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Home My WebLink About6657 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 GOODS AND SERVICES AGREEMENT CIMCO-GC SYSTEMS CONTROL VALVE REBUILD SERVICES THIS AGREEMENT, is entered into between the City of Bremerton, a Washington Municipal Corporation("City"), and Cimco-GC Systems, Inc. ("Vendor"), whose mailing address is: PO Box 848, Sumner, WA 98390. The parties agree as follows: I. VENDOR SERVICES. The Vendor shall provide the following goods and materials and/or perform the following services for the City: As proposed in Exhibit A, the vendor shall perform rebuilds of the listed control valves consisting of a full disassemble and cleaning of the main valve and pilot controls, replacement of all rubber parts, reassembly, operation testing, and putting the valve back in service while on-site. Any metal or plastic parts in the valves or pilot controls requiring replacement (seat, stem, bearings/guides, ball valves, strainers, tubing or fittings, etc.) will be billed over and above the proposed price. II. TIME OF COMPLETION. Vendor shall complete the work and provide all goods, materials and services within 60 calendar days from the date all parties have signed this Agreement. III. COMPENSATION. The City shall pay the Vendor the amount of $55,859.07 (tax included) for the combined 2024 and 2025 years rebuild as proposed and up to an additional $24,140.93 for any replacement parts required for a total not to exceed amount of $80,000.00, including applicable Washington State Sales Tax, for the goods, materials and services contemplated in this Agreement. Payment will be made upon completion and acceptance of work. Net 30 days of invoice receipt. A. Defective or Unauthorized Work. The City reserves its right to withhold payment from Vendor for any defective or unauthorized goods,materials or services. If Vendor is unable, for any reason, to complete any part of this Agreement, the City may obtain the goods, materials or services on its own or from a third party,and Vendor shall be liable to the City for any additional costs incurred by the City. "Additional costs" shall mean all reasonable costs,including legal costs and attorney fees, incurred by the City beyond the maximum Agreement price specified above. The City further reserves its right to deduct the cost to complete this Agreement, including any Additional Costs, from any and all amounts due or to become due the Vendor. IV. INDEPENDENT CONTRACTOR. Vendor is and shall be at all times acting as an independent contractor and not as an employee of the City. The Vendor shall secure at its expense, and shall be responsible for all payments of income tax, social security, state disability insurance compensation, unemployment compensation, and all other payroll deductions for the Vendor, officer, agents, employees and subcontractors. The Vendor shall also secure all applicable business licenses, if required, in connection with the contract services, including all required licenses for Vendor's officers, agents, employees and subcontractors. V. TERMINATION. The City may terminate this Agreement for good cause. "Good cause" Page 1 of 14 Goods and Services Agreement Rev.09/2021 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 A. The Vendor's refusal or failure to supply a sufficient number of properly skilled workers or proper materials for completion of this Agreement. B. The Vendor's failure to complete this Agreement within the time specified in this Agreement. C. The Vendor's failure to make full and prompt payment to subcontractors or for material or labor. D. The Vendor's failure to comply with federal, state or local laws,rules or regulations. E. The Vendor's filing for bankruptcy or becoming adjudged bankrupt. If the City terminates this Agreement for good cause, the Vendor shall not receive any further monies due under this Agreement until the goods, materials, and services required by this Agreement are completed and fully performed by the City or a third party of the City's choosing. VI. CHANGES. The City may issue a written change order for any change in the goods, materials or services to be provided during the performance of this Agreement. If the Vendor determines, for any reason,that a change order is necessary,Vendor must submit a written change order request to an authorized agent of the City within fourteen (14) calendar days of the date Vendor knew or should have known of the facts and events giving rise to the requested change. If the City determines that the change increases or decreases the Vendor's costs or time for performance, the City will make an equitable adjustment. The City will attempt, in good faith, to reach agreement with the Vendor on all equitable adjustments. However, if the parties are unable to agree, the City will determine the equitable adjustment as it deems appropriate. The Vendor shall proceed with the change order work upon receiving either a written change order from the City or an oral order from the City before actually receiving the written change order. If the Vendor fails to require a change order within the time allowed, the Vendor waives its right to make any claim or submit subsequent change order requests for that portion of the contract work. If the Vendor disagrees with the equitable adjustment the Vendor must complete the change order work; however, the Vendor may elect to protest the adjustment as provided below: A. Procedure and Protest by the Vendor. If the Vendor disagrees with anything required by a change order, another written order, or an oral order from the City, including any direction, instruction, interpretation, or determination by the City, the Vendor shall: 1. Immediately give a signed written notice of protest to the City; 2. Supplement the written protest within fourteen (14) calendar days with a written statement that provides the following information: a. The date of the Vendor's protest. b. The nature and circumstances that caused the protest. c. The provisions in this Agreement that support the protest. d. The estimated dollar cost, if any, of the protested work and how that Page 2 of 14 Goods and Services Agreement Rev. 09/2021 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 estimate was determined. e. An analysis of the progress schedule showing the schedule change or disruption if the Vendor is asserting a schedule change or disruption. 3. The Vendor shall keep complete records of extra costs and time incurred as a result of the protested work. The City shall have access to any of the Vendor's records needed for evaluating the protest. The City will evaluate all protests, provided the procedures in this section are followed. If the City determines that a protest is valid, the City will adjust payment for work or time by an equitable adjustment. No adjustment will be made for an invalid protest. B. Vendor's Duty to Complete Protested Work. In spite of any protest, the Vendor shall proceed promptly to provide the goods,materials and services required by the City under this Agreement. C. Vendor's Acceptance of Changes. The Vendor accepts all requirements of a change order by: (1) endorsing it, (2) writing a separate acceptance, or (3) not protesting in the way this section provides. A change order that is accepted by Vendor as provided in this section shall constitute full payment and final settlement of all claims for contract time and for direct, indirect and consequential costs, including costs of delays related to any work, either covered or affected by the change. D. Failure to Protest Constitutes Waiver. By not protesting as this section provides, the Vendor also waives any additional entitlement and accepts from the City any written or oral order(including directions, instructions, interpretations, and determination). E. Failure to Follow Procedures Constitutes Waiver. By failing to follow the procedures of this section, the Vendor completely waives any claims for protested work and accepts from the City any written or oral order (including directions, instructions, interpretations, and determination). VII. CLAIMS. The Vendor shall give written notice to the City of all claims other than change orders within fourteen(14) calendar days of the occurrence of the events giving rise to the claims. Any claim for damages, additional payment for any reason, or extension of time, whether under this Agreement or otherwise, shall be conclusively deemed to have been waived by the Vendor unless a timely written claim is made in strict accordance with the applicable provisions of this Agreement; or, if(and only if) no such provision is applicable, unless that claim is set forth in detail in writing and received by the City within seven (7) calendar days from the date Vendor knew, or should have known, of the facts giving rise to the claim. At a minimum, a Vendor's written claim must include the information set forth regarding protests in Section VI(A)(2)(a)-(e). FAILURE TO PROVIDE A COMPLETE, WRITTEN NOTIFICATION OF CLAIM WITHIN THE TIME ALLOWED SHALL BE AN ABSOLUTE WAIVER OF ANY CLAIMS ARISING IN ANY WAY FROM THE FACTS OR EVENTS SURROUNDING THAT CLAIM OR CAUSED BY THAT DELAY. Page 3 of 14 Goods and Services Agreement Rev. 09/2021 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 Vendor must, in any event, file any claim or bring any suit arising from or connected with this Agreement within 120 calendar days from the date the contract work is complete. VIII. WARRANTY. The Vendor shall correct all defects in workmanship and materials within one year from the date of the City's acceptance of the contract work. When defects are corrected, the warranty for that portion of the work shall extend for one year from the date such correction is completed and accepted by the City. The Vendor shall begin to correct any defects within seven (7) calendar days of its receipt of notice from the City of the defect. If the Vendor does not accomplish the corrections within a reasonable time, the City may complete the corrections and the Vendor shall pay all costs incurred by the City in order to accomplish the correction. IX. INDEMNIFICATION. Vendor shall defend, indemnify and hold the City, its officers, officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or suits, including all legal costs and attorney fees, arising out of or in connection with the performance of this Agreement. Vendor's obligation to indemnify shall not extend to that portion of damages caused by the City's sole negligence. The City's inspection or acceptance of any of Vendor's work when completed shall not be grounds to avoid any of these covenants of indemnification. Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the Vendor and the City,its officers,officials, employees, agents and volunteers,the Vendor's liability hereunder shall be only to the extent of the Vendor's negligence. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THIS INDEMNIFICATION CONSTITUTES THE VENDOR'S WAIVER OF IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER. The provisions of this section shall survive the expiration or termination of this Agreement. X. INSURANCE. The Vendor shall procure and maintain for the duration of this Agreement, insurance against claims for injuries to persons or damage to property that may arise from or in connection with the performance of the contract work by the Vendor, its agents, representatives, employees or subcontractors. Before beginning work on the project described in this Agreement, the Vendor shall provide a Certificate of Insurance evidencing: A. Automobile Liability insurance with limits no less than $1,000,000 combined single limit per accident for bodily injury and property damage; and Page 4 of 14 Goods and Services Agreement Rev. 09/2021 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 B. Commercial General Liability insurance written on an occurrence basis with limits no less than$1,000,000 combined single limit per occurrence and $2,000,000 aggregate for personal injury, bodily injury and property damage. Coverage shall include but not be limited to: blanket contractual; products/completed operations/broad form property damage; and employer's liability. C. Excess Liability insurance with limits not less than $1,000,000 limit per occurrence and aggregate. D. Workers Compensation insurance as statutorily required by the Industrial Insurance Act of the State of Washington, Title 51, Revised Code of Washington and employer's liability with limits not less than $1,000,000. Any payment of deductible or self-insured retention shall be the sole responsibility of the Vendor. All required policies shall be provided on an "occurrence" basis except professional liability insurance (if required), which shall be provided on a"claims-made" basis. The City shall be named as an additional insured on the Commercial General Liability insurance policy, as respects work performed by or on behalf of the Vendor and a copy of the endorsement naming the City as additional insured shall be attached to the Certificate of Insurance. The City reserves the right to receive a certified copy of all the required insurance policies. The Vendor's Commercial General Liability insurance shall contain a clause stating that coverage shall apply separately to each insured against whom claim is made or suit is brought, except with respects to the limits of the insurer's liability. The Vendor's insurance shall be primary 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 coverage applies. It shall be an affirmative obligation upon Vendor to advise the City's Risk Manager by fax at(360)473-5161,or by certified mail, return receipt requested to City of Bremerton, Attn: Risk Management, 345 6th Street, Suite 100, Bremerton,WA 98337 within two days of the cancellation, suspension or substantive change of any insurance policy required herein, and failure to do so shall be construed to be a breach of this Agreement. The City also reserves its unqualified right to require at any time and for any reason, proof of coverage in the form of a duplicate of the insurance policy with all endorsements as evidence of coverage. XI. MISCELLANEOUS. A. Licenses and Taxes. Vendor shall possess a current Bremerton Business License and any regulatory license required to fulfill Vendor's obligations under this Agreement. B&O taxes shall be paid when due, and Vendor, by this Agreement, assigns any payments due under Page 5of14 Goods and Services Agreement Rev.09/2021 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 this Agreement to the City Clerk for payment of such taxes which have been declared delinquent. B. Conflict and Precedence. In the event of a conflict between the contract documents, the document which rates higher on the following list shall take precedence: 1. Amendments/Change Orders to Goods and Services Agreement 2. Goods and Services Agreement 3. Specifications 4. Terms and Conditions 5. Vendor's Proposal C. Documents Incorporated by Reference. The following documents are incorporated by reference, including but not limited to: 1. Terms and Conditions, 2. Specifications, 3. Proposal, and 4. Non-Collusion Affidavit. D. Use of Photographs and Images. Vendor shall not use or distribute photographs or images depicting City officials, personnel,property, or equipment whether prepared by Vendor or provided by City without prior written consent of the City. The City will not unreasonably withhold its consent. E. Equal Employment Opportunity Statement. In the hiring of employees for the performance of work under this Agreement, the Vendor, its subcontractors, or any person acting on behalf of Vendor shall not discriminate in any employment practice on the basis of age (40+), sex, race, creed, color, national origin, sexual orientation/gender identity, marital status, military status, or the presence of any physical, mental or sensory disability. F. ADA Statement. The City of Bremerton does not discriminate on the basis of disability in programs and activities, which it operates pursuant to the requirements of the Americans with Disabilities Act of 1990, and ADA Amendments Act. This policy extends to both employment and admission to participation in the programs, services and activities of the City of Bremerton. Reasonable accommodation for employees or applicants for employment will be provided. G. Compliance with Laws. Vendor shall comply with all federal, state and local laws, rules and regulations throughout every aspect in the performance of this Agreement. H. Prevailing Wages. Vendor shall file a "Statement of Intent to Pay Prevailing Wages"with the State of Washington Depai l.ilient of Labor& Industries prior to commencing the contract work. Vendor shall pay prevailing wages and comply with Chapter 39.12 of the Revised Code of Washington, as well as any other applicable prevailing wage rate provisions. The latest prevailing wage rate revision issued by the Department of Labor and Industries is attached. I. Work Performed at Vendor's Risk. Vendor shall take all precautions necessary and shall be responsible for the safety of its employees, agents, and subcontractors in the performance Page 6 of 14 Goods and Services Agreement Rev.09/2021 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 shall be responsible for the safety of its employees, agents, and subcontractors in the performance of this Agreement. All work shall be done at Vendor's own risk, and Vendor shall be responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with the work. J. Governing Law. This Agreement shall be governed and construed in accordance with the laws of the State of Washington. If any dispute arises between the City and Vendor under any of the provisions of this Agreement, resolution of that dispute shall be available exclusively under the jurisdiction, venue and rules of the Kitsap County Superior Court, Kitsap County, Washington. K. Attorney's Fees. In any claim or lawsuit for damages arising from the parties' performance of this Agreement, each party shall be responsible for payment of its own legal costs and attorney's fees incurred in defending or bringing such claim or lawsuit; however, nothing in this subsection shall limit the City's right to indemnification under Section IX of this Agreement. L. Written Notice. All communications regarding this Agreement shall be sent to the parties at the addresses listed below, unless otherwise notified. Any written notice shall become effective upon delivery, but in any event three (3) calendar days after the date of mailing by registered or certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this Agreement. Notices to be sent to: Notices to be sent to: CITY: VENDOR: Attn: Larry Erickson Attn: Beau Swet City of Bremerton Cimco-GC Systems 100 Oyster Bay Ave N P.O. Box 848 Bremerton, WA 98312 Sumner, WA 98390 M. Assignment. Any assignment of this Agreement by the Vendor without the written consent of the City shall be void. N. Modification. No waiver, alteration, or modification of any of the provisions of this Agreement shall be binding unless in writing and signed by a duly authorized representative of the City and Vendor. O. Severability. If any one or more sections, subsections, or sentences of this Agreement are held to be unconstitutional or invalid, that decision shall not affect the validity of the remaining portion of this Agreement and the remainder shall remain in full force and effect. P. Entire Agreement. The written provisions and terms of this Agreement, together with any attached Exhibits, supersede all prior verbal statements by any representative of the City, and those statements shall not be construed as forming a part of or altering in any manner this Agreement. This Agreement and any attached Exhibits contain the entire Agreement between the Page 7 of 14 Goods and Services Agreement Rev. 09/2021 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 contained in this Agreement, the terms of this Agreement shall prevail. IN WITNESS WHEREOF, the parties below have executed this Agreement. CITY: VENDOR: City of Bremerton Cimco-GC Systems c-DocuSigned by: �DocuSigned'b/y: azebn,U 2K,Att S.W By: 9 BY: `-33169905631D E0... -BAF4 5E8E74 Print Name: Greg wheeler Print Name: Beau Swet Its: Mayo3/13/2024 Its: Service Date: Date: APPROVED AS TO FORM: ATTEST: Doc_ �.acu/Signed by: ,-DocuSigned by: B - G� t la By: gi New% J . -2 4 4�. .. KYLIE J. F ,,62 Bremerton City Attorney ANGELA4 d(5 k, City Clerk R:1Legal\Legal\Forrns\FORMS ON COBWEB\Goods and Services Agreement Rev 09 2021.docx Page 8 of 14 Goods and Services Agreement Rev. 09/2021 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 Exhibit A r cimco-GC SYSTEMS 2310 INTER AVE PUYALLUP,WA 98372 800-525-9425 February 1, 2024 City of Bremerton 100 Oyster Bay Ave. Bremerton, WA 98312 Attn: Mr. Larry Erickson Re: Proposal for 2024 Cla-Val Maintenance Rebuild Dear Mr. Erickson: According to our records you have twelve total Cla-Val control valves due for a rebuild this year. The cost for this work will be $26,913.43 per the attached list and includes listed parts and any prevailing wage filing and requirements and sales tax. The rebuild consists of a full disassemble and cleaning of the main valve and pilot controls, the replacement of all rubber parts, the assembly, testing operation and putting the valve back in service while on-site. If any metal or plastic parts in the valves or pilot controls require replacement (seat, stem, bearings/guides, ball valves, strainers, tubing or fittings etc.) other that what is already included in this quote, they will be billed over and above this quoted price. If required, the city shall supply all equipment, additional personnel, and complete any documentation required to meet OSHA regulations for confined space entry as well as supplying any traffic revisions which may be necessary for work in public rights-of-way. Let me know if you have any questions or if there are changes to be made. Regards, Beau Valet Service Manager Cimco-GC Systems, LLC Page 9 of 14 Goods and Services Agreement Rev.09/2021 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 ai mco- ��L SYSTEMS 2310 INTER AVE PUYALLUP,WA 98372 800-525-9425 A February 8, 2024 City of Bremerton 100 Oyster Bay Ave. Bremerton, WA 98312 Attn: Mr. Larry Erickson Re: Proposal for 2025 Cla-Val Maintenance Rebuild Dear Mr. Erickson: According to our records you have ten total Cla-Val control valves due for a rebuild in 2025. The cost for this work will be $28,945.64 per the attached list and includes listed parts on valve sheet, any prevailing wage filing and requirements and sales tax. The rebuild consists of a full disassemble and cleaning of the main valve and pilot controls, the replacement of all rubber parts, the assembly, testing operation and putting the valve back in service while on-site. If any metal or plastic parts in the valves or pilot controls require replacement (seat, stem, bearings/guides, ball valves, strainers, tubing or fittings etc.) other that what is already included in this quote, they will be billed over and above this quoted price. If required, the city shall supply all equipment, additional personnel, and complete any documentation required to meet OSHA regulations for confined space entry as well as supplying any traffic revisions which may be necessary for work in public rights-of-way. Let me know if you have any questions or if there are changes to be made. Regards, Beau &vet Service Manager Cimco-GC Systems, LLC Page 10 of 14 Goods and Services Agreement Rev. 09/2021 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 BREMERTON 2024 VALVE REBUILD RESERVOIR 11 CV72 1 — 12" 210G-16AB CDS6A Needs new diaphragm washer and disc retainer— Included in quote IMPERIAL WAY— BREMERTON INDUSTRIAL PARK CV35 1 — 3" 90G-01 AS 1 — 8" 90G-01 BY 1" BYPASS 100 OYSTER BAY AVE CV63 1 —4" 50G-01B PUMP STATION 8 CV66 1 — 8" 93EG-01 BY 1 —4" 52G-03B CV52 WERNER ROAD & UPS CV11 1 — 2" 90G-01 BCSVY 1 —6" 90G-01 BCSVY WERNER ROAD & CHURCH CV9 1 — 2" 90G-01 BCSVY 1 —6" 90G-01 BCSVY Page 9 of 12 Goods and Services Agreement Rev. 09/2021 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 UNION & POINDEXTER CV10 1 -2" 90G-01 BCSVY 1 -6" 90G-01 BCSVY Page 10 of 12 Goods and Services Agreement Rev.09/2021 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 BREMERTON 2025 VALVE REBUILD RESERVOIR 16 CV71 1 - 12" 210G-42BY CDS4 W/X105L2W NEW CDS6A PILOT 500 UNION AVE & WERNER ROAD (WSP) CV39 1 - 2" 90G-01 BCSVY 1 - 6" 90G-01 BCSVY WELL 18 CV68 1 - 2'/z" 61G-02 W/X105L2W CSM11 1720 WARREN AVE CV57 16" 131 G-02BCEMSYKCKX KX=LATCH SOLENOID, W/X117E, W/X144 120/60 AC 2476 SNYDER AVE CV58 16" 631 G-02BCEMSYKCKX KX=LATCH SOLENOID, W/X117E, W/X144 120/60 AC MANETTE BRIDGE CV56 8" 131 G-02BCEMSYKCKX KX=LATCH SOLENOID, W/X117E, W/X144D„ 120V. Page 13 of 14 Goods and Services Agreement Rev.09/2021 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 PAGE 2 WELL 19 CV69 1 - 3" 61G-02 W/X105L2W CSM11 CV69 1 -4" 81 G-02V CV64 1 - 8" 131-AMBCSY Page 14 of 14 Goods and Services Agreement Rev. 09/2021 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 GCSYSTEM2 ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/D D/YWY) 6/01/2023 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 T CONACT NAME: Teresa Swi berg Propel Insurance I PHONE(A/C,No,Ext):800 499-0933 FAX(A/C,No): 866 577-1326 1201 Pacific Avenue; Suite 1000 E-MAIL teressa.swiber ro elinsurance.com ADDRESS: berg p COM Middle Market INSURER(S)AFFORDING COVERAGE NAIC# Tacoma,WA 98402-4321 INSURER,a:Cincinnati Insurance Company 10677 INSURED INSURER B Cimco-GC Systems LLC INSURER C PO Box 848 INSURER D Sumner,WA 98390-0150 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 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. LTRY EXP R TYPE OF INSURANCE INSRL WVD POLICY NUMBER (IVIIIVSUBR OI/DD/YYYY) (IVIIY EFF M/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY EPP0617445 06/01/2023 06/01/2024 EACH OCCURRENCE $1,000,000 CLAIMS-MADE XI OCCUR PREMISESO(Eaoccurence) $500,000 X PO Ded:500 MED EXP(Any one person) $10,000 PERSONAL 8 ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 RO POLICY P X JECT- LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY EBA0617445 06/01/2023 06/01/2024 (Ea aBcideD SINGLE LIMIT $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY (Per accident) A X UMBRELLA LIAB X OCCUR EPP0617445 06/01/2023 06/01/2024 EACH OCCURRENCE $2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $2,000,000 DED RETENTION$ $ WORKERS COMPENSATION EPP0617445 06/01/2023 06/01/2024 PER 1STATUTE EERH AND EMPLOYERS'LIABILITY /N A ANY PROPRIETOR/PARTNER/EXECUTIVE' WA STOP GAP E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Bremerton. Additional Insured Status applies per attached form(s). CERTIFICATE HOLDER CANCELLATION Cityof SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE BremertonTHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 345 6th Street, Suite 100 ACCORDANCE WITH THE POLICY PROVISIONS. Bremerton,WA 98337 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #55947241/M 5946956 C LJ O2 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 This page has been left blank intentionally. DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS' COMMERCIAL GENERAL LIABILITY BROADENED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Endorsement -Table of Contents: Coverage: Begins on Page: 1. Employee Benefit Liability Coverage 3 2. Unintentional Failure To Disclose Hazards 9 3. Damage To Premises Rented To You 9 4. Supplementary Payments 10 5. Medical Payments 10 6. 180 Day Coverage For Newly Formed Or Acquired Organizations 10 7. Waiver Of Subrogation 11 8. Automatic Additional Insured -Specified Relationships: 11 • Managers Or Lessors Of Premises; • Lessor Of Leased Equipment; • Vendors; • State Or Governmental Agency Or Subdivision Or Political Subdivision - Permits Or Authorizations Relating To Premises; and • Mortgagee,Assignee Or Receiver 9. Property Damage To Borrowed Equipment 14 10. Employees As Insureds - Specified Health Care Services And Good Samaritan Services 15 11. Broadened Notice Of Occurrence 15 12. Nonowned Aircraft 15 13. Bodily Injury Redefined 15 14. Expected Or Intended Injury Redefined 15 15. Former Employees As Insureds 15 16. Voluntary Property Damage Coverage And Care, Custody Or Control Liability Coverage 16 17. Broadened Contractual Liability-Work Within 50' Of Railroad Property 17 18. Alienated Premises 17 B. Limits Of Insurance: The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorse- ment, except as provided below: 1. Employee Benefit Liability Coverage Each Employee Limit: $1,000,000 Aggregate Limit: $3,000,000 Deductible Amount: $ 1,000 3. Damage To Premises Rented To You The lesser of: a. The Each Occurrence Limit shown in the Declarations; or b. $500,000 unless otherwise stated $ 4. Supplementary Payments a. Bail Bonds: $2,500 Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission. Page 1 of 17 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 b. Loss Of Earnings: $ 500 5. Medical Payments Medical Expense Limit: $ 10,000 9. Property Damage To Borrowed Equipment Each Occurrence Limit: $10,000 Deductible Amount: $ 250 16. Voluntary Property Damage Coverage (Coverage a.) And Care, Custody Or Control Liability Coverage (Coverage b.) Limits Of Insurance Coverage a. $1,000 Each Occurrence $5,000 Aggregate Coverage b. $5,000 Each Occurrence unless otherwise stated $ Deductible Amount(Each Occurrence) Coverage a. $250 Coverage b. $250 unless otherwise stated $ COVERAGE PREMIUM BASIS RATE ADVANCE PREMIUM (a) Area (For Limits in Excess of (For Limits in Excess of (b) Payroll $5,000) $5,000) (c) Gross Sales (d) Units (e) Other b. Care, Custody Or Control TOTAL ANNUAL PREMIUM $ Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission. Page 2 of 17 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 C. Coverages this endorsement pro- vided: 1. Employee Benefit Liability Coverage a. The followingis added to Section I - a) You did not have knowledge of a Coverages: claim or "suit" on or Employee Benefit Liability Cover- before the "first ef- age fective date" of this endorsement. (1) Insuring Agreement You will be (a) We will pay those sums that deemed to have the insured becomes legally knowledge of a obligated to pay as damag- claim or "suit" es caused by any act, error when any "author- or omission of the insured, ized representa- or of any other person for tive"; whose acts the insured is legally liable, to which this i) Reports all, or insurance applies. We will any part, of the have the right and duty to act, error or defend the insured against omission to us any "suit" seeking those or any other damages. However, we will insurer; have no duty to defend ii) Receives a against any "suit" seeking written or ver- damages to which this in- bal demand or surance does not apply. We claim for dam- may, at our discretion, in- ages because vestigate any report of an of the act, er- act, error or omission and ror or omis- settle any claim or "suit" that sion; and may result. But: 1) The amount we will payb) There is no other applicable insur- for damages is limited ance. as described in Section Ill - Limits Of Insur- (2) Exclusions ance; and This insurance does not apply to: 2) Our right and duty to defend ends when we (a) Bodily Injury, Property have used up the appli- Damage Or Personal And cable limit of insurance Advertising Injury in the payment of judg- "Bodily injury", "property ments or settlements. damage" or "personal and No other obligation or liabil- advertising injury". ity to pay sums or perform (b) Dishonest, Fraudulent, acts or services is covered Criminal Or Malicious Act unless explicitly provided for under Supplementary Damages arising out of any Payments. intentional, dishonest, (b) This insurance applies to fraudulent, criminal or mali- cious act, error or omission, damages only if the act, er- committed by any insured, ror or omission, is negligent- including the willful or reck- ly committed in the "admin- less violation of any statute. istration" of your "employee benefit program"; and (c) Failure To Perform A Con- 1) Occurs during the policy tract period; or Damages arising out of fail- ure Occurred prior to the of performance of con- 2) tract by any insurer. "first effective date" of Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission. Page 3 of 17 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 (d) Insufficiency Of Funds (i) Taxes, Fines Or Penalties Damages arising out of an Taxes, fines or penalties, in- insufficiency of funds to cluding those imposed un- meet any obligations under der the Internal Revenue any plan included in the Code or any similar state or "employee benefit program". local law. (e) Inadequacy Of Perfor- (j) Employment-Related Prac- mance Of Invest- tices ment/Advice Given With Respect To Participation Any liability arising out of any: Any claim based upon: (1) Refusal to employ; 1) Failure of any invest- ment to perform; (2) Termination of employ- ment; 2) Errors in providing in- formation on past per- (3) Coercion, demotion, formance of investment evaluation, reassign- vehicles; or ment, discipline, defa- mation, harassment, 3) Advice given to any humiliation, discrimina- person with respect to tion or other employ- that person's decision to ment - related practices, participate or not to par- acts or omissions; or ticipate in any plan in- cluded in the "employee (4) Consequential liability benefit program". as a result of (1), (2) or (3) above. (f) Workers' Compensation And Similar Laws This exclusion applies whether the insured may be Any claim arising out of your held liable as an employer failure to comply with the or in any other capacity and mandatory provisions of any to any obligation to share workers' compensation, un- damages with or repay employment compensation someone else who must pay insurance, social security or damages because of the in- disability benefits law or any jury. similar law. (3) Supplementary Payments (g) ERISA Section I - Coverages, Sup- Damages for which any in- plementary Payments - Cover- sured is liable because of li- ages A And B also apply to this ability imposed on a fiduci- Coverage. ary by the Employee Re- tirement Income Security b. Who Is An Insured Act of 1974, as now or As respects Employee Benefit Lia- hereafter amended, or by bility Coverage, Section II - Who Is any similar federal, state or An Insured is replaced by the follow- local laws. ing: (h) Available Benefits (1) If you are designated in the Dec- Any claim for benefits to the larations as: extent that such benefits are (a) An individual, you and your available, with reasonable spouse are insureds, but on- effort and cooperation of the ly with respect to the con- insured, from the applicable duct of a business of which funds accrued or other col- you are the sole owner. lectible insurance. (b) A partnership or joint ven- ture, you are an insured. Your members, your part- Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission. Page 4 of 17 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 ners, and their spouses are zation. However, coverage under also insureds but