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HomeMy WebLinkAbout6030 PARK USE AGREEMENT This Agreement is made and entered into as of the dace hilly executed below, by and between the CITY OF BREMERTON, a Washington municipal corporation ("City"), and RL:C'KF.R TIIIC TRUCKER LLC, a Washington domr,-slic limited liability company ("Permittee"). WHEREAS, City is the owner of certain real properties in the City of Bremerton, Kitsap County, Washington, commonly known as Ivy Green Cemetery, located at 1401 Naval Avenue, Bremerton, Washington and Lions Park, located at 251 Lebo Boulevard, Bremerwn, Washington (hereinafter "Properties"); and WHEREAS. Permitter: desires Iii utilise the Properties on two separate days for the purpose of filming L1,40 scenes for a movie and the City is willing to authorize such use in exchange for a fee:and WIJEKEAS, the Director of Parks and Recreation thereinafter "Director''), at his discretion, may authorize the exclusive use of C'ily parks.on a limited basis li,r spiecial events and activities in accordance with department policies, NOW, THEREFORE. in consideration of the mutual berretta to he derived by the parties hereto. it is agreed: I. INCORPORATION OF RECITALS:ALS: The foregoing recitals are incorporated herein by this reference and made a part hereof. 2. USE: City hereby authoriz;s Permittee the exclusive use of the Properties for the purpose of alining scenes for a movie ('•I:se"). The following parameters must also be met, and are included in the definition of"Use": (a) I'ermittee's Use of the Properties is limited to one weekday and one weekend in tieptemher 2019, us lirl lows: September 4. 24119 & September ti, 2019. Another date may be agreed upon by the Director and Permittee in writing if requested by Permittee, and an additional fee may be required by the City. The City may change the date upon thirty (30) days written notice to Permittee. The City may change the date upon shorter notice in case of an emergency; this change must be reasonable and must only occur if the City needs to use the Properties b r an unforeseen repair or other similar circumstance_ (b) for filming at the Ivy Cireeu Cemetery on epternbcr 4, 2019, the Use shall commncncr no earlier than 5:041 p.m. and end no later than 11:00 p.m.. including all sel-up and clean-up. *Specify exact location at site where filming is approved. 1 — it11(At:k THE TRUCKER LLC Ay Green Cemetery & Lions Park Use Agreement (e) For filming at Lions Park on September 8. 2019, the t hie shall commence no earlier than 12:00 p.m. and end no later than 6;00 p.m., including all sct-up and clean-up. "Specify exact location in,park where filming is authorir d (d) The the will be occlusive. and Permittee agrees to only use as much space on the Properties as is absolutely necessary for Permittee's filming activity. Pcnnittcc may close off the area(s) of the Properties necessary for its Use. te) The filming at Ivy Green Cemetery is for one scene wherein two people are digging a hole to bury a body. and wherein a third person appears deceased: no action scenes, stunt work, or other physical activity beyond normal park activity are allowed under this Agreement. No digging or disturbing ground will be allowed. A mound of sail may be used to simulate a grave. :At no time will any grave markers or heLLlsuines be filmed in a way that the engraved names can be identified. (t) The filming al lions Park is for one scene wherein two people are htnvin a conversation: no action scenes, stunt work, or other physical activity beyond normal park activity are allowed under this Agreement. (g) Permittee shall allow no more than lIteen (15) people on the Properties. including actors, stiff, and any other individuals associated with Pennitlee's activities. (h) Permittee may nod drive a vehicle onto the Properties. However. a private City-owned driveway exists near the Property which is accessible to