, will directly subcontract for , performance of the work of heating, ventilation and air conditioning, plumbing, as described in Chapter 18.106 RCW, and electrical, as described in Chapter 19.28 RCW or naming more than one subcontractor to perform the same work will result in your bid being non-responsive and therefore void. Subcontractor(s) with whom the bidder will directly subcontract that are proposed to perform the work of heating, ventilation and air conditioning, plumbing, as described in Chapter 18.106 RCW, and electrical as described in Chapter 19.28 RCW must be listed below. The work to be performed is to be listed below the subcontractor(s) name. • • 1 [: _ • _�� • > • . ! ! i / • 111 _ 1 . • 1. 1. _ • • • 1. � .1 _ 1 _ . • /. 1 !..? 1 • 111 •• . 1 • • • _ • � !y 1 ! 111: • • _ • , i • 1 . 1 ! , 1 • • 1 r 7. Subcontractor Name Work to be Performed t h or i M • ..ae�M�r1� '$ Subcontractor Name Work to be Performed Subcontractor Name Work to be Performed Subcontractor Name Work to be Performed Subcontractor Name Work to be Performed " Bidder's are notified that is the opinion of the enforcement agency that PVC or metal conduit, junction boxes, etc, are considered electrical equipment and therefore considered part of electrical work; even if the installation is for future use and no wiring or electrical current is connected during the project. SR DOT Form 271-015A EF Revised 08/2012 APWA-WA Division 1 Committee rev. 1/8/2016 Proposal for Incorporating Recycled Materials into the Project In compliance with a new law that went into effect January 1, 2016 (SH81695), the Bidder shall propose below, the total percent of construction aggregate and concrete materials to be incorporated into the Project that are recycled materials. Calculated percentages must be within the amounts allowed in Section 9-03.21(1)E, Table on Maximum Allowable Percent (By Weight) of Recycled Material, of the Standard Specifications. Proposed total percentage: percent. Note: Use of recycled materials is highly encouraged within the limits shown above, but does not constitute a Bidder Preference, and will not affect the determination of award, unless two or more lowest responsive Bid totals are exactly equal, in which case proposed recycling percentages will be used as a tie-breaker, per the APWA GSP in Section 1-03.1 of the Special Provisions. Regardless, the Bidder's stated proposed percentages will become a goal the Contractor should do its best to accomplish. Bidders will be required to report on recycled materials actually incorporated into the Project, in accordance with the APWA GSP in Section 1-06.6 of the Special Provisions. f A A Bidder: Signature of Authorized Official: Date: City of Bremerton Local Agency Performance Bond PERFORMANCE BOND to [City of Bremerton or Bond No. 0208340 County], WA The [City of Bremerton or County], Washington ([City or County]) has awarded to Johansen Excavating, In (Principal), a contract for the construction of the project designated as *Lebo Boulevard ,Project No.8-0-152(026)-1 , in [location], Washington (Contract), and said Principal is required to furnish a bond for performance of all obliga ions un er a Contract. *Roadway Improvement Project The Principal, and Berkley Insurance Company (Surety), a corporation, organized under the laws of the State of Delaware and licensed to do business in the State of Washington as surety and named in the current list of "Surety Companies Acceptable in Federal Bonds" as published in the Federal Register by the Audit Staff Bureau of Accounts, U.S. Treasury Dept., are jointly and severally held and firmly bound to the [City or County], in the sum of *Four Million Nine Hundred Thirtv Four Thousand US Dollars ($ 4,934,570.06 ) Total Contract Amount, subject to the provisions herein. *Five Hundred Seventy and 06/100 This statutory performance bond shall become null and void, if and when the Principal, its heirs, executors, administrators, successors, or assigns shall well and faithfully perform all of the Principal's obligations under the Contract and fulfill all terms and conditions of all duly authorized modifications, additions, and changes to said Contract that may hereafter be made, at the time and in the manner therein specified; and if such performance obligations have not been fulfilled, this bond shall remain in force and effect. The Surety for value received agrees that no change, extension of time, alteration or addition to the terms of the Contract, the specifications accompanying the Contract, or to the work to be performed under the Contract shall in any way affect its obligation on this bond, and waives notice of any change, extension of time, alteration or addition to the terms of the Contract or the work performed. The Surety agrees that modifications and changes to the terms and conditions of the Contract that increase the total amount to be paid the Principal shall automatically increase the obligation of the Surety on this bond and notice to Surety is not required for such increased obligation. This bond may be executed in two (2) original counterparts, and shall be signed by the parties' duly authorized officers. This bond will only be accepted if it is accompanied by a fully executed and original power of attorney for the office executing on behalf of the surety. PRINCIPAL Johansen Excavatin , Inc. 4/13/2017 Pri tr ignature / bate 'SM 14r, IA EB[:� y 2a! Printed Name Date VICE �AF�I DFS Q P c?t2f�TleNS Title SURETY Berkley Insur nce Company 4/11/2017 Surety Signature Date Karen C. Swanson 4/11/2017 Printed Name Date Attorney--in-Fact Title Name, address, and telephone of local office/agent of Surety Company is: Propel Insurance P. O. Box 2940 Tacoma, WA 98401 (253) 759-2200 Approved as to form: [City or County] Attorney, [City of or County] DOT Form 272-002A EF 08/2012 Date City of Bremerton Local Agency Payment Bond PUBLIC WORKS PAYMENT BOND to [City of Bremerton or County], WA Bond No. 0208340 The [City of Bremerton or County], Washington ([City or County]) has awarded to Johansen Excavating, Inc.(Principal), a contract for the construction of the project designated as *Lebo Boulevard Project No. 8-0-152(026)-1 , in [location], Washington (Contract), and said Principal is required under the terms of that Contract to furnish a payment bond in accord with Title 39.08 Revised Code of Washington (RCW) and (where applicable) 60.28 RCW. *Roadway Improvement Project The Principal, and Berkley Insurance Company (Surety), a corporation organized under the laws of the State of Delaware and licensed to do business in the State of Washington as surety and named in the current list of "Surety Companies Acceptable in Federal Bonds" as published in the Federal Register by the Audit Staff Bureau of Accounts, U.S. Treasury Dept., are jointly and severally held and firmly bound to the [City or County], in the sum of *Four Million Nine Hundred Thirtv Four Thousand US Dollars ($ 4,934.570.06 ) Total Contract Amount, subject to the provisions herein. *Five Hundred Seventy and 06/100 This statutory payment bond shall become null and void, if and when the Principal, its heirs, executors, administrators, successors, or assigns shall pay all persons in accordance with RCW 39.08, 39.12, and 60.28 including all workers, laborers, mechanics, subcontractors, and materialmen, and all person who shall supply such contractor or subcontractor with provisions and supplies for the carrying on of such work, and all taxes incurred on said Contract under Titles 50 and 51 RCW and all taxes imposed on the Principal under Title 82 RCW; and if such payment obligations have not been fulfilled, this bond shall remain in full force and effect. The Surety for value received agrees that no change, extension of time, alteration or addition to the terms of the Contract, the specifications accompanying the Contract, or to the work to be performed under the Contract shall in any way affect its obligation on this bond, and waives notice of any changes, extension of time, alteration or addition to the terms of the Contract or the work performed. The Surety agrees that modifications and changes to the terms and conditions of the Contract that increase the total amount to be paid the Principal shall automatically increase the obligation of the Surety on this bond and notice to Surety is not required for such increased obligation. This bond -may be executed in two (2) original counterparts, and shall be signed by the parties' duly authorized officers. This bond will only be accepted if it is accompanied by a fully executed and original power of attorney for the office executing on behalf of the surety. PRINCIPAL Johansen Excavating nc. Prin ipal ignature 13ate Printed Name Dat \/1 6C— Tk--:;, I DE414— OF OPCP_AT- iow S Title SURETY Berkley Ins ance Company 4/11/2017 Surety Signature Date Karen C. Swanson Printed Name Attorney -in -Fact Title Name, address, and telephone of local office/agent of Surety Company is: Propel Insurance P. O. Box 2940 Tacoma, WA 98401 (253) 759-2200 Approved as to form: 4/11/2017 Date [City or County] Attorney, [City of or County] Date DOT Form 272-003A EF 08/2012 No. BI -1220g POWER OF ATTORNEY BERKLEY INSURANCE COMPANY WILMINGTON, DELAWARE NOTICE: The warning found elsewhere in this Power of Attorney affects the validity thereof. Please review carefully. KNOW ALL MEN BY THESE PRESENTS, that BERKLEY INSURANCE COMPANY (the "Company"), a corporation duly organized and existing under the laws of the State of Delaware, having its principal office in Greenwich, CT, has made, constituted and appointed, and does by these presents make, constitute and appoint: Karen C. Swanson; Julie R. Truitt; Brent E. Heilesen; Christopher Kinyon; Jamie Diemer; Carley Espiritu; Peter J. Comfort, Annelies M. Richie; Kyle Joseph Howat; Mary S. Norrell; or Heather L. Allen of Propel Insurance of Tacoma, WA its true and lawful Attorney -in -Fact, to sign its name as surety only as delineated below and to execute, seal, acknowledge and deliver any and all bonds and undertakings, with the exception of i .E Financial Guaranty Insurance, providing that no single obligation shall exceed Fifty Million and 00/100 U.S. Dollars V (U.S.$50,000,000.00), to the same extent as if such bonds had been duly executed and acknowledged by the regularly elected officers of the Company at its principal office in their own proper persons. This Power of Attorney shall be construed and enforced in accordance with, and governed by, the laws of the State of Delaware, oa) without giving effect to the principles of conflicts of laws thereof. This Power of Attorney is granted pursuant to the following > �, resolutions which were duly and validly adopted at a meeting of the Board of Directors of the Company held on January 25, 2010: c RESOLVED, that, with respect to the Surety business written by Berkley Surety Group, the Chairman of the Board, Chief o2 Executive Officer, President or any Vice President of the Company, in conjunction with the Secretary or any Assistant Secretary are hereby authorized to execute powers of attorney authorizing and qualifying the attomey-in-fact named therein to o execute bonds, undertakings, recognizances, or other suretyship obligations on behalf of the Company, and to affix the = corporate seal of the Company to powers of attorney executed pursuant hereto; and said officers may remove any such 0 .° attomey-in-fact and revoke any power of attorney previously granted; and further RESOLVED, that such power of attorney limits the acts of those named therein to the bonds, undertakings, recognizances, or E-. other suretyship obligations specifically named therein, and they have no authority to bind the Company except in the manner and to the extent therein stated; and further RESOLVED, that such power of attorney revokes all previous powers issued on behalf of the attorney-in-fact named; and E further RESOLVED, that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any power of attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or 3 other suretyship obligation of the Company; and such signature and seal when so used shall have the same force and effect as though manually affixed. The Company may continue to use for the purposes herein stated the facsimile signature of any person or persons who shall have been such officer or officers of the Company, notwithstanding the fact that they may have T� E ceased to be such at the time when such instruments shall be issued. IN WITNESS WHEREOF, the Com any has ca sed these presents to be signed and attested by its appropriate officers and its corporate seal hereunto affixed this day of , 2016. O v Attest: / Berkley Insurance Company ~V o (Seal) By o Ira S. Lederman Je after o Executive Vice President & Secretary S for V President o E WARNING: THIS POWER INVALID IF NOT PRINTED ON BLUE "BERKLEY" SECURITY PAPER. STATE OF CONNECTICUT) 0 ) ss: o COUNTY OF FAIRFIELD ) Sworn to before me, a Notary Public in the State of Connecticut, this ay of 2016, by Ira S. Lederman and M Jeffrey M. Halter who are sworn to me to be the Executive Vice President and ecr ary, and a Senior Vice President, respectively, of Berkley Insurance Company.MARIA C. RUNDBAKEN NOTARY PUBLIC o MY COMMISSION EXPIRES Notary Public, State of Connecticut U � APRIL 30, 2019 CERTIFICATE I, the undersigned, Assistant Secretary of BERKLEY INSURANCE COMPANY, DO HEREBY CERTIFY that the foregoing is a true, correct and complete copy of the original Power of Attorney; that said Power of Attorney has not been revoked or rescinded and that the authority of the Z Attomey-in-Fact set forth therein, who executed the bond or undertaking to which this Power of Attorney is attached, is in full force and effect as of this date. Given under my hand and seal of the Company, this day of _ i . (Seal) Vincent P. Forte " -`/ Please verify the authenticity of the instrument attached to this Power by: Toll -Free Telephone: (800) 456-5486; or Electronic Mail: BSGInquiry&erkleysurety.com Any written notices, inquiries, claims or demands to the Surety on the bond attached to this Power should be directed to: Berkley Surety Group 412 Mount Kemble Ave. Suite 310N Morristown, NJ 07960 Attention: Surety Claims Department Or Email: BSGClaim@berkleysurety.com Please include with all communications the bond number and the name of the principal on the bond. Where a claim is being asserted, please set forth generally the basis of the claim. In the case of a payment or performance bond, please also identify the project to which the bond pertains. Berkley Surety Group is an operating unit of W. R. Berkley Corporation that underwrites surety business on behalf of Berkley Insurance Company, Berkley Regional Insurance Company and Carolina Casualty Insurance Company. RELEASE OF RETAINAGE BOND OF CONTRACTOR Bond No. 0208342 KNOW ALL MEN BY THESE PRESENTS: That we Johansen Excavating, Inc. (hereinafter called Principal), and Berkley Insurance Company a corporation organized and doing business under and by virtue of the laws of the state of Delaware and duly licensed for the purpose of making, guaranteeing or becoming sole surety upon bonds or undertakings required and authorized by the State of Washington, (hereinafter called Surety), as Surety, are held firmly bound unto City of Bremerton , (hereinafter called Obligee) in the just and full sum of *Two Hundred Forty-six Thousand Seven Hundred Twenty-eight L$246,728.50 ) plus 5% of any increases in the contract amount that have occurred or may occur, due to change orders, increases in the quantities or the addition of any new item of work *And 50/100THS THE CONDITIONS OF THIS OBLIGATION ARE SUCH THAT, Whereas, the said Principal on the day of April —'2017 entered into a written contract with the said obligee for Lebo Boulevard Roadway Improvement Project which said contract is hereby referred to and made a part hereof by reference. WHEREAS, Pursuant to Chapter 60.28 RCW, the above named Principal has requested release of retained percentage earned or which may be earned under said contract, and, WHEREAS, the obligee is willing to release retained percentage in advance of contract terms relating to payment provided the principal shall file bond to indemnify the obligee for all loss, cost or damages which the obligee may sustain by reason of payment of retainage to the principal, which bond shall be subject to all claims and liens in the same manner and same priority as apply to the retainage percentage released, or to be: released, NOW, THEREFORE, the condition of this obligation is such that if the principal shall indemnify the obligee for all loss, cost or damages wluch the obligee may sustain by reason of payment of retained percentage to the principal then this obligation shall be null and void unless otherwise to remain in full force and effect. IN WITNESS WHEREOF, said principal and said Surety have caused these presents to be duly signed and sealed this 11th day of April 3 2017 . Johansen Excavating, Inc. By: Princi Berkley Insurance Company By: e-• 4"' Karen C. Swanson Attorney -in -Fact No. BI -1220g POWER OF ATTORNEY BERKLEY INSURANCE COMPANY WILMINGTON, DELAWARE NOTICE: The warning found elsewhere in this Power of Attorney affects the validity thereof. Please review carefully. KNOW ALL MEN BY THESE PRESENTS, that BERKLEY INSURANCE COMPANY (the "Company"), a corporation duly organized and existing under the laws of the State of Delaware, having its principal office in Greenwich, CT, has made, constituted and appointed, and does b resents make constitute and appoint: Karen C. Swanson Julie R. Truitt Brent E. Heilesen e, PP � Y these P PP ; Christopher Kinyon; Jamie Diemer; Carley Espiritu; Peter J. Comfort; Annelies M. Richie; Kyle Joseph Howat; Mary S. Norrell; or Heather L. Allen of Propel Insurance of Tacoma, WA its true and lawful Attorney -in -Fact, to sign its name as surety only as delineated below and to execute, seal, acknowledge and deliver any and all bonds and undertakings, with the exception of s .E Financial Guaranty Insurance, providing that no single obligation shall exceed Fifty Million and 00/100 U.S. Dollars (U.S.$50,000,000.00), to the same extent as if such bonds had been duly executed and acknowledged by the regularly elected officers of the Company at its principal office in their own proper persons. a This Power of Attorney shall be construed and enforced in accordance with, and governed by, the laws of the State of Delaware, owithout giving effect to the principles of conflicts of laws thereof. This Power of Attorney is granted pursuant to the following resolutions which were duly and validly adopted at a meeting of the Board of Directors of the Company held on January 25, 2010: o RESOLVED, that, with respect to the Surety business written by Berkley Surety Group, the Chairman of the Board, Chief o2 Executive Officer, President or any Vice President of the Company, in conjunction with the Secretary or any Assistant Secretary are hereby authorized to execute powers of attorney authorizing and qualifying the attorney-in-fact named therein to o execute bonds, undertakings, recognizances, or other suretyship obligations on behalf of the Company, and to affix the 3 S corporate seal of the Company to powers of attorney executed pursuant hereto; and said officers may remove any such c attorney-in-fact and revoke any power of attorney previously granted; and further RESOLVED, that such power of attorney limits the acts of those named therein to the bonds, undertakings, recognizances, or H other suretyship obligations specifically named therein, and they have no authority to bind the Company except in the manner and to the extent therein stated; and further RESOLVED, that such power of attorney revokes all previous powers issued on behalf of the attorney-in-fact named; and further RESOLVED, that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any power of attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or CZ 3 other suretyship obligation of the Company; and such signature and seal when so used shall have the same force and effect as Ez though manually affixed. The Company may continue to use for the purposes herein stated the facsimile signature of any o , person or persons who shall have been such officer or officers of the Company, notwithstanding the fact that they may have n E ceased to be such at the time when such instruments shall be issued. IN WITNESS WHEREOF, the Company has ca sed these presents to be signed and attested by its appropriate officers and its ° ° corporate seal hereunto affixed thigday of , 2016. O o Attest: Berkley Insurance Company !t(Seal) By Ira S. Lederman Jeft'President afterExecutive Vice Pnt & Secretary S tor' Z - o E WARNING: THIS POWER INVALID IF NOT PRINTED ON BLUE "BERKLEY" SECURITY PAPER. 2 ' STATE OF CONNECTICUT) 0 ) ss: o COUNTY OF FAIRFIELD ) -5 N �� = y Sworn to before me, a Notary Public in the State of Connecticut, this 1„ ay of 2016, by Ira S. Lederman and ca —Jeffrey M. Hafter who are sworn to me to be the Executive Vice President and ecr ary, and a Senior Vice President, respectively, of Berkley Insurance Company.MARIAC. RUNDBAKEN NOTARY PUBLIC o ?UMI'i el' - My COMMISSION EXPIRES Notary Public, State of Connecticut c APRIL 30, 2019 CERTIFICATE r- I, the undersigned, Assistant Secretary of BERKLEY INSURANCE COMPANY, DO HEREBY CERTIFY that the foregoing is a true, correct and complete copy of the original Power of Attorney; that said Power of Attorney has not been revoked or rescinded and that the authority of the y Attorney -in -Fact set forth therein, who executed the bond or undertaking to which this Power of Attorney is attached, is in full force and effect as . of this date. 1 ` Given under my hand and seal of the Company, this ! day of (Seal) Vincent P. Forte Please verify the authenticity of the instrument attached to this Power by: Toll -Free Telephone: (800) 456-5486; or Electronic Mail: BSGInquiry@berkleysurety.com Any written notices, inquiries, claims or demands to the Surety on the bond attached to this Power should be directed to: Berkley Surety Group 412 Mount Kemble Ave. Suite 310N Morristown, NJ 07960 Attention: Surety Claims Department Or Email: BSGClaim cr.berkleysurety.com Please include with all communications the bond number and the name of the principal on the bond. Where a claim is being asserted, please set forth generally the basis of the claim. In the case of a payment or performance bond, please also identify the project to which the bond pertains. Berkley Surety Group is an operating unit of W. R. Berkley Corporation that underwrites surety business on behalf of Berkley Insurance Company, Berkley Regional Insurance Company and Carolina Casualty Insurance Company. City of Bremerton Local Agency Performance Bond PERFORMANCE BOND to [City of Bremerton or Bond No. 0208340 County], WA The [City of Bremerton or County], Washington ([City or County]) has awarded to Johansen Excavating, IngTrincipal), a contract for the construction of the project designated as 'Lebo Boulevard Project No.8-0-152(026)-1 , in [location], Washington (Contract), and said Principal is required to furnish a bond for performance of all obliga ions un er a Contract. *Roadway Improvement Project The Principal, and Berkley Inc .ran .P Company (Surety), a corporation, organized under the laws of the State of Delaware and licensed to do business in the State of Washington as surety and named in the current list of "Surety Companies Acceptable in Federal Bonds" as published in the Federal Register by the Audit Staff Bureau of Accounts, U.S. Treasury Dept., are jointly and severally held and firmly bound to the [City or County], in the sum of *Four Million Nine Hundred Thirtv Four Thousand US Dollars ($ 4,934,570.06 ) Total Contract Amount, subject to the provisions herein. *Five Hundred Seventy and 06/100 This statutory performance bond shall become null and void, if and when the Principal, its heirs, executors, administrators, successors, or assigns shall well and faithfully perform all of the Principal's obligations under the Contract and fulfill all terms and conditions of all duly authorized modifications, additions, and changes to said Contract that may hereafter be made, at the time and in the manner therein specified; and if such performance obligations have not been fulfilled, this bond shall remain in force and effect. The Surety for value received agrees that no change, extension of time, alteration or addition to the terms of the Contract, the specifications accompanying the Contract, or to the work to be performed under the Contract shall in any way affect its obligation on this bond, and waives notice of any change, extension of time, alteration or addition to the terms of the Contract or the work performed. The Surety agrees that modifications and changes to the terms and conditions of the Contract that increase the total amount to be paid the Principal shall automatically increase the obligation of the Surety on this bond and notice to Surety is not required for such increased obligation. This bond may be executed in two (2) original counterparts, and shall be signed by the parties' duly authorized officers. This bond will only be accepted if it is accompanied by a fully executed and original power of attorney for the office executing on behalf of the surety. P;ZMR= J 4 P in�al Signature 6ate Printed Name 6ate V, CZ nf��Tla1Js Title SURE BerkleyTot'O' nce Company 4— 4/11/2017 Surety Signature Date Karen C. Swanson 4/11/2017 Printed Name Date Attorney--in-Fact Title Name, address, and telephone of local office/agent of Surety Company is: Propel Insurance P. O. Box 2940 Tacoma, WA 98401 (253) 759-2200 Approved as to form: [City or County] Attorney, [City of or County] Date DOT Form 272-002A EF 08/2012 City of Bremerton Local Agency Payment Bond PUBLIC WORKS PAYMENT BOND to [City of Bremerton or County], WA Bond No. 0208340 The rcity of Bremerton or County], Washington ([City or County]) has awarded to Johansen Excavating, Inc. (Principal), a contract for the construction of the project designated as *Lebo Boulevard Project No. 8-0-152(026)-1 , in [location], Washington (Contract), and said Principal is required under the terms of that Contract to furnish a payment bond in accord with Title 39.08 Revised Code of Washington (RCW) and (where applicable) 60.28 RCW. *Roadway Improvement Project The Principal, and Berkley Insurance Company (Surety), a corporation organized under the laws of the State of Delaware and licensed to do business in the State of Washington as surety and named in the current list of "Surety Companies Acceptable in Federal Bonds" as published in the Federal Register by the Audit Staff Bureau of Accounts, U.S. Treasury Dept., are jointly and severally held and firmly bound to the [City or County], in the sum of *Four Million Nine Hundred Thirtv Four Thousand US Dollars ($ 4,934 570.06 ) Total Contract Amount, subject to the provisions herein. *Five Hundred Seventy and 06/100 This statutory payment bond shall become null and void, if and when the Principal, its heirs, executors, administrators, successors, or assigns shall pay all persons in accordance with RCW 39.08, 39.12, and 60.28 including all workers, laborers, mechanics, subcontractors, and materialmen, and all person who shall supply such contractor or subcontractor with provisions and supplies for the carrying on of such work, and all taxes incurred on said Contract under Titles 50 and 51 RCW and all taxes imposed on the Principal under Title 82 RCW; and if such payment obligations have not been fulfilled, this bond shall remain in full force and effect. The Surety for value received agrees that no change, extension of time, alteration or addition to the terms of the Contract, the specifications accompanying the Contract, or to the work to be performed under the Contract shall in any way affect its obligation on this bond, and waives notice of any changes, extension of time, alteration or addition to the terms of the Contract or the work performed. The Surety agrees that modifications and changes to the terms and conditions of the Contract that increase the total amount to be paid the Principal shall automatically increase the obligation of the Surety on this bond and notice to Surety is not required for such increased obligation. This bond may be executed in two (2) original counterparts, and shall be signed by the parties' duly authorized officers. This bond will only be accepted if it is accompanied by a fully executed and original power of attorney for the office executing on behalf of the surety. Johansen Excavating, Inc. V) ('e- des r Dj )Pir h) tt)tjS Title SURETY Berkley Insur nce Company 4/11/2017 Surety Signature Date Karen C. Swanson 4/11/2017 Printed Name Date Attorney -in -Fact Title Name, address, and telephone of local office/agent of Surety Company is: Propel Insurance P. O. Box 2940 Tacoma, WA 98401 (253) 759-2200 Approved as to form: [City or County] Attorney, [City of or County] Date DOT Farm 272-003A EF 08/2012 RELEASE OF RETAINAGE BOND OF CONTRACTOR Bond No. 0208342 KNOW ALL MEN BY THESE PRESENTS: That we Johansen Excavating, Inc. (hereinafter called Principal), and Berkley Insurance Company a corporation organized and doing business under and by virtue of the laws of the state of Delaware and duly licensed for the purpose of malting, guaranteeing or becoming sole surety upon bonds or undertakings required and authorized by the State of Washington, (hereinafter called Surety), as Surety, are held firmly bound unto City of Bremerton , (hereinafter called Obligee) in the just and full sum of *Two Hundred Forty-six Thousand Seven Hundred Twenty-eight 6246,728.50 ) plus 5% of any increases in the contract amount that have occurred or may occur, due to change orders, increases in the quantities or the addition of any new item of work *And 501100THS THE CONDITIONS OF THIS OBLIGATION ARE SUCH TPIAT, Whereas, the said Principal on the day of April , 2017 entered into a written contract with the said obligee for Lebo Boulevard Roadway Improvement Project which said contract is hereby referred to and made a part hereof by reference. WHEREAS, Pursuant to Chapter 60.28 RCW, the above named Principal has requested release of retained percentage earned or which may be earned under said contract, and, WHEREAS, the obligee is willing to release retained percentage in advance of contract terms relating to payment provided the principal shall file bond to indenmify the obligee for all loss, cost or damages which the obligee may sustain by reason of payment of retainage to the principal, which bond shall be subject to all claims and liens in the same manner and same priority as apply to the retainage percentage released, or to be released, NOW, THEREFORE, the condition of this obligation is such that if the principal shall indemnify the obligee for all loss, cost or damages which the obligee may sustain by reason of payment of retained percentage to the principal then this obligation shall 'be null and void unless otherwise to remain in full force and effect. IN WITNESS WHEREOF, said principal and said Surety have caused these presents to be duly signed and sealed this 11th day of_ April 1 2017 . Johansen Excavating, Inc. By: 7<�- Principt) Berkley Insurance Company ^ By: Karen C. Swanson Attorney -in -Fact IJ 4 Client#: 121565 IOHAEXCA ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE IDD/YYYY) 410712017 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 Propel Insurance Tacoma Commercial InsuranceE-MAIL 1201 Pacific Ave, Suite 1000 Tacoma, WA 98402 CONTACT Lisa Anderson PHONE g00 499-0933 FAx 866 577-1326 � Ext : AIc, No ADDRESS: lisa.anderson@propelinsurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: The Phoenix Insurance Company 1/ 25623 INSURED INSURER B: Travelers Property Casualty Coo 25674 Johansen Excavating, Inc P.O. Box 6 Buckley, WAA 98321 INSURER C: Allied World Assurance Company 19489 INSURER D: Hartford Fire Insurance Company 19682 INSURER E: Travelers Indemnity Company of 25666 INSURER F: GEN'L AGGREGATE LIMIT APPLIES PER: PRO - POLICY X] ECT 1:1 LOC OTHER: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MWDD/YYYY POLICY EXP MWDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FXOCCUR X PD Ded:5,000 X X DTC07G23530117PHX 2/01/2017 02/0112018 EACH OCCURRENCE $1,000000 PREMISESOEaocccur"',:. $300,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO - POLICY X] ECT 1:1 LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 $ E AUTOMOBILE X X X LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS OMP $2K DED. X COLL $SK DED. X X DT8107G23530117TIA 2/01/2017 02/011201 COEaMBINED SINGLE LIMIT accitlent $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) en) $ PROPERTY DAMAGE $ Per accident $ B X UMBRELLA LIAB EXCESS LIAR X OCCUR CLAIMS -MADE X X CUPlJ0581001726TIL 2101/2017 02/01/2018 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 DED I X I RETENTION $10,000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y I N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N /A DTC07G23530117PHX WA Stop Gap Only 2/01/2017 02/01/201 PTAT UT E 1 11 EORH E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 C D D POLLUTION LIAB. LEASED/RENT EQUIP SCHEDULED EQUIP 03097659 52UUMZN6555 52UUMZN6555 01112712116 2101/2017 2101/2017 08/271201 02/01/2018 02/01/201 $2MM Limit/$25K DED. $250,000 / $1,000 DED. SEE BELOW / $1,000 DED. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Lebo Boulevard Roadway Improvements City of Bremerton, Public Works & Utilities, and its officers, elected officials, employees, agents, and volunteers are Additional Insured per attached Endorsements. City of Bremerton Public Works & Utilities 100 Oyster Bay AVE N. Bremerton, WA 98312 ACORD 25 (2014/01) 1 of 1 #S2662983/M2565911 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 ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD LMA00 This page has been left blank intentionally. COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL. INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED — (Section II) is amended c) The insurance provided to the additional in- to include any person or organization that you sured does not apply to "bodily injury" or agree in a "written contract requiring insurance" "property damage" caused by "your work" to include as an additional insured on this Cover- and included in the "products -completed op - age Part, but: erations hazard" unless the "written contract a) Only with respect to liability for "bodily injury", requiring insurance" specifically requires you "property damage" or "personal injury"; and to provide such coverage for that additional insured, and then the insurance provided to b) If, and only to the extent that, the injury or the additional insured applies only to such damage is caused by acts or omissions of "bodily injury" or "property damage" that oc- you or your subcontractor in the performance curs before the end of the period of time for of "your work" to which the "written contract which the "written contract requiring insur- requiring insurance" applies. The person or ance" requires you to provide such coverage organization does not qualify as an additional or the end of the policy period, whichever is insured with respect to the independent acts earlier. or omissions of such person or organization. 3. The insurance provided to the additional insured 2. The insurance provided to the additional insured by this endorsement is excess over any valid and by this endorsement is limited as follows: collectible "other insurance", whether primary, a) In the event that the Limits of Insurance of excess, contingent or on any other basis, that is this Coverage Part shown in the Declarations available to the additional insured for a loss we exceed the limits of liability required by the cover, under this endorsement. However, if the "written contract requiring insurance", the in- "written contract requiring insurance" specifically surance provided to the additional insured requires that this insurance apply on a primary shall be limited to the limits of liability re- basis or a primary and non-contributory basis, quired by that "written contract requiring in- this insurance is primary to "other insurance" surance". This endorsement shall not in- available to the additional insured which covers crease the limits of insurance described in that person or organization as a named insured Section III — Limits Of Insurance. for such loss, and we will not share with that b) The insurance provided to the additional in- "other insurance". But the insurance provided to sured does nota I to "bodily injury", "prop- apply y � 1 the additional insured by this endorsement still is "other or "personal injury" arising out arising excess over any valid and collectible in - ofdamage" of the rendering of, or failure to render, any surance", whether primary, excess, contingent or professional architectural, engineering or sur- on any other basis, That is available to the addi- veying services, including: tional insured when that person or organization is an additional insured under such "other insur- L The preparing, approving, or failing to ance". prepare or approve, maps, shop draw- 4. As a condition of coverage provided to the ings, opinions, reports, surveys, field or- additional insured by this endorsement: ders or change orders, or the preparing, approving, or failing to prepare or ap- a) The additional insured must give us written prove, drawings and specifications; and notice as soon as practicable of an "occur - ii. Supervisory, inspection, architectural or engineering activities. claim. To the extent possible, such notice should include: CG D2 46 08 05 O 2005 The St. Paul Travelers Companies, Inc. Page 1 of 2 COMMERCIAL GENERAL LIABILITY L How, when and where the 'occurrence" or offense took place; ii. The names and addresses of any injured persons and witnesses; and iii. The nature and location of any injury or damage arising out of the 'occurrence" or offense. b) If a claim is made or "suit" is brought against the additional insured, the additional insured must: Ii. Immediately record the specifics of the claim or "suit' and the date received; and ii. Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the claim or "suit' as soon as practicable. c) The additional insured must immediately send us copies of all legal papers received in connection with the claim or "suit', cooperate with us in the. investigation or settlement of the claim or defense against the "suit', and otherwise comply with all policy conditions. d) The additional insured must tender the de- fense and indemnity of any claim or "suit" to any provider of 'other insurance" which would cover the additional insured for a loss we cover under this endorsement. However, this condition does not affect whether the insur- ance provided to the additional insured by this endorsement is primary to 'other insur- ance" available to the additional insured which covers that person or organization as a named insured as described in paragraph 3. above. 5. The following definition is added to SECTION V. — DEFINITIONS: "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or organization as an additional in- sured an this Coverage Part, provided that the "bodily injury" and "property damage" oc- curs and the "personal injury" is caused by an offense committed: a. After the signing and execution of the contract or agreement by you; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period. Page 2 of 2 @ 2005 The St. Paul Travelers Companies, Inc. CG D2 46 08 05 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS XTEND ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. Aircraft Chartered With Pilot B. Damage To Premises Rented To You C. Increased Supplementary Payments D. Incidental Medical Malpractice E. Who Is An Insured — Newly Acquired Or Formed Organizations F. Who Is An Insured — Broadened Named Insured — Unnamed Subsidiaries G. Blanket Additional Insured — Owners, Managers Or Lessors Of Premises PROVISIONS A. AIRCRAFT CHARTERED WITH PILOT The following is added to Exclusion g., Aircraft, Auto Or Watercraft, in Paragraph 2. of SECTION I — COVERAGES — COVERAGE A BODILY IN- JURY AND PROPERTY DAMAGE LIABILITY: This exclusion does not apply to an aircraft that is: (a) Chartered with a pilot to any insured; (b) Not owned by any insured; and (c) Not being used to carry any person or prop- erty for a charge. B. DAMAGE TO PREMISES RENTED TO YOU 1. The first paragraph of the exceptions in Ex- clusion j., Damage To Property, in Para- graph 2. of SECTION I — COVERAGES — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY is deleted. H. Blanket Additional Insured — Lessors Of Leased Equipment I. Blanket Additional Insured — States Or Political Subdivisions — Permits J. Knowledge And Notice Of Occurrence Or Offense K. Unintentional Omission L. Blanket Waiver Of Subrogation M. Amended Bodily Injury Definition N. Contractual Liability — Railroads INJURY AND PROPERTY DAMAGE LI- ABILITY: Exclusions c. and g. through n. do not apply to "premises damage". Exclusion f.(1)(a) does not apply to "premises damage" caused by: a. Fire; b. Explosion; c. Lightning; d. Smoke resulting from such fire, explosion, or lightning; or e. Water; unless Exclusion f. of Section I — Coverage A — Bodily Injury And Property Damage Liability is replaced by another endorsement to this Coverage Part that has Exclusion — All Pollu- tion Injury Or Damage or Total Pollution Ex- clusion in its title. 2. The following replaces the last paragraph of A separate limit of insurance applies to Paragraph 2., Exclusions, of SECTION I — "premises damage" as described in Para - COVERAGES — COVERAGE A. BODILY graph 6. of SECTION 111 — LIMITS OF IN- SURANCE. CG D3 16 11 11 © 2011 The Travelers Indemnity Company. All rights reserved. Page 1 of 6 COMMERCIAL GENERAL LIABILITY 3. The following replaces Paragraph 6. of SEC- TION III — LIMITS OF INSURANCE: Subject to 5. above, the Damage To Prem- ises Rented To You Limit is the most we will pay under Coverage A for damages because of "premises damage" to any one premises. The Damage To Premises Rented To You Limit will apply to all "property damage" proximately caused by the same "occur- rence", whether such damage results from: fire; explosion; lightning; smoke resulting from such fire, explosion, or lightning; or water; or any combination of any of these causes. The Damage To Premises Rented To You Limit will be: a. The amount shown for the Damage To Premises Rented To You Limit on the Declarations of this Coverage Part; or b. $300,000 if no amount is shown for the Damage To Premises Rented To You Limit on the Declarations of this Coverage Part. 4. The following replaces Paragraph a. of the definition of "insured contract" in the DEFINI- TIONS Section: a. A contract for a lease of premises. How- ever, that portion of the contract for a lease of premises that indemnifies any person or organization for "premises damage" is not an "insured contract'; 5. The following is added to the DEFINITIONS Section: "Premises damage" means "property dam- age" to: a. Any premises while rented to you or tem- porarily occupied by you with permission of the owner; or b. The contents of any premises while such premises is rented to you, if you rent such premises for a period of seven or fewer consecutive days. 6. The following replaces Paragraph 4.b.(1)(b) of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: (b) That is insurance for "premises damage"; or 7. Paragraph 4.b.(1)(c) of SECTION IV — COMMERCIAL GENERAL LIABILITY CON- DITIONS is deleted. C. INCREASED SUPPLEMENTARY PAYMENTS 1. The following replaces Paragraph 1.b. of SUPPLEMENTARY PAYMENTS — COVER- AGES A, AND B of SECTION I — COVER- AGE: b. Up to $2,500 for the 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 fur- nish these bonds. 2. The following replaces Paragraph 1.d. of SUPPLEMENTARY PAYMENTS — COVER- AGES A AND B of SECTION I — COVER- AGES: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit"', including actual loss of earnings up to $500 a day because of time off from work. D. INCIDENTAL MEDICAL MALPRACTICE 1. The following is added to the definition of "oc- currence" in the DEFINITIONS Section: "Occurrence" also means an act or omission committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to a person. 2. The following is added to Paragraph 2.a.