only with this provision: respect to the conduct of your business. (a) Is afforded only until the 180th day after you acquire (c) A limited liability company, or form the organization or you are an insured. Your the end of the policy period, members are also insureds, whichever is earlier; and but only with respect to the conduct of your business. (b) Does not apply to any act, Your managers are in- error or omission that was sureds, but only with respect committed before you ac- to their duties as your man- quired or formed the organi- agers. zation. (d) An organization other than a c. Limits Of Insurance partnership, joint venture or As respects Employee Benefit Lia- limited liability company, you bility Coverage, Section III - Limits are an insured. Your "execu- Of Insurance is replaced by the fol- tive officers" and directors lowing: are insureds, but only with respect to their duties as (1) The Limits of Insurance shown in your officers or directors. Section B. Limits Of Insurance, Your stockholders are also 1. Employee Benefit Liability insureds, but only with re- Coverage and the rules below fix spect to their liability as the most we will pay regardless stockholders. of the number of: (e) A trust, you are an insured. (a) Insureds; Your trustees are also in- sureds, but only with respect (b) Claims made or "suits" to their duties as trustees. brought; (2) Each of the following is also an (c) Persons or organizations insured: making claims or bringing "suits" (a) Each of your "employees" who is or was authorized to (d) Acts, errors or omissions; or administer your "employee (e) Benefits included in your benefit program"; "employee benefit program". (b) Any persons, organizations (2) The Aggregate Limit shown in or "employees" having prop- Section B. Limits Of Insurance, er temporary authorization 1. Employee Benefit Liability to administer your "employ- Coverage of this endorsement is ee benefit program" if you the most we will pay for all dam- die, but only until your legal ages because of acts, errors or representative is appointed; omissions negligently committed or in the "administration" of your (c) Your legal representative if "employee benefit program". you die, but only with re- (3) Subject to the limit described in spect to duties as such. That (2) above, the Each Employee representative will have all Limit shown in Section B. Limits your rights and duties under Of Insurance, 1. Employee this Coverage Part. Benefit Liability Coverage of (3) Any organization you newly ac- this endorsement is the most we quire or form, other than a part- will pay for all damages sus- nership, joint venture or limited tained by any one "employee", liability company, and over which including damages sustained by you maintain ownership or major- such "employee's" dependents ity interest, will qualify as a and beneficiaries, as a result of: Named Insured if no other similar (a) An act, error or omission; or insurance applies to that organi- Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission. Page 5 of 17 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 (b) A series of related acts, er- tification of the action taken, rors or omissions, regard- you shall promptly reim- less of the amount of time burse us for such part of the that lapses between such Deductible Amount as we acts, errors or omissions; have paid. negligently committed in the d. Additional Conditions "administration" of your "employ- ee benefit program". As respects Employee Benefit Lia- bility Coverage, Section IV - Com- However, the amount paid under mercial General Liability Condi- this endorsement shall not ex- tions is amended as follows: ceed, and will be subject to the limits and restrictions that apply (1) Item 2. Duties In The Event Of to the payment of benefits in any Occurrence, Offense, Claim Or plan included in the "employee Suit is replaced by the following: benefit program." 2. Duties In The Event Of An (4) Deductible Amount Act, Error Or Omission, Or Claim Or Suit (a) Our obligation to pay dam- ages on behalf of the in- a. You must see to it that sured applies only to the we are notified as soon amount of damages in ex- as practicable of an act, cess of the Deductible error or omission which Amount stated in the Decla- may result in a claim. rations as applicable to To the extent possible, Each Employee. The limits notice should include: of insurance shall not be re- (1) What the act, error duced by the amount of this or omission was deductible. and when it oc- (b) The Deductible Amount curred; and stated in the Declarations (2) The names and applies to all damages sus- addresses of any- tained by any one "employ- one who may suf- ee", including such "employ- fer damages as a ee's" dependents and bene- result of the act, ficiaries, because of all acts, error or omission. errors or omissions to which this insurance applies. b. If a claim is made or (c) The terms of this insurance, "suit" d against including those with respect any insurreed,, y yoot u must: to: (1) Immediately record and dutyto the specifics of the 1) Our right claim or "suit" and defend the insured the date received; against any "suits" and seeking those damag- es; and (2) Notify us as soon 2) Your duties, and the du- as practicable. ties of any other in- You must see to it that volved insured, in the we receive written no- event of an act, error or tice of the claim or "suit" omission, or claim; as soon as practicable. apply irrespective of the ap- c. You and any other in- plication of the Deductible volved insured must: Amount. (1) Immediately send (d) We may pay any part or all us copies of any of the Deductible Amount to demands, notices, effect settlement of any summonses or le- claim or "suit" and, upon no- gal papers re- Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission. Page 6 of 17 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 ceived in connec- tion by equal shares, tion with the claim we will follow this meth- or "suit"; od also. Under this ap- (2) Authorize us to ob- proach each insurer t contributes equal ain records and amounts until it has other information; paid its applicable limit (3) Cooperate with us of insurance or none of in the investigation the loss remains, or settlement of the whichever comes first. claim or defense If any of the other in- against the "suit"; surance does not permit and contribution by equal (4) Assist us, upon our shares, we will contrib- request, in the en- ute by limits. Under this forcement of any method, each insurer's right against any share is based on the person or organi- ratio of its applicable zation which may limit of insurance to the be liable to the in- total applicable limits of sured because of insurance of all insur- an act, error or ers. omission to which c. No Coverage this insurance may also apply. This insurance shall not t cover any loss for which d. No insured will, except the insured is entitled to at that insured's own recovery under any cost, voluntarily make a other insurance in force payment, assume any previous to the effective obligation, or incur any date of this Coverage expense without our Part. consent. (2) Item 5. Other Insurance is re- e. Additional Definitions placed by the following: As respects Employee Benefit 5. Other Insurance Lia- bility Coverage, Section V - Defini- tions is amended as follows: If other valid and collectible (1) The following definitions are insurance is available to the added: insured for a loss we cover under this Coverage Part, 1. "Administration" means: our obligations are limited as follows: a. Providing information to "employees", including a. Primary Insurance their dependents and beneficiaries, with re- This insurance is prima- spect to eligibility for or ry except when c. below scope of "employee applies. If this insurance benefit programs"; is primary, our obliga- tions are not affected b. Interpreting the "em- unless any of the other ployee benefit pro- insurance is also prima- grams"; ry. Then, we will share with all that other insur- c. Handling records in ance by the method de- connection with the scribed in b. below. "employee benefit pro- grams"; or b. Method Of Sharing d. Effecting, continuing or If all of the other insur- terminating any "em- ance permits contribu- ployee's" participation in Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission. Page 7 of 17 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 any benefit included in c. Unemployment insur- the "employee benefit ance, social security program". benefits, workers' com- However, "administration" pensation and disability benefits; and does not include: deduc- d. Vacation plans, includ- a. Handling payroll ing buy and sell pro- tions; or grams; leave of ab- b. The failure to effect or sence programs, includ- maintain any insurance ing military, maternity, or adequate limits of family, and civil leave; coverage of insurance, tuition assistance plans; including but not limited transportation and to unemployment insur- health club subsidies. ance, social security 4, "First effective date" means benefits, workers' com- the date upon which cover- pensation and disability age was first effected in a benefits. series of uninterrupted re- 2. "Cafeteria plans" means newals of insurance cover- plans authorized by applica- age. ble law to allow "employees" (2) The following definitions are de- to elect to pay for certain leted in their entirety and re- benefits with pre-tax dollars. placed by the following: 3. "Employee benefit pro- 8. "Employee" means a person grams" means a program actively employed, formerly providing some of all of the employed, on leave of ab- following benefits to "em- sence or disabled, or retired. ployees", whether provided "Employee" includes a through a "cafeteria plan" or "leased worker". "Employee" otherwise: does not include a "tempo- a. Group life insurance; ray worker". group accident or health 21. "Suit" means a civil proceed- insurance; dental, vision ing in which money damag- and hearing plans; and es because of an act, error flexible spending ac- or omission to which this in- counts; provided that no surance applies are alleged. one other than an "em- "Suit" includes: ployee" may subscribe to such benefits and a. An arbitration proceed- such benefits are made ing in which such dam- generally available to ages are claimed and to those "employees" who which the insured must satisfy the plan's eligibil- submit or does submit ity requirements; with our consent; b. Profit sharing plans, b. Any other alternative employee savings dispute resolution pro- plans, employee stock ceeding in which such ownership plans, pen- damages are claimed sion plans and stock and to which the in- subscription plans, pro- sured submits with our vided that no one other consent; or than an "employee" may subscribe to such c. An appeal of a civil pro- benefits and such bene- ceeding. fits are made generally available to all "employ- ees" who are eligible under the plan for such benefits; Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission. Page 8 of 17 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 2. Unintentional Failure To Disclose Haz- 2) Rust or other cor- ards rosion, decay, de- Section IV - Commercial General Liabil- latent hidden or ityConditions, 7. Representations is or latent defect or P any quality in amended by the addition of the following: property that caus- Based on our dependence upon your rep- es it to damage or resentations as to existing hazards, if un- destroy itself; intentionally you should fail to disclose all 3) Smog; such hazards at the inception date of your policy, we will not reject coverage under 4) Mechanical break- this Coverage Part based solely on such down, including