Parks and Recreation vehicles: this access may be made available to Permittee upon coordination with Parks and Recreation staff �. USE CONDITIONS: Pennittee. for itself and its successors and assigns, covenants as follows: (a) This authorization is given only for the above stated Use. Any extension or modification of the scope of the Use must he approved in writing by the l)i rector. (h) Pcnnitlee shall maintain the Properties in good condition and shall be responsible tion any damage resulting from it_ t se. (c) Pcrrnittee shall he responsible for the clean-up and removal of liner, debris. and all other items resulting from its Use. equipment � (dl Permittee will inform the Director or his designee of any damage to the Properties immediately. (e) No sal; of any items shall take place on the Properties. RUCK 1NF. TRUCK Ft? !.t C Ivy Green Cemetery& Leon Park L;ye Agreement (r) No alcohol of non-prescribed drug shall he consumed on the Properties, and no person under the influence of any such substance shall be allowed onto the Properties by Permittee. 4. CONSII)I?RATION: 1n consideration fair the Use stated herein. Permittee shall pay a fee in the amount of Three hundred dollars and zero cents ($300.00), 5. TERMINATION: This Agreement shall terminate upon completion of the Use. In the event Permittee fails ur observe or perform any of the covenants, conditions, or prtwinions of this Agreement, the Director or his designee may immediately terminale Permittee's Use. 6. INDEMNIFICATION: Permittee shall defend, indemnify and hold the City, its ollicers, officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or suits, including all legal costs and attorney Cees, arising out of or in connection with Permittee's Use or the Properties pursuant to this A€reenient, except for that portion' ot'the injuries and damages caused by the('it}''s sole negligence. IT IS FURTHER SPF,CIFlCAi.I.Y AND EXPRESSLY INDERSFOOD THAI. THE INI)EMN1FlCAIION PROVIDED HEREIN CONSI'l1'UTES PERMITTE1?'S WAIVFR OF IMMUNITY l.JNI)FIt INDUS IRIAL INSURANCE, TITLE 51 RCW, SOLI{EY FOR TILE PURPOSI':S OF THIS INDEMNIFICATION. I'IIE PARTIES FURTHER ACKNUW'LEDG1'. TI IAT THEY 1I.AVE MU WALLY Nl?(iOTIATGi) 'I ITIS WAIVER. The provisions of this section shall survive the expiration or termination of this A^rccmc:nt. 7. INSURANCE: I'ennitlee shall procure and maintain for the duration of its Use insurance against claims lir injuries to persons or damage to property arising from or in connection with the iJse by Permittee, its agents,representatives, employees or subcontraci.ors. Ti► the extent Permittee wishes to eNclude actors from all required insurance coverage for subcontractors under this Agreement Permittee must provide the City with«aivers signed by the actors that explicitly cover the City within the waivers. Prior to the date of Use, Permittee shall provide to the City a Certificate of lri_.ut..+rce evidencing; (a) Automobile Liability insurance with limits no less than $1.000,000 combined t;inOe limit per accident for bodily injury and property damage; and (Ill Commercial Liability insurance written it an occurrence basis with limits no less than S1,000.000 combined single limit per occurrence and $1.000.000 aggregate int personal injury. bodily injury and property damage. ('overage shall include but not be limited to: blanket contractual; productsicotnplcctcd operations.'broad form 3 -RUC KI k T!!