(1) of SECTION II — WHO IS AN INSURED: Paragraph (1)(d) above does not apply to "bodily injury" arising out of providing or fail- ing to provide: (i) "Incidental medical services" by any of your "employees" who is a nurse practi- tioner, registered nurse, licensed practical nurse, nurse assistant, emergency medi- cal technician or paramedic; or (ii) First aid or "Good Samaritan services" by any of your "employees" or "volunteer workers", other than an employed or vol- unteer doctor. Any such "employees" or "volunteer workers" providing or failing to provide first aid or "Good Samaritan ser- vices" during their work hours for you will be deemed to be acting within the scope of their employment by you or performing duties related to the conduct of your busi- ness. Page 2 of 6 © 2011 The Travelers Indemnity Company. All rights reserved. CG D3 16 11 11 3. The following is added to Paragraph 5. of SECTION III — LIMITS OF INSURANCE: For the purposes of determining the applica- ble Each Occurrence Limit, all related acts or omissions committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to any one per- son will be deemed to be one 'occurrence". 4. The following exclusion is added to Para- graph 2., Exclusions, of SECTION I — COV- ERAGES — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY: Sale Of Pharmaceuticals "Bodily injury" or "property damage" arising out of the willful violation of a penal statute or ordinance relating to the sale of pharmaceuti- cals committed by, or with the knowledge or consent of, the insured. S. The following is added to the DEFINITIONS Section: "Incidental medical services" means: a. Medical, surgical, dental, laboratory, x-ray or nursing service or treatment, advice or instruction, or the related furnishing of food or beverages; or b. The furnishing or dispensing of drugs or medical, dental, or surgical supplies or appliances. "Good Samaritan services" means any emer- gency medical services for which no compen- sation is demanded or received. 6. The following is added to Paragraph 4.b., Ex- F cess Insurance, of SECTION IV — COM- MERCIAL GENERAL LIABILITY CONDI- TIONS: The insurance is excess over any valid and collectible other insurance available to the in- sured, whether primary, excess, contingent or on any other basis, that is available to any of your "employees" or "volunteer workers" for "bodily injury" that arises out of providing or failing to provide "incidental medical ser- vices", first aid or "Good Samaritan services" to any person to the extent not subject to. Paragraph 2.a.(1) of Section II — Who Is An Insured. E. WHO IS AN INSURED — NEWLY ACQUIRED OR FORMED ORGANIZATIONS The following replaces Paragraph 4. of SECTION II — WHO IS AN INSURED: COMMERCIAL GENERAL LIABILITY 4. Any organization you newly acquire or form, other than a partnership, joint venture or lim- ited liability company, of which you are the sole owner or in which you maintain the ma- jority ownership interest, will qualify as a Named Insured if there is no other insurance which provides similar coverage to that or- ganization. However: a. Coverage under this provision is afforded only: (1) Until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier, if you do not report such organization in writing to us within 180 days after you acquire or form it; or (2) Until the end of the policy period, when that date is later than 180 days after you acquire or form such organization, if you report such organization in writing to us within 180 days after you acquire or form it, and we agree in writing that it will con- tinue to be a Named Insured until the end of the policy period; 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 in- jury" or "advertising injury" arising out of an offense committed before you acquired or formed the organization. WHO IS AN INSURED — BROADENED NAMED INSURED — UNNAMED SUBSIDIARIES The following is added to SECTION 11 — WHO IS AN INSURED: Any of your subsidiaries, other than a partnership, joint venture or limited liability company, that is not shown as a Named Insured in the Declara- tions is a Named Insured if you maintain an own- ership interest of more than 50% in such subsidi- ary on the first day of the policy period. No such subsidiary is an insured for "bodily injury" or "property damage" that occurred, or "personal injury" or "advertising injury" caused by an of- fense committed after the date, if any, during the policy period, that you no longer maintain an ownership interest of more than 50% in such sub- sidiary. CG D3 16 11 11 © 2011 The Travelers Indemnity Company. All rights reserved. Page 3 of 6 COMMERCIAL GEN�RAL LIABILITY G. BLANKET ADDITIONAL INSURED — OWNERS, MANAGERS OR LESSORS OF PREMISES The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that is a premises owner, manager or lessor and that you have agreed in a written contract or agreement to in- clude as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage", "personal injury" or "advertising injury" that: a. Is "bodily injury" or "property damage" that occurs, or is "personal injury" or "advertising injury" caused by an offense that is commit- ted, subsequent to the execution of that con- tract or agreement; and b. Arises out of the ownership, maintenance or use of that part of any premises leased to you. The insurance provided to such premises owner, manager or lessor is subject to the following pro- visions: a. The limits of insurance provided to such premises owner, manager or lessor will be the minimum limits which you agreed to pro- vide in the written contract or agreement, or the limits shown on the Declarations, which- ever are less. b. The insurance provided to such premises owner, manager or lessor does not apply to: (1) Any "bodily injury" or "property damage" that occurs, or "personal injury" or "adver- tising injury" caused by an offense that is committed, after you cease to be a tenant in that premises; or (2) Structural alterations, new construction or demolition operations performed by or on behalf of such premises owner, lessor or manager. c. The insurance provided to such premises owner, manager or lessor is excess over any valid and collectible other insurance available to such premises owner, manager or lessor, whether primary, excess, contingent or on any other basis, unless you have agreed in the written contract or agreement that this in- surance must be primary to, or non- contributory with, such other insurance, in which case this insurance will be primary to, and non-contributory with, such other insur- ance. H. BLANKET ADDITIONAL INSURED — LESSORS OF LEASED EQUIPMENT The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that is an equipment lessor and that you have agreed in a written con- tract or agreement to include as an insured on this Coverage Part is an insured, but only with re- spect to liability for "bodily injury", "property dam- age", "personal injury" or "advertising injury" that: a. Is "bodily injury" or "property damage" that occurs, or is "personal injury" or "advertising injury" caused by an offense that is commit- ted, subsequent to the execution of that con- tract or agreement; and b. Is caused, in whole or in part, by your acts or omissions in the maintenance, operation or use of equipment leased to you by such equipment lessor. The insurance provided to such equipment lessor is subject to the following provisions: a. The limits of insurance provided to such equipment lessor will be the minimum limits which you agreed to provide in the written contract or agreement, or the limits shown on the Declarations, whichever are less. b. The insurance provided to such equipment lessor does not apply to any "bodily injury" or "property damage" that occurs, or "personal injury" or "advertising injury" caused by an of- fense that is committed, after the equipment lease expires. c. The insurance provided to such equipment lessor is excess over any valid and collectible other insurance available to such equipment lessor, whether primary, excess, contingent or on any other basis, unless you have agreed in the written contract or agreement that this insurance must be primary to, or non-contributory with, such other insurance, in which case this insurance will be primary to, and non-contributory with, such other in- surance. I. BLANKET ADDITIONAL INSURED — STATES OR POLITICAL SUBDIVISIONS — PERMITS The following is added to SECTION II — WHO IS AN INSURED: Any state or political subdivision that has issued a permit in connection with operations performed by you or on your behalf and that you are required Page 4 of 6 © 2011 The Travelers Indemnity Company. All rights reserved. CG D3 16 11 11 by any ordinance, law or building code to include as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage", "personal in- jury" or "advertising injury" arising out of such op- erations. The insurance provided to such state or political subdivision does not apply to: a. Any "bodily injury," "property damage," "per- sonal injury" or "advertising injury" arising out of operations performed for that state or po- litical subdivision; or b. Any "bodily injury" or "property damage" in- cluded in the "products -completed operations hazard". J. KNOWLEDGE AND NOTICE OF OCCUR- RENCE OR OFFENSE The following is added to Paragraph 2., Duties In The Event of Occurrence, Offense, Claim or Suit, of SECTION IV — COMMERCIAL GEN- ERAL LIABILITY CONDITIONS: e. The following provisions apply to Paragraph a. above, but only for the purposes of the in- surance provided under this Coverage Part to you or any insured listed in Paragraph 1. or 2. of Section II — Who Is An Insured: (1) Notice to us of such "occurrence" or of- fense must be given as soon as practica- ble only after the "occurrence" or offense is known by you (if you are an individual), any of your partners or members who is an individual (if you are a partnership or joint venture), any of your managers who is an individual (if you are a limited liability company), any of your "executive offi- cers" or directors (if you are an organiza- tion other than a partnership, joint venture or limited liability company) or any "em- ployee" authorized by you to give notice of an "occurrence" or offense. (2) If you are a partnership, joint venture or limited liability company, and none of your partners, joint venture members or man- agers are individuals, notice to us of such "occurrence" or offense must be given as soon as practicable only after the "occur- rence" or offense is known by: (a) Any individual who is: (i) A partner or member of any part- nership or joint venture; COMMERCIAL GENERAL LIABILITY (ii) A manager of any limited liability .. company; or (iii) An executive officer or director of any other organization; that is your partner, joint venture member or manager; or (b) Any "employee" authorized by such partnership, joint venture, limited li- ability company or other organization to give notice of an "occurrence" or offense. (3) Notice to us of such "occurrence" or of an offense will be deemed to be given as soon as practicable if it is given in good faith as soon as practicable to your work- ers' compensation insurer. This applies only if you subsequently give notice to us of the "occurrence" or offense as soon as practicable after any of the persons de- scribed in Paragraphs e. (1) or (2) above discovers that the "occurrence" or offense may result in sums to which the insurance provided under this Coverage Part may apply. However, if this Coverage Part includes an en- dorsement that provides limited coverage for "bodily injury" or "property damage" or pollution costs arising out of a discharge, release or es- cape of "pollutants" which contains a requirement that the discharge, release or escape of "pollut- ants" must be reported to us within a specific number of days after its abrupt commencement, this Paragraph e. does not affect that require- ment. K. UNINTENTIONAL OMISSION The following is added to Paragraph 6., Repre- sentations, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: The unintentional omission of, or unintentional error in, any information provided by you which we relied upon in issuing this policy will not preju- dice your rights under this insurance. However, this provision does not affect our right to collect additional premium or to exercise our rights of cancellation or nonrenewal in accordance with applicable insurance laws or regulations. L. BLANKET WAIVER OF SUBROGATION The following is added to Paragraph 8., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — COMMERCIAL GENERAL LI- ABILITY CONDITIONS: CG D3 16 11 11 © 2011 The Travelers Indemnity Company. All rights reserved. Page 5 of 6 COMMERCIAL GENERAL LIABILITY If the insured has agreed in a contract or agree- ment to waive that insured's right of recovery against any person or organization, we waive our right of recovery against such person or organiza- tion, but only for payments we make because of: a. "Bodily injury" or "property damage" that oc- curs; or b. "Personal injury" or "advertising injury" caused by an offense that is committed; subsequent to the execution of that contract or agreement. M. AMENDED BODILY INJURY DEFINITION The following replaces the definition of "bodily injury" in the DEFINITIONS Section: 3. "Bodily injury" means bodily injury, mental anguish, mental injury, shock, fright, disability, humiliation, sickness or disease sustained by a person, including death resulting from any of these at any time. N. CONTRACTUAL LIABILITY — RAILROADS 1. The following replaces Paragraph c. of the definition of "insured contract" in the DEFINI- TIONS Section: c. Any easement or license agreement; 2. Paragraph f.(1) of the definition of "insured contract" in the DEFINITIONS Section is de- leted. � Page 6 of 6 © 2011 The Travelers Indemnity Company. All rights reserved. CG D3 16 11 11 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY ISSUE DATE: - - THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY DESIGNATED PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Project(s): EACH "PROJECT" FOR WHICH YOU HAVE AGREED, IN A WRITTEN CONTRACT WHICH IS IN EFFECT DURING THIS POLICY PERIOD, TO PROVIDE A SEPARATE GENERAL AGGREGATE LIMIT, PROVIDED THAT THE CONTRACT IS SIGNED AND EXECUTED BY YOU BEFORE THE "BODILY INJURY" OR "PROPERTY DAMAGE" OCCURS. A. For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under COVERAGE A. (SECTION 1), and for all medical expenses caused by accidents un- der COVERAGE C (SECTION 1), which can be attributed only to operations at a single desig- nated "project" shown in the Schedule above: 1. A separate Designated Project General Ag- gregate Limit applies to each designated "pro- ject", and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations, unless separate Designated Project General Aggregate(s) are sched- uled above. 2. The Designated Project General Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A., except damages because of "bodily injury" or "prop- erty damage" included in the "products - completed operations hazard", and for medi- cal expenses under COVERAGE C, regard- less of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". Designated Project General Aggregate(s): GENERAL AGGREGATE LIMIT SHOWN ON THE DECLARATIONS 3. Any payments made under COVERAGE A. for damages or under COVERAGE C. for medical expenses shall reduce the Desig- nated Project General Aggregate Limit for that designated "project". Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they re- duce any other Designated Project General Aggregate Limit for any other designated "project" shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Project General Ag- gregate Limit. B. For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under COVERAGE A. (SECTION 1), and for all medical expenses caused by accidents un- der COVERAGE C. (SECTION 1), which cannot be attributed only to operations at a single desig- nated "project" shown in the Schedule above: CG D2 11 01 04 Copyright, The Travelers Indemnity Company, 2004 Page 1 of 2 COMMERCIAL GENERAL LIABILITY 1. Any payments made under COVERAGE A. for damages or under COVERAGE C. for .medical expenses shall reduce the amount available under the General Aggregate Limit or the Products -Completed Operations Ag- gregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Desig- nated Project General Aggregate Limit. C. Part 2. of SECTION III — LIMITS OF INSURANCE is deleted and replaced by the following: 2. The General Aggregate Limit is the most we will pay for the sum of: a. Damages under Coverage B; and b. Damages from "occurrences" under COVERAGE A (SECTION I) and for all medical expenses caused by accidents under COVERAGE C (SECTION 1) which cannot be attributed only to operations at a single designated "project" shown in the SCHEDULE above. D. When coverage for liability arising out of the "products -completed operations hazard" is pro- vided, any payments for damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard" will reduce the Products -Completed Operations Ag- gregate Limit, and not reduce the General Aggre- gate Limit nor the Designated Project General Aggregate Limit. E. For the purposes of this endorsement the Defini- tions Section is amended by the addition of the following definition: "Project" means an area away from premises owned by or rented to you at which you are per- forming operations pursuant to a contract or agreement. For the purposes of determining the applicable aggregate limit of insurance, each "project" that includes premises involving the same or connecting lots, or premises whose con- nection is interrupted only by a street, roadway, waterway or right-of-way of a railroad shall be considered a single "project". F. The provisions of SECTION III — LIMITS OF INSURANCE not otherwise modified by this en- dorsement shall continue to apply as stipulated. Page 2 of 2 Copyright, The Travelers Indemnity Company, 2004 CG D2 11 01 04 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS F. HIRED AUTO — LIMITED WORLDWIDE COV- ERAGE — INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE — GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after .you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION 11 — COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT J. PERSONAL PROPERTY K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section 11. C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COV- ERED AUTOS LIABILITY COVERAGE: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. 2. The following replaces Paragraph b. in B.S., Other Insurance, of SECTION IV — BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee under a contract in an "employee's" name, with your CA T3 53 02 15 @2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO permission, while performing duties related to the conduct of your busi- ness. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". D. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any "employee" of yours is an "insured" while us- ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs. E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2), of SECTION II — COVERED AUTOS LIABIL- ITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident" we cover. We do not have to furnish these bonds. 2. The following replaces Paragraph A.2.a.(4), of SECTION II — COVERED AUTOS LIABIL- ITY COVERAGE: (a) With respect to any claim made or "suit" brought outside the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada: (i) You must arrange to defend the "in- sured" against, and investigate or set- tle any such claim or "suit" and keep us advised of all proceedings and ac- tions. (ii) Neither you nor any other involved "insured" will make any settlement without our consent. (iii) We may, at our discretion, participate in defending the "insured" against, or in the settlement of, any claim or "suit". (iv) We will reimburse the "insured" for sums that the "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, that the "in- sured" pays with our consent, but only up to the limit described in Para- graph C., Limits Of Insurance, of SECTION II — COVERED AUTOS LIABILITY COVERAGE. (4) All reasonable expenses incurred by the (v) We will reimburse the "insured" for "insured" at our request, including actual the reasonable expenses incurred loss of earnings up to $500 a day be- with our consent for your investiga- cause of time off from work. tion of such claims and your defense of the "insured" against any such F. HIRED AUTO — LIMITED WORLDWIDE COV- "suit", but only up to and included ERAGE — INDEMNITY BASIS within the limit described in Para - The following replaces Subparagraph (5) in Para- graph C., Limits Of Insurance, of graph B.7., Policy Period, Coverage Territory, SECTION II — COVERED AUTOS of SECTION IV — BUSINESS AUTO CONDI- LIABILITY COVERAGE, and not in TIONS: addition to such limit. Our duty to (5) Anywhere in the world, except any country or make such payments ends when we jurisdiction while any trade sanction, em- have used up the applicable limit of bargo, or similar regulation imposed by the insurance in payments for damages, United States of America applies to and pro- settlements or defense expenses. hibits the transaction of business with or (b) This insurance is excess over any valid within such country or jurisdiction, for Cov- and collectible other insurance available ered Autos Liability Coverage for any covered to the "insured" whether primary, excess, "auto"- that you lease, hire, rent or borrow contingent or on any other basis. without a driver for a period of 30 days or less (c) This insurance is not a substitute for re - and that is not an "auto" you lease, hire, rent quired or compulsory insurance in any or borrow from any of your "employees", country outside the United States, its ter - partners (if you are a partnership), members ritories and possessions, Puerto Rico and (if you are a limited liability company) or Canada. members of their households. Page 2 of 4 © 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. (d) It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE — GLASS The following is added to Paragraph D., Deducti- ble, of SECTION III — PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT The following replaces the last sentence of Para- graph AA.b., Loss Of Use Expenses, of SEC- TION III — PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT The following replaces the first sentence in Para- graph A.4.a., Transportation Expenses, of SECTION III — PHYSICAL DAMAGE COVER- AGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. J. PERSONAL PROPERTY I COMMERCIAL AUTO (2) In or on your covered "auto". This coverage applies only in the event of a total theft of your covered "auto". No deductibles apply to this Personal Property coverage. K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to 'loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of 'loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war - rarity; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one 'loss". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV — BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or 'loss" ap- plies only when the "accident" or "loss" is known to: (a) You (if you are an individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee" authorized by you to give no- tice of the "accident" or "loss". M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDI- TIONS: The following is added to Paragraph A.4., Cover- 5. Transfer Of Rights Of Recovery Against age Extensions, of SECTION III — PHYSICAL Others To Us DAMAGE COVERAGE: We waive any right of recovery we may have Personal Property against any person or organization to the ex- tent required of you by a written contract We will pay up to $400 for 'loss" to wearing ap- signed and executed prior to any "accident" parel and other personal property which is: or "loss", provided that the "accident" or "loss" (1) Owned by an "insured"; and arises out of operations contemplated by CA T3 53 02 15 © 2015 The Travelers Indemnity Company. All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO such contract. The waiver applies only to the The unintentional omission of, or unintentional person or organization designated in such error in, any information given by you shall not contract. prejudice your rights under this insurance. How - N. UNINTENTIONAL ERRORS OR OMISSIONS ever this provision does not affect our right to col - The following is added to Paragraph B.2., Con- lect additional premium or exercise our right of cealment, Misrepresentation, Or Fraud, of cancellation or non -renewal. SECTION IV — BUSINESS AUTO CONDITIONS: Page 4 of 4 © 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. I COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED o PRIMARY AND NONCONTRIBUTORY WITH OTHER INSURANCE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM PROVISIONS 1. The following is added to Paragraph A.1.c., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in SECTION II. 2. The following is added to Paragraph B.5., Other Insurance of SECTION IV — BUSINESS AUTO CONDITIONS: Regardless of the provisions of paragraph a. and paragraph d. of this part 5. Other Insurance, this insurance is primary to and non-contributory with applicable other insurance under which an addi- tional insured person or organization is the first named insured when the written contract or agreement between you and that person or or- ganization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy pe- riod, requires this insurance to be primary and non-contributory. CA T4 74 02 15 © 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. This page has been left blank intentionally. UMBRELLA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS This endorsement modifies insurance provided under the following: COMMERCIAL EXCESS LIABILITY (UMBRELLA) INSURANCE The following is added to Paragraph 11., OUR RIGHT TO RECOVER FROM OTHERS., of SECTION IV — CONDITIONS.: If the insured has agreed in a contract or agreement to waive that insured's right of recovery against any person or organization, we waive our right of recovery against such person or organization, but only for payments we make because of: a. "Bodily injury" or "property damage" caused by an "occurrence" that takes place: or b. "Personal injury" or "advertising injury" caused by an "offense" that is committed; subsequent to the execution of the contract or agree- ment. UM 04 88 07 08 © 2008 The Travelers Companies, Inc. Page 1 of 1 Includes the copyrighted material of Insurance Services Office, Inc. with its permission. This page has been left blank intentionally. AGENDA BILL 8 CITY OF BREMERTON CITY COUNCIL SUBJECT: ` Change Order No. 2 and Study Session Date: Administrative Authorization for Closeout of COUNCIL MEETING Date: the Lebo Boulevard Roadway Improvement Department: Project—.Presenter: '�J u,�vQ '�'l�' Phone: October 11, 2017 October 18, 2017 PW&U Rick Zimburean (360) 473-5334 SUMMARY: The attached spreadsheet details the Lebo project budget, current expenses, and anticipated final amounts. For the main construction contract, we anticipate 1 additional close out change order, for a total of 3. Change Order No. 2 is $158,921.57. The total combined amount for. change orders 1 and 2 is $325,858.91, which is 6.6% of the original contract amount. Per Bremerton Municipal Code 2.76.110, changes totaling over $200,000 require Council approval. In order to manage this project efficiently to conclusion, we are asking for Council authorization for the Mayor to sign the remaining change orders, so long as the project budget is not exceeded. Please note current projections show us to finalizing the project at $6,469,984.00 which is below the project budget. ATTACHMENTS: 1. Change Order No. 2 with Schedule A 2. Financial Summary Spreadsheet for the Lebo Boulevard Roadway Improvement Project FISCAL IMPACTS (Include Budgeted Amount): The Lebo Boulevard Road Improvement Project budget is $6,581,150 and is funded from the Transportation Improvement Board, the City's Stormwater Utility, and the City's Water Utility. STUDY SESSION AGENDA: ©'No Presentation ❑ Full Presentation STUDY SESSION ACTION: Z Consent Agenda ❑ General Business ❑ Public Hearing RECOMMENDED MOTION: Move to approve Change Order No. 2 for the Lebo Boulevard Roadway Improvement Project, and authorize the Mayor to finalize and execute Change Order No. 2, and to finalize and execute subsequent change orders necessary to close out the project, within the overall project budget, with substantially the same terms and conditions as presented. COUNCIL ACTION: Form Updated 01/07/15 [Approve ❑ Deny ❑ Table ❑ Continue ❑ No Action CIT1� OF BREMERTON' CH►NGE ORDER �6aiEu�� "4 9�`dk'3°" ..���7 F �k OONIMtl7 Al�ipT § ?.fir, w � � ,,� n i( fb 101 10 �' �" 4��°5 I�TCMANOS •.. i � SYBIOTAL �'� �' � Mp" _ � TALI : t� reb.' ` .. w ..,- AF7Ht.7MIS CFIAINiS 1 '� ` ' "` AMA,428.87 ` , r %r` r Mt M a „ m =� mono a - .gym CK Q CD i - .. m Lim a O ' •^'. v+3. j t 2 ln' ro 7 a m z o.. r, <7•d 7 x x x',n - , • d Y. y A. • p y1 -_ ' ” .'., -.N O O to A ;O.ln W:O �+ app "• .4?' - T00 tD pOp In ppOO 14 Cn ., z. ,.. i IN PQ lJ7 tD W V1 W 0�1 A V 00 A 00 W 'O1 01 •N� N ' 'N4 J, O O1 N W O1 W,N O1 YI N • - .40 t - `�j� N W A GJ lfl ,..0 V {p {O� ,• p�j ' F!7 O• J V w tD JN N, W `l�0 m O (n00 O 00 O� O Of G r 01 - �.. WIN 00: ;O 00 . O) Q1 ,.000 N 4 IV to4m o. - .,A Kj 0 a a c all 0 0 0 ;0' o o: -N (n 'O O O O A s ,, YI ASF+ N 1p - N t!rYIN Ig "N N V, to A O V+ W;Oip Ln Co, tD co 01 ,:lD N ., .. LD' pp p{ VG 'N O1 N O1',p1 N" Ol � Y O O O -O O A e 1n O ' 4 4-1 • - - PROJECT NAME PROJECT NO: CITY OF BREMERTON CHANGE ORDER CONTRACT CHANGE ORDER NO: LEBO COMMUNITY BOULEVARD RECONSTRUCTION ORIGINAL CONTRACT AMOUNT: 3 CONTRACTOR: JOHANSEN EXCAVATING INC. $4,934,570.06 DAYS: 90 PREVIOUSLY APPROVED CHANGES: Change Order 01: $166,937.34 DAYS: 4 Change Order 02: $166,921.57 DAYS: 30 Total: $333,858.91 DAYS: 34 THIS CHANGE: $18,204.16 DAYS: 0 REVISED CONTRACT AMOUNT: $5,286,633.13 DAYS: 124 This Change Order covers changes to the subject contract as described herein. The Contractor shall construct, furnish equipment and materials, and perform all work as necessary or required to complete the Change Order Items. The increase or decrease in contract price shown below includes any applicable taxes. DESCRIPTION OF CHANGES INCREASE IN (DECREASE) IN CONTRACT CONTRACT AMOUNT AMOUNT ($► � a ($) Contractor acknowledges and accepts that this Change Order constitutes final settlement of all claims of any kind or nature arising from or connected with any work either covered' or affected by this Change Order, including, without limitation, claims related to contract time, on- site or home office overhead, or lost profits. Nothing in this Change Order shall limit the City's right to bring a claim for past performance. Reduction of Scope: Landscape Irrigation $4,807.79 Topsoil and Compost Unit of Measure Conversion & Addition $8,768.75 Safety Improvements- Sheridan Plaza Drop Off Zone $10,078.20 ESC LEAD for Additional Days $4,165.00 Please see the attached documents for description and details NET CHANGE IN CONTRACT AMOUNT $18,204.16 INCREASE OR (DECREASE) ESTIMATED SALES TAX AT 9.0°% (NIA) $0.00 TOTAL INCLUDING SALES TAX $18,204.16 Contractor acknowledges and accepts that this Change Order constitutes final settlement of all claims of any kind or nature arising from or connected with any work either covered' or affected by this Change Order, including, without limitation, claims related to contract time, on- site or home office overhead, or lost profits. Nothing in this Change Order shall limit the City's right to bring a claim for past performance. CONTRACT CHANGE ORDER NO: 3 PROJECT NAME: LEBO COMMUNITY BOULEVARD RECONSTRUCTION The undersigned Contractor approves the foregoing Change Order as to the changes, if any, in the contract price specified for each item, including any and all supervision costs and other miscellaneous costs relating to the change in work, and as to the extension of time allowed, if any, for completion of the entire work due to said Change Order. This document will become a supplement of the contract and all provisions will apply hereto. It is understood that this Change Order shall be effective when approved by the City of Bremerton. The parties whose names appear below warrant that they are authorized to enter into a change order that is binding on the parties of this contract. In addition, Contractor warrants that it has or will inform the surety of this change, and shall take appropriate action to modify any bonds required under the contract to address this change. CONTRACTOR E2XT-y- SRS Acce ted: \ — DATE: %k/14/'201+ PROJECT MANAGER Council action is required as project cost will exceed approved budget. 0 Yes *No Council action is required as change exceeds Mayors authority per BMC 2.76.110. D Yes 0 No Recommended: DATE: t11-17-17 DIRECTOR OF PUBLIC WO D UTILITIES Recommended: DATE: X7C nC#— A roved: DATE: 11 ` 17 r APPROVED AS TO FORM: Bremerton City Attorney Page 2 of 2 ATTEST: City Clerk Marva Qhkreel PUBLIC WORKS Pa rameirix PIt i CHANGE ORM -SCHEDULEA ENu+NrEwNG. PLANNI40, EtMe0N7ILWAL SCIENCES Iii — 9 CHANGE MDER M Oats: 17 -Nov -17 I Contractor: Johansen Exeavall2e. Inc. Conwd No. TIB: 8.246110261.1 DESC:RMON OF Ch1ANG9 . You are hereby requested to comply with the follow charges from the contract Plans and ficatbns: Such work Wit be compensated by: *tech one or more of the following as applicable [X ] Increase or [XI Decrease in bid items: 0 Fria Account: swum ftlerlpftn 'erepien Lensceps Inlgation - Serial Le0e 20 - The City decided to remove the landscape Irrlgatlon system at Juniper from the aoope of the project This bid Item's lump sum price, 6/E has been dacreased to $28,332.85. uM Topsoll Type A - Sedal Letter 19 The City agreed to convert this Item's unit of measure from Square Yards to Cteic Yards to due the varyingldepths that the Rem was 73 placed. This allows for a fair measurable way to compensate the contractor. This bid Rem has boon converted and Increased to $6250 per Cubic Yard for a total of Aq. No 513,125A0. 84E Compost - Serial Letter 18 - Ccrnpost Is necessary in order to Install the " a to the City of Bremsrtonb standard detail. There was no bid it to compensate the contractor tot for the needed compost and it wee not listed as incidental to the Use planing. This bid Item has been added to the contract at a price of $75.60 per Cubic Yard for a t local of $1„380.80. S31,112.64 Sheridan plaza Drop Off Zone - Serial Letter 23 - The contractor did not Include the subcontractor cost of the seat well in the bid to complete tlhis work. This bid Item's 64K lump sum price has been Increased to $55,013.25 1 94M ESC LEAD for Additional Days - Soft Letter 15.34 Days were added dwughout the cant;= The City has approved the contractors request to compensate for ESC LEAD costs Incurred for the additional working days This bid Rem has been added to the contract at a lump sum price $4,165.00. r hri7t�tt'r � sOn 1 Iniha 'erepien FC"Cee Mr uM EC"Pwuu Ic" hw ICnw Aq. No 1 84E Landscape Impaf}an SL 020Orill Chtnart SS 288 428.97 t LS S31,112.64 531 C " Rev. 1 LS S28 352.85 S26,352.8 $4.8D7.79 0 2 73 11Type A SL 19 1049 'BY 95.45 95717.0 ev • r 407.95 0 3 101 SL 18 0 CY 50.00 Rev. 1s'Cy 575.601. 1.380.80 0 4 94K Man Plaza Drop On Zone SL 23Oft 1 LS 944 5. 944 835.0 Rev.1 LS 5 555 25 $10 o7a.20 0 5 94M ESC LEAD for Add�ktnal Days SL 22 0 LS 50. Rev: I 1 LS S4.165 -M MJ65. 0 $10,204.16 0 r hri7t�tt'r � sOn 1 comma, AAAOUNT I sNETCHAHGE$ h rSUSTMA4 a ."' TAXI_% °.. 1 LIfTERTHIS'CHANOE�' 518.204.18 99,288.833.13 �iORDER Chtnart SS 288 428.97 NIA $5.288.033.13 r hri7t�tt'r � sOn 1 AGENDA BILL CITY OF BREMERTON CITY COUNCIL SUBJECT: Change Order No. 4 with Study Session Date: Decer Johansen Excavating, Inc. for the Lebo COUNCIL MEETING Date: Decer Boulevard Roadway Improvement Project; Department: PW & and Budget Adjustment for Project Closeout Presenter: Rick 2 Phone: 360-4 SUMMARY: The attached spreadsheets detail the Lebo projectt budget, current exp anticipated final amounts. We anticipate this revised project budget will exceed the $6,581,150 budget by $411,851 (6.3%), with Council's approval of Change Order 4 added project expense detailed in Change Order 4 is due primarily to increased mat which were either incorrectly calculated by the project design team, or became nece conditions encountered in the field. Please note we expect the Transportation Impr( will provide additional funding to defray a significant amount of this additional expen; additional TIB commitment has not yet been finalized. ATTACHMENTS: 1. Change Order No. 4 2. Lebo Boulevard Roadway Improvement Project Financial Summary 3. Lebo Boulevard Roadway Improvement Project Financial Detail ber 13, 2017 ber 20.2017 and ttached). The 'ial quantities ►ary due to ement Board ; however, the FISCAL IMPACTS (Include Budgeted Amount): The Lebo Boulevard Road Improvement Project budget is $6,581,150 and is funded from the Transportation Improvement Board, the City's Stormwater Utility, and the City's Water Utility. This action will increase the project budget to $6,993,001 and increase/decrease the funding elements of the original project revenue budget plan as follows: TIB Grant: increase $532,007; Stormwater Capital Fund: decrease $252,675; Sewer Capital Fund: add $87,202; Water Capital Fund: increase $45,318. Please note the Transportation Improvement Board Executive Director has not yet committed to the grant increase. if TIB participation is less than projected, the difference is proposed to be provided from the City's Stormwater Capital Fund. j STUDY SESSION AGENDA: ❑ No Presentation ® Full Presentation I STUDY SESSION ACTION: ® Consent Agenda ❑ General Business ❑ Public Hearing RECOMMENDED MOTION: Move to approve Change Order No. 4 for the Lebo Boulevard Roadway Improvement Project; increase the Project Budget to $6,993,001; authorize the Mayor to finalize and execute Change Order No. 4; and authorize the Mayor to finalize and execute subsequent change orders necessary to close out the project, within the revised project budget, with substantially the same terms and conditions as presented. f � COUNCIL ACTION: [[Approve Deny i ❑ Table ❑ Continue ❑ No Action Form Updated 01/07/15 CITY OF BREMERTON CHANGE ORDER CONTRACT CHANGE ORDER NO:' 4 PROJECT NAME: LEBO COMMUNITY BOULEVARD RECONSTRUCTION PROJECT NO: CONTRACTOR: JOHANSEN. EXCAVATING INC. ORIGINAL CONTRACT AMOUNT: $4,93.4,570.06.. DAYS:... 90 PREVIOUSLY APPROVED CHANGES: Change Order 01: Change Order 02: Change Order 03: Total: THIS CHANGE: REVISED CONTRACT AMOUNT: $166, 937.34 DAYS: 4 $166,921.57 DAYS: 30 $18,204.16 DAYS: 0 $537,100.31 DAYS: 0 $5,823.,733.44 DAYS:. 124 This Change Order covers changes to the subject contract as described herein. The Contractor shall construct, furnish equipment and materials, and perform all work as necessary or required to complete the Change Order Items. The increase or decrease in contract price shown below includes any applicable taxes. DESCRIPTION OF CHANGES INCREASE IN (DECREASE) IN CONTRACT CONTRACT AMOUNT AMOUNT ($) 3 � Contractor acknowledges and accepts that this Change Order constitutes final settlement of all claims of any kind or nature arising from or connected with any work either covered or affected by this Change Order, including, without limitation, claims related to contract time, on-site or home office overhead, or lost profits. Nothing in this Change Order shall limit the City's right to bring a claim for past performance. The undersigned Contractor approves the foregoing Change Order as to the changes, if any, in the contract price specified for each item, including any and all supervision costs and other miscellaneous Year End Change Order— Reconcile all totals to date. Please see the attached documents for description and details $537,100.31 NET CHANGE IN CONTRACT AMOUNT INCREASE OR (DECREASE) $537,100.311 ESTIMATED SALES TAX AT 9.0% (N/A) $0.00 TOTAL INCLUDING SALES TAX $537,100.39' Contractor acknowledges and accepts that this Change Order constitutes final settlement of all claims of any kind or nature arising from or connected with any work either covered or affected by this Change Order, including, without limitation, claims related to contract time, on-site or home office overhead, or lost profits. Nothing in this Change Order shall limit the City's right to bring a claim for past performance. The undersigned Contractor approves the foregoing Change Order as to the changes, if any, in the contract price specified for each item, including any and all supervision costs and other miscellaneous CONTRACT CHANGE ORDER NO: 4 PROJECT NAME: LEBO COMMUNITY BOULEVARD RECONSTRUCTION costs relating to the change in work, and as to the extension of time allowed, if any, for completion of th'e entire work due to said Change Order. This document will become a supplement of the contract and all provisions will apply hereto. It is understood that this Change Order shall be effective when approved by the City of Bremerton. The parties whose names appear below warrant that they are authorized to enter into a change order that is binding on the parties of this contract. In addition, Contractor warrants that it has or will inform the surety of this change, and shall take appropriate action to modify any bonds required under the contract to address this change. C DATE: 12/ W PROJECT MANAGER — Council action is required as project.cost will exceed approved budget. Yes ❑ No Council action is required as change exceeds Mayors authority per BMC 2.761.110. Yes ❑ No � I Recommended DATE'/L DIRECTOR 0r PUBLIC WORKS AND UTILITIES i Recommended:DATE: ?ofti £-et�cii KAy0 Approved, DATE1 APPROVED AS TO FORM: Brem rton City Attorney Page 2 of 2 I ATTEST: l City Clerk From: PROPEL INSURANCFax: (253) 759-2200 To: Fax: {360} 473-2330 Page 2 of 2101 60r_2018 1015 AM Client* 121565 JOHAEXCA DATE (MMIDDIYYYY) ACORDT,, CERTIFICATE OF LIABILITY INSURANCE 1 1/3012018 THIS CERTIFICATE IS ISSUED ASA 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(les) 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 NAME: CT Lisa Anderson Propel Insurance PHONE $00 499-0933 VAIC FAX 866 577-1326 Tacoma Commercial Insurance C �/ E-MAIL o Ext):: AlC No RECEI� Y E� ADDRESS: Ilsa.anderson@propelinsurance.Gom VE 1201 Pacific Ave, Suite 1000 G E INSURER(S) AFFORDING COVERAGE NAIC 0 Tacoma, WA 98402 INSURERA: The Phoenix Insurance Company 25623 INSURED ,JAN 3 0 2018 INSURERS: Travelers Property Casualty Coo 25674 Johansen Excavating, Inc. INSURERC:Allied World Assurance Company 19489 Johansen Construction Company, Inc. P.O. Box 674 Clty of Bremerton INSURER D : Hartford Fire Insurance Company 19682 Buckley WA 88321 Risk Management INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FORTHE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACTOR 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. LTR j TYPE OF INSURANCE ;'INSR WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MMIDC YEFF ( POLICY YYYY) A X COMMERCIAL GENERAL LIABILITY X X DTC07G235301 PHX18 210112018 02101/2019 EACH OCCURRENCE $11,000,000 CLAIMS -MADE X OCCUR i _ �AMAGE70RENTED REMISES Ea orur cote $300,000 X PD Ded: $5,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 j GEN -'L AG zREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO- PGI.CY X JECT LOC PRODUCTS - COMPIOPAGG $2,000,000 OTI IFIR A iAUTO.'.f0'1ILELIABILITY X X DT8107G235301PHX1$ 2101/2018 02/01/2019 COMc61 caenntSINGLEUMUT $1,000,000 X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X HIRED AUTOS X NION-OWNED AJTOS PROPERTY DAMAGE $ (Per accidert X Comp $21K Ded. X Call $5K Ded. i $ B j X UMBRELLA LIAB )( OCCUR X X CUPlJO581001826 0210112018 0210112019 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE;AGGREGATE $5,000,000 $ DED X I RETENTION $$110,000 A ;WORKERS COMPENSATION DTC07G235301 PHX1$ 2/0112018 02/0112019 PER OTH- STATUTE ER AND EMPLOYERS' LIABILITYYIN! !ANY PROPRIETOP.IPARTNERIEXECUTIVE. WA Stop Gap Only E.L. EACH ACCIDENT $1,000,000 IJFFICcR,MEMBER EXCLUDED? jNIA ! (Mandatory in NH) EL DISEASE - EA EMPLOYEE $1,000,000 i If yes, describe under f DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 C Pollution L(ab. 03097659 812712017 0812712018 $2m ITT Limitf$25K Ded. D '; Leased/Rent Equip 52UUMZN6555 210112018 02/0112019 $250,0001$1,000 Ded. D ';Scheduled Equip. 52UUMZN6555 2101/2018 02/0112019 SEE BELOW 1$1 000 Ded. DESCRIPTION OF OPERATIONS I LOCATIONS J VEHICLES (ACORD 101, Additional Remarks Schedule, may b -attached it ore space is required) Re: Lebo Boulevard Roadway Improvements � �' ��� `'3\ I City of Bremerton, Public Works & Utilities, and its officers, elected officials, employees, agents, and volunteers are Additional Insured per attached Endorsements. It MULUtK City of Bremerton Public Works & Utilities 100 Oyster Bay AVE N. Bremerton, WA 98312 ACORD 25 (2014101) 1 of 1 #S30380001M3037501 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 ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD LMA00 From: PROPEL INSURANCFax: (253) 759-2200 To: Fax: (360) 473-2330 Page 3 of 2101 60r-01 8 10:15 AM This page has been left blank intentionally. From: PROPEL INSURANC Fax: (253) 759-2200 To: Fax: (.360) 473-2330 Page 4 of 21 01M/2018 10:16 AM COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under Vie following-, COMMERCIAL GENERAL LIABILITY COVERAGE PART' 1. WHO IS AN INSURED — (Section 11) is amended to include any person or organization that you agree in a "written contract requiring insurance" to include as an additional insured on this Cover- age Part., but: a) Orly with respect. to liability for "bodily injury*, "property damage," or "personal injury"-, and b) It, and only to the extent that, the injury or damage Is caused by acts or omissions ,of you or your subcontractor in the performance of "your work" to which the "written �,-Ontract requiring insurance" applies. The pc; son or organization does not qualify as an additional insured with respect to the independent acts or omissions of -such person or organization. 