failure. rupture or bursting a To Premises Rented To You caused by centrif- 3. Damage ugal force; a. The last Paragraph of 2. Exclusions 5) Settling, cracking, under Section I - Coverage A- Bod- shrinking or ex- ily Injury And Property Damage Li- pansion; ability is replaced by the following: Exclusions c. throu h do not 6) Nesting or infesta- 9 9• a pPy tion, or discharge to "property damage" by fire, explo- or release of waste sion, lightning, smoke or soot to products or secre- premises while rented to you or tem- tions, by insects, porarily occupied by you with permis- birds, rodents or sion of the owner, for which the other animals; or amount we will pay is limited to the Damage To Premises Rented To 7) Presence, growth, You Limit as described in Section III proliferation, - Limits Of Insurance. spread or any ac- tivity of fungus, in- b. The insurance provided under Sec- cluding mold or tion I - Coverage A - Bodily Injury mildew, and any And Property Damage Liability ap- mycotoxins, plies to "property damage" arising out spores, scents or of water damage to premises that are byproducts pro- both rented to and occupied by you. duced or released (1) As respects Water Damage Le- by fungi. gal Liability, as provided in Para- (b) "Property damage" caused graph 3.b. above: directly or indirectly by any The exclusions under Section I - of the following: Coverage A- Bodily Injury And (i) Earthquake, volcanic Property Damage Liability, 2. eruption, landslide or Exclusions, other than i. War any other earth move- and the Nuclear Energy Liabil- ment; ity Exclusion (Broad Form), are deleted and the following are (ii) Water that backs up or added: overflows or is other- wise discharged from a This insurance does not apply to: sewer, drain, sump, (a) "Property damage": sump pump or related equipment; (i) Assumed in any con- tract or agreement; or (iii) Water under the ground surface pressing on, or (ii) Caused by or resulting flowing or seeping from any of the follow- through: ing: 1) Foundations, walls, 1) Wear and tear; floors or paved surfaces; Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission. Page 9 of 17 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 2) Basements, you with permission of whether paved or the owner; not; or b. In the case of damage 3) Doors, windows or by fire, explosion, light- other openings. ning, smoke or soot, (c) "Property damage" caused while rented to you; or by or resulting from water c. In the case of damage that leaks or flows from by water, while rented plumbing, heating, air condi- to and occupied by you. tioning, fire protection sys- tems, or other equipment, (2) The most we will pay is limited as caused by or resulting from described in Section B. Limits freezing, unless: Of Insurance, 3. Damage To Premises Rented To You of this (i) You did your best to endorsement. maintain heat in the building or structure; or 4. Supplementary Payments (ii) You drained the equip- Under Section I - Supplementary Pay- ment and shut off the ments - Coverages A And B: water supply if the heat a. Paragraph 2. is replaced by the fol- was not maintained. lowing: (d) "Property damage" to: Up to the limit shown in Section B. (i) Plumbing, heating, air Limits Of Insurance, 4.a. Bail Bonds conditioning, fire protec- of this endorsement for cost of bail tion systems, or other bonds required because of accidents equipment or applianc- or traffic law violations arising out of es; or the use of any vehicle to which the Bodily Injury Liability Coverage ap- (ii) The interior of any plies. We do not have to furnish these building or structure, or bonds. to personal property in the building or structure, b. Paragraph 4. is replaced by the fol- caused by or resulting lowing: from rain, snow, sleet or All reasonable expenses incurred by ice, whether driven by the insured at our request to assist us wind or not. in the investigation or defense of the c. Limit Of Insurance claim or "suit", including actual loss of earnings up to the limit shown in Sec- With respect to the insurance afford- tion B. Limits Of Insurance, 4.b. ed in Paragraphs 3.a. and 3.b. above, Loss Of Earnings of this endorsement the Damage To Premises Rented per day because of time off from To You Limit as shown in the Decla- work. rations is amended as follows: 5. Medical Payments (1) Paragraph 6. of Section III - Expense The Medical Limit of AnyOne Limits Of Insurance is replaced by the following: Person as stated in the Declarations is amended to the limit shown in Section B. 6. Subject to Paragraph 5. Limits Of Insurance, 5. Medical Pay- above, the Damage To ments of this endorsement. Premises Rented To You Limit is the most we will pay 6. 180 Day Coverage For Newly Formed under Coverage A - Bodily Or Acquired Organizations Injury And Property Dam- Section II - Who Is An Insured is age Liability for damages amended as follows: because of "property dam- age"to any one premises: Subparagraph a. of Paragraph 3. is re- a. While rented to you, or placed by the following: temporarily occupied by a. Insurance under this provision is af- forded only until the 180th day after Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission. Page 10 of 17 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 you acquire or form the organization use of that part of the prem- or the end of the policy period, ises leased to you, subject whichever is earlier; to the following additional exclusions: 7. Waiver Of Subrogation This insurance does not ap- Section IV - Commercial General Liabil- ply to: ity Conditions, 9. Transfer Of Rights Of Recovery Against Others To Us is (i) Any "occurrence" which amended by the addition of the following: takes place after you cease to be a tenant in We waive any right of recovery we may that premises; have against any person or organization against whom you have agreed to waive (ii) Structural alterations, such right of recovery in a written contract new construction or or agreement because of payments we demolition operations make for injury or damage arising out of performed by or on be- your ongoing operations or "your work" half of such additional done under a written contract or agree- insured. ment with that person or organization and included in the "products-completed oper- (b) Lessor Of Leased Equip- ations hazard". However, our rights may ment only be waived prior to the "occurrence" Any person or organization giving rise to the injury or damage for from whom you lease which we make payment under this Cov- equipment when you and erage Part. The insured must do nothing such person(s) or organiza- after a loss to impair our rights. At our re- tion(s) have agreed per Par- quest, the insured will bring "suit" or trans- agraph 8.a.(1) of this en- fer those rights to us and help us enforce dorsement to provide insur- those rights. ance. Such person(s) or or- 8. Automatic Additional Insured - Speci- ganization(s) are insureds fied Relationships only with respect to liability for "bodily injury", "property a. The following is added to Section II - damage" or "personal and Who Is An Insured: advertising injury" caused, in whole or in part, by your (1) Any person(s) or organization(s) maintenance, operation or described in Paragraph 8.a.(2) of use of equipment leased to this endorsement (hereinafter re- you by such person(s) or or- ferred to as additional insured) ganization(s). A person's or whom you are required to add as organization's status as an an additional insured under this additional insured under this Coverage Part by reason of a endorsement ends when written contract, written agree- their contract or agreement ment, written permit or written with you for such leased authorization. equipment ends. However, (2) Only the following persons or or- this insurance does not ap- ganizations are additional in- ply to any "occurrence" sureds under this endorsement, which takes place after the and insurance coverage provided equipment lease expires. to such additional insureds is lim- (c) Vendors ited as provided herein: Any person or organization (a) Managers Or Lessors Of Premises (referred to below as ven- dor) with whom you have The manager or lessor of a agreed per Paragraph premises leased to you with 8.a.(1) of this endorsement whom you have agreed per to provide insurance, but on- Paragraph 8.a.(1) of this en- ly with respect to "bodily in- dorsement to provide insur- jury" or "property damage" ance, but only with respect arising out of"your products" to liability arising out of the which are distributed or sold ownership, maintenance or in the regular course of the Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission. Page 11 of 17 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 vendor's business, subject or repair opera- to the following additional tions, except such exclusions: operations per- formed at the ven- (i) The insurance afforded dor's premises in the vendor does not connection with the apply to: sale of the product; 1) "Bodily injury" or 7) Products which, af- "property damage" ter distribution or for which the yen- sale by you, have dor is obligated to been labeled or re- pay damages by labeled or used as reason of the as- a container, part or sumption of liability ingredient of any in a contract or other thing or sub- agreement. This stance by or for the exclusion does not vendor; or apply to liability for damages that the 8) "Bodily injury" or vendor would have "property damage" in the absence of arising out of the the contract or sole negligence of agreement; the vendor for its own acts or omis- 2) Any express war- sions or those of ranty unauthorized its employees or by you; anyone else acting 3) Any physical or on its behalf. How- chemical change in ever, this exclusion the product made does not apply to: intentionally by the a) The excep- vendor; tions contained 4) Repackaging, ex- in Paragraphs cept when un- (c) (i) 4) or 6) packed solely for of this en- the purpose of in- dorsement; or spection, demon- b) Such inspec- stration, testing, or tions, adjust- the substitution of ments, tests or parts under in- servicing as structions from the the vendor has manufacturer, and agreed to then repackaged in make or nor- the original con- mally under- tainer; takes to make 5) Any failure to make in the usual such inspections, course of adjustments, tests business, in or servicing as the connection vendor has agreed with the distri- to make or normal- bution or sale ly undertakes to of the prod- make in the usual ucts. course of busi- (ii) This insurance does not ness, in connection apply to any insured with the distribution person or organization: or sale of the products; 1) From whom you 6) Demonstration, in- have acquired such products, or stallation, servicing any ingredient, part Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission. Page 12 of 17 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 or container, enter- (e) Mortgagee, Assignee Or ing into, accompa- Receiver nying or containing such products; or Any person or organization with whom you have agreed 2) When liability in- per Paragraph 8.a.(1) of this cluded within the endorsement to provide in- "products- surance, but only with re- completed opera- spect to their liability as tions hazard" has mortgagee, assignee, or re- been excluded un- ceiver and arising out of the der this Coverage ownership, maintenance, or Part with respect to use of the premises by you. such products. However, this insurance (d) State Or Governmental does not apply to structural alterations, new construction Agency Or Subdivision Or and demolition operations Political Subdivision - performed by or for that per- Permits Or Authorizations son or organization. Relating To Premises (3) The insurance afforded to addi- Any state or governmental tional insureds described in Par- agency or subdivision or po- agraph 8.a.