/: TRUCKER/:'R LLC Ivy(;rent Cemetery & Lions Park L! e Agreemertl property damage; explosion, collapse and underground (XCU) if applicable: and employer's liability. (c) Drone Insurance will be required and is subject to approval by City. The above insurance limits do not affect Pennittee's duty to indemnify the City in the event the limits are insufficient to cover any injury or damage that may occur in connection with the Use of the Properties. Any payment of deductible or self-insured retention shall be the sole responsibility of Permittee. '1 he City shall be named a> an additional insured mi the insurance policy-, with respect to f'crmiltee s Use of the Properties, and a copy of the endorsement naming the City as additional insured shall be attached to the Certificate of I nsurance. l'ennittce`s insurance shall contain a clause stating that coverage shall apply separately to each insured against whom claim is made or suit is brought, except with respects to the limits of the insurer's liability. Permittees insurance shall be primary and non-contributory insurance as respects the City and shall contain a waiver of subrogation against the City for claims arising out of any operations. liabilities and obligations to which coverne applies. 8. NIIISCFIJLANEOU S PROVISIONS: the following provisions apply to this Agreement: (a) Governing law and Venue. This Agreement shall be construed and interpreted pursuant to Washington law and any controversy or interpretation hereof shall be by the state courts of Washington with venue in Kitsap County, Washington. thlliindin This Agreement ment shall he binding upon and inure to the Binding I;ffcct. benefit of the parties hereto and their respective successors and assigns. (c) Entire Agreement. •I his Agreement represents the entire agreement between the parties with respect to the subject matter hereof. All prior negotiations, agreements, representations,or warranties shall be of no further force or effect and are superseded by this Agreement. (d) Severahility. In the event that one or more provisions of this Agreement arc determined to be invalid by a court of competent jurisdiction, the remainder of the Agreement shall remain in gull force and effect. IN Wit NESS WI IEREOF the parties hereto have caused this Agreement to be executed as of the day and year signed below/. 4 —R!.KER Tlii PRUCATR I.LC Ivy Green Cemetery et Lions Parkf;ce Agreement CITY OF BREMERTON RLJCKF Till, TRUCKER LL(• BY: LAss'm. ko\tt BY: Mayer DATF; bo t2c)1c1 DATE; Approved tI5 to 1.0t111: '40-(4 14Z1 • Attor 5—RUCKER THE TRUCKER LLE Ivy Green Cemetery& Lims Park (i.se Agreement DATE(MM/DD/YYYY) ACRD CERTIFICATE OF LIABILITY INSURANCE ‘........ 08/30/2019 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 rights to the certificate holder in lieu of such endorsement(s). CONTPRODUCER NAME: Deborah West Movielnsure.com Insurance Services (A/c No.Ext): 888-959-0772 ext 301 FAX (A/C. (818)293-1702 9036 Reseda Blvd#105 E-MAIL Northridge, CA 91324 ADDRESS: debbiet movieinsure.com INSURER(S)AFFORDING COVERAGE NAIC# Phone No.(888)959-0772 Fax No.(818)293-1702 INSURER A: EFM-Empire Fire and Marine Insurance Company 21326 INSURED INSURER B: NAS-North American Specialty Insurance Company 29874 Rucker The Trucker, LLC 500 North National Avenue, Unit 10 INSURER C: Bremerton, WA 98312 .3 . 1 I INSURER D: 014,v) "1 0 A , INSURER E: Phone No.310-869-5278 Fax No. , 0 INSURER F: COVERAGES CERTIFICATE NUMBER:831777 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. INSRLTYPE OF INSURANCE ANSA SUBRDPOLICY NUMBER POLICY EFF POLICY EXP LIMITS (MM/DD/YYYY) (MM/DD/YYYY) EFM X COMMERCIAL GENERAL LIABILITY EN6729190-00 08/28/2019 09/17/2019 EACH OCCURRENCE $ 1 000,000 DAMAGE CLAIMS-MADE X OCCUR X X PREM SESO(Ea occurrence) $ 100 000 MED EXP(Any one person) $ 5 000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PES LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ EFM AUTOMOBILE LIABILITY EN6729190-00 08/28/2019 09/17/2019 EO acccident)INGLE LIMIT $ 1 000,000 ANY AUTO X BODILY INJURY(Per person) $ Included OWNED SCHEDULED BODILY INJURY(Per accident) $ Included AUTOS ONLY AUTOS NAS X AUTOS ONLY X ATOS ONLY EKN 1005492-00 08/28/2019 09/17/2019 pednDAMAG er Auto $( r accident) Ma Aggregate 12000 5,000 X AUTO PHYSICAL DAMAGE $ UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ NAS Inland Marine EKN1005492-00 08/28/2019 09/17/2019 See Attached DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES Coverage Location: United States&Canada Certificate Holder is named as an Additional Insured and Loss Payee as their interests may appear. Production Rucker All coverages expire at 12:01 a.m.Standard Time. CERTIFICATE HOLDER CANCELLATION City of Bremerton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ATTN: Stephanie Olson & Director, Jeff Elevado THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 345 Sixth Street, Suite 100 ACCORDANCE WITH THE POLICY PROVISIONS. Bremerton, WA 98337 United States Of America AUTHORIZED REPRESENTATIVE o• Phone No. 1 Fax No. ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD This certificate of insurance does not affirmatively or negatively amend,extend,or alter the coverage afforded by the insurance policy. DATE(MM/DD/YY) � ADDITIONAL COVERAGE DETAILS 08/30/2019 INSURED Rucker The Trucker, LLC The following is attached to and made part of certificate number 831777. Policy Details Coverage Limit Deductible Inland Marine Company: North American Specialty Insurance Company Policy Number: EKN1005492-00 *Period: 08/28/2019-09/17/2019:20 Day(s) Rented Equipment 100,000 1,500 Owned Equipment Excluded Rented Props,Sets,Wardrobe Excluded Rented Furs,Jewelry,Art&Antiques Coverage Excluded Negative Film,Videotape and Digitalized Image Excluded Faulty Stock,Camera&Processing Excluded Faulty Stock,Camera&Processing-Broad Form Excluded Extra Expense Excluded Third Party Property Damage 250,000 1,500 Office Contents Excluded Cast Coverage Cast Extra Expense Excluded Cast Covered Person Extension(no sickness) Excluded Cast Covered Person Extension Aggregate(sickness) Excluded Cast Covered Person Extension Per Person(sickness) Excluded Cast Family Bereavement Extension Excluded Animal Death, Illness, Injury Excluded Animal Extra Expense Excluded Hired/Non-Owned Physical Damage-Aggregate 500,000 Hired/Non-Owned Physical Damage-Per Vehicle 125,000 10%of loss,$1,500 minimum, $7,500 maximum Rental Cost Reimbursement Excluded Civil Authority Excluded Agency And Talent Re-Shoot Costs Excluded Strikes or Civil Protest Excluded Waiver of Subrogation Excluded Coverage Extension Endorsement Coverage Extension Endorsement Excluded Entertainment Enhancement Endorsement Entertainment Enhancement Endorsement Excluded Terrorism Included *All coverages expire at 12:01 a.m.Standard Time. Coverage is not afforded for stunts&pyrotechnics except for those declared,scheduled and accepted by the insurance company(s). For a complete listing of coverages,terms,conditions and exclusions,please view your policy. APM-CERT-DETAILS 1205 Certificate Number 831777 DATE(MM/DD/YY) SCHEDULE OF FORMS 08/30/2019 Insured: Rucker The Trucker,LLC This Schedule of Forms is attached to and made part of certificate number 831777,as of 08/30/2019 at 04:57 PM PT, and lists the forms included in the policy(s) and subsequent endorsement(s)at the time this certificate was issued. Form# Ed. Name Inland Marine Policy Inland Marine Notices SP5369 0514 SwissRe Front Jacket NAS-GLB-NOTICE 0901 Privacy Notice and Disclosure Forms NAS-ABIM-DEC 0808 Commercial Inland Marine Declarations NAS-ABF-SCH 0608 Schedule of Forms NAS-NI-SCH 0101 Named Insured Schedule NAS-LS-EXT 0101 Location Schedule NAS-AB-008 0909 Schedule of Productions NAS-AB-CPCA 0808 Common Conditions,Definitions and Exclusions NAS-ABME-POL 0608 Miscellaneous Equipment Coverage Form NAS-ABTPD-POL 0608 Third Party Property Damage Coverage Form NAS-ABVPD-POL 0212 Vehicle Physical Damage Coverage Form NAS-AB-745 0909 Vehicle Physical Damage Limit&Rate Schedule NAS-AB-003 0608 Minimum Premium Endorsement NAS-AB-725 0608 Loss Payable form NAS-AB-748 0118 Aircraft Exclusion Amendatory Endorsement NAS-AB-006 0608 Unscheduled Production,Presentation or Event Exclusion NAS-AB-600 0608 Production Stunt,Pyrotechnic&Animal Exposure Exclusion NAS-AB-711 1109 Excluded Property Endorsement NAS-AB-733 0608 Unattended