2. The insurance provided to the additional insured by this endorsement is limited as follows-, a) In, the event that the Lifnits of Insurance .of this Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring insurance", the in- surance provided. to the 'additional insured shall be limited to the limits of liability re- quired by that 'written contract requiring J!1- surance". This endorsement shall not in- crease the limits of insurance described in Section III — Limits Of Insurance, bi The insurance provided to the additional, in- sured does not apply to 'bodily injury", "Prop- erty damage" of "personal. injury* arising out of the rendering of,, or failure to render. any professional architectural, engineering or sur- veying services, including: I. The preparing, approving, or failing to prepare or -approve, maps, shop draw- ings, opinions, reports, surveys, field. ce- ders or change orders, or the preparing, approving, or failing to prepare or ap- prove, drawings and specffications;, and it. Supervisory, inspection, architectural or engineering activities. c) The insurance provided to the additional in- sured does not apply to *bodily injury" or .property damage' caused by "your work" and included in the 'products -completed op- erations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional insured, and then the insurance provided to the additional Insured applies only to such "bodily -injury" or "property damageQ that oc- curs -before the end of the period of time for which the "written contract requiring insur- ance" requires you .to provide. such coverage or the end of the policy period, whichever is earlier, 3. The insurance provided to the additional insured by this endorsement is excess over any valid and collectible "other insurance", whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss we cover under this endorsement. However, if the .written, contract requiring insurance." specifically requires 1hat this insurance apply on a primary basis or a- primary and non-contributory basis, this insurance is primary to "other insurance" available to the additional insured which covers drat person or organIzaticon as a named insured for such toss, and we will not share with that "other insurance". But the Insurance provided to the additional insured, by this. endorsement still is excess over any valid and collectible "other In- surance", whether primary, excess, contingent or on any other basis, that is available to the addi- tional insured when that person or organization is an additional insured under such "other insur- ance". 4. As a, condition of coverage provided to the additional insured by this endorsement., a) The additional insured must give us written noltice as soon as practicable. of an "or cur - rence or an offensewhich may result in a claim. To the extent possible, such notice should include: CG D2 46 08 05 0 2005 The St. Paul Travelers Companies, Inc, Page 1 of 2 From: PROPEL INSVRANC Fax: (253) 769-2200 To: COMMERCIAL GENERAL LIABILITY 1. How, when and where the *occurrence" or offense took place; II. The names and addresses of any injured persons and witnesses; and ill. The nature and location of any injury or damage arising out of the "occurrence" or offense-. b) If a claim is made or "suit" is brought, against. the. additional insured, the additional insured must, I. Immediately record the specifics of the claim or "suit" and the date received; and fl. Notify us as soon as practicable. The additional insured, must see to it that we receive written notice of the claim or "suit` as soon as practicable, c) The additional insured must immediately send us copies of all legal papers received in connection with the claim or "suit`, cooperate with us in the linvestigatbn',,:,t settlement of the claim or defense agalin,'t the "-sufto, and otherwisa comply with all policy conditions., d) The addibonal insured must Lender the de- fense and Indemnity of any claim or "suit" to Fax: (.360) 473-2330 Page 5 of 21 011301201 8 10:16 AM any provider of "other insurance" which would cover the additional insured for a loss we cover under this endorserrent:. However, this condition does not affect whether the insur- ance provided to the. additional Insured by this endorsement is primary to "other Insur- an.ce" available to the additional insured which covers that person or orgpnizationas'a named insured as described in paragraph 3. above, 5. The following defunRion is added to SECTION V. DEFINITIONS: "Written contract requiring insurance" means that part of any written contractor agreement under which you are required to include a person or organization as an additional in- sured on, this Coverage Part, provided that the "bodily injury' and "property damage"oc- ours and the "personal injury" is caused by an offense committed:: a. After the signing and execution of the contract or agreement by yo*j,. b. While that part of the contract or agreement is in effed; and, , c. Before the end, of the policy period. Page 2 of 2 C 2005 The St. Paul Travelers Companies, Inc. CG 02 46 08 05 From: PROPEL INSURANCFax: (253) 759-2200 To: Fax: (364) 473-2330 Page 6 of 21 01;30!2018 10:15 AM COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS XTEND ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE —This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. Aircraft Chartered With Pilot B. Damage To Premises Rented To You C. Increased Supplementary Payments D. Incidental Medical Malpractice E. Who Is An Insured — Newly Acquired Or Formed Organizations F. Who Is An Insured — Broa( -ned Named Insured —Unnamed Subsidiaries G. Blanket Additional Insured --- Owners, Managers Or Lessors Of Premises PROVISIONS A. AIRCRAFT CHARTERED WITH PILOT The following is added to Exclusion g., Aircraft, Auto Or Watercraft, in Paragraph 2. of SECTION 1 — COVERAGES — COVERAGE A BODILY IN- JURY AND PROPERTY DAMAGE LIABILITY: This exclusion does not apply to an aircraft that is: (a) Chartered with a pilot to any insured; (b) Not owned by any insured; and (c) Not being used to carry any person or prop- erty for a charge. B. DAMAGE TO PREMISES RENTED TO YOU 1. The first paragraph of the exceptions in Ex- clusion j., Damage To Property, in Para- graph 2. of SECTION I — COVERAGES — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY is deleted. 2. The following replaces the last paragraph of Paragraph 2., Exclusions, of SECTION I — COVERAGES — COVERAGE A. BODILY H. Blanket Additional Insured — Lessors Of Leased Equipment. 1. Blanket Additional Insured — States Or Political Subdivisions — Permits J. Knowledge And Notice Of Occurrence Or Offense K. Unintentional Omission L. Blanket Waiver Of Subrogation M. Amended Bodily Injury Definiti&i. N. Contractual Liability — Railroads INJURY AND PROPERTY DAMAGE LI- ABILITY: Exclusions c. and g. through n. do not apply to "premises damage". Exclusion f.(1)(a) does not apply to "premises damage" caused by: a. Fire; b. Explosion; c. Lightning; d. Smoke resulting from such fire, explosion, or lightning; or e. Water; unless Exclusion f. of Section I — Coverage A — Bodily Injury And Property Damage Liability is replaced by another endorsement to this Coverage Part that has Exclusion — All Pollu- tion Injury Or Damage or Total Pollution Ex- clusion in its title. A separate limit of insurance applies to "premises damage" as described in Para- graph 6. of SECTION III — LIMITS OF IN- SURANCE. CG D3 1611 11 G` 2011 The Travelers Indemnity Company. Al rights reserved. Page 1 of 6 From: PROPEL INSVRANCFax: (253) 769-2200 To: COMMERCIAL GENERAL LIABILITY 3. The following replaces Paragraph 6. of SEC- TION III — LIMITS OF INSURANCE: Subject to 5. above, the Damage To Prem- ises Rented To You Limit is the most we will pay under Coverage A for damages because of "premises damage" to any one premises. The Damage To Premises Rented To You Limit will apply to all "property damage" proximately caused by the same "occur- rence", whether such damage results from: fire; explosion; lightning; smoke resulting from such fire, explosion, or lightning; or water; or any combination of any of these causes. The Damage To Premises Rented To You Limit will be: a. The amount shown for the Damage To Premises Rented To You Limit on the Declarations of this Coverage Part; or b. $300,000 if no amount is shown for the Damage To Premises Rented To You Limit on the Declarations of this Coverage Part. 4. The following r?places Paragraph a. of the definition of "ini:red contract" in the DEFINI- TIONS Section: a. A contract for a lease of premises. How- ever, that portion of the contract for a lease of premises that indemnifies any person or organization for "premises damage" is not an "insured contract"; 5. The following is added to the DEFINITIONS Section: "Premises damage" means "property dam- age" to: a. Any premises while rented to you or tem- porarily occupied by you with permission of the owner; or b. The contents of any premises while such premises is rented to you, if you rent such premises for a period of seven or fewer consecutive days. 6. The following replaces Paragraph 4.b.(1)(b) of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: (b) That is insurance for "premises damage"; or 7. Paragraph 4.b.(1)(c) of SECTION IV — COMMERCIAL GENERAL LIABILITY CON- DITIONS is deleted, Fax: (360) 473-2330 Page 7 of 21 0113012018 10:15 AM C. INCREASED SUPPLEMENTARY PAYMENTS 1. The following replaces Paragraph 1.b. of SUPPLEMENTARY PAYMENTS — COVER- AGES A AND B of SECTION I — COVER- AGE: b. Up to $2,500 for the 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 fur- nish these bonds. 2. The following replaces Paragraph 1.d, of SUPPLEMENTARY PAYMENTS — COVER- AGES A AND B of SECTION 1 — COVER- AGES: d. All reasonable expenses incurred by the insured at our request.to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. D. INCIDENTAL MEDICAL MALPRACTICE 1. The following is added to the definition of "oc- currence" in the DUFINITIONS Section: "Occurrence" also means an act or omission committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to a person. 2. The following is added to Paragraph 2.a.(1) of SECTION 11— WHO IS AN INSURED: Paragraph (1)(d) above does not apply to "bodily injury" arising out of providing or fail- ing to provide: (i) "Incidental medical services" by any of your "employees" who is a nurse practi- tioner, registered nurse, licensed practical nurse, nurse assistant, emergency medi- cal technician or paramedic; or (ii) First aid or "Good Samaritan services" by any of your "employees" or "volunteer workers", other than an employed or vol- unteer doctor. Any such "employees" or "volunteer workers" providing or failing to provide first aid or "Good Samaritan ser- vices" during their work hours for you will be deemed to be acting within the scope of their employment by you or performing duties related to the conduct of your busi- ness. Page 2 of 6 C 2011 The Travelers Indemnity Company. All rights reserved. CG D3 16 1111 From: PROPEL INSURANC Fax: (253) 769-2200 To: 3. The following is added to Paragraph 5. of SECTION 111— LIMITS OF INSURANCE: For the purposes of determining the applica- ble Each Occurrence Limit, all related acts or omissions committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to any one per- son will be deemed to be one 'occurrence". 4. The following exclusion is added to Para- graph 2., Exclusions, of SECTION I — COV- ERAGES — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY: Sale Of Pharmaceuticals "Bodily injury" or "property damage" arising out of the willful violation of a penal statute or ordinance relating to the sale of pharmaceuti- cals committed by, or with the knowledge or consent of, the insured. 5. The following is added to the DEFINITIONS Section: "Incidental medical services" means: a. Medical, surgical, dental, laboratory, x-ray or,'r7rsing service or treatment, advice or ins ruction or the related furnishing of food.or beverages; or b. The 'furnishing or dispensing of drugs or medical, dental, or surgical supplies or appliances. "Good Samaritan services" means any emer- gency medical services for which no compen- sation is demanded or received. 6. The following is added to Paragraph 4.b., Ex- cess Insurance, of SECTION IV — COM- MERCIAL GENERAL LIABILITY CONDI- TIONS: The insurance is excess over any valid and collectible other insurance available to the in- sured, whether primary, excess, contingent or on any other basis, that is available to any of your "employees" or 'volunteer workers" for "bodily injury" that arises out of providing or failing to provide "incidental medical ser- vices", first aid or "Good Samaritan services" to any person to the extent not subject to Paragraph 2.a.(1) of Section 11 — Who Is An Insured. E. WHO IS AN INSURED — NEWLY ACQUIRED OR FORMED ORGANIZATIONS The following replaces Paragraph 4. of SECTION II — WHO IS AN INSURED: Fax: (360)473-2330 Page 8 of 2101 t30001 8 10:15 AM COMMERCIAL GENERAL LIABILITY 4. Any organization you newly acquire or form, other than a partnership, joint venture or lim- ited liability company, of which you are the sole owner or in which you maintain the ma- jority ownership interest, will qualify as a Named Insured if there is no other insurance which provides similar coverage to that or- ganization. However: a. Coverage under this provision is afforded only: (1) Until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier, if you do not report such organization in writing to us within 180 days after you acquire or form it; or (2) Until the end of the policy period; when that date is later than 180 days after you acquire or form such organization, if you report such organization in writing to us within 180 days after you acquire or form it, and we agree in writing that it will con- tinue to<be a Named Insured until the end of the -pul icy period; 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 in- jury" or "advertising injury" arising out of an offense committed before you acquired or formed the organization. F. WHO IS AN INSURED — BROADENED NAMED INSURED — UNNAMED SUBSIDIARIES The following is added to SECTION 11 — WHO IS AN INSURED: Any of your subsidiaries, other than a partnership, joint venture or limited liability company, that is not shown as a Named Insured in the Declara- tions is a Named Insured if you maintain an own- ership interest of more than 50% in such subsidi- ary on the first day of the policy period. No such subsidiary is an insured for "bodily injury" or "property damage" that occurred, or "personal injury" or "advertising injury" caused by an of- fense committed after the date, if any, during the policy period, that you no longer maintain an ownership interest of more than 50% in such sub- sidiary. CG D3 16 11 11 CC 2011 The Travelers Indemnity Company. Al rights reserved. Page 3 of 6 From: PROPEL INSURANC Fax: (253) 759-2200 To: Fax: (350) 473-2330 Page 9 of 2101;300-018 10:15 AM COMMERCIAL GENERAL LIABILITY G. BLANKET ADDITIONAL INSURED — OWNERS, H. BLANKET ADDITIONAL INSURED — LESSORS MANAGERS OR LESSORS OF PREMISES OF LEASED EQUIPMENT The following is added to SECTION II — WHO IS The following is added to SECTION II — WHO IS AN INSURED: AN INSURED: Any person or organization that is a premises Any person or organization that is an equipment owner, manager or lessor and that you have lessor and that you have agreed in a written con - agreed in a written contract or agreement to in- tract or agreement to include as an insured on elude as an additional insured on this Coverage this Coverage Part is an insured, but only with re - Part is an insured, but only with respect to liability "bodily "property "personal spec, to liability for y yinjury", property dam - for injury", damage", "advertising age", personal injury or "advertising injury" that: y" or dve" injury" or injury" that: a. Is "bodily injury" or "property damage" that a• Is "bodily injury" or "property damage" that "personal occurs, or is "personal injury" or "advertising occurs, or is injury" or "advertising injury" caused by an offense that is commit- Injury" caused by an offense that is commit- ted, subsequent to the execution of that con - ted, subsequent to the execution of that con- tract or agreement; and tract or agreement; and b. Arises out of the ownership, maintenance or b. Is caused, in whole or in part, by your acts or use of that part of any premises leased to omissions in the maintenance, operation or you. use of equipment leased to you by such equipment lessor. The insurance provided to such premises owner, The insurance provided to such equipment lessor manager or lessor is subject to the following pro- is subject to the following provisions: visions: a.. The limits of insurance provided to such a. Th-' limits of insurance provided to such . rxemises owner, manager or lessor will be ec;Opment lessor will be the minimum limits the minimum limits which you agreed to pro- which you agreed to provide in the written contract vide in the written contract or agreement, or or agreement, or the limits shown on the limits shown on the Declarations, which- the Declarations, whichever are less. ever are less. b. The insurance provided to such equipment b. The insurance provided to such premises lessor does not apply to any "bodily injury" or "property "personal owner, manager or lessor does not apply to: damage" that occurs, or "advertising injury" or injury" caused by an of - (1) Any "bodily injury" or "property damage" fense that is committed, after the equipment that occurs, or "personal injury" or "adver- lease expires. tising injury" caused by an offense that is c. The insurance provided to such equipment committed, after you cease to be a tenant lessor is excess over any valid and collectible in that premises; or other insurance available to such equipment (2) Structural alterations, new construction or lessor, whether primary, excess, contingent demolition operations performed by or on or on any other basis, unless you have behalf of such premises owner, lessor or agreed in the written contract or agreement manager. that this insurance must be primary to, or c. The insurance provided to such premises non-contributory with, such other insurance, owner, manager or lessor is excess over any in which case this insurance will be primary valid and collectible other insurance available to, and non-contributory with, such other in- to such premises owner, manager or lessor, surance. whether primary, excess, contingent or on 1. BLANKET ADDITIONAL INSURED — STATES any other basis, unless you have agreed in OR POLITICAL SUBDIVISIONS — PERMITS the written contract or agreement that this in- surance must be primary to, or non- The following is added to SECTION II — WHO IS contributory with, such other insurance, in AN INSURED: which case this insurance will be primary to, Any state or political subdivision that has issued a and non-contributory with, such other insur- permit in connection with operations performed by ance, you or on your behalf and that you are required Page 4 of 6 cc 2011 The Travelers Indemnity Company. All rights reserved. CG D3 16 11 11 From: PROPEL INSURANCFax: (253) 758-2200 To: by any ordinance, law or building code to include as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage", "personal in- jury" or "advertising injury" arising out of such op- erations. The insurance provided to such state or political subdivision does not apply to: a. Any "bodily injury," "property damage," "per- sonal injury" or "advertising injury" arising out of operations performed for that state or po- litical subdivision; or b. Any "bodily injury" or "property damage" in- cluded in the "products -completed operations hazard". J. KNOWLEDGE AND NOTICE OF OCCUR- RENCE OR OFFENSE The following is added to Paragraph 2., Duties In The Event of Occurrence, Offense, Claim or Suit, of SECTION IV — COMMERCIAL GEN- ERAL LIABILITY CONDITIONS: e. The following provisions apply to Paragraph a. above, but only for the purposes of the in- surance provided under this Coverage Part to you or any insured listed in Paragraph 1. or 2. of Section 11— Who Is An Insured: (1) Notice to us of such "occurrence" or of- fense must be given as soon as practica- ble only after the "occurrence" or offense is known by you (if you are an individual), any of your partners or members who is an individual (if you are a partnership or joint venture), any of your managers who is an individual (if you are a limited liability company), any of your "executive offi- cers" or directors (if you are an organiza- tion other than a partnership, joint venture or limited liability company) or any "em- ployee" authorized by you to give notice of an "occurrence" or offense. (2) If you are a partnership, joint venture or limited liability company, and none of your partners, joint venture members or man- agers are individuals, notice to us of such "occurrence" or offense must be given as soon as practicable only after the "occur- rence" or offense is known by: Fax: (360) 473-2330 Page 10 of 2101 MP -01 8 1015 AM COMMERCIAL GENERAL LIABILITY (ii) A manager of any limited liability company; or (iii) An executive officer or director of any other organization; that is your partner, joint venture member or manager; or (b) Any "employee" authorized by such partnership, joint venture, limited li- ability company or other organization to give notice of an "occurrence" or offense. (3) Notice to us of such "occurrence" or of an offense will be deemed to be given as soon as practicable if it is given in good faith as soon as practicable to your work- ers' compensation insurer. This applies only if you subsequently give notice to us of the "occurrence" or offense as soon as practicable after any of the persons de- scribed in Paragraphs e. (1) or (2) above discovers that the "occurrence" or offense may result in sums to which the insurance provided under this Coverage Part may apply. However, if this Coverage Part includes an en- dorsement that provides limited coverage for "bodily injury" or "property damage" or pollution costs arising out of a discharge, release or es- cape of "pollutants" which contains a requirement that the discharge, release or escape of "pollut- ants" must be reported to us within a specific number of days after its abrupt commencement, this Paragraph e. does not affect that require- ment. K. UNINTENTIONAL OMISSION The following is added to Paragraph 6., Repre- sentations, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: The unintentional omission of, or unintentional error in, any information provided by you which we relied upon in issuing this policy will not preju- dice your rights under this insurance. However, this provision does not affect our right to collect additional premium or to exercise our rights of cancellation or nonrenewal in accordance with applicable insurance laws or regulations. L. BLANKET WAIVER OF SUBROGATION (a) Any individual who is: The following is added to Paragraph 8., Transfer (i) A partner or member of any part- Of Rights Of Recovery Against Others To Us, nership or joint venture; of SECTION IV — COMMERCIAL GENERAL LI- ABILITY CONDITIONS: CG D3 16 11 11 C 2011 The Travelers Indemnity Company. All rights reserved. Page 5 of 6 From: PROPEL INSURANCFax: (253) 759-2200 To: COMMERCIAL GENERAL LIABILITY If the insured has agreed in a contract or agree- ment to waive that insured's right of recovery against any person or organization, we waive our right of recovery against such person or organiza- tion, but only for payments we make because of: a. "Bodily injury" or "property damage" that oc- curs; or b. "Personal injury" or "advertising injury" caused by an offense that is committed; subsequent to the execution of that contract or agreement. M. AMENDED BODILY INJURY DEFINITION The following replaces the definition of "bodily injury" in the DEFINITIONS Section: Fax: (360) 473-2330 Page 11 of 21 01!30!2018 10:15 AM 3. "Bodily injury" means bodily injury, mental anguish, mental injury, shock, fright, disability, humiliation, sickness or disease sustained by a person, including death resulting from any of these at any time. N. CONTRACTUAL LIABILITY — RAILROADS 1. The following replaces Paragraph c. of the definition of "insured contract" in the DEFINI- TIONS Section: c. Any easement or license agreement; 2. Paragraph f.(1) of the definition of "insured contract" in the DEFINITIONS Section is de- leted. Page 6 of 6 G 2011 The Travelers Indemnity Company. All rights reserved. CG D3 16 11 11 From: PROPEL INSURANCFax: (253) 759-2200 To: Fax: (380} 473-2330 Page 12 of 2101;300-018 10:15 AM COMMERCIAL GENERAL LIABILITY POLICY NUMBER: ISSUE DATE: - - THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY DESIGNATED PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Project(s): EACH "PROJECT" FOR. WHICH YOU HAVE AGREED, IN A WRITTEN CONTRACT WHICH IS IN EFFECT DURING THIS POLICY PERIOD, TO PROVIDE A SEPARATE GENERAL AGGREGATE LIMIT, PROVIDED THAT THE CONTRACT IS SIGNED AND EXECUTED BY YOU BEFORE THE "BODILY INJURY" OR "PROPERTY DAMAGE" OCCURS. A. For all sums which the insured becomes Isgally obligated to pay as damages caused by 'occur- rences" under COVERAGE A. (SECTION 1), and for all medical expenses caused by accidents un- der COVERAGE C (SECTION 1), which can be attributed only to operations at a single desig- nated "project" shown in the Schedule above: 1. A separate Designated Project General Ag- gregate Limit applies to each designated "pro- ject", and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations, unless separate Designated Project General Aggregate(s) are sched- uled above. 2. The Designated Project General Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A., except damages because of "bodily injury" or "prop- erty damage" included in the "products - completed operations hazard", and for medi- cal expenses under COVERAGE C, regard- less of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". Designated Project General Aggregate(s): GENERAL AGGREGATE LIMIT SHOWN ON THE DECLARATIONS 3. Any payments made under COVERAGE .4. for damages or under COVERAGE C. for medical expenses shall reduce the Desig- nated Project General Aggregate Limit for that designated "project". Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they re- duce any other Designated Project General Aggregate Limit for any other designated "project" shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Project General Ag- gregate Limit. B. For all sums which the insured becomes legally obligated to pay as damages caused by '"occur- rences" under COVERAGE A. (SECTION 1), and for all medical expenses caused by accidents un- der COVERAGE C. (SECTION 1), which cannot be attributed only to operations at a single desig- nated "project" shown in the Schedule above: CG D2 11 01 04 Copyright, The Travelers Indemnity Company, 2004 Page 1 of 2 From: PROPEL INSURANCFax: (253) 759-2200 To: COMMERCIAL GENERAL LIABILITY 1. Any payments made under COVERAGE A. for damages or under COVERAGE C. for .medical expenses shall reduce the amount available under the General Aggregate Limit or the Products -Completed Operations Ag- gregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Desig- nated Project General Aggregate Limit. C. Part 2. of SECTION III —LIMITS OF INSURANCE is deleted and replaced by the following: 2. The General Aggregate Limit is the most we will pay for the sum of: a. Damages under Coverage B; and b. Damages from "occurrences" under COVERAGE A (SECTION 1) and for all medical expenses caused by accidents under COVERAGE C (SECTION 1) which cannot be attributed only to operations at a single designated "project" shown in the SCHEDULE above. D. When coverage for liability arising out of the "products -completed operations hazard" is pro- Fax: (350) 473-2330 Page 13 of 2101 Wr_201 0 10:15 AM vided, any payments for damages because of "bodily injury" or "property damage" included in the "products-cornpleted operations hazard" will reduce the Products -Completed Operations Ag- gregate Limit, and not reduce the General Aggre- gate Limit nor the Designated Project General Aggregate Limit. E. For the purposes of this endorsement the Defini- tions Section is amended by the addition of the following definition: "Project" means an area away from premises owned by or rented to you at which you are per- forming operations pursuant to a contract or agreement. For the purposes of determining the applicable aggregate limit of Insurance, each "project" that includes premises involving the same or connecting lots, or premises whose con- nection is interrupted only by a street, roadway, waterway or right-of-way of a railroad shall be considered a single "project". F. The provisions of SECTION III — LIMITS OF INSURANCE not otherwise modified by this en- dorsement shall continue to apply as stipulated. Page 2 of 2 Copyright, The Travelers Indemnity Company, 2004 CG D211 01 04 From: PROPEL INSURANCFax: (253) 759-2200 To: Fax: (356) 473-2330 Page 14of 210116002018 10:15 Ate COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS —INCREASED LIMITS F. HIRED AUTO — LIMITED WORLDWIDE COV- ERAGE — WDEMNITY BASIS G. WAIVER OI # DEDUCTIBLE —GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION 11 — COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT 1. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT J. PERSONAL PROPERTY K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAI-VER OF SUBROGATION N. UNINTENTIONr-1L ERRORS OR OMISSIONS this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section IL C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COV- ERED AUTOS LIABILITY COVERAGE: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. 2. The following replaces Paragraph b. in B.S., Other Insurance, of SECTION IV — BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in an "employee's" name, with your CA T3 53 02 15 0) 2015 The Travelers Indemnity Company, All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. From: PROPEL INSURANCFax: (253) 759-2200 To: COMMERCIAL AUTO permission, while performing duties related to the conduct of your busi- ness. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". D. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any "employee" of yours is an "insured" while us- ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs. E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2), of SECTION 11— COVERED AUTOS LIABIL- ITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident' we cover. We do not have to furnish these bonds. 2. rhe following replaces Paragraph A.2.a.(4), or SECTION II — COVERED AUTOS LIABIL- ITY COVERAGE: Fax: (380) 479-2330 Page 15of 21 0113012013 10:15 AM (a) With respect to any claim made or "suit" brought outside the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada: (i) You must arrange to defend the "in- sured" against, and investigate or set- tle any such claim or "suit' and keep us advised of all proceedings and ac- tions. (ii) Neither you nor any other involved "insured" will make any settlement without our consent. (iii) We may, at our discretion, participate in defending the "insured" against, or in the settlement of, any claim or "suit'. (iv) We will reimburse the "insured" for sums that the "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, that the "in- �,, sured" pays with our consent, but only up to the limit described in Para- graph C., Limits Of Insurance, of SECTION 11 — COVERED AUTOS LIABILITY COVERAGE. (4) All reasonable expenses incurred by the (v) We will reimburse the "insured" for "insured" at our request, including actual the reasonable expenses incurred loss of earnings up to $500 a day be- with our consent for your investiga- cause of time off from work, tion of such claims and your defense F. HIRED AUTO — LIMITED WORLDWIDE COV- of the "insured" against any such "suit", but only up to and included ERAGE — INDEMNITY BASIS within the limit described in Para - The following replaces Subparagraph (5) in Para- graph C., Limits Of Insurance, of graph B.T., Policy Period, Coverage Territory, SECTION II — COVERED AUTOS of SECTION IV — BUSINESS AUTO CONDI- LIABILITY COVERAGE, and not in TIONS: addition to such limit. Our duty to (5) Anywhere in the world, except any country or make such payments ends when we jurisdiction while any trade sanction, em- have used up the applicable limit of bargo, or similar regulation imposed by the insurance in payments for damages, United States of America applies to and pro- settlements or defense expenses. hibits the transaction of business with or (b) This insurance is excess over any valid within such country or jurisdiction, for Cov- and collectible other insurance available ered Autos Liability Coverage for any covered to the "insured" whether primary, excess, "auto" that you lease, hire, rent or borrow contingent or on any other basis. without a driver for a period of 30 days or less (c) This insurance is not a substitute for re - and that is not an "auto" you lease, hire, rent quired or compulsory insurance in any or borrow from any of your "employees", country outside the United States, its ter - partners (if you are a partnership), members ritories and possessions, Puerto Rico and (if you are a limited liability company) or Canada. members of their households. Page 2 of 4 C) 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. From: PROPEL INSURANCFax: (253) 759-2200 To: You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. (d) It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. The following is added to Paragraph D., Deducti- ble, of SECTION III — PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT The following replaces the last sentence of Para- graph A.4.b., Loss Of Use Expenses, of SEC- TION III — PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". 1. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT The following replaces the first sentence in Para- graph A.4.a., Transportation Expenses; of SECTION 111 — PHYSICAL DAMAGE COVER- AGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto' of the private passengertype. J. PERSONAL PROPERTY Fax: {360) 473-2330 Page 16of 21 016012018 10:15 AM COMMERCIAL AUTO (2) In or on your covered "auto". This coverage applies only in the event of a total theft of your covered "auto". No deductibles apply to this Personal Property coverage. K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION 111 — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of "loss" set forth in Paragraphs A.i.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR BOSS The fallowing is added to Paragraph A.2.a., of SECTION IV — BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or "loss" ap- plies only when the "accident" or 'loss" is known to: (a) You (if you are an individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee" authorized by you to give no- tice of the "accident" or "loss". M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.S., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDI- TIONS: The following is added to Paragraph AA., Cover- 5. Transfer Of Rights Of Recovery Against age Extensions, of SECTION 111 — PHYSICAL Others To Us DAMAGE COVERAGE: We waive any right of recovery we may have Personal Property against any person or organization to the ex- tent required of you by a written contract We will pay up to $400 for "loss" to wearing ap- signed and executed prior to any "accident" parel and other personal property which is: or "lass", provided that the "accident" or "loss" (1) Owned by an "insured"; and arises out of operations contemplated by CA T3 53 02 15 Q 2D15 The Travelers Indemnity Company. All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. From: PROPEL INSt1RANCFax: (253) 758-2200 To: COMMERCIAL AUTO such contract. The waiver applies only to the person or organization designated in such contract. N. UNINTENTIONAL ERRORS OR OMISSIONS The following is added to Paragraph B.2., Con- cealment, Misrepresentation, Or Fraud, of SECTION IV — BUSINESS AUTO CONDITIONS: Fax: (360) 473-2330 Page 17 of 2101 MP -01 8 10:15 AM The unintentional omission of, or unintentional error in, any information given by you shall not prejudice your rights under this insurance. How- ever this provision does not affect our right to col- lect additional premium or exercise our right of cancellation or non -renewal. Page 4 of 4 © 2015 The Travelers Indemnity Company, all rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. From: PROPEL INSURANCFax: (253) 759-2200 To: Fax: (360) 473-2330 Page 18 of 21 016012018 10:15 AM COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. r — — A, IIIHIIIIIN'• ZI 1141 =0111 1101z"YA 9 , This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM •• s 1. The following is added to Paragraph A.1.c., 1tltho Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision cc r tained in SECTION II. 2. The following is added to Paragraph B.5., Other Insurance of SECTION IV — BUSINESS AUTO CONDITIONS: Regardless of the provisions of paragraph a. and paragraph d. of this part 5. Other Insurance, this insurance is primary to and non-contributory with applicable other insurance under which an addi- tional insured person or organization is the first named insured when the written contract or agreement between you and that person or or- ganization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy pe- riod, requires this insurance to be primary ,-nd non-contributory. CA T4 74 02 15 C 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services office, Inc. with its permission. From: PROP ELINSURANCFax: (253)768-2200 To: Fax: (360)473-2330 Page 18 of 2101Y301201810:15AM This page has been left blank intentionally. From: PROPEL INSURANC Fax: (253) 759-2200 To: Fax: (360) 473-2330 Page 20of 21 0113012012 10:15 AM ; V THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL EXCESS LIABILITY (UMBRELLA) INSURANCE The following is added to Paragraph 11., OUR RIGHT TO RECOVER FROM OTHERS., of SECTION IV — CONDITIONS.: if the insured has agreed in a contract or agreement to waive that insured's right of recovery against any person or organization, we waive our right of recovery against such person or organization, but only for payments we make because of: a. "Bodily injury" or "property damage" caused by an "occurrence" that takes place; or b. "Personal injury" or "advertising injury" caused by an "offense" that is committed: subsequent to the execution of the contract or agree- ment. UM 04 $S 07 08 Q 2008 The Travelers Companies, Inc. Page 1 of 1 Includes the copyrighted material of Insurance Services Office. Inc. with its permission. From: PROPEL INSURANC Fax: (253) 759-2200 To: Fax: (360) 473-2330 Page 21 of 21 0113012018 10:16 RM This page has been left blank. intentionally. From: PROPEL INSURANCE i Fax: 12537592200 To: FAX To: Phone Fax Phone 1 (360) 473-2330 Fax: (360) 473-2330 Page: 1 of 23 01/3012019 10:59 AM Date: 01/30/2019 Pages including cover sheet: 23 From: I PROPEL INSURANCE CERTIF 1 Phone 1 (253) 759-2200 * 8888 j Fax Phone! 12537592200 From: PROPEL INSURANCE i Fax: 12537592200 To: Fax: (360) 473-2330 Page: 2 of 23 01/3012019 10:59 AM Client#: 121565 JOHAEXCA DATE (MMIDDIYYYY) ACORDT. CERTIFICATE OF LIABILITY INSURANCE 1/30/2019 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 have ADDITIONAL INSURED provisions or 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Lisa Anderson Propel Insurance PHONE800 499-0933 FAX 866 577-1326 (A1C, No, I (A1C, No): Tacoma Commercial Insurance E-MAIL ADDRESS: lisa-anderson@propelinsurance.com P 1201 Pacific Ave, Suite 1000 INSURERS] AFFORDING COVERAGE NAIC M Tacoma, WA 98402 INSURERA : The Phoenix Insurance Company 25623 INSURED INSURER B: Travelers Property Casualty CoofAmerica 25674 Johansen Construction Company, Inc. INSURER C: Allied World Assurance Company (US) Inc 19489 Johansen Excavating, Inc. Charter Oak Fire Insurance Company 25615 INSURER D : p Y P.O. Box 674 Travelers Indemnity Com an of America 25666 Buckley, WA 98321 INSURER E : Y P Y COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTH E POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR INSR WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MMIDDIYYYY) (MMIDDIYYYY) A X COMMERCIAL GENERAL LIABILITY DTC07G235301 PHX19 2101/2019 02101/2020 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO $300,000 X PD Ded: $5,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,000 POLICY X JECT F7 LOC PRODUCTS - COMPfOPAGO $2,000,000 OTHER $ E AUTOMOBILE LIABILITY 8103L5953571926G 2101/2019 02101/2020 ( (1 aaccicct Edenn SINGLE LIMITt)$ 1, 000, 000 Ea X ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ X HIRED NON -OWNED X PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident X Comp $2K Ded. X Coll $2K Ded. $ B X UMBRELLA LIAB X OCCUR CUPlJ0581001926 2101/2019 02101/2020 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE s5,000,000 DED X RETENTION $$10,000 $ A WORKERS COMPENSATION DTC07G235301 PHX19 2101/2019 02101/2020 STATUTE EERH AND EMPLOYERS' LIABILITY Y l N ANY PROPRIETORfPARTNERfEXECUTIVE WA Stop Gap Only E.L. EACH ACCIDENT $1,000,000 OFFICERfMEMBEREXCLUDED? � NIA (Mandatory in Ni E DISEASE - EA EMPLOYEE $1,000,0100 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $1,000,000 C Pollution Liab. 03097659 8127/2018 02101/2020 $2,000,0001$25k Ded. D Leased/Rent Equip QT660ON247348COF19 2101/2019 02101/2020 $350,000 Any One Item D Scheduled Equip QT660ON247348COF 2101/2019 02101/2020 SEE BELOW 1$1,000 Ded. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Lebo Boulevard Roadway Improvements City of Bremerton, Public Works & Utilities, and its officers, elected officials, employees, agents, and volunteers are Additional Insured per attached Endorsements. CERTIFICATE HOLDER CANCELLATION City of Bremerton Public Works & Utilities 100 Oyster Bay AVE N. Bremerton, WA 98312 ACORD 25 (2016103) 1 of 1 #S35203811M3519767 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 © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD LMA00 From: PROPEL INSURANCE i Fax: 12537592200 To: Fax: (360) 473-2330 Page: 3 of 23 01/3012019 10:59 AM This page has been left blank intentionally. From: PROPEL INSURANCE a Fax: 12537592200 To: Fax: (360) 473-2330 Page: 4 of 23 01/3012019 10:59 AM Cfll"JMERChAt GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET:ADDITIONAL x This endorsement edifies. insurance provided under tie following, COMMERCIAL GENERAL LIABILITY COVERAGE FART' 1. WHO iS AN. INSURED — (Section ll ) is amended to include any person or organization that you agree in a "written contract requiring insurance" to include as an additional insured on this Cover- age Part, but: a) O Ny with respect to liability for "bodily injury",: "property darnage" or "Personal injury"; and b) If; and .only to the extent that, the. Injury .or damage is caused by arts or omissions .of you or your subcontractor in the performance of "your 'work" to which the "written contract requiring insurance" applies, The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. 2. The insurance provided to the additional insured by this en. do rs.ement is limiters as foliows.- a) In the event that the Limits of Insurance of this Coverage Part shown in the Declarations exceed the limits. of :liability required by the "w:ritten contract requiring insurance", the in- surance providedto the additional insured shall be limited to the limits of Liability re- quired by that "written contract requiring in- surance". This endorsement shall not in- crease the limits of insurance described in Section tIl — Limits Of Insurance. b) The insurance :provided to the additional in- sured does not apply to "bodily injury", "°prop- fdILy UU11;1 dHU Uk PU€_SU91di IQ�JiJa, +' t{f B.