(1) of this endorse- litical subdivision with which ment: you have agreed per Para- graph 8.a.(1) of this en- (a) Only applies to the extent dorsement to provide insur- permitted by law; and ance, subject to the follow- ing additional provision: (b) Will not be broader than that which you are required by This insurance applies only the written contract, written with respect to the following agreement, written permit or hazards for which the state written authorization to pro- or governmental agency or vide for such additional in- subdivision or political sub- sured; and division has issued a permit or authorization in connec- (c) Does not apply to any per- tion with premises you own, son, organization, vendor, rent or control and to which state, governmental agency this insurance applies: or subdivision or political subdivision, specifically (i) The existence, mainte- named as an additional in- nance, repair, construc- sured under any other provi- tion, erection or removal sion of, or endorsement of advertising signs, added to, this Coverage awnings, canopies, cel- Part, provided such other lar entrances, coal provision or endorsement holes, driveways, man- covers the injury or damage holes, marquees, hoist for which this insurance ap- away openings, side- plies. walk vaults, street ban- ners or decorations and b. With respect to the insurance afford- similar exposures; or ed to the additional insureds de- scribed in Paragraph 8.a.(1) of this (ii) The construction, erec- endorsement, the following is added tion or removal of eleva- to Section III - Limits Of Insurance: tors; or The most we will pay on behalf of the (iii) The ownership, mainte- additional insured is the amount of in- nance or use of any el- surance: evators covered by this insurance. (1) Required by the written contract, written agreement, written permit or written authorization described Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission. Page 13 of 17 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 in Paragraph 8.a.(1) of this en- tion I - Coverage A - Bodily Injury dorsement; or And Property Damage Liability: (2) Available under the applicable Paragraphs (3) and (4) of this exclu- Limits of Insurance shown in the sion do not apply to tools or equip- Declarations; ment loaned to you, provided they are whichever is less. not being used to perform operations at the time of loss. This endorsement shall not increase b. With respect to the insurance provid- the applicable Limits of Insurance ed by this section of the endorse- shown in the Declarations. ment, the following additional provi- c. Section IV - Commercial General sions apply: Liability Conditions is amended to (1) The Limits of Insurance shown in include the following: the Declarations are replaced by Automatic Additional Insured Pro- the limits designated in Section vision B. Limits Of Insurance, 9. Property Damage To Borrowed This insurance applies only if the Equipment of this endorsement "bodily injury" or "property damage" with respect to coverage provid- occurs, or the "personal and advertis- ed by this endorsement. These ing injury" offense is committed: limits are inclusive of and not in (1) During the policy period; and addition to the limits being re- placed. The Limits of Insurance (2) Subsequent to your execution of shown in Section B. Limits Of the written contract or written Insurance, 9. Property Damage agreement, or the issuance of a To Borrowed Equipment of this written permit or written authori- endorsement fix the most we will zation, described in Paragraph pay in any one "occurrence" re- 8.a.(1). gardless of the number of: d. Section IV - Commercial General (a) Insureds; Liability Conditions is amended as (b) Claims made or "suits" follows: brought; or Condition 5. Other Insurance is (c) Persons or organizations amended to include: making claims or bringing Primary And Noncontributory In- "suits". surance (2) Deductible Clause This insurance is primary to and will (a) Our obligation to pay dam- not seek contribution from any other ages on your behalf applies insurance available to an additional only to the amount of dam- insured per Paragraph 8.a.(1) of this ages for each "occurrence" endorsement provided that: which are in excess of the (1) The additional insured is a Deductible Amount stated in Named Insured under such other Section B. Limits Of Insur- insurance; and ance, 9. Property Damage To Borrowed Equipment of (2) You have agreed in writing in a this endorsement. The limits contract, agreement, permit or of insurance will not be re- authorization described in 8.a.(2) duced by the application of of this endorsement that this in- such deductible amount. surance would be primary and would not seek contribution from (b) Section IV - Commercial any other insurance available to General Liability Condi- the additional insured. tions, 2. Duties In The Event Of Occurrence, Of- 9. Property Damage To Borrowed Equip- fense, Claim Or Suit, ap- ment plies to each claim or "suit" irrespective of the amount. a. The following is added to Exclusion 2.j. Damage To Property under Sec- Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission. Page 14 of 17 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 (c) We may pay any part or all 12. Nonowned Aircraft of the deductible amount to effect settlement of any The following is added to Exclusion 2.g. claim or "suit" and, upon no- Aircraft, Auto Or Watercraft under Sec- tification of the action taken, tion I - Coverage A - Bodily Injury And you shall promptly reim- Property Damage Liability: burse us for such part of the This exclusion does not apply to an air- deductible amount as has craft you do not own, provided that: been paid by us. 10. Employees As Insureds - Specified a. The pilot in command holds a current P effective certificate, issued by a duly Health Care Services And Good Samar- constituted authority of the United itan Services States of America or Canada, desig- Paragraph 2.a.(1)(d) under Section II - Hating that person as a commercial or Who Is An Insured does not apply to: airline transport pilot; a. Your "employees" who provide pro- b. The aircraft is rented with a trained, fessional health care services on your paid crew; and behalf as a duly licensed nurse, c. The aircraft does not transport per- emergency medical technician or sons or cargo for a charge. paramedic in the jurisdiction where an "occurrence" or offense to which this 13. Bodily Injury Redefined insurance applies takes place; or Section V - Definitions, 4. "Bodily injury" b. Your "employees" or "volunteer work- is replaced by the following: ers", other than an employed or vol- unteer doctor, providing first aid or 4. "Bodily injury" means bodily harm or good samaritan services during their injury, sickness, disease, disability, work hours for you will be deemed to humiliation, shock, fright, mental an- be acting within the scope of their guish or mental injury, including care, employment by you or performing du- loss of services or death resulting ties related to the conduct of your from any of these at any time. business. 14. Expected Or Intended Injury Redefined 11. Broadened Notice Of Occurrence The last sentence of Exclusion 2.a. Ex- Paragraph a. of Condition 2. Duties In pected Or Intended Injury under Sec- The Event Of Occurrence, Offense, tion I - Coverage A - Bodily Injury And Claim Or Suit under Section IV - Com- Property Damage Liability is replaced by mercial General Liability Conditions is the following: replaced by the following: This exclusion does not apply to "bodily a. You must see to it that we are notified injury" or "property damage" resulting from as soon as practicable of an "occur- the use of reasonable force to protect per- rence" or an offense which may result sons or property. in a claim. To the extent possible, no- 15. Former Employees As Insureds tice should include: The following is added to Paragraph 2. (1) How, when and where the "oc- under Section II -Who Is An Insured: currence" or offense took place; The names and addresses of 2. Each of the following is also an in- (2) sured: any injured persons and wit- nesses; and Any of your former "employees", di- rectors, managers, members, part- (3) The nature and location of any ners or "executive officers", including injury or damage arising out of but not limited to retired, disabled or the "occurrence" or offense. those on leave of absence, but only This requirement applies only when for acts within the scope of their em- the "occurrence" or offense is known ployment by you or for duties related to an "authorized representative". to the conduct of your business. Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission. Page 15 of 17 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 16. Voluntary Property Damage Coverage (2) Exclusions a. Coverage D - Voluntary Property This insurance does not apply to Damage Coverage "property damage" that would be es is amended to excluded by Coverage A- Bodi- Section I - Coverages ly Injury And Property Damage include the following: Liability, 2. Exclusions, except (1) Insuring Agreement for j. Damage To Property, par- agraphs (3), (4), (5) and (6), k. (a) We will pay the cost to re- Damage To Your Product, and pair or replace "property I. Damage To Your Work. damage" to property of oth- ers arising out of operations (3) Definitions incidental to your business For purposes of Voluntary when: Property Damage Coverage 1) Damage is caused by only, the following definitions un- you; or der Section V - Definitions are replaced by the following: 2) Damage occurs while in your possession. 16. "Occurrence" means an in- cident, including continuous At your written request, we or repeated exposure to will make this payment re- substantially the same gen- gardless of whether you are eral harmful conditions that at fault for the "property result in "property damage". damage". 20. "Property damage" means If you, at our request, re- physical injury to tangible place, or make any repairs property. "Electronic data" is to, damaged property of not tangible property, and others, the amount we will "property damage" does not pay under Voluntary Prop- include disappearance, ab- erty Damage Coverage will straction or theft. be determined by your actu- al cost to replace or repair b. Care, Custody Or Control Liability the damaged property, ex- Coverage cluding any profit or over- For purposes of the coverage provid- head. ed by Care, Custody Or Control Li- Any payment we make un- ability Coverage in this endorsement der Voluntary Property only: Damage Coverage shall not (1) Section I - Coverage A - Bodily be interpreted as an admis- Injury And Property Damage sion of liability by you or by Liability, 2. Exclusions, j. us. Damage To Property, Subpara- It shall be your duty, not our graphs (3), (4) and (5) do not ap- duty, to defend any claim or ply to 'property damage" to the "suit" to which this insurance property of others described applies. therein. No other obligation or liabil- (2) It shall be your duty, not our duty, ity to pay sums or perform to defend any claim or "suit" to acts or services is covered. which this insurance applies. (b) This insurance applies to No other obligation or liability to "property damage" only if: pay sums or perform acts or ser- vices is covered. 1) The "property damage" takes place in the "cov- This Paragraph (2) supersedes erage territory"; and any provision in the Coverage Part to the contrary. 