Vehicle Limitation Endorsement CL0103 0310 Amendatory Endorsement-Washington NAS-AB-740-WA 0808 Washington Changes CL0600 0115 Certified Terrorism Loss SP4161 B 0608 Exclusion of Other Than Certified Acts of Terrorism SP6069 0115 Disclosure pursuant to TRIA SP5694 1012 International Trade or Economic Sanctions SP3881 0307 Signature Page Entertainment Production Package Notices U-GU-319-F 0109 Important Notice-In Witness Clause U-GL-1197-A CW 0104 Asbestos Exclusion Endorsement U-GU-1191-ACW 0315 Sanctions Exclusion Endorsement U-GU-874-A 0611 Notice of Disclosure for Agent and Broker Compensation U-GU 789-B 1118 Kentucky-Local Government Taxes Appeal Process U-GU-741-M LA 0119 Louisiana Citizens Property Insurance Corporation 2005 Emergency Assessment Common EM3652 0108 Jacket-EF&M EM3601 0303 Common Declarations UGU619ACW 1002 Schedule of Forms and Endorsements IL0146 0810 Common Policy Conditions-Washington EM0860 0709 Definition of Productions and Budget Limitations EM0871WA 0709 Minimum Earned Premium Endorsement EM0877 0709 Scheduled Events,Presentations and Productions EM4811 0709 Unscheduled Events,Presentations and Productions Exclusions IL0003 0908 Calculation of Premium General Liability EM3602 0302 Commercial GL Coverage Declarations UGU619ACW 1002 Schedule of Forms and Endorsements CG0001 0413 Commercial General Liability Coverage Form IL0198 0908 Nuclear Energy Liability Exclusion Endorsement(Broad Form) CG2011 0413 Additional Insured-Managers of Lessors of Premises CG2012 0413 Additional Insured-State or Governmental Agency or Subdivision or Political Subdivision-Permits or Authorizations CG2026 0413 Additional Insured-Designated Person or Organization CG2028 0413 Additional Insured-Lessor of leased equipment U-GL-1171-A-CW 0703 Fungi Bacteria Exclusion U-GL-1178-A-CW 0703 Asbestos Exclusion U-GL-1199-A 0404 Asbestos Exclusion Endorsement CG2404 0509 Waiver of Transfer of Rights of Recovery Against Others to Us U-GL-1327-BCW 0413 Other Insurance Amendment-Primary And Non-Contributory CG2001 0413 Primary and Noncontributory-Other Insurance Condition EM4634 0704 Lead Exclusion EM4630 1106 Field of Entertainment Productions Exclusion CG2109 0615 Exclusion-Unmanned Aircraft EM4633 1106 Removal of Coverage for Premises in the Short Term Control of the Insured CG0197 1207 Washington-Employment Related Practices Exclusion EM4650 0905 Commercial General Liability Changes APA-CERT-FORMLIST 0914 Certificate Number.831777 Page 1 of 2 DATE(MM/DD/YY) SCHEDULE OF FORMS 08/30/2019 Insured: Rucker The Trucker,LLC This Schedule of Forms is attached to and made part of certificate number 831777,as of 08/30/2019 at 04:57 PM PT,and lists the forms included in the policy(s) and subsequent endorsement(s)at the time this certificate was issued. Form# Ed. Name CG2106 0514 Exclusion-Access or Disclosure of Confidential or Personal Information and Data-Related Liability-Wth Limited Bodily Injury Exception EM0858 0709 Undeclared Productions Exclusion Endorsement EM0859 0311 Definition of Employee CG0181 0508 Washington Changes IL0123 1113 Washington Changes-Defense Costs U-GL-1517-ACW 0112 Collection or Distribution of Material or Information in Violation of Law Exclusion U-GU-630-DCW 0115 Disclosure of Important Information Relating to Terrorism Risk Insurance Act U-GU-767-BCW 0115 Cap on Losses From Certified Acts of Terrorism Automobile EM3603 0310 Business Auto Declarations Page UGU619ACW 1002 Schedule of Forms and Endorsements CA0001 0310 Business Auto Coverage Form CA2048 1013 Designated Insured IL0198 0908 Nuclear Energy Liability Exclusion Endorsement(Broad Form) EM4755 0905 Business Auto Changes EM0858 0709 Undeclared Productions Exclusion Endorsement EM0859 0311 Definition of Employee CA0135 0108 Washington Changes EM4747 0705 Unattended Vehicle Exclusion IL0123 1113 Washington Changes-Defense Costs U-CA-531-B 0208 Notice Regarding Terrorism Premium(for Commercial Automobile