�uM1T .CJ LiI of the rendering of, or failure to render, any professional architectural, engineering or sur- veying .services., Including: i. The preparing, approving, or failing to prepare or approve, maps,. strap draw- ings, opinions, reports, surveys, field or- ders or change carders, or the preparing, approving, or falling to prepare or .ap- prove„ drawings and specifications; and ii. Supervisory, inspection, architectural or engineering activities.. c) The insurance provided. to the; additional in- sured does not apply to "bodily injury" or "'property damage": caused by "your work" and included In the "products -completed op- erations, hazard" unless the "written contract requiring insurance°" specifically requires you to provide such coverage for that additional insured, and then the insurance provided to the additional insured applies only to such. "beadily :injury" or "property damage"' that oc:- curs before. the end of the period of time for which the "written contract requiring insur- anc " requires you to provide such coverage or the end of the policy period, whichever is earlier; 3. The insurance provided to the additional insured by this endorsement is excess over any -valid and collectible "rather insurance", +whether primary, excess, contingent or an any other basis, that is available to the additional insured for a loss we cover under this endorsement. However, if the "written contract requiring insurance" specifically requires that this insurance apply on. a :primary basis or a primary and non:. -contributory basis, this insurance is primary to "other insuranice" available to the additional insured which covers M,�!S.. person or '.,+rgi?s.i�{,4 VVt i P� ,P ilOOR.FFe11"4 aia."-.;,i r'G!J for such Foss, and we will not share with that "othewr insurance". But the insurance provided to the additional insured by this endorsement skill is excess over any valid and collectible "other in- surance"., n- surance whether primary, excess, contingent or on any rather basis, that is available to the addi- tional insured when that person or organization is an additional inseured under such "other insur- ance". 4. As a condition of coverage provided to the additional insured by this endorsement:. a) The additional insured must give us written notice .as soon as practicable of ars "aco.ur- rence" or .an offense which may resu t in a. claim.. To the extent possible, such notice should include', CG D2 46 08 05 C 2005 The St. Paul Travelers Companies, Inc. Page. 1 of 2 From: PROPEL INSURANCE I Fax: 12537592200 To: COMMERCIAL GENERAL LIABILITY 1. Haw, when and whore the "occurrence" or offense took place; IL The names and addresses of any injured persons and. witnesses; and iii. The nature and location of any injury or damage arising out of the "occurrence" or offense.. b) If a claim is made or "suit" Is brought against the. additiOn2l insured, the additional insured must" I. Immediately recordthe specifics of the claim or "suit" and the date received; and fl. Notify US as soon as practicable. The additional insured must see to it that we receive written notice of the darn Or"Wit" as soon as practicable. c) The additional insured must imrnediateiy send us copies of all legal papers received in connection with the claim or "suit`", cooperate with Us in the investigation or settlement of the claim or defense against the "suit", and otherwise comply with all policy conditions. d) The additional Insured must tender.the de- fense and. indemnity of any claim or "suit" to Fax: (360) 473-2330 Page: 5 of 23 01/3012019 10:59 AM any provider of "other insurance" which would cover the additional insured for a loss we cover under this endorsement- However, this condition does not affect whether the insur- ance -provided to the additional insured by this endorsement is primary to "other insur- ance" available to the additional insured which covers that person or organization as 2. named insured nsured as described in paragraph 3. above. 5. The following definition is added to SECTION V. DEFINITIONS- "Written contract requiring insurance" means that part of any written contractor agreement under which you are required to include a person or organization as an additional in- sured on this Coverage Part, provided that the "bodily injury" and "property damage"' oc- curs and the "personal :injury" is caused by an offense committed: a. After the signing and execution of the contractor agreement by you', b. While that part of the contract or agreement is in effect-, and c. Before the end of the policy period, Page 2 of 2 C 2005 The St. Paul Travelers Companies, Inc. CG D2 46 08 05 From: PROPEL INSURANCE i Fax: 12537592200 To: Fax: (360) 473-2330 Page: 6 of 23 01/3012019 10:59 AM COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS XTEND ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. Aircraft Chartered With Pilot B. Damage To Premises Rented To You C. Increased Supplementary Payments D. Incidental Medical Malpractice E. Who Is An Insured — Newly Acquired Or Formed Organizations F. Who Is An Insured — Broadened Named Insured — Unnamed Subsidiaries G. Blanket Additional Insured — Owners, Managers Or Lessors Of Premises PROVISIONS A. AIRCRAFT CHARTERED WITH PILOT The following is added to Exclusion g., Aircraft, Auto Or Watercraft, in Paragraph 2. of SECTION I — COVERAGES — COVERAGE A BODILY IN- JURY AND PROPERTY DAMAGE LIABILITY: This exclusion does not apply to an aircraft that is.. (a) Chartered with a pilot to any insured; (b) Not owned by any insured; and (c) Not being used to carry any person or prop- erty for a charge. B. DAMAGE TO PREMISES RENTED TO YOU 1. The first paragraph of the exceptions in Ex- clusion j., Damage To Property, in Para- graph 2. of SECTION I — COVERAGES — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY is deleted. H. Blanket Additional Insured — Lessors Of Leased Equipment I. Blanket Additional Insured — States Or Political Subdivisions — Permits J. Knowledge And Notice Of Occurrence Or Offense K. Unintentional Omission L. Blanket Waiver Of Subrogation M. Amended Bodily Injury Definition N. Contractual Liability — Railroads INJURY AND PROPERTY DAMAGE LI- ABILITY: Exclusions c. and g. through n. do not apply to "premises damage". Exclusion f.(1)(a) does not apply to "premises damage" caused by: a. Fire; b. Explosion; c. Lightning; d. Smoke resulting from such fire, explosion, or lightning; or e. Water; unless Exclusion f. of Section I — Coverage A — Bodily Injury And Property Damage Liability is replaced by another endorsement to this Coverage Part that has Exclusion — All Pollu- tion Injury Or Damage or Total Pollution Ex- clusion in its title. 2. The following replaces the last paragraph of A separate limit of insurance applies to Paragraph 2., Exclusions, of SECTION I — "premises damage" as described in Para - COVERAGES — COVERAGE A. BODILY graph 6. of SECTION III —LIMITS OF IN- SURANCE. CG D3 16 11 11 © 2011 The Travelers Indemnity Company. All rights reserved. Page 1 of 6 From: PROPEL INSURANCE i Fax: 12537592200 To: COMMERCIAL GENERAL LIABILITY 3. The following replaces Paragraph 6. of SEC- TION III —LIMITS OF INSURANCE: Subject to 5. above, the Damage To Prem- ises Rented To You Limit is the most we will pay under Coverage A for damages because of "premises damage" to any one premises. The Damage To Premises Rented To You Limit will apply to all "property damage" proximately caused by the same "occur- rence", whether such damage results from: fire; explosion; lightning; smoke resulting from such fire, explosion, or lightning; or water; or any combination of any of these causes. The Damage To Premises Rented To You Limit will be: a. The amount shown for the Damage To Premises Rented To You Limit on the Declarations of this Coverage Part; or b. $300,000 if no amount is shown for the Damage To Premises Rented To You Limit on the Declarations of this Coverage Part. 4. The following replaces Paragraph a. of the definition of "insured contract" in the DEFINI- TIONS Section: a. A contract for a lease of premises. How- ever, that portion of the contract for a lease of premises that indemnifies any person or organization for "premises damage" is not an "insured contract"; 5. The following is added to the DEFINITIONS Section: "Premises damage" means "property dam- age" to: a. Any premises while rented to you or tem- porarily occupied by you with permission of the owner; or b. The contents of any premises while such premises is rented to you, if you rent such premises for a period of seven or fewer consecutive days. 6. The following replaces Paragraph 4.b.(1)(b) of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: (b) That is insurance for "premises damage", or 7. Paragraph 4.b.(1)(c) of SECTION IV — COMMERCIAL GENERAL LIABILITY COW DITIONS is deleted. Fax: (360) 473-2330 Page: 7 of 23 01/3012019 10:59 AM C. INCREASED SUPPLEMENTARY PAYMENTS 1. The following replaces Paragraph 1.b. of SUPPLEMENTARY PAYMENTS — COVER- AGES A AND B of SECTION I — COVER- AGE: b. Up to $2,500 for the 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 fur- nish these bonds. 2. The following replaces Paragraph 1.d. of SUPPLEMENTARY PAYMENTS — COVER- AGES A AND B of SECTION I — COVER- AGES: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. D. INCIDENTAL MEDICAL MALPRACTICE 1. The following is added to the definition of "oc- currence" in the DEFINITIONS Section: "Occurrence" also means an act or omission committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to a person. 2. The following is added to Paragraph 2.a.(1) of SECTION II —WHO IS AN INSURED: Paragraph (1)(d) above does not apply to "bodily injury" arising out of providing or fail- ing to provide: (i) "Incidental medical services" by any of your "employees" who is a nurse practi- tioner, registered nurse, licensed practical nurse, nurse assistant, emergency medi- cal technician or paramedic; or (ii) First aid or "Good Samaritan services" by any of your "employees" or "volunteer workers", other than an employed or vol- unteer doctor. Any such "employees" or "volunteer workers" providing or failing to provide first aid or "Good Samaritan ser- vices" during their work hours for you will be deemed to be acting within the scope of their employment by you or performing duties related to the conduct of your busi- ness. Page 2 of 6 © 2011 The Travelers Indemnity Company. All rights reserved. CG D3 16 11 11 From: PROPEL INSURANCE i Fax: 12537592200 To: The following is added to Paragraph 5. of SECTION III — LIMITS OF INSURANCE: For the purposes of determining the applica- ble Each Occurrence Limit, all related acts or omissions committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to any one per- son will be deemed to be one 'occurrence". The following exclusion is added to Para- graph 2., Exclusions, of SECTION I — COV- ERAGES — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY: Sale Of Pharmaceuticals "Bodily injury" or "property damage" arising out of the willful violation of a penal statute or ordinance relating to the sale of pharmaceuti- cals committed by, or with the knowledge or consent of, the insured. 5. The following is added to the DEFINITIONS Section: "Incidental medical services" means: a. Medical, surgical, dental, laboratory, x-ray or nursing service or treatment, advice or instruction, or the related furnishing of food or beverages, or b. The furnishing or dispensing of drugs or medical, dental, or surgical supplies or appliances. "Good Samaritan services" means any emer- gency medical services for which no compen- sation is demanded or received. Fax: (360) 473-2330 Page: 8 of 23 01/3012019 10:59 AM COMMERCIAL GENERAL LIABILITY 4. Any organization you newly acquire or form, other than a partnership, joint venture or lim- ited liability company, of which you are the sole owner or in which you maintain the ma- jority ownership interest, will qualify as a Named Insured if there is no other insurance which provides similar coverage to that or- ganization. However: a. Coverage under this provision is afforded only: (1) Until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier, if you do not report such organization in writing to us within 180 days after you acquire or form it; or 6. The following is added to Paragraph 4.b., Ex- F cess Insurance, of SECTION IV — COM- MERCIAL GENERAL LIABILITY CONDI- TIONS: The insurance is excess over any valid and collectible other insurance available to the in- sured, whether primary, excess, contingent or on any other basis, that is available to any of your "employees" or "volunteer workers" for "bodily injury" that arises out of providing or failing to provide "incidental medical ser- vices", first aid or "Good Samaritan services" to any person to the extent not subject to Paragraph 2.a.(1) of Section II — Who Is An Insured. E. WHO IS AN INSURED — NEWLY ACQUIRED OR FORMED ORGANIZATIONS The following replaces Paragraph 4. of SECTION II —WHO IS AN INSURED: (2) Until the end of the policy period, when that date is later than 180 days after you acquire or form such organization, if you report such organization in writing to us within 180 days after you acquire or form it, and we agree in writing that it will con- tinue to be a Named Insured until the end of the policy period; 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 in- jury" or "advertising injury" arising out of an offense committed before you acquired or formed the organization. WHO IS AN INSURED — BROADENED NAMED INSURED — UNNAMED SUBSIDIARIES The following is added to SECTION II — WHO IS AN INSURED: Any of your subsidiaries, other than a partnership, joint venture or limited liability company, that is not shown as a Named Insured in the Declara- tions is a Named Insured if you maintain an own- ership interest of more than 50% in such subsidi- ary on the first day of the policy period. No such subsidiary is an insured for "bodily injury" or "property damage" that occurred, or "personal injury" or "advertising injury" caused by an of- fense committed after the date, if any, during the policy period, that you no longer maintain an ownership interest of more than 50% in such sub- sidiary. CG D3 16 11 11 © 2011 The Travelers Indemnity Company. All rights reserved. Page 3 of 6 From: PROPEL INSURANCE i Fax: 12537592200 To: COMMERCIAL GENERAL LIABILITY G. BLANKET ADDITIONAL INSURED — OWNERS, MANAGERS OR LESSORS OF PREMISES The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that is a premises owner, manager or lessor and that you have agreed in a written contract or agreement to in- clude as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage", "personal injury" or "advertising injury" that: a. Is "bodily injury" or "property damage" that occurs, or is "personal injury" or "advertising injury" caused by an offense that is commit- ted, subsequent to the execution of that con- tract or agreement; and b. Arises out of the ownership, maintenance or use of that part of any premises leased to you. The insurance provided to such premises owner, manager or lessor is subject to the following pro- visions: The limits of insurance provided to such premises owner, manager or lessor will be the minimum limits which you agreed to pro- vide in the written contract or agreement, or the limits shown on the Declarations, which- ever are less. b. The insurance provided to such premises owner, manager or lessor does not apply to: (1) Any "bodily injury" or "property damage" that occurs, or "personal injury" or "adver- tising injury" caused by an offense that is committed, after you cease to be a tenant in that premises; or (2) Structural alterations, new construction or demolition operations performed by or on behalf of such premises owner, lessor or manager. c. The insurance provided to such premises owner, manager or lessor is excess over any valid and collectible other insurance available to such premises owner, manager or lessor, whether primary, excess, contingent or on any other basis, unless you have agreed in the written contract or agreement that this in- surance must be primary to, or non- contributory with, such other insurance, in which case this insurance will be primary to, and non-contributory with, such other insur- ance. Fax: (360) 473-2330 Page: 9 of 23 01/3012019 10:59 AM H. BLANKET ADDITIONAL INSURED — LESSORS OF LEASED EQUIPMENT The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that is an equipment lessor and that you have agreed in a written con- tract or agreement to include as an insured on this Coverage Part is an insured, but only with re- spect to liability for "bodily injury", "property dam- age", "personal injury" or "advertising injury" that: a. Is "bodily injury" or "property damage" that occurs, or is "personal injury" or "advertising injury" caused by an offense that is commit- ted, subsequent to the execution of that con- tract or agreement; and b. Is caused, in whole or in part, by your acts or omissions in the maintenance, operation or use of equipment leased to you by such equipment lessor. The insurance provided to such equipment lessor is subject to the following provisions: a. The limits of insurance provided to such equipment lessor will be the minimum limits which you agreed to provide in the written contract or agreement, or the limits shown on the Declarations, whichever are less. b. The insurance provided to such equipment lessor does not apply to any "bodily injury" or "property damage" that occurs, or "personal injury" or "advertising injury" caused by an of- fense that is committed, after the equipment lease expires. c. The insurance provided to such equipment lessor is excess over any valid and collectible other insurance available to such equipment lessor, whether primary, excess, contingent or on any other basis, unless you have agreed in the written contract or agreement that this insurance must be primary to, or non-contributory with, such other insurance, in which case this insurance will be primary to, and non-contributory with, such other in- surance. I. BLANKET ADDITIONAL INSURED — STATES OR POLITICAL SUBDIVISIONS — PERMITS The following is added to SECTION II — WHO IS AN INSURED: Any state or political subdivision that has issued a permit in connection with operations performed by you or on your behalf and that you are required Page 4 of 6 © 2011 The Travelers Indemnity Company. All rights reserved. CG D3 16 11 11 From: PROPEL INSURANCE i Fax: 12537592200 To: J by any ordinance, law or building code to include as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage", "personal in- jury" or "advertising injury" arising out of such op- erations. The insurance provided to such state or political subdivision does not apply to: a. Any "bodily injury," "property damage," "per- sonal injury" or "advertising injury" arising out of operations performed for that state or po- litical subdivision, or b. Any "bodily injury" or "property damage" in- cluded in the "products -completed operations hazard". KNOWLEDGE AND NOTICE OF OCCUR- RENCE OR OFFENSE The following is added to Paragraph 2., Duties In The Event of Occurrence, Offense, Claim or Suit, of SECTION IV — COMMERCIAL GEN- ERAL LIABILITY CONDITIONS: The following provisions apply to Paragraph a. above, but only for the purposes of the in- surance provided under this Coverage Part to you or any insured listed in Paragraph 1. or 2. of Section II —Who Is An Insured: (1) Notice to us of such "occurrence" or of- fense must be given as soon as practica- ble only after the "occurrence" or offense is known by you (if you are an individual), any of your partners or members who is an individual (if you are a partnership or joint venture), any of your managers who is an individual (if you are a limited liability company), any of your "executive offi- cers" or directors (if you are an organiza- tion other than a partnership, joint venture or limited liability company) or any "em- ployee" authorized by you to give notice of an "occurrence" or offense. (2) If you are a partnership, joint venture or limited liability company, and none of your partners, joint venture members or man- agers are individuals, notice to us of such "occurrence" or offense must be given as soon as practicable only after the "occur- rence" or offense is known by: Fax: (360) 473-2330 Page: 10 of 23 01/3012019 10:59 AM COMMERCIAL GENERAL LIABILITY (ii) A manager of any limited liability company; or (iii) An executive officer or director of any other organization, that is your partner, joint venture member or manager; or (b) Any "employee" authorized by such partnership, joint venture, limited li- ability company or other organization to give notice of an "occurrence" or offense. (3) Notice to us of such "occurrence" or of an offense will be deemed to be given as soon as practicable if it is given in good faith as soon as practicable to your work- ers' compensation insurer. This applies only if you subsequently give notice to us of the "occurrence" or offense as soon as practicable after any of the persons de- scribed in Paragraphs e. (1) or (2) above discovers that the "occurrence" or offense may result in sums to which the insurance provided under this Coverage Part may apply. However, if this Coverage Part includes an en- dorsement that provides limited coverage for "bodily injury" or "property damage" or pollution costs arising out of a discharge, release or es- cape of "pollutants" which contains a requirement that the discharge, release or escape of "pollut- ants" must be reported to us within a specific number of days after its abrupt commencement, this Paragraph e. does not affect that require- ment. K. UNINTENTIONAL OMISSION The following is added to Paragraph 6., Repre- sentations, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: The unintentional omission of, or unintentional error in, any information provided by you which we relied upon in issuing this policy will not preju- dice your rights under this insurance. However, this provision does not affect our right to collect additional premium or to exercise our rights of cancellation or nonrenewal in accordance with applicable insurance laws or regulations. L. BLANKET WAIVER OF SUBROGATION (a) Any individual who is: The following is added to Paragraph 8., Transfer (i) A partner or member of any part- Of Rights Of Recovery Against Others To Us, nership or joint venture, of SECTION IV — COMMERCIAL GENERAL LI- ABILITY CONDITIONS: CG D3 16 11 11 © 2011 The Travelers Indemnity Company. All rights reserved. Page 5 of 6 From: PROPEL INSURANCE i Fax: 12537592200 To: COMMERCIAL GENERAL LIABILITY If the insured has agreed in a contract or agree- ment to waive that insured's right of recovery against any person or organization, we waive our right of recovery against such person or organiza- tion, but only for payments we make because of: a. "Bodily injury" or "property damage" that oc- curs; or b. "Personal injury" or "advertising injury" caused by an offense that is committed; subsequent to the execution of that contract or agreement. M. AMENDED BODILY INJURY DEFINITION The following replaces the definition of "bodily injury" in the DEFINITIONS Section: Fax: (360) 473-2330 Page: 11 of 23 01/3012019 10:59 AM 3. "Bodily injury" means bodily injury, mental anguish, mental injury, shock, fright, disability, humiliation, sickness or disease sustained by a person, including death resulting from any of these at any time. N. CONTRACTUAL LIABILITY —RAILROADS 1. The following replaces Paragraph c. of the definition of "insured contract" in the DEFINI- TIONS Section: c. Any easement or license agreement; 2. Paragraph f.(1) of the definition of "insured contract" in the DEFINITIONS Section is de- leted. Page 6 of 6 © 2011 The Travelers Indemnity Company. All rights reserved. CG D3 16 11 11 From: PROPEL INSURANCE i Fax: 12537592200 To: POLICY NUMBER: Fax: (360) 473-2330 Page: 12 of 23 01/3012019 10:59 AM COMMERCIAL GENERAL LIABILITY ISSUE DATE: - - THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY DESIGNATED PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Project(s): EACH "PROJECT" FOR WHICH YOU HAVE AGREED, IN A WRITTEN CONTRACT WHICH IS IN EFFECT DURING THIS POLICY PERIOD, TO PROVIDE A SEPARATE GENERAL AGGREGATE LIMIT, PROVIDED THAT THE CONTRACT IS SIGNED AND EXECUTED BY YOU BEFORE THE "BODILY INJURY" OR "PROPERTY DAMACE" OCCURS. A. For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under COVERAGE A. (SECTION 1), and for all medical expenses caused by accidents un- der COVERAGE C (SECTION 1), which can be attributed only to operations at a single desig- nated "project" shown in the Schedule above: 1. A separate Designated Project General Ag- gregate Limit applies to each designated "pro- ject", and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations, unless separate Designated Project General Aggregate(s) are sched- uled above_ 2. The Designated Project General Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A., except damages because of "bodily injury" or "prop- erty damage" included in the "products - completed operations hazard", and for medi- cal expenses under COVERAGE C, regard- less of the number of: a. Insureds, b. Claims made or "suits" brought, or c. Persons or organizations making claims or bringing "suits". Designated Project General Aggregate(s): GENERAL AGGREGATE LIMIT SHOWN ON THE DECLARATIONS 3. Any payments made under COVERAGE A. for damages or under COVERAGE C. for medical expenses shall reduce the Desig- nated Project General Aggregate Limit for that designated "project". Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they re- duce any other Designated Project General Aggregate Limit for any other designated "project" shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Project General Ag- gregate Limit. B, For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under COVERAGE A. (SECTION 1), and for all medical expenses caused by accidents un- der COVERAGE C. (SECTION 1), which cannot be attributed only to operations at a single desig- nated "project" shown in the Schedule above: CG D2 11 01 04 Copyright, The Travelers Indemnity Company, 2004 Page 1 of 2 From: PROPEL INSURANCE i Fax: 12537592200 To: COMMERCIAL GENERAL LIABILITY 1. Any payments made under COVERAGE A. for damages or under COVERAGE C. for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products -Completed Operations Ag- gregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Desig- nated Project General Aggregate Limit. C. Part 2. of SECTION III — LIMITS OF INSURANCE is deleted and replaced by the following: 2. The General Aggregate Limit is the most we will pay for the sum of: a. Damages under Coverage B; and b. Damages from "occurrences" under COVERAGE A (SECTION I) and for all medical expenses caused by accidents under COVERAGE C (SECTION 1) which cannot be attributed only to operations at a single designated "project" shown in the SCHEDULE above. D. When coverage for liability arising out of the "products -completed operations hazard" is pro- Fax: (360) 473-2330 Page: 13 of 23 01/3012019 10:59 AM vided, any payments for damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard" will reduce the Products -Completed Operations Ag- gregate Limit, and not reduce the General Aggre- gate Limit nor the Designated Project General Aggregate Limit. E. For the purposes of this endorsement the Defini- tions Section is amended by the addition of the following definition: "Project" means an area away from premises owned by or rented to you at which you are per- forming operations pursuant to a contract or agreement. For the purposes of determining the applicable aggregate limit of insurance, each "project" that includes premises involving the same or connecting lots, or promises whose con- nection is interrupted only by a street, roadway, waterway or right-of-way of a railroad shall be considered a single "project". F. The provisions of SECTION III — LIMITS OF INSURANCE not otherwise modified by this en- dorsement shall continue to apply as stipulated. Page 2 of 2 Copyright, The Travelers Indemnity Company, 2004 CG D2 11 01 04 From: PROPEL INSURANCE i Fax: 12537592200 To: Fax: (360) 473-2330 Page: 14 of 23 01/3012019 10:59 AM COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS F. HIRED AUTO — LIMITED WORLDWIDE COV- ERAGE — INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE — GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT J. PERSONAL PROPERTY K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COV- ERED AUTOS LIABILITY COVERAGE: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. 2. The following replaces Paragraph b. in B.5., Other Insurance, of SECTION IV — Bill NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow-, and (2) Any covered "auto" hired or rented by your "employee" under a contract in an "employee's" name, with your CA T3 53 02 15 © 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. From: PROPEL INSURANCE i Fax: 12537592200 To: COMMERCIAL AUTO permission, while performing duties related to the conduct of your busi- ness. However, any "auto' that is leased, hired, rented or borrowed with a driver is not a covered "auto". D. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any "employee" of yours is an "insured" while us- ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs. E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2), of SECTION II — COVERED AUTOS LIABIL- ITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident" we cover. We do not have to furnish these bonds. 2. The following replaces Paragraph A.2.a.(4), of SECTION II — COVERED AUTOS LIABIL- ITY COVERAGE: (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day be- cause of time off from work. F. HIRED AUTO — LIMITED WORLDWIDE COV- ERAGE — INDEMNITY BASIS The following replaces Subparagraph (5) in Para- graph B.7., Policy Period, Coverage Territory, of SECTION IV — BUSINESS AUTO CONDI- TIONS: (5) Anywhere in the world, except any country or jurisdiction while any trade sanction, em- bargo, or similar regulation imposed by the United States of America applies to and pro- hibits the transaction of business with or within such country or jurisdiction, for Cov- ered Autos Liability Coverage for any covered "auto" that you lease, hire, rent or borrow without a driver for a period of 30 days or less and that is not an "auto" you lease, hire, rent or borrow from any of your "employees", partners (if you are a partnership), members (if you are a limited liability company) or members of their households. Fax: (360) 473-2330 Page: 15 of 23 01/3012019 10:59 AM (a) With respect to any claim made or "suit" brought outside the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada: (i) You must arrange to defend the "in- sured" against, and investigate or set- tle any such claim or "suit" and keep us advised of all proceedings and ac- tions. (ii) Neither you nor any other involved "insured" will make any settlement without our consent. (iii) We may, at our discretion, participate in defending the "insured" against, or in the settlement of, any claim or "suit". (iv) We will reimburse the "insured" for sums that the "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, that the "in- sured" pays with our consent, but only up to the limit described in Para- graph C., Limits Of Insurance, of SECTION II — COVERED AUTOS LIABILITY COVERAGE. (v) We will reimburse the "insured" for the reasonable expenses incurred with our consent for your investiga- tion of such claims and your defense of the "insured" against any such "suit", but only up to and included within the limit described in Para- graph C., Limits Of Insurance, of SECTION II — COVERED AUTOS LIABILITY COVERAGE, and not in addition to such limit. Our duty to make such payments ends when we have used up the applicable limit of insurance in payments for damages, settlements or defense expenses. (b) This insurance is excess over any valid and collectible other insurance available to the "insured" whether primary, excess, contingent or on any other basis. (c) This insurance is not a substitute for re- quired or compulsory insurance in any country outside the United States, its ter- ritories and possessions, Puerto Rico and Canada. Page 2 of 4 © 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. From: PROPEL INSURANCE i Fax: 12537592200 To: You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. (d) It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE — GLASS The following is added to Paragraph D., Deducti- ble, of SECTION III — PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT The following replaces the last sentence of Para- graph A.4.b., Loss Of Use Expenses, of SEC- TION III — PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT The following replaces the first sentence in Para- graph A.4.a., Transportation Expenses, of SECTION III — PHYSICAL DAMAGE COVER. - AGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. J. PERSONAL PROPERTY Fax: (360) 473-2330 Page: 16 of 23 01/3012019 10:59 AM COMMERCIAL AUTO (2) In or on your covered "auto". This coverage applies only in the event of a total theft of your covered "auto". No deductibles apply to this Personal Property coverage. K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage underthis policy; b. The airbags are not covered under any war- ranty-, and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV — BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or "loss" ap- plies only when the "accident" or "loss" is known to: (a) You (if you are an individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee" authorized by you to give no- tice of the "accident" or "loss". M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDI- TIONS: The following is added to Paragraph A.4., Cover- 5. Transfer Of Rights Of Recovery Against age Extensions, of SECTION III — PHYSICAL Others To Us DAMAGE COVERAGE: We waive any right of recovery we may have Personal Property against any person or organization to the ex - We will a u to $400 for "lass" to wearing a tent required of you by a written contract pay P 9 p- signed and executed prior to any "accident" parel and other personal property which is: or "loss", provided that the "accident" or "loss" (1) Owned by an "insured"; and arises out of operations contemplated by CA T3 53 02 15 © 2015 The Travelers Indemnity Company. All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. From: PROPEL INSURANCE i Fax: 12537592200 To: COMMERCIAL AUTO such contract. The waiver applies only to the person or organization designated in such contract. N. UNINTENTIONAL ERRORS OR OMISSIONS The following is added to Paragraph 13.2., Con- cealment, Misrepresentation, Or Fraud, of SECTION IV — BUSINESS AUTO CONDITIONS: Fax: (360) 473-2330 Page: 17 of 23 01/3012019 10:59 AM The unintentional omission of, or unintentional error in, any information given by you shall not prejudice your rights under this insurance. How- ever this provision does not affect our right to col- lect additional premium or exercise our right of cancellation or non -renewal. Page 4 of 4 O 21)15 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. From: PROPEL INSURANCE . Fax: u,n,mmv To: Fax: (3w)w,'mw Page: mmm 01u01201910:59mn COMMERCIAL AUTO This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM 1. The following is added to Paragraph A.I.c.. Who Is An Insured, of SECTION U — COVERED AUTOS LIABILITY COVERAGE. Any person ororganization who is required under awritten contract oragreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy perind, to be named as anaddi- tiona| insured is on "insured" for Covered Autos Liability Coverage, but only for damages to which this insurance applies and only tothe extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in SECTION III. 2. The following is added to Paragraph B.5.. Other Insurance ofSECTION KY—BUS|NESS AUTO Regardless ofthe provisions nfparagraph a. and paragraph d. of this part 5. Other Insurance, this insurance is primary to and non-contributory with applicable other insurance under which anaddi- tional insured person or organization is the first named insured when the written contract or agreement between you and that person or or- ganization, FOanization. that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is ineffect during the policy pe - nod, requires this insurance to be primary and non-contributory. CA T4 74O215 (D2O15The Travelers Indemnity Company. All rights reserved. Page of From: PROPEL INSURANCE i Fax: 12537592200 To: Fax: (360) 473-2330 Page: 19 of 23 01/3012019 10:59 AM This page has been left blank intentionally. From: PROPEL INSURANCE i Fax: 12537592200 To: Fax: (360) 473-2330 Page: 20 of 23 01/3012019 10:59 AM COMMERCIAL INLAND MARINE. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the IM PAK COVERAGE FORM. The following is added to Section E — ADDITIONAL Ib. Pay any claim for loss or damage jointly to you COVERAGE CONDITIONS, and the Loss Payee as your interests may ap- Loss Payable Provision pear - In the event of a Covered Cause of Loss to Covered Property in which both you and a Loss Payee share an Insurable interest, we will. a. Adjust the loss or damage with you; and This endorsement applies to all Covered Property for which a Loss Payee is on file with us or your insur- ance agent or insurance broker. CM TS 60 0110 0 2009 The Travelers Indemnity Company Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission, From: PROPEL INSURANCE i Fax: 12537592200 To: Fax: (360) 473-2330 Page: 21 of 23 01/3012019 10:59 AM This page has been left blank intentionally. From: PROPEL INSURANCE I Fax: 12537592200 To: Fax: (360) 473-2330 Page: 22 of 23 01/3012019 10:59 AM 11R� :10[ :1 IN AL AAJ This endorsement moes insurance provided under the following: COMMERCIAL EXCESS LIABILITY (UMBRELLA) INSURANCE ffixlr i1111113 a. "Bodily injury" or "property damage" caused by an ..occurrence" that takes place; or b. "Personal injury" or "advertising injury" caused by an "offense" that is committed; subsequent to the execution of the contract or agree- ment. UM 04 88 07 08 Q 2008 The Travelers Companies, Inc, Page I of 1 Includes the copyrighted material of Insurance Services Office, Inc. with its permission. From: PROPEL INSURANCE i Fax: 12537592200 To: Fax: (360) 473-2330 Page: 23 of 23 01/3012019 10:59 AM This page has been left blank intentionally. From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: 2 of 63 0112912021 12:14 PM Client#, 121565 JOHAEXCA DATE (MCWDWYYYY) ACORD. CERTIFICATE OF LIABILITY INSURANCE 1/2912021 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. 1 >>ORTANT. lithe certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or 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 (foes not confer any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Lisa Anderson NAME: Propel Insurance E-MAILss:Xt� � de� nn�prgpelinsurance comtl�: $55 77 -1325 Tacoma Commercial Insurance E-�II RE 33 1201 Pacific Ave, Suite 1000 INSURER(S) Arrom NG COVERAGE NAIC # Tacoma, WA 98402 INSURER A: The Phoenix Insurance Company 25623 INSURED INSURER B Travelers Property Casualty CoofAmerica 25674 Johansen Construction Company, LLC .. ....... ....... ........ ........ . ........ ..... ... INSURER c: Are rance Company. Charter Oak F Assurance I �...�........ S) Inc 194$9 PO DqX 674 INSURER D : Allied World re Insurance Company������ ����� Travelers Ind 25615 Buckley, WA 98321 ......... .... ..... ........... ..... INsttR1=R E emnity CoGa of Cannceticut 256$2 COVERAGES CERTIFICATE NUMBER. 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 CONTRACTOR 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. IN RR ............. TYPE OF INSURANCE '.INSRADDLSUBR WVD POLICY NUMBER .............. .................. ................ ......... .. ... ............ ............... .............. .................. (MlWD�IYYYY) ', €M ©IYYYVY) LIMITS .................. ........ .............. .......... ... A X COMMERCIAL GENERAL LIABILITY ',. DTC07G235301 PHX21 2/01/2021 02/01/2022 EACH OCCURRENCF : $1,000,000 .. CLAIMS -MAUL X OCCUR '.. '.. RR SFS FR oCCcu€rence $ 300,000 X PD Ded: $5,000 MED EXP {An anc erson) ....„ _. $ 10,000 PERSONAL& ADV INJURY _ S 1,000,000 _.... GEN'LAGGREGATE LIMIT APPLIESPER:GENERALAGGREGA'TE ;52,000,000 PRO- POLICY X JECV ..-_ LOO '., .... .............. .. '.., PRODUCTS - COMP/OP AGG ...... ., ............,..,.....,... S 2,000,000 OTHER: WA Stop Gap s1,000,000 E AUTOMOBILE LIABILITY 8103L5953572126G CDMBINED SNGI F LIMIT 2/01/2021,02/01/202 $1000,000 .............. ........................ X', ANY AUTO BODILY INJURY (Per person) $ OWNER SCHEDULED AU'I OS ONLY AUTOS PODII.,Y INJURY (Per accident) ' $ HIRED NON -OWNED X' X PROPERTY DAMAGE AUTOS ONI..Y AU COS ONLY (Per accident) Xcornp $2K Tied X Coll S2K Ded $ B X UiNBRELLA LIAR X OCCUR CUPl J0581002126 2/01/2021 02/01/202 EACH OCCURRENCE .. $10 OW 000 EXCESS LIARAGGREGATE ...... ClCI AIMS MADE ..... $10r000,000 ... ....... DED I X RETFNTION S$10,000 S A WORKERS COMPENSATION DTC07G235301 PHX21 2101/2021 02101/202 STATUTE x ER AND EMPLOYERS' LIABILITY YIN .... ... ........ ANY PROPRIETORMARTNFRIEXFC:UTIVF WA Stop Gap Only F I EACH. ACCIDENT OFFICERIMEMBEREXCLUDED? N NIA ... ... .$1,000,000 ..... .................. (Mandatary In NH) E.I. DISEASE - EA EMPI OYEEI $1,000,000 If yes, describe under DESCRIPTION OF OPFRATIONS below F.I L. DISEASE POl ICY I [MIT .......$2,000,0001$25K ...... $1,000,000 C Pollution Lia. 03097655 210112021 02101/202 D Leased/Rent Equip QT6600N247348COF21 2/01/2021 02/01/202 $250,000 Limit D Scheduled Equip OT660ON247348COF 2#0112021021011202 SEE BELOW 1$1,000 Ded. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Lebo Boulevard Roadway Improvements City of Bremerton, Public Works & Utilities, and its officers, elected officials, employees, agents, and volunteers are Additional Insured per attached Endorsements. City of Bremerton Public Works & Utilities 100 Oyster Bay AVE N. Bremerton, WA 98312 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 1988-2015 ACORD CORPORATION, All rights reserved. ACORD 25 (2016103) 1 of 1 The ACORD dame and logo are registered marks of ACORD #S4465788/M4465782 LMA00 From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: 3 of 63 0112912021 12:14 PM This page has been left blank intentionally. From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: 4 of 63 0112912021 12:14 PM COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (Includes Products -Completed Operations If Required By Contract) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 7 T07T]F1T+7L1M The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that you agree in a written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only: a. With respect to liability for "bodily injury" or "property damage" that occurs, or for "personal injury" caused by an offense that is committed, subsequent to the signing of that contract or agreement and while that part of the contract or agreement is in effect; and b. If, and only to the extent that, such injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your worke' to which the written contract or agreement applies. Such person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. The insurance provided to such additional insured is subject to the following provisions: a. If the Limits of Insurance of this Coverage Part shown in the Declarations exceed the minimum limits required by the written contract or agreement, the insurance provided to the additional insured will be limited to such minimum required limits. For the purposes of determining whether this limitation applies, the minimum limits required by the written contract or agreement will be considered to include the minimum limits of any Umbrella or Excess liability coverage required for the additional insured by that written contract or agreement. This provision will not increase the limits of insurance described in Section III — Limits Of Insurance. (1) Any `bodily injury", "property damage" or ""personal injury" arising out of the providing, or failure to provide, any professional architectural, engineering or surveying services, including: (a) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders or change orders, or the preparing, approving, or failing to prepare or approve, drawings and specifications; and (b) Supervisory, inspection, architectural or engineering activities. (2) Any "bodily injury" or "property damage" caused by "your work" and included in the "products -completed operations hazard" unless the written contract or agreement specifically requires you to provide such coverage for that additional insured during the policy period. c. The additional insured must comply with the following duties! (1) Give us written notice as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, such notice should include: (a) How, when and where the "occurrence" or offense took place; (b) The names and addresses of any injured persons and witnesses; and (c) The nature and location of any injury or damage arising out of the "occurrence" or offense. b. The insurance provided to such additional (2) If a claim is made or "suit" is brought against insured does not apply to: the additional insured: CG D2 46 04 19 0 2018 The Travelers Indemnity Company. All rights reserved. Page 1 of 2 From: PROPEL INSURANCE ( Fax: 12537592200 To: COMMERCIAL GENERAL LIABILITY Fax: (360) 473-2330 Page: 5 of 63 0112912021 12:14 PM (a) Immediately record the specifics of the claim or"suit" and the date received; and (b) Notify us as soon as practicable and see to it that we receive written notice of the claim or "suit" as soon as practicable. (3) Immediately send us copies of all legal papers received in connection with the claim or "suit", cooperate with us in the investigation or settlement of the claim or defense against the "suit", and otherwise comply with all policy conditions. (4) Tender the defense and indemnity of any claim or "suit" to any provider of other insurance which would cover such additional insured for a loss we cover. However, this condition does not affect whether the insurance provided to such additional insured is primary to other insurance available to such additional insured which covers that person or organization as a named insured as described in Paragraph 4., Other Insurance, of Section Ill Commercial General Liability Conditions. Page 2 of 2 0 201 B The Travelers Indemnity Company. All rights reserved. CG 02 46 04 19 From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: 6 of 63 0112912021 12:14 PM COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. III III 0 - - J This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general coverage description only. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. Who Is An Insured — Unnamed Subsidiaries C. Incidental Medical Malpractice 13. Blanket Additional Insured — Governmental D. Blanket Waiver Of Subrogation Entities — Permits Or Authorizations Relating To E. Contractual Liability— Railroads Operations F. Damage To Premises Rented To You PROVISIONS a. An organization other than a partnership, joint A. WHO IS AN INSURED — UNNAMED venture or limited liability company; or SUBSIDIARIES lb. A trust; The following is added to SECTION II — WHO IS as indicated in its name or the documents that AN INSURED: govern its structure. Any of your subsidiaries, other than a partnership, B. BLANKET ADDITIONAL INSURED — joint venture or limited liability company, that is GOVERNMENTAL ENTITIES — PERMITS OR not shown as a Named Insured in the AUTHORIZATIONS RELATING TO OPERATIONS Declarations is a Named Insured if: You are the sole owner of, or maintain an ownership interest of more than 50% in, such subsidiary on the first day of the policy period; and b. Such subsidiary is not an insured under similar other insurance. No such subsidiary is an insured for "bodily injury" or "property damage" that occurred, or "personal and advertising injury" caused by an offense committed: a. Before you maintained an ownership interest of more than 50% in such subsidiary; or The following is added to SECTION 11 — WHO IS AN INSURED: Any governmental entity that has issued a permit or authorization with respect to operations performed by you or on your behalf and that you are required by any ordinance, law, building code or written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" arising out of such operations. The insurance provided to such governmental entity does not apply to: b. After the date, if any, during the policy period a. Any "bodily injury"' "property damage" or that you no longer maintain an ownership "personal and advertising injury" arising out of interest of more than 50% in such subsidiary. operations performed for the governmental For purposes of Paragraph 1. of Section 11 — Who entity; or Is An Insured, each such subsidiary will be b. Any "bodily injury" or "property damage" deemed to be designated in the Declarations as. included in the "products -completed operations hazard". CG D3 16 02 19 0 2017 The Travelers Indemnity Company. All rights reserved. Page 1 of 3 Includes copyrighted material of Insurance Services Office, Inc_ with its permission. From: PROPEL INSURANCE ( Fax: 12537592200 To: COMMERCIAL GENERAL LIABILITY C. INCIDENTAL MEDICAL MALPRACTICE 1. The following replaces Paragraph b. of the definition of "occurrence" in the DEFINITIONS Section: b. An act or omission committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to a person, unless you are in the business or occupation of providing professional health care services. 2. The following replaces the last paragraph of Paragraph 2.a.(1) of SECTION II — WHO IS AN INSURED: Unless you are in the business or occupation of providing professional health care services, Paragraphs (1)(a), (b), (c) and (d) above do not apply to "bodily injury" arising out of providing or falling to provide: (a) "Incidental medical services" by any of your "employees" who is a nurse, nurse assistant, emergency medical technician or paramedic; or (b) First aid or "Good Samaritan services" by any of your "employees" or "volunteer workers", other than an employed or volunteer doctor. Any such "employees" or "volunteer workers" providing or failing to provide first aid or "Good Samaritan Services" during their work hours for you will be deemed to be acting within the scope of their employment by you or performing duties related to the conduct of your business. 3. The following replaces the last sentence of Paragraph 5. of SECTION III — LIMITS OF INSURANCE: For the purposes of determining the applicable Each Occurrence Limit, all related acts or omissions committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to any one person will be deemed to be one "occurrence". 4. The following exclusion is added to Paragraph 2., Exclusions, of SECTION I — COVERAGES — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY: Sale Of Pharmaceuticals "Bodily injury" or "property damage" arising out of the violation of a penal statute or ordinance relating to the sale of Fax: (360) 473-2330 Page: 7 of 63 0112912021 12:14 PM pharmaceuticals committed by, or with the knowledge or consent of, the insured. 5. The following is added to the DEFINITIONS Section: "Incidental medical services" means: a. Medical, surgical, dental, laboratory, x-ray or nursing service or treatment, advice or instruction, or the related furnishing of food or beverages; or b. The furnishing or dispensing of drugs or medical, dental, or surgical supplies or appliances. S. The following is added to Paragraph 4.b., Excess Insurance, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: This insurance is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to any of your "employees" for "bodily injury" that arises out of providing or falling to provide "incidental medical services" to any person to the extent not subject to Paragraph 2.a.(1) of Section 11 — Who Is An Insured. 1 �� �31_1►� 1:(ii iii'�r1=1 i�1 � ��►7 �`�I] =3 I�►I�7=� it I+►7 i� 1 The following is added to Paragraph S., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: If the insured has agreed in a contract or agreement to waive that insured"s right of recovery against any person or organization, we waive our right of recovery against such person or organization, but only for payments we make because of: a. "Bodily injury" or "property damage" that occurs; or b "Personal and advertising injury" caused by an offense that is committed; subsequent to the execution of the contract or agreement. E. CONTRACTUAL LIABILITY — RAILROADS 1. The following replaces Paragraph c. of the definition of "insured contract" in the DEFINITIONS Section: c. Any easement or license agreement; Page 2 of 3 0 2017 The Travelers Indemnity Company. All rights reserved. CG D3 16 0219 Includes copyrighted material of Insurance Services Office, Inc., with its permission. From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: B of 63 0112912021 12:14 PM COMMERCIAL GENERAL LIABILITY 2. Paragraph f.(1) of the definition of "insured a. Any premises while rented to you or contract" in the DEFINITIONS Section is temporarily occupied by you with permission deleted. of the owner, or F. DAMAGE TO PREMISES RENTED TO YOU b. The contents of any premises while such The following replaces the definition of "premises premises is rented to you, if you rent such damage" in the DEFINITIONS Section: premises for aC period of seven or fewer "Premises damageIE means "property damageEF to: consecutive dayil. CG D3 16 02 19 0 2017 The Travelers Indemnity Company. All rights reserved. Page 3 of 3 Includes copyrighted material of Insurance Services Office, Inc., with its permission. From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: 9 of 63 0112912021 12:14 PM This page has been left blank intentionally, From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: 10 of 63 0112912021 12:14 PM COMMERCIAL GENERAL LIABILITY POLICY NUMBER: ISSUE DATE: - - THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY DESIGNATED PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Prvject(s): EACH "PROJECT" FOR WHICH YOU HAVE AGREED, IN A WRITTEN CONTRACT WHICH IS IN EFFECT DURING THIS POLICY PERIOD, TO PROVIDE A SEPARATE GENERAL AGGREGATE LIMIT, PROVIDED THAT THE CONTRACT IS SIGNED AND EXECUTED BY YOU BEFORE THE "BODILY INJURY" OR "PROPERTY DAMAGE" OCCURS. A. For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under COVERAGE A. (SECTION 1), and for all medical expenses caused by accidents un- der COVERAGE C (SECTION 1), which can be attributed only to operations at a single desig- nated "protect" shown in the Schedule above. 1. A separate Designated Project General Ag- gregate Limit applies to each designated "pro- ject", and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations, unless separate Designated Project General Aggregate(s) are sched- uled above. 2. The Designated Project General Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A., except damages because of "bodily injury" or "prop- erty damage" included in the "products - completed operations hazard", and for medi- cal expenses under COVERAGE C, regard- less of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". Designated Project General Aggregate(s): GENERAL AGGREGATE LIMIT SHOWN ON THE DECLARATIONS 3. Any payments made under COVERAGE A. for damages or under COVERAGE C. for medical expenses shall reduce the Desig- nated Project General Aggregate Limit for that designated "project". Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they re- duce any other Designated Project general Aggregate Limit for any other designated .project" shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Project General Ag- gregate Limit. S. For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under COVERAGE A. (SECTION 1), and for all medical expenses caused by accidents un- der COVERAGE C. (SECTION 1), which cannot be attributed only to operations at a single desig- nated "project" shown in the Schedule above: CIS D2 11 01 04 Copyright, The Travelers Indemnity Company, 2004 Page 1 of 2 From: PROPEL INSURANCE ( Fax: 12537592200 To: COMMERCIAL GENERAL LIABILITY Fax: (360) 473-2330 Page: 11 of 63 0112912021 12:14 PM 1. Any payments made under COVERAGE A. for damages or under COVERAGE G. for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products -Completed Operations Ag- gregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Desig- nated Project General Aggregate Limit. C. Part 2. of SECTION III — LIMITS OF INSURANCE is deleted and replaced by the following: 2. The General Aggregate Limit is the most we will pay for the sum of; a. Damages under Coverage 13; and b. Damages es from "occurrences" under COVERAGE A (SECTION 1) and for all medical expenses caused by accidents under COVERAGE C (SECTION 1) which cannot be attributed only to operations at a single designated "project" shown in the SCHEDULE above. D. When coverage for liability arising out of the "'products -completed operations hazard" is pro- vided, any payments for damages because of "bodily injury" or "property damage" included in the "products --completed operations hazard" will reduce the Products -Completed Operations Ag- gregate Limit, and not reduce the General Aggre- gate Limit nor the Designated Project General Aggregate Limit. E. For the purposes of this endorsement the Defini- tions Section is amended by the addition of the following definition: "Project" means an area away from premises owned by or rented to you at which you are per- forming operations pursuant to a contract or agreement. For the purposes of determining the applicable aggregate limit of insurance, each '.project" that includes premises involving the same or connecting lots, or premises whose con- nection is interrupted only by a street, roadway, waterway or right -ref -way of a railroad small be considered a single "project". F. The provisions or SECTION III — LIMITS OF INSURANCE not otherwise modified by this en- dorsement shall continue to apply as stipulated. Page 2 of 2 Copyright, The Travelers Indemnity Company, 2004 CG D2 1101 04 From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: 12 of 63 0112912021 12:14 PM COMMERCIAL GENERAL LIABILITY Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights, duties and what is and is not covered. Throughout this policy the words "you" and "your" refer to the Named Insured shown in the Declarations, and any other person or organization qualifying as a Named Insured under this policy. The words "we""us" and "our" refer to the company providing this insurance. The ward "insured" means any person or organization qualifying as such under Section II — Who Is An Insured. Other words and phrases that appear in quotation marks have special meaning. Refer to Section V — Definitions. SECTION I — COVERAGES COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of "bodily injury" or "property damage" to which this insurance applies. We will have the right and duty to defend the insured against any "suit" seeking those damages. However, we will have no duty to defend the insured against any "suit" seeking damages for "bodily injury" or "property damage" to which this insurance does not apply. We may, at our discretion, investigate any "occurrence" and settle any claim or "suit" that may result. But: (1) The amount we will pay for damages is limited as described in Section III — Limits Of Insurance; and (2) Our right and duty to defend end when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. (1) The "bodily injury" or "property damage" is caused by an "occurrence" that takes place in the "coverage territory"; (2) The "bodily injury" or "property damage" occurs during the policy period; and (3) Prior to the policy period, no insured listed under Paragraph 1. of Section II — Who Is An Insured and no "employee" authorized by you to give or receive notice of an "occurrence" or claim knew that the "bodily injury"' or "property damage" had occurred, in whole or in part. If such a listed insured or authorized "employee" knew, prior to the policy period, that the "bodily injury'" or "property damage" occurred, then any continuation, change or resumption of such "bodily injury" or "property damage" during or after the policy period will be deemed to have been known prior to the policy period. c. "Bodily injury" or "property damage" which occurs during the policy period and was not, prior to the policy period, known to have occurred by any Insured listed under Paragraph 1. of Section ]I — Who Is An Insured or any "employee" authorized by you to give or receive notice of an "occurrence" or claim, Includes any continuation, change or resumption of that "bodily injury" or "property damage" after the end of the policy period. d "Bodily injury" or "property damage" will be deemed to have been known to have occurred at the earliest time when any insured listed under Paragraph 1. of Section II — Who Is An Insured or any "employee" authorized by you to give or receive notice of an "occurrence" or claim: (1) Reports all, or any part, of the "bodily injury" or "property damage" to us or any other insurer; No other obligation or liability to pay sums or (2) Receives a written or verbal demand or perform acts or services is covered unless claim for damages because of the "bodily explicitly provided for under Supplementary injury" or "property damage'; or Payments. (3) Becomes aware by any other means that b. This insurance applies to "bodily injury' and "bodily injury" or "property damage" has "property damage" only if- occurred or has begun to occur. CG T1 00 02 19 0) 2017 The Travelers Indemnity Company. All rights reserved. Page 1 of 21 Includes copyrighted material of Insurance services Office, Inc. with its permission. From: PROPEL INSURANCE ( Fax: 12537592200 To: COMMERCIAL GENERAL LIABILITY Fax: (360) 473-2330 Page: 13 of 63 0112912021 12:14 PM e. Damages because of "bodily injury" include dame claimed by any person or organization for care, loss of services or death resulting at any time from the "bodily injury". 2. Exclusions This insurance does not apply to: 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. b. Contractual Liability "Bodily injury" or "property damage" for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages: (1) That the insured would have in the absence of the contract or agreement; or (2) Assumed in a contract or agreement that is an "insured contract", provided that the "bodily injury" or "property damage" occurs subsequent to the execution of the contract or agreement. Solely for the purposes of liability assumed in an "insured contract", reasonable attorneys' fees and necessary litigation expenses incurred by or for a party other than an insured will be deemed to be damages because of "bodily injury' or "property damage", provided that: (a) Liability to such party for, or for the cost of, that partys defense has also been assumed in the same "insured contract"; and (b) Such attorneys' fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged. c. Liquor Liability "Bodily injury"' or "property damage" for which any insured may be held liable by reason of: (1) Causing or contributing to the intoxication of any person, (3) Any statute, ordinance or regulation relating to the sale, gift, distribution or use of alcoholic beverages. This exclusion applies only if you are in the business of manufacturing, distributing, selling, serving or furnishing alcoholic beverages. For the purposes of this exclusion, permitting a person to bring alcoholic beverages on your premises, for consumption on your premises, whether or not a fee is charged or a license is required for such activity, is not by itself considered the business of selling, serving or furnishing alcoholic beverages. d. Workers' Compensation And Similar Laws Any obligation of the insured under a workers' compensation, disability benefits or unemployment compensation law or any similar law. e. Employer's )viability "Bodily injury" to: (1) An "employee" of the insured arising out of and in the course of: (a) Employment by the insured; or (b) Performing duties related to the conduct of the insured's business; or (2) The spouse, child, parent, brother or sister of that "employee" as a consequence of Paragraph (1) above. This exclusion applies whether the insured may be liable as an employer or in any other capacity and to any obligation to share damages with or repay someone else who must pay damages because of the injury. This exclusion does not apply to liability assumed by the insured under an "insured contract". f. Pollution (1) "Bodily injury" or "property damage" arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of "pollutants": (a) At or from any premises, site or location which is or was at any time owned or occupied by, or rented or loaned to, any insured. However, this subparagraph does not apply to: (2) The furnishing of alcoholic beverages to a (i) "Bodily injury" if sustained within a person under the legal drinking age or building and caused by smoke, under the influence of alcohol; or fumes, vapor or soot produced by or originating from equipment that Page 2 of 21 0 2017 The Travelers Indemnity Company. All rights reserved. CG T1 00 02 18 Includes copyrighted material of Insurance Services Office, Inc. with its permission. From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: 14 of 63 0112912021 12:14 PM COMMERCIAL GENERAL LIABILITY is used to heal, cool or dehumidify the building, or produced by or originating from equipment that is used to heat water for personal use by the building's occupants or their guests; (ii) "Bodily injury' or "property damage" for which you may be held liable, if you are a contractor and the owner or lessee of such premises, site or location has been added to your policy as an additional insured with respect to your ongoing operations performed for that additional insured at that premises, site or location and such premises, site or location is not and never was owned or occupied by, or rented or loaned to, any insured, other than that additional insured; or (iii) "Bodily injury' or "property damage" arising out of heat, smoke or fumes from a "hostile fire"; (b) At or from any premises, site or location which is or was at any time used by or for any insured or others for the handling, storage, disposal, processing or treatment of waste; (c) If such "pollutants" are or were at any time transported, handled, stoned, treated, disposed of, or processed as waste by or for: (i) Any insured; or (ii) Any person or organization for whom you may be legally responsible; (d) At or from any premises, site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured's behalf are performing operations if the "pollutants" are brought on or to the premises, site or location in connection with such operations by such insured, contractor or subcontractor. However, this subparagraph does not apply to: (i) "Bodily injury' or "property damage" arising out of the escape of fuels, lubricants or other operating fluids which are needed to perform the normal electrical, hydraulic or mechanical functions necessary for the operation of "mobile equipment" or its parts, if such fuels, lubricants or other operating fluids escape from a vehicle part designed to hold, store or receive them. This exception does not apply if the "bodily injury"' or "property damage" arises out of the intentional discharge, dispersal or release of the fuels, lubricants or other operating fluids, or if such fuels, lubricants or other operating fluids are brought on or to the premises, site or location with the intent that they be discharged, dispersed or released as part of the operations being performed by such insured, contractor or subcontractor; (ii) "Bodily injury' or "property damage" sustained within a building and caused by the release of gases, fumes or vapors from materials brought into that building in connection with operations being performed by you or on your behalf by a contractor or subcontractor; or (III) "Bodily injury' or "property damage" arising out of heat, smoke or fumes from a "hostile fine"; or (e) At or from any premises, site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured's behalf are or were at any time performing operations to test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of, "pollutants". (2) Any loss, cost or expense arising out of any: (a) Request, demand, order or statutory or regulatory requirement that any insured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or In any way respond to, or assess the effects of, "pollutants", or CG T1 00 02 19 m 2017 The Travelers Indemnity Company. All rights reserved. Page 3 of 21 Includes copyrighted material of Insurance services Office, Inc. with its permission. From: PROPEL INSURANCE ( Fax: 12537592200 To: COMMERCIAL GENERAL LIABILITY Fax: (360) 473-2330 Page: 15 of 63 0112912021 12:14 PM () Claim or suit by or on behalf of any (b) The operation of any of the machinery governmental authority or any other or equipment listed in Paragraph f.(2) person or organization because of or f.(3) of the definition of "mobile testing for, monitoring, cleaning up, equipment"; or removing, containing, treating, (g) An aircraft that is: detoxifying or neutralizing, or in any way responding to, or assessing the (a) Chartered with a pilot to any insured; effects of, "pollutants". (b) Not owned by any insured, and g. Aircraft, Auto Or Watercraft (c) Not being used to carry any person or "Bodily injury" or "property damage" arising out property for a charge. of the ownership, maintenance, use or h. Mobile Equipment entrustment to others of any aircraft, "auto" or "Bodily injury' or "property damage" arising out watercraft owned or operated by or rented or of loaned to any insured. Use includes operation and "loading or unloading". (1) The transportation of "'mobile equipment" by an "auto" owned or operated by or This exclusion applies even if the claims rented or loaned to any insured; or against any insured allege negligence or other wrongdoing in the supervision, hiring, ()The use of "mobile equipment" in, or while employment, training or monitoring of others by in practice for, or while being prepared for, that insured, if the "occurrence" which caused any prearranged racing, speed, demolition, the "bodily injury' or "property damage" involved or stunting activity. the ownership, maintenance, use or L War entrustment to others of any aircraft, "auto" or "Bodily injury' or "property damage" arising out watercraft that is owned or operated by or of: rented or loaned to any insured. (1) War, including undeclared or Civil war, This exclusion does not apply to. (2) Warlike action by a military force, including (1) A watercraft while ashore on premises you action in hindering or defending against an own or rent; actual or expected attack, by any (2) A watercraft you do not own that is: government, sovereign or other authority (a) 50 feet long or less; and using military personnel or other agents; or (b) Not being used to carry any person or (3) Insurrection, rebellion, revolution, usurped property for a charge; power, or action taken by governmental authority in hindering or defending against (3) Parking an "auto" an, or an the ways next any of these. to, premises you own or rent, provided the "auto" is not owned by or rented or loaned it Damage To Property to you or the insured; "Property damage" to: (4) Liability assumed under any "Insured (1) Property you own, rent, or occupy, contract"for the ownership, maintenance or including any costs or expenses incurred use of aircraft or watercraft; by you, or any other person, organization or (5) 'Bodily injury' or "property damage" arising entity, for repair, replacement, out of: enhancement, restoration or maintenance of such property for any reason, including (a) The operation of machinery or prevention of injury to a person or damage equipment that is attached to, or part to another's property; of, a land vehicle that would qualify as "mobile equipment" under the definition () Premises you sell, give away or abandon, if of "mobile equipment" if such land the "property damage" arises out of any vehicle were not subject to a part of those premises; compulsory or financial responsibility (3) Property loaned to you; law, or other motor vehicle insurance (4) Personal property in the care, custody or law, where it is licensed or principally control of the insured; garaged; or Page 4 of 21 0 2017 The Travelers Indemnity Company. All rights reserved. CG T1 00 02 19 Includes copyrighted material of Insurance Services Office, Inc, with its permission. From: PROPEL INSURANCE ( Fax: 12537592200 To: (5) That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations, if the "property damage" arises out of those operations; or (6) That particular part of any property that must be restored, repaired or replaced because "your work" was incorrectly performed on it. Paragraphs (1), (3) and (4) of this exclusion do not apply to "premises damage". A separate limit of insurance applies to "premises damage" as described in Paragraph B. of Section III — Limits Of Insurance. Paragraph (2) of this exclusion does not apply if the premises are "your work" and were never occupied, rented or held for rental by you. Paragraphs (3), (4), (5) and (6) of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph (6) of this exclusion does not apply to "property damage" included in the "products - completed operations hazard". It. Damage To Your product "Property damage" to "your product" arising out of it or any part of it. I. Damage To Your Work "Property damage" to "your work" arising out of it or any part of it and included in the "products - completed operations hazard". This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor. m. Damage To Impaired property Or property Not Physically Injured "Property damage" to "impaired property' or property that has not been physically injured, arising out of: (1) A defect, deficiency, inadequacy or dangerous condition in "your product" or '"your work"; or (2) A delay or failure by you or anyone acting on your behalf to perform a contract or agreement in accordance with its term. This exclusion does not apply to the loss of use of other property arising out of sudden and Fax: (360) 473-2330 Page: 16 of 63 0112912021 12:14 PM COMMERCIAL GENERAL LIABILITY accidental physical injury to "your product" or "your work" after it has been put to its intended use. In. Recall Of Products, Work Or Impaired Property Damages claimed for any loss, cost or expense incurred by you or others for the loss of use, withdrawal, recall, inspection, repair, replacement, adjustment, removal or disposal of (1) "Your product"; (2) "Your work"; or (3) "Impaired property"; if such product, work, or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect, deficiency, inadequacy or dangerous condition in it. o. personal And Advertising Injury "Bodily injury" arising out of "personal and advertising injury". p. Electronic Data Damages arising out of the loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate "electronic data". However, this exclusion does not apply to liability for damages because of "bodily injury". q. Unsolicited Communication "Bodily injury' or "property damage" arising out of any actual or alleged violation of any law that restricts or prohibits the sending, transmitting or distributing of "unsolicited communication". r. Access Or Disclosure Of Conridential Or Personal Information "Bodily injury" or "property damage" arising out of any access to or disclosure of any person's or organization's confidential or personal information. s. Asbestos (1) "Bodily injury" or "property damage" arising out of the actual or alleged presence or actual, alleged or threatened dispersal of asbestos, asbestos fibers or products containing asbestos, provided that the "bodily injury" or "property damage" is caused or contributed to by the hazardous properties of asbestos. CG T1 00 02 19 0 2017 The Travelers Indemnity Company. All rights reserved. Page 5 of 21 Includes copyrighted material of Insurance services Office, Inc. with its permission. From: PROPEL INSURANCE ( Fax: 12537592200 To: COMMERCIAL GENERAL LIABILITY Fax: (360) 473-2330 Page: 17 of 63 0112912021 12:14 PM (2) "Bodily injury' or "property damage" ansing out of the actual or alleged presence or actual, alleged or threatened dispersal of any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapors, soot, fumes, acids, alkalis, chemicals and waste, and that are part of any claim or "suit" which also alleges any "bodily Injury' or "property damage" described In Paragraph (1) above. (3) Any loss, cost or expense arising out of any: (a) Request, demand, order or statutory or regulatory requirement that any insured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of, asbestos, asbestos fibers or products containing asbestos; or (b) Claim or suit by or on behalf of any governmental authority or any other person or organization because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to, or assessing the effects of, asbestos, asbestos fibers or products containing asbestos. t. Employment -Related Practices "Bodily injury" to: (1) A person arising out of any: (a) Refusal to employ that person, () Termination of thatperson's employment; or (c) Employment -related practice, policy, act or omission, such as coercion, demotion, evaluation, reassignment, discipline, failure to promote or advance, harassment, humiliation, discrimination, libel, slander, violation of the person's right of privacy, malicious prosecution or false arrest, detention or imprisonment applied to or directed at that person, regardless of whether such practice, policy, act or omission occurs, is applied or is committed before, during or after the time of that person's employment; or (2) The spouse, child, parent, brother or sister of that person as a consequence of "bodily injury' to that person at whom any of the employment -related practices described in Paragraph (a), (b), or (c) above is directed. This exclusion applies whether the insured may be liable as an employer or in any other capacity and to any obligation to share damages with or repay someone else who must pay damages because of the "bodily Injury'. Exclusions c. through n. do not apply to "premises damage". A separate limit of insurance applies to "premises damage" as described in Paragraph 6. of Section III — Limits Of Insurance. COVERAGE B — PERSONAL AND ADVERTISING INJURY LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of "personal and advertising injury' to which this insurance applies. We will have the right and duty to defend the insured against any "suit" seeking those damages. However, we will have no duty to defend the insured against any "suit" seeking damages for "personal and advertising injury' to which this insurance does not apply. We may, at our discretion, investigate any offense and settle any claim or "suit" that may result. But, (1) The amount we will pay for damages is limited as described in Section III — Limits Of Insurance; and (2) Our right and duty to defend end when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sum or perform acts or services is covered unless explicitly provided for under Supplementary Payments. b. This insurance applies to "personal and advertising injury" caused by an offense arising out of your business but only if the offense was committed in the "coverage territory" during the policy period. 2. Exclusions This insurance does not apply to: a. Knowing Violation Of Rights Of Another "Personal and advertising injury" caused by or at the direction of the insured with the knowledge that the act would violate the rights of another and would inflict "personal and advertising injury"'. Page 6 of 21 m 2017 The Travelers Indemnity Company. All rights reserved. CG T1 00 02 18 Includes copyrighted material of Insurance Services Office, Inc, with its permission. From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: 18 of 63 0112912021 12:14 PM COMMERCIAL GENERAL LIABILITY This exclusion does not apply to "personal against a cMI or alternative dispute injury" caused by malicious prosecution. resolution proceeding in which b. Material Published With Knowledge Of damages to which this insurance Falsity applies are alleged. "Personal and advertising injury' arising out of f• Breach Of Contract oral or written publication, including publication "Advertising injury" arising out of a breach of by electronic mans, of material, if done by or at contract. the direction of the insured with knowledge of g, Quality Or Performance Of Goads — Failure its falsity. To Conform To Statements c. Material Published Or Used Prior To Policy "Advertising injury" arising out of the failure of Period goods, products or services to conform with (1) "Personal and advertising injury" arising out any statement of quality or performance made of oral or written publication, including in your "advertisement'. publication by electronic means, of material h, Wrong Description Of Prices whose first publication took place before the beginning of the policy period; or "Advertising injury' arising out of the wrong description of the price of goods, products or (2) "Advertising Injury" arising out of services stated in your "advertisement". infringement of copyright, "title" or "slogan" in your "advertisement" whose first i. Intellectual Property infringement in your "advertisement" was "Personal and advertising injury" arising out of committed before the beginning of the any actual or alleged infringement or violation of policy period. any of the following rights or laws, or any other d. Criminal Acts "personal and advertising injury" alleged in any claim or "suit" that also alleges any such "Personal and advertising injury" arising out of a infringement ringement or violation: criminal act committed by or at the direction of the insured. Copyright; e. Contractual Liability (2) Patent; "Personal and advertising injury' for which the (3) Trade dress; insured has assumed liability in a contract or (4) Trade name; agreement. This exclusion does not apply to (6) Trademark; liability for damages: (B) Trade secret; or (1) That the insured would have in the absence of the contract or agreement; or (7) Other intellectual property rights or laws. (2) Because of "personal injury' assumed by This exclusion does not apply to: you in a contract or agreement that is an (1) "Advertising injury' arising out of any actual "insured contract", provided that the or alleged infringement or violation of "personal injury' is caused by an offense another's copyright, "title" or "slogan" in committed subsequent to the execution of your "advertisement"; or the contract or agreement. Solely for the purposes of liability assumed by you in an (2) Any other "personal and advertising injury' "insured contract", reasonable attorneys' alleged in any claim or "suit" that also fees and necessary litigation expenses alleges any such infringement or violation incurred by or for a party other than an of another's copyright, "title" or "slogan" in insured will be deemed to be damages your "advertisement". because of "personal injury', provided that: j. Insureds In Media And Internet Type (a) Liability to such party for, or for the Businesses cost of, that party's defense has also "Personal and advertising injury' caused by an been assumed by you in the same offense committed b an insured whose y ""' E� insured contract ; and business is: (b) Such attorneys' fees and litigation expenses are for defense of that party (1) Advertising, "broadcasting" or publishing; CG T1 00 02 19 0 2017 The Travelers Indemnity Company. All rights reserved. Page 7 of 21 Includes copyrighted material of Insurance services Office, Inc. with its permission. From: PROPEL INSURANCE ( Fax: 12537592200 To: COMMERCIAL GENERAL LIABILITY Fax: (360) 473-2330 Page: 19 of 63 0112912021 12:14 PM (2) Designing or determining content of websites for others; or (3) An Internet search, access, content or service provider. However, this exclusion does not apply to Paragraphs a.(1), (2) and (3) of the definition of "'personal injury". For the purposes of this exclusion: (1) Creating and producing correspondence written In the conduct of your business, bulletins, financial or annual reports, or newsletters about your goods, products or services will not be considered the business of publishing, and (2) The placing of frames, borders or links, or advertising, for you or others anywhere on the Internet will not, by itself, be considered the business of advertising, "broadcasting" or publishing. . Electronic Chatrooms Or Bulletin Boards "Personal and advertising injury" arising out of an electronic chatroom or bulletin board the insured hosts or owns, or over which the insured exercises control. I. Unauthorized Use Of Another's Name Or Product "Personal and advertising injury' arising out of the unauthorized use of another"s name or product in your e-mail address, domain name or metatag, or any other similar tactics to mislead anothers. potential customers. m. Pollution "Personal and advertising injury" arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of "pollutants" at any time. . Pollution -Related Any loss, cost or expense arising out of any: (1) Request, demand, order or statutory or regulatory requirement that any insured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of, "pollutants"; or neutralizing, or in any way responding to, or assessing the effects of, "pollutants". o. War "Personal and advertising injury" arising out of: (1) War, including undeclared or civil war, (2) Warlike action by a military force, including action in hindering or defending against an actual or expected attack, by any government, sovereign or other authority using military personnel or other agents, or (3) Insurrection, rebellion, revolution, usurped power, or action taken by governmental authority in hindering or defending against any of these. p. Unsolicited Communication "Personal and advertising injury" arising out of any actual or alleged violation of any law that restricts or prohibits the sending, transmitting or distributing of "unsolicited communication". q. Access Or Disclosure Of Confidential Or Personal Information "Personal and advertising injury" arising out of any access to or disclosure of any person's or organization's confidential or personal information. r. Asbestos (1) "Personal and advertising injury" arising out of the actual or alleged presence or actual, alleged or threatened dispersal of asbestos, asbestos fibers or products containing asbestos, provided that the "personal and advertising injury" is caused or contributed to by the hazardous properties of asbestos. (2) "Personal and advertising injury' arising out of the actual or alleged presence or actual, alleged or threatened dispersal of any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapors, soot, fumes, acids, alkalis, chemicals and waste, and that are part of any claim or "suit" which also alleges any "personal and advertising injury' described in Paragraph (1) above. (3) Any loss, cost or expense arising out of any: (2) Claim or suit by or on behalf of any (a) Request, demand, order or statutory or governmental authority or any other person regulatory requirement that any insured or organization because of testing for, or others test for, monitor, clean up, monitoring, cleaning up, removing, remove, contain, treat, detoxify or containing, treating, detoxifying or neutralize, or in any way respond to, or Page 8 of 21 m 2017 The Travelers Indemnity Company. All rights reserved. CG T1 00 02 18 Includes copyrighted material of Insurance Services Office, Inc. with its permission. From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: 20 of 63 0112912021 12:14 PM COMMERCIAL GENERAL LIABILITY assess the effects of, asbestos, (3) Because of your operations, asbestos fibers or products containing provided that: asbestos; or (a) The accident takes place in the "coverage (b) Claim or suit by or on behalf of any territory" and during the policy period; governmental authority or any other person or organization because of (b) The expenses are incurred and reported to testing for, monitoring, cleaning up, us within one year of the date of the removing, containing, treating, accident; and detoAfying or neutralizing, or in any (c) The injured person submits to examination, way responding to, or assessing the at our expense, by physicians of our choice effects of, asbestos, asbestos fibers or as often as we reasonably require. products containing asbestos. b. We will make these payments regardless of s. Employment -Related Practices fault. These payments will not exceed the "Personal injury"to: applicable limit of insurance. We will pay reasonable expenses for: (1) A person arising out of any: (1) First aid administered at the time of an (a) Refusal to employ that person; accident, () Termination of that person's (2) Necessary medical, surgical, X-ray and employment; or dental services, including prosthetic (c) Employment -related practice, policy, devices; and act or omission, such as coercion, (3) Necessary ambulance, hospital, demotion, evaluation, reassignment, professional nursing and funeral services. discipline, failure to promote or advance, harassment, humiliation, 2. Exclusions discrimination, libel, slander, violation We will not pay expenses for "bodily injury": of the person's right of privacy, a. Any Insured malicious prosecution or false arrest, To any insured, except "volunteer workers". detention or imprisonment applied to or directed at that person, regardless of b. Hired Person whether such practice, policy, act or To a person hired to do work for or on behalf of omission occurs, is applied or is any insured or a tenant of any insured. committed before, during or after the c. Injury On Normally Occupied Premises time of that person's employment; or To a person injured on that part of premises (2) The spouse, child, parent, brother or sister you own or rent that the person normally of that person as a consequence of occupies. "personal injury" to that person at whom any of the employment -related practices d. Workers' Compensation And Similar I�ws described in Paragraph (a), (b), or (c) To a person, whether or not an "employee" of above is directed. any insured, if benefits for the "bodily injury" are This exclusion applies whether the insured may payable or must be provided under a workers' be liable as an employer or in any other capacity compensation or disability benefits law or a and to any obligation to share damages with or similar law. repay someone else who must pay damages e. Athletics Activities because of the "personal injury'. To a person inured while practicing, p j p g, instructing COVERAGE C — MEDICAL PAYMENTS or participating in any physical exercises or 1. Insuring Agreement games, sports, or athletic contests. a. We will pay medical expenses as described f. Products -Completed Operations Hazard below for"bodily injury"caused by an accident: Included within the "products -completed (1) On premises you own or rent; operations hazard". (2) On ways next to premises you own or rent; gx Coverage A Exclusions or Excluded under Coverage A. CG T1 00 02 19 m 2017 The Travelers Indemnity Company. All rights reserved. Page 9 of 21 Includes copyrighted material of Insurance services Office, Inc. with its permission. From: PROPEL INSURANCE ( Fax: 12537592200 To: COMMERCIAL GENERAL LIABILITY SUPPLEMENTARY PAYMENTS 1. We will pay, with respect to any claim we investigate or settle, or any "suit" against an insured we defend. a. All expenses we incur. b. Up to $2,500 for the cost of ball 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. c. The cost of bonds to release attachments, but only for bond amounts within the applicable limit of insurance. We do not have to furnish these bonds. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. e. All court costs taxed against the insured in the "suit". However, these payments do not Include attorneys" fees or attorneys' expenses taxed against the insured. f. Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the applicable limit of insurance, we will not pay any prejudgment interest based on that period of time after the offer. g. All interest on the full amount of any judgment that accrues after entry of the judgment and before we have paid, offered to pay, or deposited in court the part of the judgment that is within the applicable limit of insurance. These payments will not reduce the limits of insurance. 2. If we defend an insured against a "suit" and an indemnitee of the insured is also named as a party to the "suit", we will defend that indemnitee if all of the following conditions are met: a. The "suit" against the indemnitee seeks damages for which the insured has assumed the liability of the indemnitee in a contract or agreement that is an "insured contract"; b. This insurance applies to such liability assumed by the insured; c. The obligation to defend, or the cost of the defense of, that indemnitee, has also been Fax: (360) 473-2330 Page: 21 of 63 0112912021 12:14 PM assumed by the insured in the same "insured contract"; d. The allegations in the "suit" and the information we know about the "occurrence" or offense are such that no conflict appears to exist between the interests of the insured and the interests of the indemnitee; e. The indemnitee and the insured ask us to conduct and control the defense of that indemnitee against such "suit" and agree that we can assign the same counsel to defend the insured and the indemnitee, and f. The indemnitee: (1) Agrees in writing to: (a) Cooperate with us in the investigation, settlement or defense of the "suit"; (b) Immediately send us copies of any demands, notices, summonses or legal papers received in connection with the ""suit"; (c) Notify any other insurer whose coverage is available to the indemnitee; and (d) Cooperate with us with respect to coordinating other applicable insurance available to the indemnitee; and (2) Provides us with written authorization to! (a) Obtain records and other information related to the "suit"; and (b) Conduct and control the defense of the indemnitee in such "suit". So long as the above conditions are met, attorneys' fees incurred by us in the defense of that indemnitee, necessary litigation expenses incurred by us and necessary litigation expenses incurred by the indemnitee at our request will be paid as Supplementary Payments. Notwithstanding the provisions of Paragraph 2.b.(2) of Section I — Coverages — Coverage A — Bodily Injury And Property Damage Liability or Paragraph 2.e. of Section I — Coverages — Coverage B — Personal And Advertising Injury Liability, such payments will not be deemed to be damages for "bodily injury", "property damage" or "personal injury", and will not reduce the limits of insurance. Our obligation to defend an insured's indemnitee and to pay for attorneys' fees and necessary litigation expenses as Supplementary Payments ends when: Page 10 of 21 0 2017 The Travelers Indemnity Company. All rights reserved. CG T1 00 02 19 Includes copyrighted material of Insurance Services Office, Inc, with its permission. From: PROPEL INSURANCE ( Fax: 12537592200 To: a. We have used up the applicable limit of insurance in the payment of judgments, settlements or medical expenses; or b. The conditions set forth above, or the terms of the agreement described in Paragraph f. above, are no longer met. SECTION II — WHO IS AN INSURED 1. If you are designated in the Declarations as: a. An individual, you and your spouse are insureds, but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture, you are an insured. Your members, your partners, and their spouses are also insureds, but only with respect to the conduct of your business. c. A limited liability company, you are an insured. Your members are also insureds, but only with respect to the conduct of your business. Your managers are insureds, but only with respect to their duties as your managers. d. An organization other than a partnership, joint venture or limited liability company, you are an insured. Your "executive officers" and directors are insureds, but only with respect to their duties as your officers or directors. Your stockholders are also insureds, but only with respect to their liability as stockholders. e. A trust, you are an insured. Your trustees are also insureds, but only with respect to their duties as trustees. 2. Each of the following is also an insured: Your "volunteer workers" only while performing duties related to the conduct of your business, or your "employees", other than either your "'executive officers" (if you are an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company), but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However, none of these "employees" or "volunteer workers" are insureds for: (1) "Bodily injury" or "personal 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 employment or performing duties related to the conduct of your business, or to your other "volunteer Fax: (360) 473-2330 Page: 22 of 63 0112912021 12:14 PM COMMERCIAL GENERAL LIABILITY 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 Paragraph (1)(a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. Unless you are in the business or occupation of providing professional health care services, Paragraphs (1)(a), (b), (c) and (d) above do not apply to "bodily injury' arising out of providing or failing to provide first aid or "Good Samaritan services" by any of your "employees" or "volunteer workers", other than an employed or volunteer doctor. Any such "employees" or "volunteer workers" providing or failing to provide first aid or "Good Samaritan services" during their work hours for you will be deemed to be acting within the scope of their employment by you or performing duties related to the conduct of your business. (2) "Property damage" to property: (a) Owned, occupied or used by; (b) Rented to, in the care, custody or control of, or over which physical control is Ding exercised for any purpose by, you, any of your "employees", "volunteer workers", any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability company). b. Any person (other than your "employee" or "volunteer worker), or any organization, while acting as your real estate manager. c. Any person or organization having proper temporary custody of your property if you die, but only: (1) With respect to liability arising out of the maintenance or use of that property; and (2) Until your legal representative has been appointed. CG T1 00 02 19 0 2017 The Travelers Indemnity Company. All rights reserved. Page 11 of 21 Includes copyrighted material of Insurance Services Office, Inc. with its permission. From: PROPEL INSURANCE ( Fax: 12537592200 To: COMMERCIAL GENERAL LIABILITY Fax: (360) 473-2330 Page: 23 of 63 0112912021 12:14 PM d. Your legal representative if you die, but only with respect to duties as such. That representative will have all your rights and duties under this Coverage Part. e. Any person or organization that, with your express or implied consent, either uses or is responsible for the use of a watercraft that you do not own that is: (1) 50 feet long or less; and (2) Not being used to carry any person or property for a charge. 3. Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and of which you are the sole owner or in which you maintain an ownership interest of more than 50%, will qualify as a famed Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; S 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. For the purposes of Paragraph 1. of Section II — Who Is An Insured, each such organization will be deemed to be designated in the Declarations as: a. An organization, other than a partnership, joint venture or limited liability company; or b. A trust; as indicated in its name or the documents that govern its structure. 4. Any person or organization that is a premises owner, manager or lessor and that you have agreed in a written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury" "property damage" or "personal and advertising injury" that: a. Is "bodily injury" or "property damage" that occurs, or is "personal and advertising injury" caused by an offense that is committed, subsequent to the signing of that contract or agreement; and b. Arises out of the ownership, maintenance or use of that part of any premises leased to you. The insurance provided to such premises owner, manager or lessor is subject to the following provisions: a. The limits of insurance provided to such premises owner, manager or lessor will be the minimum limits that you agreed to provide in the written contract or agreement, or the limits shown in the Declarations, whichever are less. . The insurance provided to such premises owner, manager or lessor does not apply to: (1) Any "bodily injury" or "property damage" that occurs, or "personal and advertising injury" caused by an offense that is committed, after you cease to be a tenant in that premises; or (2) Structural alterations, new construction or demolition operations performed by or on behalf of such premises owner, manager or lessor. Any person or organization that is an equipment lessor and that you have agreed in a written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage", or "personal and advertising injury"that. a. Is "bodily injury" or "property damage" that occurs, or is "personal and advertising injuryy' caused by an offense that is committed, subsequent to the signing of that contract or agreement; and b. Is caused, in whole or in part, by your acts or omissions in the maintenance, operation or use of equipment leased to you by such equipment lessor. The insurance provided to such equipment lessor is subject to the following provisions: a. The limits of insurance provided to such equipment lessor will be the minimum limits that you agreed to provide in the written contract or agreement, or the limits shown in the Declarations, whichever are less. b. The insurance provided to such equipment lessor does not apply to any "bodily injury' or "property damage" that occurs, or "personal and advertising injury" caused by an offense that is committed, after the equipment lease expires. No person or organization is an insured with respect to the conduct of any current or past partnership, joint Page 12 of 21 0) 2017 The Travelers Indemnity Company. All rights reserved. CG T1 00 02 19 Includes copyrighted material of Insurance Services Office, Inc, with its permission. From: PROPEL INSURANCE ( Fax: 12537592200 To: venture or limited liability company that is not shown as a Named Insured in the Declarations. This paragraph does not apply to any such partnership, joint venture or limited liability company that othervuise qualifies as an insured under Section II —Who Is An Insured. SECTION III — LIMITS OF INSURANCE 1. The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of: a. Insureds, b. Claim made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 2. The General Aggregate Limit is the most we will pay for the sum of: a. Medical expenses under Coverage C; b. Damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard"; and c. Damages under Coverage B. 3. The Products -Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of "bodily injury" and "property damage" included in the "products -completed operations hazard". 4. Subject to Paragraph 2. above, the Personal And Advertising Injury Limit is the most we will pay under Coverage B for the sum of all damages because of all "personal injury" and "advertising injury" sustained by any one person or organization. S. Subject to Paragraph 2. or 3. above, whichever applies, the Each Occurrence Limit is the most we will pay for the sum of: a. Damages under Coverage A; and ib. Medical expenses under Coverage C; because of all "bodily injury" and "property damage" arising out of any one "occurrence". For the purposes of determining the applicable Each Occurrence Limit, all related acts or omissions committed in providing or failing to provide first aid or "Good Samaritan services" to any one person will be deemed to be one "occurrence". Fax: (360) 473-2330 Page: 24 of 63 0112912021 12:14 PM COMMERCIAL GENERAL LIABILITY a. The amount shown for the Damage To Premises Rented To You Limit in the Declarations of this Coverage Part; or Ib. $300,000 if no amount is shown for the Damage To Premises Rented To You Limit in the Declarations of this Coverage Part. 7. Subject to Paragraph a. above, the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of "bodily injury' sustained by any one person. The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the policy period is extended after issuance for an additional period of less than 12 months. In that case, the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. SECTION IV— COMMERCIAL GENERAL LIABILITY CONDITIONS 1. Bankruptcy Bankruptcy or insolvency of the insured or of the insured's estate will not relieve us of our obligations under this Coverage Part. 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit a. You must see to it that we are notified as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, notice should include: (1) How, when and where the "occurrence" or offense took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the "occurrence" or offense. llbIf a claim is made or "suit" is brought against any insured, you must: (1) Immediately record the specifics of the claim or "suit" and the date received; and (2) Notify us as soon as practicable. You must see to it that we receive written notice of the claim or "suit" as soon as practicable. S. Subject to Paragraph 5. above, the Damage To c. You and any other involved insured must: Premises Rented To You Limit is the most we will (1) Immediately send us copies of any pay under Coverage A for damages because of demands, notices, summonses or legal "premises damage" to any one premises. The papers received in connection with the Damage To Premises Rented To You Limit will be: claim or "salt"; CG T1 00 02 19 m 2017 The Travelers Indemnity Company. All rights reserved. Page 13 of 21 Includes copyrighted material of Insurance Services Office, Inc. with its permission. From: PROPEL INSURANCE ( Fax: 12537592200 To: COMMERCIAL GENERAL LIABILITY Fax: (360) 473-2330 Page: 25 of 63 0112912021 12:14 PM (2) Authorize us to obtain records and other information; (3) Cooperate with us in the investigation or settlement of the claim or defense against the "suit"; and (4) Assist us, upon our request, In the enforcement of any right against any person or organization which may be liable to the insured because of injury or damage to which this insurance may also apply. d. No insured will, except at that insured's own cost, voluntarily make a payment, assume any obligation, or incur any expense, other than for first aid, without our consent. e. The following provisions apply to Paragraph a. above, but only for purposes of the insurance provided under this Coverage Part to you or any insured listed in Paragraph 1. or 2. of Section II —'Who Is An Insured: (1) Notice to us of such "occurrence" or offense must be given as soon as practicable only after the "occurrence" or offense is known to you (if you are an individual), any of your partners or members who is an individual (if you are a partnership or joint venture), any of your managers who is an individual (if you are a limited liability company), any of your "executive officers" or directors (if you are an organization other than a partnership, joint venture, or limited liability company), any of your trustees who is an individual (if you are a trust) or any "employee" authorized by you to give notice of an "occurrence"" or offense. (2) If you are a partnership, joint venture, limited liability company or trust, and none of your partners, joint venture members, managers or trustees are individuals, notice to us of such "occurrence" or offense must be given as soon as practicable only after the "occurrence" or offense is known by: (a) Any individual who is: (i) A partner or member of any partnership or joint venture; (ii) A manager of any limited liability company; (iii) An executive officer or director of any ether organization; or (iv) A trustee of any trust; that is your partner, joint venture member, manager or trustee; or (b) Any employee authorized by such partnership, joint venture, limited liability company, trust or other organization to give notice of an "occurrence" or offense. (3) Notice to us of such "occurrence" or offense will be deemed to be given as soon as practicable if it is given in good faith as soon as practicable to your workers' compensation insurer. This applies only if you subsequently give notice to us of the "occurrence" or offense as soon as practicable after any of the persons described in Paragraph e.(1) or (2) above discovers that the "occurrence" or offense may result in sums to which the insurance provided under this Coverage Part may apply. However, if this policy includes an endorsement that provides limited coverage for "bodily injury" or "property damage" or pollution costs arising out of a discharge, release or escape of "pollutants" which contains a requirement that the discharge, release or escape of"pollutants" must be reported to us within a specific number of days after its abrupt commencement, this Paragraph a. does not affect that requirement. 3. Legal Action Against Us o person or organization has a right under this Coverage Part: a. To join us as a party or otherwise bring us into a "suit" asking for damages from an insured, or b. To sue us on this Coverage Dart unless all of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured; but we will not be liable for damages that are not payable under the terms of this Coverage Part or that are in excess of the applicable limit of insurance. An agreed settlement means a settlement and release of liability signed by us, the insured, and the claimant or the claimant's legal representative. Page 14 of 21 m 2017 The Travelers Indemnity Company. All rights reserved. CG T1 00 02 19 Includes copyrighted material of Insurance Services Office, Inc. with its permission. From: PROPEL INSURANCE ( Fax: 12537592200 To: 4. Other Insurance If valid and collectible other insurance is available to the insured for a loss we cover under Coverages A or B of this Coverage Part, our obligations are limited as described in Paragraphs a. and b. below. As used anywhere in this Coverage Part, other insurance means insurance, or the funding of losses, that is provided by, through or on behalf of: (i) Another insurance company; (ii) Us or any of our affiliated insurance companies, except when the Non cumulation of Each Occurrence Limit provision of Paragraph 5. of Section III — Limits Of Insurance or the Non cumulation of Personal and Advertising Injury Limit provision of Paragraph 4. of Section III — Limits of Insurance applies because the Amendment — Non Cumulation Of Each Occurrence Limit Of Liability And Non Cumulation Of Personal And Advertising Injury Limit endorsement is included in this policy; (iii) Any risk retention group; or (iv)Any self-insurance method or program, in which case the insured will be deemed to be the provider of other insurance. Other insurance does not include umbrella insurance, or excess insurance, that was bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. As used anywhere in this Coverage Part, other insurer means a provider of other insurance. As used in Paragraph c. below, insurer means a provider of insurance. a. Primary Insurance This insurance is primary except when Paragraph b. below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in Paragraph c. below, except when Paragraph d. below applies. b. Excess Insurance (1) This insurance is excess over: (a) Any of the other insurance, whether primary, excess, contingent or on any other basis: (i) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work"; Fax: (360) 473-2330 Page: 26 of 63 0112912021 12:14 PM COMMERCIAL GENERAL LIABILITY (ii) That is insurance for "premises damage"; (iii) If the loss arises out of the maintenance or use of aircraft, `"autos" or watercraft to the extent not subject to any exclusion in this Coverage Part that applies to aircraft, "autos" or watercraft; (iv) That is insurance available to a premises owner, manager or lessor that qualifies as an insured under Paragraph 4. of Section It — Who Is An Insured, except when Paragraph d. below applies; or (v) That is insurance available to an equipment lessor that qualifies as an insured under Paragraph 5. of Section 11 — Who Is An Insured, except when Paragraph d. below applies. (b) Any of the other insurance, whether primary, excess, contingent or on any other basis, that is available to the insured when the insured is an additional insured, or is any other insured that does not qualify as a named insured, under such other insurance. (2) When this insurance is excess, we will have no duty under Coverages A or B to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all these other insurers. (3) When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (a) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (b) The total of all deductible and self - insured amounts under all that other insurance. (4) We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. CG T1 00 02 19 0 2017 The Travelers Indemnity Company. All rights reserved. Page 15 of 21 Includes copyrighted material of Insurance services Office, Inc. with its permission. From: PROPEL INSURANCE ( Fax: 12537592200 To: COMMERCIAL GENERAL LIABILITY Fax: (360) 473-2330 Page: 27 of 63 0112912021 12:14 PM c. Method Of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. d. Primary And Ikon -Contributory Insurance If Required By Written Contract If you specifically agree in a written contract or agreement that the insurance afforded to an insured under this Coverage Part must apply on a primary basis, or a primary and non- contributory basis, this insurance is primary to other insurance that is available to such insured which covers such insured as a named insured, and we will not share with that other insurance, provided that: (1 ) The "bodily injury"or "property damage"for which coverage is sought occurs; and (2) The "personal and advertising injury" for which coverage is sought is caused by an offense that is committed; subsequent to the signing of that contract or agreement by you. S. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium, we will return the excess to the first Named Insured. c. The first Named Insured must keep records of the information we need for premium computation, and send us copies at such times as we may request. 6. Representations By accepting this policy, you agree: a. The statements in the Declarations are accurate and complete; b. Those statements are based upon representations you made to us; and c. We have issued this policy in reliance upon your representations. The unintentional omission of, or unintentional error in, any information provided by you which we relied upon in issuing this policy will not prejudice your rights under this insurance. However, this provision does not affect our right to collect additional premium or to exercise our rights of cancellation or nonrenewal in accordance with applicable insurance laws or regulations. 7. Separation Of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this Coverage Part to the first Named Insured, this insurance applies: a. As if each Nand Insured were the only Named Insured; and b. Separately to each insured against whom claim is made or "suit" is brought. 8. Transfer Of Rights Of Recovery Against Others To Lis If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the Insured will bring "surf" or transfer those rights to us and help us enforce them. 9. When We Do Not Renew If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expiration date. If notice is mailed, proof of mailing will be sufficient proof of notice. SECTION V — DEFINITIONS I. "Advertisement" means a notice that is broadcast or published to the general public or specific market segments abut your goods, products or services for the purpose of attracting customers or supporters. For the purposes of this definition: a. Notices that are published include material placed on the Internet or on similar electronic means of communication; and b. Regarding websites, only that part of a website that is about your goods, products or services for the purposes of attracting customers or supporters is considered an advertisement. Page 16 of 21 m 2017 The Travelers Indemnity Company. All rights reserved. CG T1 00 02 19 Includes copyrighted material of Insurance Services Office, Inc, with its permission. From: PROPEL INSURANCE ( Fax: 12537592200 To: 2. "Advertising injury': a. Means injury caused by one or more of the following offenses: (1) Oral or written publication, including publication by electronic means, of material in your "advertisement" that slanders or libels a person or organization or disparages a person's or organization's goods, products or services, provided that the claim Is made or the "suit" is brought by a person or organization that claims to have been slandered or libeled, or that claims to have had its goods, products or services disparaged; (2) Oral or written publication, including publication by electronic means, of material in your "advertisement" that: (a) Appropriates a person's name, voice, photograph or likeness; or (b) Unreasonably places a person in a false light; or (3) Infringement of copyright, "title" or "slogan" in your "advertisement", provided that the claim is made or the "suit" Is brought by a person or organization that claims ownership of such copyright, "title" or "slogan". b. Includes "bodily injury" caused by one or more of the offenses described in Paragraph a. above. 3. "Auto" means: a. A land motor vehicle, trailer or semitrailer designed for travel on public roads, including any attached machinery or equipment, or b. Any other land vehicle that is subject to a compulsory or financial responsibility law, or other motor vehicle insurance law, where it is licensed or principally garaged. However, "auto" does not include "mobile equipment'. 4. "Bodily injury' means: a. Physical harm, including sickness or disease, sustained by a person; or Fax: (360) 473-2330 Page: 28 of 63 0112912021 12:14 PM COMMERCIAL GENERAL LIABILITY b. In, by or with any other electronic means of communication, such as the Internet, if that material is part of: (1) Radio or television programming being transmitted; (2) Other entertainment, educational, instructional, music or news programming being transmitted; or (3) Advertising transmitted with any of such programming. 6. "Coverage territoryy' means: a. The United States of America (including its territories and possessions), Puerto Rico and Canada; b. Intemational waters or airspace, but only if the injury or damage occurs in the course of travel or transportation between any places included in Paragraph a. above; or c. All other parts of the world if the injury or damage arises out of: (1) Geis or products made or sold by you in the territory described in Paragraph a. above; (2) The activities of a person whose home is in the territory described in Paragraph a. above, but is away for a short time on your business; or (3) "Personal and advertising injury" offenses that take place through the Internet or similar electronic means of communication; provided the insured's responsibility to pay damages is determined in a "suit" on the merits in the territory described in Paragraph a. above, or in a settlement we agree to. 7. "Electronic data" means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software (including systems and applications software), hard or floppy disks, CD-ROMs, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. b. Mental anguish, injury or illness, or emotional 8. "Employee" includes a "leased worker". "Employee" distress, resulting at any time from such does not include a "temporary worker". physical harm, sickness or disease. 9. "Executive officer" means a person holding any of 5. "Broadcasting" means transmitting any audio or the officer positions created by your charter, visual material for any purpose, constitution, bylaws or any other similar governing a. By radio ortelevision; or document. CG T1 00 02 19 0 2017 The Travelers Indemnity Company. All rights reserved. Page 17 of 21 Includes copyrighted material of Insurance services Office, Inc. with its permission. From: PROPEL INSURANCE ( Fax: 12537592200 To: COMMERCIAL GENERAL LIABILITY Fax: (360) 473-2330 Page: 29 of 63 0112912021 12:14 PM 10. "Good Samaritan services" means any emergency medical services for which no compensation is demanded or received. 11. "Hostile fire" means a fire which becomes uncontrollable or breaks out from where it was intended to be. 12. "Impaired property" means tangible property, other than "your product" or "your work", that cannot be used or is less useful because: a. It incorporates "your product" or "your work" that is known or thought to be defective, deficient, inadequate or dangerous; or b. You have failed to fulfill the terms of a contract or agreement; if such property can be restored to use by the repair, replacement, adjustment or removal of "your product" or "your work" or your fulfilling the terms of the contract or agreement. 13. "Insured contract" means: 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 "premises damage" is not an "insured contract"'; b. A sidetrack agreement; c. Any easement or license agreement, except in connection with construction or demolition operations on or within 50 feet of a railroad; d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a municipality; e. An elevator maintenance agreement; f. That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury', "property damage" or "personal injury' to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement! (1) That indemnifies a railroad for "bodily injury" or "property damage" arising out of construction or demolition operations, within 50 feet of any railroad property and affecting any railroad bridge or trestle, tracks, roadbeds, tunnel, underpass or crossing, (2) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a) Preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; or (3) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured"s rendering or failure to render professional services, including these listed in Paragraph (2) above and supervisory, inspection, architectural or engineering activities. 14. "Leased worker" means a person leased to you by a labor leasing firm under an agreement between you and the labor leasing firm, to perform duties related to the conduct of your business. "Leased worker" does not include a "temporary worker". 15. "Loading or unloading" means the handling of property: a. After it is moved from the place where it is accepted for movement into or onto an aircraft, watercraft or "auto"; b. While it is in or on an aircraft, watercraft or "auto"; or c. While it is being moved from an aircraft, watercraft or "auto" to the place where it is finally delivered; but "loading or unloading" does not include the movement of property by means of a mechanical device, other than a hand truck, that is not attached to the aircraft, watercraft or "auto". 16. "Mobile equipment" means any of the following types of land vehicles, including any attached machinery or equipment: a. Bulldozers, farm machinery, forklifts and other vehicles designed for use principally off public reads; . Vehicles maintained for use solely on or next to premises you own or rent; c. Vehicles that travel on crawler treads; Page 18 of 21 0 2017 The Travelers Indemnify Company. All rights reserved. CG T1 00 02 19 Includes copyrighted material of Insurance Services Office, Inc, With its permission. From: PROPEL INSURANCE ( Fax: 12537592200 To: d. Vehicles, whether self-propelled or not, maintained primarily to provide mobility to permanently mounted: (1) Power cranes, shovels, loaders, diggers or drills; or (2) Road construction or resurfacing equipment such as graders, scrapers or rollers; e. Vehicles not described in Paragraph a., b., c. or d. above that are not self-propelled and are maintained primarily to provide mobility to permanently attached equipment of the following types (1) Air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting and well servicing equipment; or (2) Cherry pickers and similar devices used to raise or lower workers; f. Vehicles not described in Paragraph a., b., c. or d. above maintained primarily for purposes other than the transportation of persons or cargo. However, self-propelled vehicles with the following types of permanently attached equipment are not "mobile equipment" but will be considered "autos"! (1) Equipment designed primarily for: (a) Snow removal; (b) Road maintenance, but not construction or resurfacing; or (c) Street cleaning; (2) Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers; and (3) Air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting and well servicing equipment. However, "mobile equipment" does not include any land vehicle that is subject to a compulsory or financial responsibility law, or other motor vehicle insurance law, where it is licensed or principally garaged. Such land vehicles are considered "autos". 17. "Occurrence" means: a. An accident, including continuous or repeated exposure to substantially the same general harmful conditions, or Fax: (360) 473-2330 Page: 30 of 63 0112912021 12:14 PM COMMERCIAL GENERAL LIABILITY b. An act or omission committed in providing or failing to provide first aid or "Good Samaritan services" to a person, unless you are in the business or occupation of providing professional health care services. 18. "Personal and advertising injury" means "personal injury"' or "advertising injury"'. 19. "Personal injury": a. Means injury, other than "advertising injury', caused by one or more of the following offenses: (1) False arrest, detention or imprisonment; (2) Malicious prosecution; (3) The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room, dwelling or premises that a person occupies, provided that the wrongful eviction, wrongful entry or invasion of the right of private occupancy is committed by or on behalf of the owner, landlord or lessor of that room, dwelling or premises, (4) Oral or written publication, including publication by electronic means, of material that slanders or lids a person or organization or disparages a person's or organization's goods, products or services, provided that the claim is made or the "suit" is brought by a person or organization that claims to have been slandered or libeled, or that claims to have had Its goods, products or services disparaged; or (6) Oral or written publication, including publication by electronic means, of material that: (a) Appropriates a person"s name, voice, photograph or likeness; or (b) Unreasonably places a person in a false light. b. Includes "bodily injury" caused by one or more of the offenses described in Paragraph a. above. 20. "Pollutants" mean any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkalis, chemicals and waste. Waste includes materials to be recycled, reconditioned or reclaimed. CG T1 00 02 19 0 2017 The Travelers Indemnity Company. All rights reserved. Page 19 of 21 Includes copyrighted material of Insurance services Office, Inc. with its permission. From: PROPEL INSURANCE ( Fax: 12537592200 To: COMMERCIAL GENERAL LIABILITY Fax: (360) 473-2330 Page: 31 of 63 0112912021 12:14 PM 21. "Premises damage" means: a. With respect to the first paragraph of the exceptions in Exclusion j. of Section I — Coverage A — Bodily Injury And Property Damage Liability, "property damage" to any premises while rented to you for a period of seven or fewer consecutive days, including the contents of such premises; or b. With respect to the exception to Exclusions c. through In. in the last paragraph of Paragraph 2. of Section I — Coverage A — Bodily Injury And Property Damage Liability, "property damage" to any premises while rented to you for a period of more than seven consecutive days, or while temporarily occupied by you with permission of the owner, caused by: (1) Fire; (2) Explosion; (3) Lightning; (4) Smoke resulting from fire, explosion or lightning; or (6) Water. But "premises damage" under this Paragraph b. does not Include "property damage" to any premises caused by: (1) Rupture, bursting, or operation of pressure relief devices; (2) Rupture or bursting due to expansion or swelling of the contents of any building or structure caused by or resulting from water; or (3) Explosion of steam boilers, steam pipes, steam engines or steam turbines. 22. "Products -completed operations hazard": a. Includes all "bodily injury" and "property damage" occurring away from premises you own or rent and arising out of "your product" or "your work" except: (1) Products that are still in your physical possession; or (2) Work that has not yet been completed or abandoned. However, "your work" will be deemed completed at the earliest of the following times: (a) When all of the work called for in your contract has been completed. (b) When all of the work to be done at the job site has been completed if your contract calls for work at more than one job site. (c) When that part of the work done at a job site has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same project. Work that may need service, maintenance, correction, repair or replacement, but which is otherwise complete, will be treated as completed. b. Does not include "bodily injury(' or "property damage" arising out of: (1) The transportation of property, unless the injury or damage arises out of a condition in or on a vehicle not owned or operated by you, and that condition was created by the "loading or unloading" of that vehicle by any insured; (2) The existence of tools, uninstalled equipment or abandoned or unused materials; or (3) Products or operations for which the classification, listed in the Declarations or in a policy Schedule, states that products - completed operations are subject to the General Aggregate Limit. 23. "Property damage" means: a. Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use will be deemed to occur at the time of the physical injury that caused it; or b. Loss of use of tangible property that is not physically injured. All such loss of use will be deemed to occur at the time of the "occurrence" that caused it. For the purposes of this insurance, "electronic data" is not tangible property. 24. "Shan": a. Means a phrase that others use for the purpose of attracting attention in their advertising. b. Does not include a phrase used as, or in, the name of: (1) Any person or organization, other than you; or (2) Any business, or any of the premises, goods, products, services or work, of any person or organization, other than you. Page 20 of 21 0 2017 The Travelers Indemnity Company. All rights reserved. CG T1 00 02 19 Includes copyrighted material of Insurance Services Office, Inc, with its permission. From: PROPEL INSURANCE ( Fax: 12537592200 To: 25. "Suit" means a civil proceeding in which damages because of "bodily injury""' "property damage" or "personal and advertising injury' to which this insurance applies are alleged. "Suit" includes: a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent; or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. 26. "Temporary worker' means a person who is furnished to you to substitute for a permanent "employee" on leave or to meet seasonal or short- term workload conditions. 27. "Title" means a name of a literary or artistic work. 28. "Unsolicited communication" means any communication, in any form, that the recipient of such communication did not specifically request to receive. 29. "Volunteer worker" means a person who is not your "employee'", and who donates his or her work and acts at the direction of and within the scope of duties determined by you, and is not paid a fee, salary or other compensation by you or anyone else for their work performed for you. 30. "Your product": a. Means: (1) Any goods or products, other than real property, manufactumd, sold, handled, distributed or disposed of by Fax: (360) 473-2330 Page: 32 of 63 0112912021 12:14 PM COMMERCIAL GENERAL LIABILITY (a) You; (b) Others trading under your name; or (c) A person or organization whose business or assets you have acquired; and (2) Containers (other than vehicles), materials, parts or equipment furnished in connection with such goods or products. b. Includes- (1) Warranties or representations made at any time with respect to the fitness, quality, durability, performance or use of "your product"; and (2) The providing of or failure to provide warnings or instructions. c. Does not include vending machines or other property rented to or Dated for the use of others but not sold. 31. "Your work a. Means: (1) Work or operations performed by you or on your behalf; and (2) Materials, parts or equipment furnished in connection with such work or operations. b. Includes- (1) Warranties or representations made at any time with respect to the fitness, quality, durability, performance or use of "your work"; and (2) The providing of or failure to provide warnings or instructions. CG T1 00 02 19 0 2017 The Travelers Indemnity Company. All rights reserved. Page 21 of 21 Includes copyrighted material of Insurance services Office, Inc. with its permission. From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: 33 of 63 0112912021 12:14 PM This page has been left blank intentionally, From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: 34 of 63 0112912021 12:14 PM COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS -- INCREASED LIMITS F. HIRED AUTO — LIMITED WORLDWIDE COV- ERAGE — INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE —GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT 1. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT J. PERSONAL PROPERTY K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. [ 1710 J4a1:11;1:1 PILIIk% 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COV- ERED AUTOS LIABILITY COVERAGE: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. 