2) The "property damage" occurs during the policy (3) "Property damage" for which period. Care, Custody Or Control Lia- bility Coverage provides cover- Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission. Page 16 of 17 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 age shall be deemed to be (3) The Voluntary Property Dam- caused by an "occurrence" but age Coverage, Aggregate Limit shall not serve to limit or restrict Of Insurance is the most we will the applicability of any exclusion pay for the sum of all damages for "property damage" under this under Voluntary Property Coverage Part. Damage Coverage. This limit c. Limits Of Insurance And Deducti- applies separately to each "cov- bles erage term". For purposes of the coverage provid- (4) Deductible Clause ed by Voluntary Property Damage (a) Our obligation to pay dam- Coverage and Care, Custody Or ages on your behalf applies Control Liability Coverage, Section only to the amount of dam- III - Limits Of Insurance is amended ages for each "occurrence" to include the following: which are in excess of the Deductible Amount stated (1) The Limits of Insurance shown in for the applicable coverage the Declarations are replaced by in the Schedule. The limits the limits designated in Section of insurance will not be re- B. Limits Of Insurance, 16. duced by the application of Voluntary Property Damage such Deductible Amount. Coverage And Care, Custody Or Control Liability Coverage, (b) Section IV - Commercial in this endorsement. These limits General Liability Condi- are inclusive of, and not in addi- tions, 2. Duties In The tion to, the limits being replaced. Event Of Occurrence, Of- The Limits of Insurance shown in fense, Claim Or Suit, ap- the Schedule fix the most we will plies to each claim or "suit" pay regardless of the number of: irrespective of the amount. (a) Insureds; (c) We may pay any part or all of the Deductible Amount to (b) Claims made or "suits" effect settlement of any brought; or claim or "suit" and, upon no- (c) Persons or organizations tification of the action taken, making claims or bringing you shall promptly reim- "suits". burse us for such part of the Deductible Amount as has (2) (a) Subject to (3) below, the been paid by us. Voluntary Property Dam- age Coverage, Each Occur- 17. Broadened Contractual Liability - Work rence Limit Of Insurance is Within 50' Of Railroad Property the most we will pay for the Section V - Definitions, 12. "Insured con- sum of damages under Vol- tract" is amended as follows: untary Property Damage Coverage; a. Paragraph c. is replaced by the fol- lowing: (b) The Care, Custody Or Con- trol Liability Coverage, c. Any easement or license agree- Each Occurrence Limit Of ment; Insurance is the most we will pay for the sum of damages b. Paragraph f.(1) is deleted in its entire- under Care, Custody Or ty. Control Liability Coverage; 18. Alienated Premises because of all "property damage" Exclusion 2.j. Damage to Property, arising out of any one "occur- Paragraph (2) under Section I - Cover- rence". age A - Bodily Injury And Property Damage Liability does not apply if the premises are "your work". Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission. Page 17 of 17 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 This page has been left blank intentionally. 000umun Envelope|o 16*851o5f\5Ae'*ax* a702'2059600ea728 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ I][ CAREFULLY. ��- A �� U~�^��U U�� ~ �UU��A��U�� ^��o° " . ^. `�» u ��nv�� n��" . .�xn~�nu~ "n~��nv�~�� n�" u ��nn"�� " "�^ �� " �nu �� |D AUTOMATIC WAIVER OF SUBROGATION W�� UUU�� U�� 0��U�� I ^�� AGREEMENT, ��U�U� �� U� A ~�� " �~nvnn"" " ��nv ^`^�� " o "��n ^"u��x � " "��nm This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Additional Insured ^ Owners, Lessees Or o/uded in the "prod o'Xs-u000p|*tod Contractors ~ Automatic Status For Other operations hazard''' but only if: Parties When RewuiredAnVVri12en ��nntreot �Jr/�gneennentVVb' You (1) The Coverage Part tu which this endorsement is attached pro- 1. Section || - Who Is An Insured is viden coverage for "bodily injury" amended 1n include uoun additional in or "property dornogc" included su/*d any person or organization you within the "products-completed have agreed in writing in a contract or operations hazard'', and agreement to odd an an additional in- sured nn this Coverage Part. (2) The written contract or writtenGuch per- ` ' suo(o) uror0aoizatiuo(y) isanadditional agreement requires you to pro- insured on|y *ithreope't tn liability for vide additional insured coverage included within the ''prnduotn- a. "Bodily irjun/'. "property daooagd' o/ completed operations hazard" "personal and advertising irjury" for that person ororganization. caused, /o whole o/ /n part, hythe |f the w/ri8encontract orn/htten pz�nnnon;� n/ ynu/ nngning opera- 1iuosby you oroo your behalf, under agreement requires you to provide that written nnot/a(t or written additional insured coverage included agreement. Ongoing operations does within the ''p/nduotn-;nnnp|eted npe,- no< apply 1n "bodily irjury'' n,''prnper- atiuns hazard" for a specified length 1y damage"occurring after: of time for that person ororyaniza hoo' the "hodi|yinjury" o/ "property (1) All vxnrk, including nnn1eriu|:, damage" must occur prior 1nthe ex- parts ur equipment furnished io piratioouf that period uf time inorder connection with such work, on for this insurance k) apply. the project (other than service, |f the w/ri8encontract orn/htten maintenance n/ repairs) 1n h� performed byurun behalf ufthe agreement requires you to provide additional inmured(n) at the |oca additional insured coverage for a tion of the covered operations Pc/onn or organization per only |S() has been completed, nr additional insured endorsement form number CQ2O10' without specifying (2) Thai portion o/"your work"out of an edition dale, and without npecifi w/hi;h \hzinju/yn, dnnnoDeorin- cu||y requiring additional insured es has been put to its intended coverage iou|odod within the "prod - use by any person nro/gaoira ucts'conop|e\ed operations hazard'", tion other than onothercontrao' this Paragraph b. doe* not apply to tor n/ subcontractor engaged in that person nrorganization. performing operations for a prin- cipal asapartof1hooano* pro- |f the written contract nr mitten agree rncn� described in Paragraph 1 jectond . above specifically requires you 10 provide addi' b. "Bodily injury' or "property damage" hona/ insured coverage 10 that person or oauosu. /o whole ^r/npart, hy'your organization: work" performed under that written contract ur written agreement and io a. Arising out of your ongoing opera- tions or arising out of"your work", or Includes copyrighted material o[Insurance GA472O918 Services Office, |no ' with its permission. Page 1pf% 000umun Envelope|o 16*851o5f\5Ae'*ax* a702'2059600ea728 b. By way ufan edition nfan |8{} addi' 2. With respect 1u the insurance afforded 1u dona| insured endorsement that in- the additional insureds described in Para- cludeS arising out of your ongoing graph B1^ the following additional emclu- nperz8ionnor arising out uf 'vuur oinnnapp|y: work", This insurance does not apply to: then the phrase c in whm/eor /o yw/t0yin Paragraph A .� ��a� and/urPara- e� Bodi|yirjury'. "prnpe� damage" "personal'Pe/nona|andedveAiningirju,y" ahn' /ep|aoodby1heph/aoeansinynutnf ing out of operations performed for the federal government, state nrnou 3. With respect 1u the insurance afforded to nicipa|ity, or the additional insureds described in Para- graph /\.11.' thek)||uwingaUUitiuna| exu|u b. "Bodily injury' nr "property damage" oionayp|ion: included within the ''produo10- oonop|e1od operations hazard." This insurance does not apply to "bodily C.injury', "property damage" or "personal C The insurance afforded to additional insureds and advertising irjury" arising out of the described in Paragraphs A. and B.� rendering of, ur the failure tn render, any 1� ()n|yapplies 10 the e>0entpernoi�eUby professional architectural, engineering o' |a\v and surveying services, including: ' 3� VYi|| not be broader than that which you a. The preparing, approving nr failing 1n are required by the written contract, writ- prepare or approve, noaPo, nhnP ten agreement, written permit or v/hMen drawings, opinions, reporto, oun/eyo, authorization 1n provide for such addition- field o/dern' ohan0enrUe/oordrar+ a| insured and ingn and specifications, or ' 3� Does not apply tuany poroon, organiza b. Supervisory, inspection, erohi1o(�ura| tinn' state, governmental agency nr sub- or engineering activities. division ur political subdivision specifically named an an additional insured for the Thiooxo|uoionapp|ieoeveni� ��eo|ainoo against any insured allege negligence or same project in the schedule of an en- other wrongdoing in the suyen/ioion, hir' dnroennent added 10 this Coverage Part. ing' employment,training nr monitoring of D. VVithrespect tn the insurance afforded tnthe othe/uby1ha1inou/ed' if1ho ''000urreno*�' additional insureds described inParagraphs which caused the "bodily injuq/'' or '`ProP- /L and B.' the following io added 1n Section III ertydanoaUo''. or the offense which ^Limits []fInsurance: caused the"personal and advertising inju ,y'", involved the rendering of, ur the fail- The most me xvi|| pay on behalf of the eddi ure to renUer, any professional archi1eo- 1iona| insured in the amount cf insurance � tura|. engineering nr surveying services. 1. Required by the written onn1rao1' \,/i11en 4. This Paragraph A does not apply 1uaUUi agreement, written permit or written au tinna| inouredndeoorikedinPara0raphB. thorira1ion described in Paragraphs A. B. Additional Insured -State OrGovernmental and B.' or Agency OrSubdivision Or Political Subdi^ 2. Available under the applicable Limits of vision ~ Automatic Status When Required Insurance shown in the Declarations, |n Written Permits OrAuthorizations whichever inless. 1 Section || ~ Who Is An Insured is amended to include as an additional in This endorsement shall not increase the app|i nured any state nr governmental agency cable Limits nf Insurance shown in the Deo|a nrnubdivioionnrpo|i1ioa| subdivioinnynu radnno have agreed in writing in a contract, E. Section |V ~ ornnmercim| General Liability a0reenoent' pe/noi1nrauthnr�ationtoadd Conditions is amended to add the ho||owing� anan additional insured on this Coverage Part. Such state or governmental agency Automatic Additional Insured Provision nr subdivision or political subdivision ioan additional insured only with respect 1uop- This insurance applies only if the "bodily inju eratinnn »erfVrnned by you nrun your be- ry" or "property damage" occurs, or the "per- half for which the state or governmental sonal and advertising injury" offense is com- agency or subdivision or political subdivi- noi8ed o|on issued, in writing, e contract, agree- 1. During the policy period, and noen1' permit orauthorization. Includes copyrighted material o[Insurance GA472O918 Services Office, |no ' with its permission. Page 2pf% 000umun Envelope|o 16*851o5f\5Ae'*ax* a702'2059600ea728 2. Subsequent 1u your execution nf the writ- As used in this endorsement, wrap-up innur- tenonrknacLnrvvri8enagroonoerk. orthe anoo means any insurance provided bya con- issuance ofa \vrittenpernoi1nrwri8eneu on|ida1eU (wxap`up) insurance program. Lhnriza1iun' described in Paragraphs /\. anUB. Primary And Noncontributory Insurance When Required By Written Contract, F. Except when G. below applies, the following in Agreement, Permit<]rAuthorization added 1uSection |V ~ Commercial General Liability Conditions, 5. Other Insurance, Except when wrap-up insurance applies 1nthe n|ainnnr 'tuiy' un behalf uf the additional in andoupe/nedonenyp/ovioion1nt�ecun1rary� oureU, this insurance io primary 1u and will not When Other Additional Insured Coverage seek contribution from any other insurance