Ins) Disclaimers This Certificate of Liability Insurance includes the Type of Insurance,Limits,and Schedule of Forms in effect as of 08/30/2019 at 04:57 PM PT.It does not affirmatively or negatively amend,extend,or alter the coverage afforded by the insurance policy nor confer any rights upon the certificate holder.You may be required to request an updated certificate in the event of subsequent policy modifications. The information included in this certificate that has been provided by Abacus Insurance Brokers,is for your information only,and does not create a contract or agency relationship between the certificate holder or any insured and Abacus Insurance Brokers.By accepting this certificate the certificate holder acknowledges that Abacus Insurance Brokers is not the agent of the certificate holder or any insured,but is solely the agent of the listed carrier(s).Abacus Insurance Brokers makes no representation whether the coverages listed herein are appropriate for the certificate holder or any insured.Please review the listed coverages carefully and direct any questions to your broker.For a complete listing of coverages,terms,conditions and exclusions,please view the referenced Policy(s). APA-CERT-FORMLIST 0914 Certificate Number.831777 Page 2 of 2 Date(MM/DDA'YYY) Certificate Verification 08/30/2019 Insured: Rucker The Trucker, LLC Abacus provides an efficient website lookup tool for certificate holders to verify the authenticity of certificates of insurance. 1. Navigate to the website and input the verification code OR Scan the QR code. 2. The actual certificate issued through the Abacus Platform will download. 3. Compare the details of the downloaded certificate to the certificate presented by the client. Website Verification Code www.abacus.net/verify-certificate ONO3H2T4SX I' ? " ❑' 4 -re - �4 About Certificates Issued through the Abacus.net Platform • Abacus requires that all certificates be issued through the Abacus Platform. Certificates issued outside of the Abacus Platform are invalid. • Certificates may be issued through the Abacus Platform by either the named insured(if registered through the Abacus Platform)or their Abacus registered insurance broker. • Certificates with any stray marks,cross outs or alterations of any sort are invalid. • Each certificate is numbered and correlates to the document issued through the Abacus Platform. APA-CERTVER 0917 Certificate Number:831777 Page 1 of 1 POLICY NUMBER: EN6729190-00 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ADDITIONAL INSURED - DESIGNATED PERSON or ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: City of Bremerton (If no entry appears above,information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED(Section II)is amended to include as an Insured the person or organization shown in the Schedule,but only with respect to liability arising out of you operations or premises owned by or rented to you. City of Bremerton 345 Sixth Street, Suite 100 Bremerton, WA 98337 CG 20 26 11 85 Copyright, Insurance Service Office, Inc., 1984 Policy Number: EN6729190-00 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART City of Bremerton 345 Sixth Street, Suite 100 Bremerton, WA 98337 The following is added to the Other Insurance Condition and supersedes any provision to the (2) You have agreed in writing in a contract or contrary: agreement that this insurance would be primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the This insurance is primary to and will not seek additional insured. contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and c CG 20 01 04 13 O Insurance Services Office, Inc. 2012 Page 1 of 1 POLICY NUMBER EN6729190-00 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: City of Bremerton Information required to complete this Schedule, if not shown above,will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 ©Insurance Services Office, Inc., 2008 Page 1 of 1 0