2. The following replaces Paragraph b. in B.S., Other Insurance, of SECTION IV — BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own. (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in an "employee's" name, with your CA T3 53 02 15 02015 The Travelers Indemnity Company. All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission, From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: 35 of 63 0112912021 12:14 PM COMMERCIAL AUTO permission, while performing duties (a) With respect to any claim made or "suit" related to the conduct of your busi- brought outside the United Mates of ness. America, the territories and possessions However, any "auto" that is leased, hired, of the United States of America, Puerto rented or borrowed with a driver is not a Rico and Canada: covered "auto". (i) You must arrange to defend the "in- D. EMPLOYEES AS INSURED sured" against, and investigate or set - tle any such claim or "suit" and keep The following is added to Paragraph A.I., Who Is us advised of all proceedings and ac- An Insured, of SECTION II — COVERED AUTOS tions. LIABILITY COVERAGE: (fit) you nor any other Involved Any "employee" of yours IS an "Insured" while us- "Neither " Insured will make any settlement ing a covered "auto" you don't own, hire or borrow without our consent. in your business or your personal affairs. (iii) may, at our discretion, participate E. SUPPLEMENTARY PAYMENTS — INCREASED In defending the "Insured" against, or in LIMITS in the settlement of, any claim or 'I. The following replaces Paragraph A.2.a.(2), "suit". of SECTION II — COVERED AUTOS LIABIL- (iv) We will reimburse the "insured" for ITY COVERAGE: sums that the "insured" legally must (2) Up to $3,000 for cost of bail bonds (in- pay as damages because of "bodily cluding bonds for related traffic law viola- injury" or "property damage" to which tions) required because of an "accident" this insurance applies, that the "in - we cover. We do not have to furnish sured" pays with our consent, but these bonds. only up to the limit described in Para- 2. The following replaces Paragraph A.2.a.(4), graph C., Limits Of Insurance, of of SECTION II — COVERED AUTOS LIABIL- SECTION II — COVERED AUTOS ITY COVERAGE: LIABILITY COVERAGE. (4) All reasonable expenses incurred by the (v) We will reimburse the "insured" for "insured" at our request, including actual the reasonable expenses incurred loss of earnings up to $ r00 a day be- with our consent for your investiga- cause of time off from work. tion of such claims and your defense of the "insured" against any such E. HIRED AUTO — LIMITED WORLDWIDE COV- "suit", but only up to and included ERAGE — INDEMNITY BASIS within the limit described in Para - The following replaces Subparagraph (5) in Para- graph C., Limits Of Insurance, of graph B.T., Policy Period, Coverage Territory, SECTION II — COVERED AUTOS of SECTION IV — BUSINESS AUTO CONDI- LIABILITY COVERAGE, and not in TIONS: addition to such limit. Our duty to (5) Anywhere in the world, except any country or make such payments ends when we jurisdiction while any trade sanction, em- have used up the applicable limit of bargo, or similar regulation imposed by the insurance in payments for damages, United States of America applies to and pro- settlements or defense expenses. hibits the transaction of business with or (b) This insurance is excess over any valid within such country or jurisdiction, for Cov- and collectible other insurance available ered Autos Liability Coverage for any covered to the "insured" whether primary, excess, "auto" that you lease, hire, rent or borrow contingent or on any other basis. without a driver for a period of 30 days or less (c) This Insurance is not a substitute for re - and that is not an "auto" you lease, hire, rent quired or compulsory insurance in any or borrow from any of your "employees", country outside the United States, its ter - partners (if you are a partnership), members ritories and possessions, Puerto Rico and (if you are a limited liability company) or Canada. members of their households. Page 2 of 4 02015 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc, with its permission, From: PROPEL INSURANCE ( Fax: 12537592200 To: You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. (d) It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE —GLASS The following is added to Paragraph D., Deducti- ble, of SECTION III — PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT The following replaces the last sentence of Para- graph A.4.b., Lass Of Use Expenses, of SEC- TION III — PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT The following replaces the first sentence in Para- graph A.4.a., Transportation Expenses, of SECTION III — PHYSICAL DAMAGE COVER- AGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. J. PERSONAL PROPERTY Fax: (360) 473-2330 Page: 36 of 63 0112912021 12:14 PM COMMERCIAL AUTO (2) In or on your covered "auto". This coverage applies only in the event of a total theft of your covered "auto". o deductibles apply to this Personal Property coverage. K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of "loss" set forth in Paragraphs A.9.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty, and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV — BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or "loss" ap- plies only when the "accident" or "loss" is known to: (a) You (if you are an individual), (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany) ; (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization), or (e) Any "employee" authorized by you to give no- tice of the "accident" or "loss". M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.S., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDI- TIONS: The following is added to Paragraph AA., Cover- S. Transfer Of Rights Of Recovery Against age Extensions, of SECTION III — PHYSICAL Others To Us DAMAGE COVERAGE: We waive any right of recovery we may have Personal Property against any person or organization to the ex- tent required of you by a written contract We will pay up to $400 for "loss" to wearing ap- signed and executed prior to any "accident" parel and other personal property which is: or "loss", provided that the "accident" or "loss" (1) Owned by an "insured"; and arises out of operations contemplated by CA T3 53 02 15 02015 The Travelers Indemnity Company. All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission, From: PROPEL INSURANCE ( Fax: 12537592200 To: COMMERCIAL AUTO Fax: (360) 473-2330 Page: 37 of 63 0112912021 12:14 PM such contract. The waiver applies only to the person or organization designated in such contract. N. UNINTENTIONAL ERRORS OR OMISSIONS The following is added to Paragraph B.2., Con- cealment, Misrepresentation, Or Fraud, of SECTION IV — BUSINESS AUTO CONDITIONS: The unintentional omission of, or unintentional error in, any information given by you shall not prejudice your rights under this insurance. How- ever this provision does not affect our right to col- lect additional premium or exercise our right of cancellation or non -renewal. Page 4 of 4 02015 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc, with its permission, From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: 38 of 63 0112912021 12:14 PM COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL Dt PRIMARY AND NON-CONTRIBUTORY r rr OTHER INSURANCE CONTRACTORS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM I a Z�►I�]R1 150LF:'3 1. The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION 11 — COVERED AUTOS LIABILITY COVERAGE: This includes any person or organization who you are required under a written contract or agreement, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to name as an additional insured for Covered Autos Liability Coverage, but only for damages to which this insurance applies and only to the extent of that person"s or organization's liability for the conduct of another "insured". 2. The following is added to Paragraph B.S., Other Insurance of SECTION IV — BUSINESS ALTO CONDITIONS: Regardless of the provisions of paragraph a. and paragraph d. of this part S. Other Insurance, this insurance is primary to and non-contributory with applicable other insurance under which an additional insured person or organization is a named insured when a written contract or agreement with you, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, requires this insurance to be primary and non- contributory. CA T4 99 02 16 6 2016 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: 39 of 63 0112912021 12:14 PM This page has been left blank intentionally, From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: 40 of 63 0112912021 12:14 PM COMMERCIAL INLAND MARINE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET LOSSPAYEES This endorsement modifies insurance provided under the IM PAK COVERAGE FORM. The following is added to Section E — ADDITIONAL b. Pay any claim for loss or damage jointly to you COVERAGE CONDITIONS: and the Loss Payee as your interests. may ap- Loss Payable Provision pear. In the event of a Covered Cause of Loss to Covered This endorsement applies to all Covered Property for Property in which both you and a Loss Payee share which a Loss Payee is on file with us or your insur- an insurable interest, we will: ance agent or insurance broker. a. Adjust the loss or damage with you; and CM TS 60 0110 0 2009 The Travelers I ndaMnity company Page I of 1 Includes copyrighted material of Insurance Services Office., Inc. with its permission, From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: 41 of 63 0112912021 12:14 PM This page has been left blank intentionally, From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: 42 of 63 0112912021 12:14 PM 1118110IS211W1:1 I a 1 F1.11 00111 Ira I1 :.1_ 1 rim THIS POLICY, IN PART, PROVIDES FOLLOW -FORM LIABILITY COVERAGE. COVERAGE WILL APPLY ON A CLAIMS -MADE BASIS WHEN FOLLOWING CLAIMS -MADE UNDERLYING INSURANCE. COVERAGE WILL APPLY ON A DEFENSE -WITHIN -LIMITS BASIS WHEN FOLLOWING UNDERLYING INSURANCE UNDER WHICH DEFENSE EXPENSES ARE PAYABLE WITHIN, AND NOT IN ADDITION TO, THE LIMITS OF INSURANCE. WHEN FOLLOWING SUCH UNDERLYING INSURANCE, PAYMENT OF DEFENSE EXPENSES UNDER THIS POLICY WILL REDUCE, AND MAY EXHAUST, THE LIMITS OF INSURANCE OF THIS POLICY. PLEASE READ THE ENTIRE POLICY CAREFULLY. Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights, duties and what is and is not covered. Throughout this policy, the words "you" and "your" refer to the Named Insured shown in the Declarations and any other person or organization qualifying as a Named Insured under this policy. The words "we", "us" and "our" refer to the company providing this insurance. The word "insured" means any person or organization qualifying as such under SECTION II — WHO IS AN INSURED. Other words and phrases that appear in quotation marks have special meaning. Refer to SECTION VI — DEFINITIONS. SECTION I — COVERAGES A. COVERAGE A — EXCESS FOLLOW -FORM LIABILITY 1. We will pay on behalf of the insured those sums, in excess of the "applicable underlying limit", that the insured becomes legally obligated to pay as damages to which Coverage A of this insurance applies, provided that the "underlying insurance" would apply to such damages but for the exhaustion of its applicable limits of insurance. If a sublimit is specified in any "underlying insurance", Coverage A of this insurance applies to damages that are in excess of that sublimit only if such sublimit is shown for that "underlying insurance" in the Schedule Of Underlying Insurance. Z Coverage A of this insurance is subject to the same terms, conditions, agreements, exclusions and definitions as the "underlying insurance", except with respect to any provisions to the contrary contained in this insurance. 3. The amount we will pay for damages is limited as described in SECTION III — LIMITS OF INSURANCE. 4. For the purposes of Paragraph 1. above: a. The applicable limit of insurance stated for the policies of "underlying insurance" in the Schedule Of Underlying Insurance will be considered to be reduced or exhausted only by the following payments: (1) Payments of judgments or settlements for damages that are covered by that "underlying insurance". However, if such "underlying insurance" has a policy period which differs from the policy period of this Excess Follow -Form And Umbrella amiability Insurance, any such payments for damages that would not be covered by this Excess EU 00 0107 16 O 2016 "rhe Travelers Indemnity Company. All rights reserved. Page 1 of 22 From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: 43 of 63 0112912021 12:14 PM UMBRELLA Fallow -Form And Umbrella Liability 5. When the "underlying insurance" applies on a Insurance because of its different claims -made basis and includes a retroactive policy period will not reduce or date provision, the retroactive date for exhaust the applicable limit of Coverage A of this insurance is the same as insurance stated for such "underlying the retroactive date of that "underlying insurance'; insurance". (2) Payments of "medical expenses" that B. COVERAGE B — UMBRELLA LIABILITY are covered by that "underlying 1. We will pay on behalf of the insured those insurance" and are incurred for sums in excess of the "self -insured retention" "bodily injury" caused by an accident that the insured becomes legally obligated to that takes place during the policy pay as damages because of "bodily injury" period of this Excess Fallow -Form "property damage" "personal injury" or And Umbrella Liability Insurance; or "advertising injury" to which Coverage B of (3) Payments of defense expenses that this insurance applies. are covered by that "underlying 2, Coverage B of this insurance applies to insurance", only if such "underlying "bodily injury" or "property damage" only if: insurance" includes such payments within the limits of insurance. a. The "bodily injury" or "property damage" is However, if such "underlying caused by an "occurrence" that takes insurance" has a policy period which place anywhere in the world; differs from the policy period of this b. The "bodily injury" or "property damage" Excess Follow -Form And Umbrella occurs during the policy period; and Liability Insurance, any such C. Prior to the policy period, no insured listed payments for defense expenses that under Paragraph 1. in Paragraph B., would not be covered by this Excess COVERAGE B — UMBRELLA Follow -Form And Umbrella Liability Insurance because of its different LIABILITY, of SECTION 11 — WHO IS AN policy period will not reduce or INSURE© and no "employee" authorized exhaust the applicable limit of by you to give or receive notice of an insurance stated for such underlying "occurrence" or claim, knew that the insurance". "bodily injury" or "property damage" had occurred, in whole or in part. If such a If the applicable limit of insurance stated listed insured or authorized "employee" for the policies of "underlying insurance" knew, prior to the policy period, that the in the Schedule Of Underlying Insurance "bodily injury" or "property damage" is actually reduced or exhausted by other occurred, in whole or in part, then any payments, Coverage A of this insurance continuation, change or resumption of is not invalidated. However, in the event such "bodily injury" or "property damage" of a loss, we will pay only to the extent during or after the policy period will be that we would have paid had such limit deemed to have been known prior to the not been actually reduced or exhausted policy period. by such other payments. 3. Coverage B of this insurance applies to b. If any "underlying insurance" has a limit of "personal injury" or "advertising injury" insurance greater than the amount shown caused by an offense arising out of your for that insurance in the Schedule of business, but only if the offense was Underlying Insurance, this insurance will committed during the policy period apply in excess of that greater amount. If anywhere in the world. any "underlying insurance" has a limit of 4. The amount we will pay for damages is limited insurance, prior to any reduction or as described in SECTION III — LIMITS OF exhaustion by payment of damages, INSURANCE. "medical expenses" or defense expenses described in Paragraph a. above, that is 5. "Bodily injury" or "property damage": less than the amount shown for that a. Which occurs during the policy period; and insurance in the Schedule Of Underlying b. Which was not prior to, but was during, the Insurance, this insurance will apply in policy period known to have occurred by excess of the amount shown for such insurance in the Schedule Of Underlying any insured listed under Paragraph 1. in Insurance. Paragraph B., COVERAGE B — Page 2 of 22 c� 2016 The Travelers Indemnity Company. All rights reserved. EU 00 0107 16 From: PROPEL INSURANCE ( Fax: 12537592200 To: UMBRELLA LIABILITY of SECTION 11 — WHO IS AN INSURED, or any "employee" authorized by you to give notice of an ,,occurrence" or claim; includes any continuation, change or resumption of the "bodily injury" or .,property damage" after the end of the policy period. 6. "Bodily injury" or "property damage" will be deemed to have been known to have occurred at the earliest time when any insured listed under Paragraph 1. in Paragraph B., COVERAGE B — UMBRELLA LIABILITY, of SECTION 11 — WHO IS AN INSURED or any "employee" authorized by you to give or receive notice of an "occurrence" or claim; a. Reports all, or any part, of the "bodily injury" or "property damage" to us or any other insurer; b. Receives a written or verbal demand or claim for damages because of the "bodily injury" or "property damage"; or C. Becomes aware by any other means that the "bodily injury" or "property damage" has occurred or has begun to occur. 7. Damages because of "bodily injury" include damages claimed by any person or organization for care, loss of services or death resulting at any time from the "bodily injury". 8. Coverage B of this insurance does not apply to damages covered by any "underlying insurance" or that would have been covered by any "underlying insurance" but for the exhaustion of its applicable limit of insurance. C. COVERAGE C — CRISIS MANAGEMENT SERVICE EXPENSES 1. We will reimburse the insured, or pay on the insured's behalf, "crisis management service expenses" to which Coverage C applies. 2. Coverage C of this insurance applies to "crisis management service expenses" that: a. Arise out of a "crisis management event" that first commences during the policy period; b. Are incurred by the insured, after a "crisis management event" first commences and before such event ends; and C. Are submitted to us within 180 days after the "crisis management advisor" advises you that the "crisis management event" no longer exists. Fax: (360) 473-2330 Page: 44 of 63 0112912021 12:14 PM UMBRELLA a. First commence at the time when any "executive officer" first becomes aware of an "event" or "occurrence" that leads to that "crisis management event", and b. End when we decide that the crisis no longer exists or when the Crisis Management Service Expenses Limit has been exhausted, whichever occurs first. 4. The amount we will pay for "crisis management service expenses" is limited as described in SECTION III — LIMITS OF INSURANCE. 5. A "self -insured retention" does not apply to "crisis management service expenses". 6. Any payment of "crisis management service expenses" that we make will not be determinative of our obligations under this insurance with respect to any claim or "suit" or create any duty to defend or indemnify any insured for any claim or "suit D. DEFENSE AND SUPPLEMENTARY PAYMENT'S 1. We will have the right and duty to defend the insured: a. Under Coverage A, against a "suit" seeking damages to which such coverage applies, if: (1) The "applicable underlying limit" is the applicable limit of insurance stated for a policy of "underlying insurance" in the Schedule Of Underlying Insurance and such limit has been exhausted solely due to payments as permitted in Paragraphs 4.a.(1), (2) and (3) of COVERAGE A — EXCESS FOLLOW -FORM LIABILITY of SECTION I — COVERAGES; or (2) The "applicable underlying limit" is the applicable limit of any "other insurance" and such limit has been exhausted by payments of judgments, settlements or medical expenses, or related costs or expenses (if such costs or expenses reduce such limits). For any "suit" for which we have the right and duty to defend the insured under Coverage A, defense expenses will be within the limits of insurance of this policy when such expenses are within the limits of insurance of the applicable "underlying insurance"; or 3. A "crisis management event" will be deemed b. Under Coverage B, against a "suit" to: seeking damages to which such coverage applies. EU 00 0107 16 ID 2016 rho Travelers Indemnity Company. All rights reserved. Page 3 of 22 From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: 45 of 63 0112912021 12:14 PM 2. We have no duty to defend any insured against any "suit": a. Seeking damages to which this insurance does not apply; or b. If any other insurer has a duty to defend. 3. When we have the duty to defend, we may, at our discretion, investigate and settle any claim or "suit". In all other cases, we may, at our discretion, participate in the investigation, defense and settlement of any claim or "suit" for damages to which this insurance may apply. If we exercise such right to participate, all expenses we incur in doing so will not reduce the applicable limits of insurance, 4. Our duty to defend ends when we have used up the applicable limit of insurance in the payment of judgments or settlements, or defense expenses if such expenses are within the limits of insurance of this policy. 5. We will pay, with respect to a claim we investigate or settle, or "suit" against an insured we defend: a. All expenses we incur. b. The cost of: (1) Bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which this insurance applies; or (2) Appeal bonds and bonds to release attachments; but only for bond amounts within the applicable limit of insurance. We do not have to furnish these bonds. C. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of such claim or "suit", including actual loss of earnings up to $1,€00 a day because of time off from work. €I. All court costs taxed against the insured in the "suit". However, these payments do not include attorneys' fees or attorneys' expenses taxed against the insured, e. Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the applicable limit of insurance, we will not pay any prejudgment interest based on that period of time after the offer. applicable limit of insurance. If we do not pay part of the judgment for any reason other than it is more than the applicable limit of insurance, we will not pay any interest that accrues on that portion of the judgment. With respect to a claim we investigate or settle, or "suit" against an insured we defend under COVERAGE A — EXCESS FOLLOW - FORM LIABILITY, these payments will not reduce the applicable limits of insurance, but only if the applicable "underlying insurance" provides for such payments in addition to its limits of insurance. With respect to a claim we investigate or settle, or "suit" against an insured we defend under COVERAGE B — UMBRELLA LIABILITY, these payments will not reduce the applicable limits of insurance. SECTION If — WHO IS AN INSURE© A. COVERAGE A — EXCESS FOLLOW -FORM LIABILITY With respect to Coverage A, the following persons and organizations qualify as insureds: 1. The Named Insured shown in the Declarations; and 2. Any other person or organization qualifying as an insured in the "underlying insurance". If you have agreed to provide insurance for that person or organization in a written contract or agreement: a. the limits of insurance afforded to such person or organization will be: (1) The amount by which the minimum limits of insurance you agreed to provide such person or organization in that written contract or agreement exceed the total limits of insurance of all applicable "underlying insurance"; or (2) The limits of insurance of this policy; whichever is less; and b. Coverage under this policy does not apply to such person or organization if the minimum limits of insurance you agreed to provide such person or organization in that written contract or agreement are wholly within the total limits of insurance of all available applicable "underlying insurance". f. All interest that accrues on the full amount B. COVERAGE B — UMBRELLA LIABILITY of any judgment after entry of the With respect to Coverage B: judgment and before we have paid, offered to pay or deposited in court the 1. The Named Insured shown in the part of the judgment that is within the Declarations is an insured, 2. If you are: Page 4 of 22 c� 2016 The Travelers Indemnity Company. All rights reserved. EU 00 0107 16 From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: 46 of 63 0112912021 12:14 PM 1118110. MINW1 a. An individual, your spouse is also an insured, but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture, your members, your partners and their spouses are also insureds, but only with respect to the conduct of your business. C. A limited liability company, your members are also insureds, but only with respect to the conduct of your business. Your managers are also insureds, but only with respect to their duties as your managers. d. An organization other than a partnership, joint venture or limited liability company, your "officers" and directors are also insureds, but only with respect to their duties as your 'officers" or directors. Your stockholders are also insureds, but only with respect to their liability as stockholders. e. A trust, your trustees are also insureds, but only with respect to their duties as trustees. 3. Each of the following is also an insured: a. Your "volunteer workers" only while performing duties related to the conduct of your business, or your "employees", other than either your "officers" (if you are an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company), but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However, none of these "employees" or "volunteer workers" are insureds for: (1) "Bodily injury" or "personal 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 employment or performing 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 paragraph (1)(a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. Unless you are in the business or occupation of providing professional health care services, paragraphs (1)(a), (b), (C) and (d) above do not apply to "bodily injury" arising out of providing or failing to provide first aid or "Good Samaritan services" by any of your "employees" or "volunteer workers" other than an employed or volunteer doctor. Any such "employees" or "volunteer workers" providing or failing to provide first aid or "Good Samaritan services" during their work hours for you will be deemed to be acting within the scope of their employment by you or performing duties related to the conduct of your business. (2) "Property damage" to property: (a) Owned, occupied or used by; or (b) rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by; you, any of your "employees" or "volunteer workers", any of your partners or members (if you are a partnership or joint venture), or any of your members (if you are a limited liability company). b. Any person (other than your "employee" or "volunteer worker"), or any organization, while acting as your real estate manager. C. Any person or organization having proper temporary custody of your property if you die, but only: (1) With respect to liability arising out of the maintenance or use of that property; and (2) Until your legal representative has been appointed. d. Your legal representative if you die, but only with respect to duties as such. That EU 00 0107 16 © 2016 The travelers indemnity Company. All rights reserved. Page 5 of 22 From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: 47 of 63 0112912021 12:14 PM representative will have all your rights and duties under this insurance. 4. Any organization, other than a partnership, joint venture or limited liability company, of which you are the sole owner, or in which you maintain an ownership interest of more than 50%, on the first day of the policy period is an insured and will qualify as a Named Insured. No such organization is an insured or will qualify as a Named Insured for "bodily injury" or "property damage" that occurred, or "personal injury" or "advertising injury" caused by an offense committed after the date, if any, during the policy period, that you no longer maintain an ownership interest of more than 50% in such organization. 5. Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and of which you are the sole owner, or in which you maintain an ownership interest of more than 50%, is an insured and 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 18dh day after you acquire or form the organization or the end of the policy period, whichever is earlier: and b. Coverage for such organization does not apply to: (1) "Bodily injury" or "property damage" that occurred: or (2) "Personal injury" or "advertising injury" arising out of an offense committed; before you acquired or formed the organization. No person or organization is an insured or will qualify as a Named 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. This paragraph does not apply to any such partnership, joint venture or limited liability company that otherwise qualifies as an insured under Paragraph B. of SECTION II — WHO IS AN INSURED. 2. Any organization, other than a partnership, joint venture or limited liability company, of which you are the sole owner, or in which you maintain an ownership interest of more than 50%, on the first day of the policy period. No such organization is an insured or will qualify as a Named Insured for "crisis management service expenses" arising out of a "crisis management event" that first commences after the date, if any, during the policy period, that you no longer maintain an ownership interest of more than 50% in such organization. 3. Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and of which you are the sole owner, or in which you maintain an ownership interest of more than 50%, if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the 18dh day after you acquire or form the organization or the end of the policy period, whichever is earlier; and b. Coverage for such organization does not apply to "crisis management service expenses" arising out of a "crisis management event" that occurred before you acquired or formed the organization, even if an "executive officer" only first becomes aware of an "event" or "occurrence" that leads to such "crisis management event" after the date you acquired or formed the organization. No person or organization is an insured or will qualify as a Named 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. SECTION III — LIMITS OF INSURANCE A. The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay for the amounts described below to which this insurance applies regardless of the number of: 1. Insureds; 2. Claims made or "suits" brought; C. COVERAGE C — CRISIS MANAGEMENT 3. Number of vehicles involved; SERVICE EXPENSES 4. Persons or organizations making claims or With respect to Coverage C, the following persons bringing "suits"; or and organizations are insureds and will qualify as 5. Coverages provided under this insurance. Named Insureds: 1. The Named Insured shown in the As indicated in Paragraph D.1. of SECTION I — Declarations. COVERAGES, for any "suit" for which we have the right and duty to defend the insured under Coverage A, defense expenses will be within the Page 6 of 22 2016 the Travelers Indemnity Company. All rights reserved. EU 00 0107 16 From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: 48 of 63 0112912021 12:14 PM 11181IMIS 211W1:1 limits of insurance of this policy when such F. The limits of insurance of this policy apply expenses are within the limits of insurance of the separately to each consecutive annual period and applicable "underlying insurance". to any remaining period of less than 12 months, B. The General Aggregate Limit is the most we will starting with the beginning of the policy period pay for the sum of all: shown in the Declarations. If the policy period is extended after issuance for an additional period of 1. Damages: and less than 12 months, the additional period will be 2. Defense expenses if such expenses are deemed part of the last preceding period for within the limits of insurance of this policy, purposes of determining the limits of insurance. except: SECTION IV — EXCLUSIONS 1. Damages and defense expenses because of This insurance does not apply to: "bodily injury" or "property damage" included A. With respect to Coverage A and Coverage B: in the "auto hazard"; 1. Asbestos 2. Damages and defense expenses because of "bodily injury" or "property damage" included Damages arising out of the actual or in the products -completed operations alleged presence or actual, alleged or hazard"; or threatened dispersal of asbestos, 3. Damages and defense expenses for which asbestos fibers or products containing asbestos, provided that the damages are insurance is provided under any Aircraft "underlying caused or contributed to by the hazardous Liability coverage Included as properties of asbestos, insurance" to which no aggregate limit applies, b. Damages arising out of the actual or C. The Products -Completed Operations Aggregate alleged presence or actual, alleged or Limit is the most we will pay for the sum of all: threatened dispersal of any solid, liquid, 1. Damages, and gaseous or thermal irritant or contaminant, including smoke, vapors, 2. Defense expenses if such expenses are soot, fumes, acids, alkalis, chemicals and within the limits of insurance of this policy; waste, and that are part of any claim or because of "bodily injury" or "property damage" "suit" which also alleges any damages included in the "products -completed operations described in Paragraph a. above. hazard". C. Any loss, cost or expense arising out of D. Subject to Paragraph B. or C. above, whichever any: applies, the Occurrence Limit is the most we will (1) Request, demand, order or statutory pay for the sum of all' or regulatory requirement that any 1. Damages, and defense expenses if such Insured or others test for, monitor, expenses are within the limits of insurance of clean up, remove, contain, treat, this policy, under Coverage A arising out of detoxify or neutralize, or in any way any one "event" to which the "underlying respond to, or assess the effects of, insurance" applies a limit of insurance that is asbestos, asbestos fibers or products separate from any aggregate limit of containing asbestos; or insurance; and (2) Claim or "suit" by or an behalf of any 2. Damages under Coverage B because of all 9 9 governmental authority or any other "bodily injury" "property damage" "personal person or organization because of injury" or "advertising injury" arising out of any testing for, monitoring, cleaning up, one 'occurrence". removing, containing, treating, For the purposes of determining the applicable detoxifying or neutralizing, or in any Occurrence Limit, all related acts or omissions way responding to, or assessing committed in the providing or failing to provide the effects of, asbestos, asbestos first aid or "Good Samaritan services" to any one fibers or products containing asbestos, person will be considered one "occurrence". 2. Employment -Related Practices E. The Crisis Management Service Expenses Limit Damages because of injury to: is the most we will pay for the sum of all "crisis management service expenses" arising out of all a. A person arising out of any: "crisis management events". Payment of such (1) Refusal to employ that person; "crisis management service expenses" is in addition to, and will not reduce, any other limit of (2) Termination of that persons insurance of this policy. employment; or l U 00 0107 16 C� 2016 The Travelers Indemnity Company. All rights reserved. Page 7 of 22 From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: 49 of 63 0112912021 12:14 PM (3) Employment -related practice, policy, the meanings given them in the Atomic act or omission, such as coercion, Energy Act of 1954 or any of its demotion, evaluation, reassignment, amendments. discipline, failure to promote or 6. Uninsured or Underinsured Motorists, No - advance, harassment, humiliation, Fault And Similar Laws discrimination, libel, slander, violation of the person's right of privacy, Any liability imposed on the insured, or the malicious prosecution or false arrest, insureds insurer, under any of the following detention or imprisonment, applied to laws: or directed at that person, regardless a, uninsured motorists, of whether such practice, policy, act or omission occurs, is applied or is b. Underinsured motorists; committed before, during or after the C. Auto no-fault or other first -party personal time of that person's employment; or injury protection (PIP), b. The spouse, child, parent, brother or d. Supplementary uninsurediunderinsured sister of that person as a consequence of motorists (New York), or injury to that person as described in Paragraphs a.(1), (2) or (3) above. e• Medical expense benefits and income loss benefits (Virginia). This exclusion applies: 7. War a. Whether the insured may be liable as an Damages arising out of: employer or in any other capacity; and b. To any obligation to share damages with a. War, including undeclared or civil war; or or repay someone else who must pay b. Warlike action by a military force, damages because of the injury, including action in hindering or defending 3. ERISA, COBRA And Similar taws against an actual or expected attack, by Any obligation of the insured under: any government, sovereign or other authority using military personnel or other a. The Employees Retirement Income agents: or Security Act Of 1974 (ERISA) or any of C. Insurrection, rebellion, revolution, usurped its amendments, power or action taken by governmental b. The Consolidated Omnibus Budget authority in hindering or defending against Reconciliation Act of 1985 (COBRA) or any of these. any of its amendments, or 8. Workers Compensation And Similar Laws C. Any similar common or statutory law of Any obligation of the insured under a workers any jurisdiction. compensation, disability benefits or 4. Medical Expenses Or Payments unemployment compensation law or any Any obligation of the insured under any similar law. "medical expenses" or medical payments B. With respect to Coverage B: coverage. 1. Expected Or Intended Bodily Injury Or 5. Nuclear Material Property Damage Damages arising out of: "Bodily injury" or "property damage" expected a. The actual, alleged or threatened or Intended from the standpoint of the insured. "bodily exposure of any person or property to; or This exclusion does not apply to injury" "property or damage" resulting from the use of b. The "hazardous properties" of; reasonable force to protect persons or any "nuclear material". property. As used in this exclusion: 2. Contractual Liability a. "Hazardous properties" includes "Bodily injury" "property damage" "personal radioactive, toxic or explosive properties; injury" or "advertising injury" for which the insured is obligated to pay damages by b. "Nuclear material" means "source reason of the assumption of liability in a material" "special nuclear material" or contract or agreement. This exclusion does "by-product material"; and not apply to liability for damages that the C. "Source material" "special nuclear insured would have in the absence of the material" and "by-product material" have contract or agreement. Page 8 of 22 '�) 2016 The Travelers Indemnity Company. All rights reserved. EU 00 0107 16 From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: 50 of 63 0112912021 12:14 PM 111811.0. MINW1 3. Liquor Liability "Bodily injury" or "property damage" for which any insured may be liable by reason of: a. Causing or contributing to the intoxication of any person, including causing or contributing to the intoxication of any person because alcoholic beverages were permitted to be brought on your premises for consumption on your premises; b. The furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol; or c. Any statute, ordinance or regulation relating to the sale, gift, distribution or use of alcoholic beverages. 4. Employers liability "Bodily injury" to: a. An "employee" of the insured arising out of and in the course of: (1) Employment by the insured; or (2) Performing duties related to the conduct of the insured's business; or b. The spouse, child, parent, brother or sister of that "employee" as a consequence of "bodily injury" described in Paragraph a. above. This exclusion applies: a. Whether the insured may be liable as an employer or in any other capacity; and b. To any obligation to share damages with or repay someone else who must pay damages because of the "bodily injury' S. pollution a. "Bodily injury" "property damage", "personal injury" or "advertising injury" arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of "pollutants". b. Any loss, cost or expense arising out of any: (1) Request, demand, order or statutory or regulatory requirement that any insured or any other person or organization test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of, "pollutants"; or (2) Claim or "suit" by or on behalf of any governmental authority or any other person or organization because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to, or assessing the effects of, "pollutants". 6. Aircraft "Bodily injury" or "property damage" arising out of the ownership, maintenance, use or entrustment to others of any aircraft owned or operated by or rented or loaned to any insured. Use includes operation and "loading or unloading" 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 "occurrence" which caused the "bodily injury" or "property damage" involved the ownership, maintenance, use or entrustment to others of any aircraft that is owned or operated by or rented or loaned to any insured. 7". Auto "Bodily injury" or "property damage" arising out of the ownership, maintenance, use or entrustment to others of any "auto". Use includes operation and "loading or unloading". 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 "occurrence" which caused the "bodily injury" or "property damage" involved the ownership, maintenance, use or entrustment to others of any "auto". This exclusion does not apply to "bodily injury" or "property damage" caused by an "occurrence" that takes place outside of the United States of America (including its territories and possessions), Puerto Rico and Canada. 8. Watercraft "Bodily injury" or "property damage" arising out of the ownership, maintenance, use or entrustment to others of any watercraft owned or operated by or rented or loaned to any insured. Use includes operation and "loading or unloading". 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 "occurrence" which caused the "bodily injury" or "property damage" involved the ownership, EU 00 0107 16 '�) 2016 The Travelers Indemnity Company. All rights reserved. Page 9 of 22 From: PROPEL INSURANCE ( Fax: 12537592200 To: maintenance, use or entrustment to others of any watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to a watercraft: a. While ashore on premises owned by or rented to any insured; or b. That is 50-feet long or less and that: (1) You own; or (2) You do not own and is not being used to carry any person or property for a charge. 9. Electronic Data Damages claimed for the loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate "electronic data". 10. Damage To Property, Products Or Work "Property damage" to: a. Property you own, rent or occupy, including any costs or expenses incurred by you, or any other person or organization, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another`s property; b. Premises you sell, give away or abandon if the "property damage" arises out of any part of those premises; C. Property loaned to you; d. Personal property in the care, custody or control of the insured; e. That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations if the "property damage" arises out of those operations; f. That particular part of any property that must be restored, repaired or replaced because "your work" was incorrectly performed on it; 9 "Your product" arising out of "your product" or any part of it: or Fax: (360) 473-2330 Page: 51 of 63 0112912021 12:14 PM 11. Damage To Impaired Property Or Property Not Physically Injured "Property damage" to "impaired property", or property that has not been physically injured, arising out of: a. A defect, deficiency, inadequacy or dangerous condition in "your product" or "your work"; or b. A delay or failure by you, or anyone acting on your behalf, to fulfill the terms of a contract or agreement. This exclusion does not apply to the loss of use of other property arising out of sudden and accidental physical injury to "your product" or "your work" after it has been put to its intended use. 12. Recall Of Products, Work Or Impaired Property Damages claimed for any loss, cost or expense incurred by you or others for the loss of use, withdrawal, recall, inspection, repair, replacement, adjustment, removal or disposal of: a. "Your product b. "Your work"; or C. "Impaired property"; if such product, work or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect, deficiency, inadequacy or dangerous condition in it. 13. Violation Of Consumer Financial Protection Laws "Bodily injury" "property damage" "personal injury" or "advertising injury" arising out of any actual or alleged violation of a "consumer financial protection law", or any other "bodily injury" "property damage" "personal injury" or "advertising injury" alleged in any claim or "suit" that also alleges any such violation. 14. Unsolicited Communication "Bodily injury" "property damage" "personal injury" or "advertising injury" arising out of any actual or alleged violation of any law that restricts or prohibits the sending, transmitting or distributing of "unsolicited communication". h. "Your work" arising out of "your work" or 15. Access Or Disclosure Of Confidential Or any part of it and included in the Personal Information "products -completed operations hazard". "Bodily injury" "property damage" "personal injury" or "advertising injury" arising out of any access to or disclosure of any person's or organization's confidential or personal information. Page 10 of 22 C� 2016 The Travelers Indemnity Company. All rights reserved. EU 00 0107 16 From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: 52 of 63 0112912021 12:14 PM 1111►11.�.7�■/+1 16. Knowing Violation Of Rights Of Another "Personal injury" or "advertising injury" caused by or at the direction of the insured with the knowledge that the act would violate the rights of another and would inflict "personal injury" or "advertising injury". 17. Material Published With Knowledge Of Falsity "Personal injury" or "advertising injury" arising out of oral or written publication, including publication by electronic means, of material, if done by or at the direction of the insured with knowledge of its falsity. 18. Material Published Or Used Prior To Policy Period a. "Personal injury" or "advertising injury" arising out of oral or written publication, including publication by electronic means, of material whose first publication took place before the beginning of the policy period; or b. "Advertising injury" arising out of infringement of copyright, "title" or "slogan" in your "advertisement" whose first infringement in your "advertisement" was committed before the beginning of the policy period. 19. Criminal Acts "Personal injury" or "advertising injury" arising out of a criminal act committed by or at the direction of the insured. 20. Breach Of Contract "Personal injury" or "advertising injury" arising out of a breach of contract, 21. Quality Or Performance Of Goods — Failure To Conform To Statements "Advertising injury" arising out of the failure of goods, products or services to conform with any statement of quality or performance made in your "advertisement". 22. Wrong Description Of Prices "Advertising injury" arising out of the wrong description of the price of goods, products or services stated In your "advertisement". 23. Intellectual Property "Personal injury" or "advertising injury" arising out of any actual or alleged infringement or violation of any of the following rights or laws, or any other "personal injury" or "advertising injury" alleged in any claim or "suit" that also alleges any such infringement or violation; a. Copyright; b. Patent; C. Trade dress; d. Trade name; e. Trademark; f. Trade secret; or g. Other intellectual property rights or laws. This exclusion does not apply to: a. "Advertising injury" arising out of any actual or alleged infringement or violation of another's copyright, "title" or "slogan" in your "advertisement"; or b. Any other "personal injury" or "advertising injury" alleged in any claim or "suit" that also alleges any such infringement or violation of another's copyright, "title" or "slogan" in your "advertisement". 24.Insureds In Media And Internet Type Business "Personal injury" or "advertising injury" arising out of an offense committed by an insured whose business is; a. Advertising, "broadcasting" or publishing; b. Designing or determining content of web - sites for others; or C. An Internet search, access, content or service provider. This exclusion does not apply to Paragraphs a.(1), (2) and (3) of the definition of "personal injury" For the purposes of this exclusion; a. Creating and producing correspondence written in the conduct of your business, bulletins, financial or annual reports, or newsletters about your goods, products or services will not be considered the business of publishing; and b. The placing of frames, borders or links, or advertising, for you or others anywhere on the Internet will not, by itself, be considered the business of advertising, "broadcasting" or publishing. 25. Electronic Chatrooms Or Bulletin Boards "Personal injury" or "advertising injury" arising out of an electronic chatroom or bulletin board the insured hosts, owns or over which the insured exercises control. 26. Unauthorized Use Of Another's Name Or Product "Personal injury" or "advertising injury" arising out of the unauthorized use of another's name or product in your e-mail address, domain name or metatag, or any other similar tactics to mislead another's potential customers. Eta 00 0107 16 C� 2016 The Travelers Indemnity Company. All rights reserved. Page 11 of 22 From: PROPEL INSURANCE ( Fax: 12537592200 To: C. With respect to Coverage C: Newly Acquired, Controlled Or Formed Entities "Crisis management service expenses" arising out of a "crisis management event" that involves any organization you newly acquire or form and that occurred prior to the date you acquired or formed that organization, even if an "executive officer" only first becomes aware of an "event" or "occurrence" that leads to such "crisis management event" after the date you acquired or formed such organization. SECTION V — CONDITIONS A. APPEALS Fax: (360) 473-2330 Page: 53 of 63 0112912021 12:14 PM 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. If this insurance is cancelled, we will send such first Named Insured any premium refund due. If we cancel, the refund will be pro rata. If such first Named Insured cancels, the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. 6. If notice is mailed, proof of mailing will be sufficient proof of notice. D. CHANGES 1. If the insured or the insured's "underlying insurer" elects not to appeal a judgment which exceeds the "applicable underlying limit" or "self -insured retention", we may do so. 2. If we appeal such a judgment, we will pay all costs of the appeal. These payments will not E. reduce the applicable limits of insurance. In no event will our liability exceed the applicable limit of insurance. 1 ?11111111.. 7,1iif:/ r4lIt2ia'l 1. Bankruptcy or insolvency of the insured or of the insured's estate will not relieve us of our obligations under this insurance. 2. In the event of bankruptcy or insolvency of any "underlying insurer", this insurance will not replace such bankrupt or insolvent "underlying insurer's" policy, and this insurance will apply as if such "underlying insurer" had not become bankrupt or insolvent. C. CANCELLATION 1. The first Named Insured shown in the Declarations may cancel this insurance by mailing or delivering to us advance written notice of cancellation. 2. We may cancel this insurance by mailing or delivering to such first Named Insured written notice of cancellation at least: a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium; or 2 This policy contains all the agreements between you and us concerning the insurance afforded. No change can be made in the terms of this insurance except with our consent. The terms of this insurance can be amended or waived only by endorsement issued by us and made a part of this policy. CURRENCY Payments for damages or expenses described in Paragraph 5. of Paragraph D., DEFENSE AND SUPPLEMENTARY PAYMENTS, of SECTION I — COVERAGES will be in the currency of the United States of America. At our sole option, we may make these payments in a different currency. Any necessary currency conversion for such payments will be calculated based on the rate of exchange published in the Wall Street Journal immediately preceeding the date the payment is processed. DUTIES REGARDING AN EVENT, OCCURRENCE, CLAIM OR SUIT 1. You must see to it that we are notified as soon as practicable of an "event" or "occurrence" which may result in a claim under this insurance. To the extent possible, notice should include: a. How, when and where the "event" or "occurrence" took place; b. The names and addresses of any persons or organizations sustaining injury, damage or loss, and the names and addresses of any witnesses; and C. The nature and location of any injury or damage arising out of the "event" or "occurrence". b. fie days before the effective date of 2. If a claim is made or "suit" is brought against cancellation if we cancel for any other reason. any insured which may result in a Claim under this insurance, you must see to it that we 3. We will mail or deliver our notice to such first receive written notice of the claim or "suit" as Named Insured's last mailing address known soon as practicable. to us. Page 12 of 22 C� 2016 The Travelers Indemnity Company. All rights reserved. EU 00 0107 16 From: PROPEL INSURANCE ( Fax: 12537592200 To: 3. With respect to Coverage A, the insured must: a. Cooperate with us in the investigation, settlement or defense of any claim or "suit"; b. Comply with the terms of the "underlying insurance"; and C. Pursue all rights of contribution or indemnity against any person or organization who may be liable to the insured because of the injury, damage or loss for which insurance is provided under this policy or any policy of "underlying insurance". 4. With respect to Coverage B, the insured must: a. Immediately send us copies of any demands, notices, summonses or legal papers received in connection with the claim or "suit"; b. Authorize us to obtain necessary records and other information; C. Cooperate with us in the investigation, settlement or defense of any claim or "suit"; and d. Assist us, upon our request, in the enforcement of any right against any person or organization which may be liable to the insured because of injury or damage to which Coverage B may apply. 5. No insured will, except at that insured's own expense, voluntarily make a payment, assume any obligation, make any admission or incur any expense, other than for first aid for "bodily injury" covered by this insurance, without our consent. 6. Knowledge of an "event" "occurrence", claim or "suit" by your agent, servant or "employee" will not constitute knowledge by you, unless your insurance or risk manager, or anyone working in the capacity as your insurance or risk manager, or anyone you designate with the responsibility of reporting an "event", "occurrence", claim or "suit": a. Has received notice of such "event", "occurrence", claim or "suit" from such agent, servant or "employee"; or Fax: (360) 473-2330 Page: 54 of 63 0112912021 12:14 PM UMBRELLA G. DUTIES REGARDING A CRISIS MANAGEMENT EVENT You must: 1. Notify us within 30 days of a "crisis management event" that may result in "crisis management service expenses". 2. Provide written notice of the "crisis management event" as soon as practicable. To the extent possible, notice should include: a. How, when and where that "crisis management event" took place; b. The names and addresses of any persons or organizations sustaining injury, damage or loss, and the named and addresses of any witnesses; C. The nature and location of any injury or damage arising out of that "crisis management event"; and d. The reason that "crisis management event" is likely to involve damages covered by this insurance in excess of the "applicable underlying limit" or "self - insured retention" and involve regional or national media coverage. H. EXAMINATION OF YOUR BOOKS AND RECORDS We may examine and audit your books and records as they relate to this insurance: 1. At any time during the policy period; 2. Up to three years after the end of the policy period; and 3. Within one year after final settlement of all claims under this insurance. 1. When the "underlying insurance" applies on a claims -made basis, any automatic or basic "extended reporting period" in such "underlying insurance" will apply to this insurance. 2. When the "underlying insurance" applies on a claims -made basis and you elect to purchase an optional or supplemental "extended reporting period" in such "underlying insurance," that "extended reporting period" will apply to this insurance only if: b. Otherwise has knowledge of such "event", a. A written request to purchase an "occurrence", claim or "suit". Extended Reporting Period endorsement for this insurance is made by you and received by us within 90 days after the end of the policy period; EU 00 0107 16 (s) 2016 The Travelers Indemnity Company. All rights reserved. Page 13 of 22 From: PROPEL INSURANCE ( Fax: 12537592200 To: 11181.01/+1 Q b. You have paid all premiums due for this policy at the time you make such request; C. You promptly pay the additional premium we charge for the Extended Reporting Period endorsement for this insurance when due. We will determine that additional premium after we have received your request for the Extended Reporting Period endorsement for this insurance. That additional premium is not subject to any limitation stated in the "underlying insurance" on the amount or percentage of additional premium that may be charged for the "extended reporting period" in such "underlying insurance"; and d. That Extended Reporting Period endorsement is issued by us and made a part of this policy. 3. Any Extended Reporting Period endorsement for this insurance will not reinstate or increase the Limits of Insurance or extend the policy period. 4. Except with respect to any provisions to the contrary contained in Paragraphs 1., 2. or 3. above, all provisions of any option to purchase an "extended reporting period" granted to you in the "underlying insurance" apply to this insurance. INSPECTIONS AND SURVEYS 1. We have the right but are not obligated to: a. Make inspections and surveys at any time; b. Give you reports on the conditions we find; and C. Recommend changes. 2. Any inspections, surveys, reports or recommendations relate only to insurability and the premiums to be charged. We do not make safety inspections. We do not undertake to perform) the duty of any person or organization to provide for the health or safety of workers or the public. We do not warrant that conditions: a. Are safe or healthful; or b. Comply with laws, regulations, codes or standards. K. LEGAL ACTION AGAINST US Fax: (360) 473-2330 Page: 55 of 63 0112912021 12:14 PM b. To sue us on this insurance unless all of its terms have been fully complied with. 1. No person or organization has a right under this insurance: M. a. To join us as a party or otherwise bring us into a "suit" asking for damages from an insured; or 2. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured. We will not be liable for damages that. a. Are not payable under the terms of this insurance; or b. Are in excess of the applicable limit of insurance. An agreed settlement means a settlement and release of liability signed by us, the insured and the claimant or the claimant's legal representative. MAINTENANCE OF UNDERLYING INSURANCE 1. The insurance afforded by each policy of "underlying insurance" will be maintained for the full policy period of this Excess Follow - Form And Umbrella Liability Insurance. This provision does not apply to the reduction or exhaustion of the aggregate limit or limits of such "underlying insurance" solely by payments as permitted in Paragraphs 4.a.(1), (2) and (3) of COVERAGE A — EXCESS FOLLOW -FORM LIABILITY of SECTION I — COVERAGES. As such policies expire, you will renew them at limits and with coverage at least equal to the expiring limits of insurance. If you fail to comply with the above requirements, Coverage A is not invalidated. However, in the event of a loss, we will pay only to the extent that we would have paid had you complied with the above requirements. 2. The first Named Insured shown in the Declarations must give us written notice of any change in the "underlying insurance" as respects: a. Coverage; b. Limits of insurance; C. Termination of any coverage; or d. Exhaustion of aggregate limits. 3. if you are unable to recover from any "underlying insurer" because you fail to comply with any term or condition of the "underlying insurance", Coverage A is not invalidated. However, we will pay for any loss only to the extent that we would have paid had you complied with that term or condition in that "underlying insurance". OTHERINSURANCE This insurance is excess over any valid and collectible "other insurance" whether such "other insurance" is stated to be primary, contributing, Page 14 of 22 C� 2016 The Travelers Indemnity Company. All rights reserved. From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: 56 of 63 0112912021 12:14 PM 1118110IS211W1:1 excess, contingent or otherwise. This provision does not apply to a policy bought specifically to apply as excess of this insurance. However, if you specifically agree in a written contract or agreement that the insurance provided to any person or organization that qualifies as an insured under this insurance must apply on a primary basis, or a primary and non-contributory basis, then insurance provided under Coverage A is subject to the following provisions: 1. This insurance will apply before any "other insurance" that is available to such additional insured which covers that person or organization as a named insured, and we will not share with that "other insurance", provided that the injury or damage for which coverage is sought is caused by an "event" that takes place or is committed subsequent to the signing of that contract or agreement by you. 2. This insurance is still excess over any valid and collectible "other insurance", whether primary, excess, contingent or otherwise, which covers that person or organization as an additional insured or as any other insured that does not qualify as a named insured. 1. The first fumed Insured shown in the Declarations is responsible for the payment of all premiums and will be the payee for any return premiums. 2. If the premium is a flat charge, it is not subject to adjustment except as provided in Paragraph 4. below. 3. If the premium is other than a flat charge, it is an advance premium only. The earned premium will be computed at the end of the policy period, or at the end of each year of the policy period if the policy period is two years or longer, at the rate shown in the Declarations, subject to the Minimum Premium. 4. Additional premium may become payable when coverage is provided for additional insureds under the provisions of SECTION II — WHO IS AN INSURED. 0. PREMIUM AUDIT P. PROHIBITED COVERAGE — UNLICENSED INSURANCE 1. With respect to loss sustained by any insured in a country or jurisdiction in which we are not licensed to provide this insurance, this insurance does not apply to the extent that insuring such loss would violate the laws or regulations of such country or jurisdiction. 2. We do not assume responsibility for: aI. The payment of any fine, fee, penalty or other charge that may be imposed on any person or organization in any country or jurisdiction because we are not licensed to provide insurance in such country or jurisdiction; or b. The furnishing of certificates or other evidence of insurance in any country or jurisdiction in which we are not licensed to provide insurance. Q. PROHIBITED COVERAGE — TRADE OR ECONOMIC SANCTIONS We will provide coverage for any loss, or otherwise will provide any benefit, only to the extent that providing such coverage or benefit does not expose us or any of our affiliated or parent companies to: 1. Any trade or economic sanction under any law or regulation of the United States of America: or 2. Any other applicable trade or economic sanction, prohibition or restriction. R. REPRESENTATIONS By accepting this insurance, you agree: 1. The statements in the Declarations and any subsequent notice relating to "underlying insurance" are accurate and complete: 2. Those statements are based upon representations you made to us; and 3. We have issued this insurance in reliance upon your representations. S. SEPARATION OF INSUREDS Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this policy to the first Named Insured shown in the Declarations, this insurance applies: The premium for this policy is the amount stated 1. As if each Named Insured were the only in Item 5. of the Declarations. The premium is a Named Insured; and flat charge unless it is specified in the Declarations as adjustable. 2. Separately to each insured against whom claim is made or "suit" is brought. EU 00 0107 16 C� 2016 The Travelers Indemnity Company. All rights reserved. Page 15 of 22 From: PROPEL INSURANCE ( Fax: 12537592200 To: 11181-010 11■/+1 Fax: (360) 473-2330 Page: 57 of 63 0112912021 12:14 PM T. WAIVER OR TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US 1. If the insured has rights to recover all or part of any payment we have made under this insurance, those rights are transferred to us and the insured must do nothing after loss to impair them. At our request, the insured will bring suit or transfer those rights to us and help us, and with respect to Coverage A, the "underlying insurer", enforce them. If the insured has agreed in a contract or agreement to waive that insured's right of recovery against any person or organization, we waive our right of recovery against that person or organization, but only for payments we make because of an "event" that takes place or is committed subsequent to the execution of that contract or agreement by such insured. 2. Reimbursement of any amount recovered will be made in the following order: a. First, to any person or organization (including us or the insured) who has paid any amount in excess of the applicable limit of insurance; b. Next, to us; and C. Then, to any person or organization (including the insured and with respect to Coverage A, the "underlying insurer") that is entitled to claim the remainder, if any. 3. Expenses incurred in the process of recovery will be divided among all persons or organizations receiving amounts recovered according to the ratio of their respective recoveries. U. TRANSFER OF YOUR RIGHTS AND DUTIES UNDER THIS INSURANCE 1. Your rights and duties under this insurance may not be transferred without our written consent except in the case of death of an individual Named Insured. 2. If you die, your rights and duties will be transferred to your legal representative but only while acting within the scope of duties as your legal representative. Until your legal representative is appointed, anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. V. UNINTENTIONAL OMISSION OR ERROR The unintentional omission of, or unintentional error in, any information provided by you which we relied upon in issuing this policy will not prejudice your rights under this insurance. However, this provision does not affect our right to collect additional premium or to exercise our rights of cancellation or nonrenewal in accordance with applicable insurance laws or regulations. W. WHEN LOSS IS PAYABLE If we are liable under this insurance, we will pay for injury, damage or loss after: 1. The insured's liability is established by; a. A court decision; or b. A written agreement between the claimant, the insured, any "underlying insurer" and us; and 2. The amount of the "applicable underlying limit" or "self -insured retention" is paid by or on behalf of the insured. SECTION VI — DEFINITIONS A. With respect to all coverages of this insurance: 1. "Applicable underlying limit" means the sum of: a. The applicable limit of insurance stated for the policies of "underlying insurance" in the Schedule Of Underlying Insurance subject to the provisions in Paragraphs 4.a.(1), (2) and (3) of COVERAGE A — XCESS FOLLOW -FORM LIABILITY of SECTION I — COVERAGES; and b. The applicable limit of insurance of any "other insurance" that applies. The limits of insurance in any policy of "underlying insurance" will apply even if: aI. The "underlying insurer" claims the insured failed to comply with any term or condition of the policy; or b. The "underlying insurer" becomes bankrupt or insolvent. 2. "Auto hazard" means all "bodily injury" and "property damage" to which liability insurance afforded under an auto policy of "underlying insurance" would apply but for the exhaustion of its applicable limits of insurance. 3. "Electronic data" means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software (including systems and applications software), hard or floppy disks, CIS-ROMs, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. 4. "Event" means an "occurrence", offense, accident, act, error, omission, wrongful act or loss. Page 16 of 22 C� 2016 The Travelers Indemnity Company. All rights reserved. EU 00 0107 16 From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: 58 of 63 0112912021 12:14 PM 1118110. OINW1 5. "Extended reporting period" means any period of time, starting with the end of the policy period of your claims -made insurance, during which claims or "suits" may be first made, brought or reported for that insurance. 6. "Medical expenses" means expenses to which any Medical Payments section of any policy of Commercial General Liability "underlying insurance" applies. 7. "Other insurance" means insurance, or the funding of losses, that is provided by, through or on behalf of: a. Another insurance company; b. Us or any of our affiliated insurance companies; C. Any risk retention group; d. Any self-insurance method or program, in which case the insured will be deemed to be the provider of such insurance; or e. Any similar risk transfer or risk management method. "Other insurance" does not include: a. Any "underlying insurance or b. Any policy of insurance specifically purchased to be excess of the limits of insurance of this policy shown in the Declarations. 8. "Products -completed operations hazard": a. Includes all "bodily injury" and "property damage" occurring away from premises you own or rent and arising out of "your product" or "your work" except: (1) Products that are still in your physical possession; or (2) Work that has not yet been completed or abandoned. However, "your work" will be deemed completed at the earliest of the following times: (a) When all the work called for in your contract has been completed; (b) When all the work to be done at the job site has been completed if your contract calls for work at more than one job site; or (c) When that part of the work done at a job site has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same project. Work that may need service, maintenance, correction, repair or replacement, but which is otherwise complete, will be treated as completed. b. Does not include "bodily injury" or "property damage" arising out of: (1) The transportation of property, unless the injury or damage arises out of a condition in or on a vehicle not owned or operated by you, and that condition was created by the "loading or unloading" of that vehicle by any insured; (2) The existence of tools, uninstalled equipment or abandoned or unused materials; or (3) Products or operations for which the classification listed in a policy of Commercial General Liability "underlying insurance" states that products -completed operations are subject to the General Aggregate Limit. 9. "Suit" means a civil proceeding which alleges damages. "Suit" includes: a. An arbitration proceeding in which damages are claimed and to which the insured must submit or does submit with our consent; or b. Any other alternative dispute resolution proceeding to which the insured submits with our consent. 10. "Underlying insurance": a. Means the policy or policies of insurance listed in the Schedule Of Underlying Insurance. b. Includes any renewal or replacement of such policies if such renewal or replacement is during the policy period of this Excess Follow -Form And Umbrella Liability Insurance. C. Does not include any part of the policy period of any of the policies described in Paragraphs a. or b. above that began before, or that continues after, the policy period of this Excess Fallow -Form And Umbrella Liability Insurance. 11. "Underlying insurer" means any insurer which provides a policy of insurance listed in the Schedule Of Underlying Insurance. I U 00 0107 16 C� 2016 The Travelers Indemnity Company. All rights reserved. Page 17 of 22 From: PROPEL INSURANCE ( Fax: 12537592200 To: B. With respect to Coverage B and, to the extent that the following terms are not defined in the "underlying insurance", to Coverage A: t "Advertisement" means a notice that is broadcast or published to the general public or specific market segments about your goods, products or services for the purpose of attracting customers or supporters. For the purposes of this definition: a. Notices that are published include material placed on the Internet or on similar electronic means of communication; and b. Regarding web sites, only that part of a web site that is about your goods, products or services for the purposes of attracting customers or supporters is considered an advertisement. 2. "Advertising injury": a. Means injury, other than "personal injury", caused by one or more of the following offenses: (1) Oral or written publication, including publication by electronic means, of material in your "advertisement" that slanders or libels a person or organization or disparages a person's or organization's goods, products or services, provided that the claim is made or the "suit" is brought by a person or organization that claims to have been slandered or libeled, or that claims to have had its goods, products or services disparaged; (2) Oral or written publication, including publication by electronic means, of material in your "advertisement" that: (a) Appropriates a persons name, voice, photograph or likeness, or (b) Unreasonably places a person in a false light; or (3) Infringement of copyright, "title" or "slogan" in your "advertisement", provided that the claim is made or the "suit" is brought by a person or organization that claims ownership of such copyright, "title" or "slogan". b. Includes "bodily injury" caused by one or more of the offenses described in Paragraph a. above. 3 "Auto" means: a. A land motor vehicle, trailer or semitrailer designed for travel on public roads, Fax: (360) 473-2330 Page: 59 of 63 0112912021 12:14 PM including any attached machinery or equipment; or b. Any other land vehicle that is subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. However, "auto" does not include "mobile equipment". 4. "Bodily injury" means: a. Physical harm, including sickness or disease, sustained by a person; or b. Mental anguish, injury or illness, or emotional distress, resulting at any time from such physical harm, sickness or disease. 5. "Broadcasting" means transmitting any audio or visual material for any purpose: a. By radio or television; or b. In, by or with any other electronic means of communication, such as the Internet, if that material is part of: (1) Radio or television programming being transmitted; (2) Other entertainment, educational, instructional, music or news programming being transmitted; or (3) Advertising transmitted with any such programming. 6. "Consumer financial identity information" means any of the following information for a person that is used or collected for the purpose of serving as a factor in establishing such persons eligibility for personal credit, insurance or employment or for the purpose of conducting a business transaction: a. Dart or all of the account number, the expiration date or the balance of any credit, debit, bank or other financial account; b. Information bearing on a persons credit worthiness, credit standing or credit capacity; C. Social security number; d. Driver's license number; or e. Birth date. 7. "Consumer financial protection law" means: a. The Fair Credit Reporting Act (FCRA) and any of its amendments, including the Fair and Accurate Credit Transactions Act (FACTA); Page 18 of 22 C� 2016 The Travelers Indemnity Company. All rights reserved. EU 00 0107 16 From: PROPEL INSURANCE ( Fax: 12537592200 To: . California's Song -Beverly Credit Card Act and any of its amendments; or C. Any other law or regulation that restricts or prohibits the collection, dissemination, transmission, distribution or use of "consumer financial identity information". 8. "Employee" includes a "leased worker`. "Employee" does not include a "temporary worker'. 9. "Good Samaritan services" means any emergency medical services for which no compensation is demanded or received. 10. "Impaired property" means tangible property, other than "your product" or "your work", that cannot be used or is less useful because: a. It incorporates "your product" or "your work" that is known or thought to be defective, deficient, inadequate or dangerous; or b. You have failed to fulfill the terms of a contract or agreement; if such property can be restored to use by the repair, replacement, adjustment or removal of your product" or "your work" or your fulfilling the terms of the contract or agreement. 11. "Leased worker" means a person leased to you by a labor leasing firm under an agreement between you and the labor leasing firm, to perform duties related to the conduct of your business. "Leased worker' does not include a "temporary worker'. 12. "Loading or unloading" means the handling of property: a. After it is moved from the place where it is accepted for movement into or onto an aircraft, watercraft or "auto"; b. While it is in or on an aircraft, watercraft or "auto"; or C. While it is being moved from an aircraft, watercraft or "auto" to the place where it is finally delivered; but "loading or unloading" does not include the movement of property by means of a mechanical device, other than a hand truck, that is not attached to the aircraft, watercraft or "auto". 13. "Mobile equipment" means any of the following types of land vehicles, including any attached machinery or equipment: a. Bulldozers, farm machinery, forklifts and other vehicles designed for use principally off public roads. Fax: (360) 473-2330 Page: 60 of 63 0112912021 12:14 PM UMBRELLA b. Vehicles maintained for use solely on or next to premises you own or rent. C. Vehicles that travel on crawler treads. d. Vehicles, whether self-propelled or not, maintained primarily to provide mobility to permanently mounted: (1) Power cranes, shovels, loaders, diggers or drills; or (2) Road construction or resurfacing equipment such as graders, scrapers or rollers. e. Vehicles not described in Paragraph a., b., c. or d. above that are not self-propelled and are maintained primarily to provide mobility to permanently attached equipment of the following types: (1) Air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting and well servicing equipment; or (2) Cherry pickers and similar devices used to raise or lower workers. f. Vehicles not described in Paragraph a., b., c. or d. above maintained primarily for purposes other than the transportation of persons or cargo. However, self-propelled vehicles with the following types of permanently attached equipment are not "mobile equipment" but will be considered "autos": (1) Equipment designed primarily for: (a) Snow removal; (b) Road maintenance, but not construction or resurfacing; or (C) Street cleaning; (2) Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers; and (3) Air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting and well servicing equipment. However, "mobile equipment" does not include any land vehicle that is subject to a compulsory or financial responsibility law, or other motor vehicle insurance law, where it is licensed or principally garaged. Such land vehicles are considered "autos". I U 00 0107 16 C� 2016 The Travelers Indemnity Company. All rights reserved. Page 19 of 22 From: PROPEL INSURANCE ( Fax: 12537592200 To: UMBRELLA 14. "Occurrence" means: a. C. With respect to "bodily injury" or "property damage": (1) An accident, including continuous or repeated exposure to substantially the same general harmful conditions, which results in "bodily injury" or "property damage". All "bodily injury" or "property damage" caused by such exposure to substantially the same general harmful conditions will be deemed to be caused by one "occurrence"; or (2) An act or omission committed in providing or failing to provide first aid or "Good Samaritan services" to a person by any of your "employees" or "volunteer workers" other than an employed or volunteer doctor, unless you are in the business or occupation of providing professional health care services; With respect to "personal injury" an offense arising out of your business that results in "personal injury". All "personal injury" caused by the same or related injurious material, act or offense will be deemed to be caused by one "occurrence", regardless of the frequency or repetition thereof, the number and kind of media used or the number of persons or organizations making claims or bringing "suits"; and With respect to "advertising injury" an offense committed in the course of advertising your goods, products and services that results in "advertising injury" All "advertising injury" caused by the same or related injurious material, act or offense will be deemed to be caused by one "occurrence", regardless of the frequency or repetition thereof, the number and kind of media used or the number of persons or organizations making claims or bringing "suits". 1. "Officer" means a person holding any of the officer positions created by your charter, constitution, bylaws or any other similar governing document. 16. "Personal injury": a. Means injury, other than "advertising injury" caused by one or more of the following offenses: Fax: (360) 473-2330 Page: 61 of 63 0112912021 12:14 PM (3) The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room, dwelling or premises that a person occupies, provided that the wrongful eviction, wrongful entry or invasion of the right of private occupancy is committed by or on behalf of the owner, landlord or lessor of that room, dwelling or premises; (4) Oral or written publication, including publication by electronic means, of material that slanders or libels a person or organization or disparages a person's or organization's goods, products or services, provided that the claim is made or the "suit" is brought by a person or organization that claims to have been slandered or libeled, or that claims to have had its goods, products or services disparaged; or (5) Oral or written publication, including publication by electronic means, of material that: (a) Appropriates a person's name, voice, photograph or likeness; or (b) Unreasonably places a person in a false light. b. Includes "bodily injury" caused by one or more of the offenses described in Paragraph a. above. 17. "Pollutants" mean any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkalis, chemicals and waste. Waste includes materials to be recycled, reconditioned or reclaimed. 18. "Property damage" means: a. Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use will be deemed to occur at the time of the physical injury that caused it; or b. Loss of use of tangible property that is not physically injured. All such loss of use will be deemed to occur at the time of the "occurrence" that caused it. For the purposes of this insurance, "electronic data" is not tangible property. 19. "Self -insured retention" is the greater of: (1) False arrest, detention or a. The amount shown in the Declarations imprisonment; which the insured must first pay under (2) Malicious prosecution; Coverage 3 for damages because of all Page 20 of 22 C) 2016 The Travelers Indemnity Company. All rights reserved. EU 00 0107 16 From: PROPEL INSURANCE ( Fax: 12537592200 To: Fax: (360) 473-2330 Page: 62 of 63 0112912021 12:14 PM "bodily injury" "property damage", "personal injury" or "advertising injury" arising out of any one "occurrence"; or b. The applicable limit of insurance of any "other insurance" that applies. 20. "Slogan": a. Means a phrase that others use for the purpose of attracting attention in their advertising. b. Does not include a phrase used as, or in, the name of: (1) Any person or organization other than you; or (2) Any business, or any of the premises, goods, products, services or work, of any person or organization other than you. 21. "Temporary worker" means a person who is furnished to you to substitute for a permanent "employee" on leave or to meet seasonal or short-term workload conditions. 22. "Title" means the name of a literary or artistic work. 23. "Unsolicited communication" means any communication, in any form, that the recipient of such communication did not specifically request to receive. 24. "Volunteer worker' means a person who is not your "employee", and who donates his or her work and acts at the direction of and within the scope of duties determined by you, and is not paid a fee, salary or other compensation by you or anyone else for their work performed by you. 25. "Your product": a. Means; (1) Any goods or products, other than real property, manufactured, sold, handled, distributed or disposed of by: (a) You, (b) Others trading under your name; or (C) A person or lousiness or acquired; and organization whose assets you have (2) Containers (other than materials, parts or furnished in connection goods or products. b. Includes: (1) Warranties or representations made at any time with respect to the fitness, quality, durability, performance or use of "your product"; and (2) The providing of or failure to provide warnings or instructions. C. Does not include vending machines or other property rented to or located for the use of others but not sold. 26. "Your work": a. Means: (1) Work or operations performed by you or on your behalf; and (2) Materials, parts or equipment furnished in connection with such work or operations. b. Includes: (1) Warranties or representations made at any time with respect to the fitness, quality, durability, performance or use of "your work'; and (2) The providing of or failure to provide warnings or instructions. C. With respect to Coverage C: 1. "Crisis management advisor` means any public relations firm or crisis management firm approved by us that is hired by you to perform "crisis management services" in connection with a "crisis management event". 2. "Crisis management event" means an "event" or "occurrence" that your "executive officer` reasonably determines has resulted, or may result, in: a. Damages covered by this Coverage A or Coverage B that are in excess of the total applicable limits of the "underlying insurance" or "self -insured retention"; and b. Significant adverse regional or national media coverage. 3. "Crisis management service expenses" means amounts incurred by you, after a "crisis management event" first commences and before such event ends: a. For the reasonable and necessary: (1) Fees and expenses of a "crisis vehicles), management advisor" in the equipment performance for you of "crisis with such management services" solely for a 'crisis management event"; and ICU 00 0107 16 C� 2016 The Travelers Indemnity Company. All rights reserved. Page 21 of 22 From: PROPEL INSURANCE ( Fax: 12537592200 To: � r j Fax: (360) 473-2330 Page: 63 of 63 0112912021 12:14 PM (2) Costs for printing, advertising, mailing of materials or travel by your directors, officers, employees or agents or a "crisis management advisor" solely for a "crisis management event"; and b. For the following expenses resulting from such "crisis management event", provided that such expenses have been approved y us: (1) Medical expenses; (2) Funeral expenses; (3) Psychological counseling; (4) Travel expenses; (5) Temporary living expenses; (6) Expenses to secure the scene of a "crisis management event"; or (7) Any other expenses pre -approved by us. 4. "Crisis management services" means those services performed by a "crisis management advisor" in advising you or minimizing potential harm to you from a "crisis management event" by maintaining or restoring public confidence in you. 5. "Executive officer" means your: a. Chief Executive Officer; b. Chief Operating Officer; c. Chief Financial Officer; d. President; e. General Counsel; . General partner (if you are a partnership); or r. Sole proprietor (if you are a sole proprietorship); or any person acting in the same capacity as any individual listed above. Page 22 of 22 i� 2016 The Travelers Indemnity Company. All rights reserved. EU 00 0107 16