Applies[>nAn Excess Basis available 1u the additional insured described in This insurance io primary 1n other insurance Paragraphs A.and B. provided 1hzt� available 1u the additional insured described in 1. The additional insured is a Named In- Paragraphs A.and B.except: oureU under such other insurance, and 1. Auothop*iuop/oviUodinSectionUV - 2. You have agreed in writing inacontract, Commercial General Liability Condi^ agreement, permit or authorization Ue d#ny' 5. Qther |nyurmnce. b. ExceyoUn~ scribed in Paragraph ALorB. that this in yurmnoe, or ouranuev/ou|U be primary and would not 000k contribution from any other inour- 2. For any other valid and collectible inour' anue available 10 the additional insured. anue available 10 the additional insured ao an additional insured by attachment ofan As used in this endorsement, wrap-up insur- endorsement to another insurance policy anue means any insurance provided Uya con- that iowri8enonanexoenshasin. |nouoh on|iUa1ed (wrap'up) insurance program. case, this insurance io also excess. H. Section |V ~ Commercial General Liability G. The following io added 1n Section UV ~ Corn~ Conditions, 9. Transfer Of Rights OfRe~ rnercie| Genera| Limbi|ityCmnditimny, 5. covery Against Others ToUyio amended by Other Insurance, and supersedes any p/uvi the addition uf the following: nion1n the contrary: VYe waive any right uf recovery wo may have Primary Insurance When Required BvWrit- against any additional insured under this en- ten Contract, Agreement, Permit Or Au- Uuroenoen1 against whom you have agreed to thohaati#n v/aive such right nf recovery ina written con- tract, written agreement, written permit or writ- Except when wrap-up insurance applies to the ten authorization because of payments we claim or 'tuif' on behalf uf the additional in- make for injury or damage arising out ofyour oured' this insurance is primary to any other ongoing operations nr 'ynurwwrk'' done under insurance available to the additional insured a written onntnzoL' written agreement, written described in Paragraphs A. and B. provided permit nrwritten authorization. However, our that rights may only Ue waived prior tn the '\/ooup 1. The additional insured ina Named In- »*»«e" giving rise 1u the injury ur damage for oured under such other insuran»eand which wenoakepaynoen1 under this Coverage � Part. The insured must Uo nothing after aloss 2. You have agreed in writing in aountran1' 1n impair our rights. At our request,the insured a8reenoent, permit or authorization de will bring ''ouit' ur transfer those rights to us scribed in Paragraph /\. orB. that this in- and help uo enforce those rights. ouranuo would ho primary tu any other in- surance available to the additional in- sured. Includes copyrighted material o[Insurance GA472O918 Services Office, |no ' with its permission. Page 3pf% DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 This page has been left blank intentionally. DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this Coverage Part restrict SUPPLEMENTARY PAYMENTS - COV- this insurance. Read the entire Coverage Part ERAGES A AND B. carefully to determine rights, duties and what is and is not covered. b. This insurance applies to "bodily injury" and "property damage" only if: Throughout this Coverage Part the words "you" and "your" refer to the Named Insured shown in (1) The "bodily injury" or "property dam- the Declarations, and any other person or organi- age" is caused by an "occurrence" zation qualifying as a Named Insured under this that takes place in the "coverage ter- Coverage Part. The words "we", "us" and "our" ritory,; refer to the Company providing this insurance. (2) The "bodily injury" or "property dam- The word "insured" means any person or organi- age" occurs during the policy period; zation qualifying as such under SECTION II-WHO and IS AN INSURED. (3) Prior to the "coverage term" in which Other words and phrases that appear in quotation "bodily injury" or "property damage" marks have special meaning. Refer to SECTION occurs, you did not know, per Para- V-DEFINITIONS. graph 1.d. below, that the "bodily in- jury" or "property damage" had oc- SECTION I- COVERAGES curred or had begun to occur, in COVERAGE A. BODILY INJURY AND PROP- whole or in part. ERTY DAMAGE LIABILITY c. "Bodily injury" or "property damage" which: 1. Insuring Agreement (1) Occurs during the "coverage term"; a. We will pay those sums that the insured and becomes legally obligated to pay as damages because of "bodily injury" or (2) Was not, prior to the "coverage "property damage" to which this insur- term", known by you, per Paragraph ance applies. We will have the right and 1.d. below, to have occurred; duty to defend the insured against any "suit" seeking those damages. However, includes any continuation, change or re- we will have no duty to defend the in- sumption of that "bodily injury" or "prop- sured against any "suit" seeking dam- erty damage" after the end of the "cover- ages for "bodily injury" or "property dam- age term" in which it first became known age" to which this insurance does not by you. apply. We may, at our discretion, investi- d. You will be deemed to know that "bodily gate any "occurrence" and settle any injury" or "property damage" has oc- claim or "suit" that may result. But: curred at the earliest time when any (1) The amount we will pay for damages "authorized representative": is limited as described in SECTION (1) Reports all, or any part, of the "bodily III- LIMITS OF INSURANCE; and injury" or "property damage" to us or (2) Our right and duty to defend ends any other insurer; when we have used up the applica- (2) Receives a written or verbal demand ble limit of insurance in the payment or claim for damages because of the of judgments or settlements under "bodily injury" or "property damage"; SECTION I - COVERAGES, COV- ERAGE A. BODILY INJURY AND (3) First observes, or reasonably should PROPERTY DAMAGE LIABILITY; have first observed, the "bodily in- SECTION I - COVERAGES, COV- jury" or"property damage"; ERAGE B. PERSONAL AND AD- VERTISING INJURY LIABILITY; or (4) Becomes aware, or reasonably medical expenses under SECTION I should have become aware, by any - COVERAGES, COVERAGE C. means other than as described in (3) MEDICAL PAYMENTS. above, that "bodily injury" or "prop- erty damage" had occurred or had No other obligation or liability to pay sums begun to occur; or or perform acts or services is covered unless expressly provided for under (5) Becomes aware, or reasonably should have become aware, of a Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 1 of 22 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 condition from which "bodily injury" (3) Any statute, ordinance or regulation or "property damage" is substantially relating to the sale, gift, distribution certain to occur. or use of alcoholic beverages. e. Damages because of "bodily injury" in- This exclusion applies only if you are in dude damages claimed by any person or the business of manufacturing, distribut- organization for care, loss of services or ing, selling, serving or furnishing alcoholic death resulting at any time from the "bod- beverages. ily injury". d. Workers' Compensation and Similar 2. Exclusions Laws This insurance does not apply to: Any obligation of the insured under a workers'compensation, disability benefits a. Expected or Intended Injury or unemployment compensation law or "Bodily injury" or "property damage" any similar law. which may reasonably be expected to re- e. Employer's Liability suit from the intentional or criminal acts of the insured or which is in fact expected or "Bodily injury"to: intended by the insured, even if the injury or damage is of a different degree or type (1) An "employee" of the insured sus- than actually expected or intended. This tained in the "workplace"; exclusion does not apply to "bodily injury" (2) An "employee" of the insured arising resulting from the use of reasonable force out of the performance of duties re- to protect persons or property. lated to the conduct of the insured's b. Contractual Liability business; or "Bodily injury" or "property damage" for (3) The spouse, child, parent, brother or which the insured is obligated to pay sister of that "employee" as a conse- damages by reason of the assumption of quence of Paragraphs (1) or (2) liability in a contract or agreement. This above. exclusion does not apply to liability for This exclusion applies: damages: (1) That the insured would have in the (1) Whether the insured may be liable as an employer or in any other ca- absence of the contract or agree- pacity; and ment; or (2) To any obligation to share damages (2) Assumed in a contract or agreement with or repay someone else who that is an "insured contract", pro- must pay damages because of the vided the "bodily injury" or "property injury. damage" occurs subsequent to the execution of the contract or agree- This exclusion does not apply to liability ment. When a claim for such "bodily assumed by the insured under an "in- injury" or "property damage" is sured contract". made, we will defend that claim pro- vided the insured has assumed the f. Pollutant obligation to defend such claim in the (1) "Bodily injury" or "property damage" "insured contract". Such defense arising out of the actual, alleged or payments will not reduce the limits of threatened discharge, dispersal, insurance. seepage, migration, release, escape c. Liquor Liability or emission of "pollutants": "Bodily injury" or "property damage" for (a) At or from any premises, site or which any insured may be held liable by location which is or was at any reason of: time owned or occupied by, or rented or loaned to, any insured. (1) Causing or contributing to the intoxi- However, Paragraph (a) does cation of any person; not apply to: (2) The furnishing of alcoholic bever- 1) "Bodily injury"to any person ages to a person under the legal injured while on any prem- drinking age or under the influence ises, site or location owned of alcohol; or or occupied by, or rented or loaned to, you provided: Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 2 of 22 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 a) The injury is caused by airborne irritants or con- the inadequate ventila- taminants used in a manu- tion of vapors; facturing process or which b) The person injured is is the product or by-product of any manufacturing proc- first exposed to such ess; vapors during the pol- icy period; and 2) "Bodily injury" or "property c) Within 30 days of such damage" for which you may be held liable, if you are a first exposure, the per- contractor, and the owner son injured is clinically or lessee of such premises, diagnosed or treated site or location has been by a physician for the added to this Coverage Part medical condition as an additional insured caused by the expo- with respect to your ongo- sure to such vapors. ing operations or "your However, Paragraph c) work" performed for that does not apply if the additional insured at that "bodily injury" is caused premises, site or location by vapors produced by and such premises, site or or originating from location is not and never equipment that is used was owned or occupied by, to heat, cool or dehu- or rented or loaned to, any midify the building, or insured, other than that ad- equipment that is used ditional insured; or to heat water for per- sonal use, by the 3) "Bodily injury" or "property building's occupants or damage" arising out of heat, their guests. smoke or fumes from a This exception 1) shall ap- "hostile fire"; ply only to Named Insureds; (b) At or from any premises, site or we shall have no duty to location which is or was at any defend or pay damages for time used by or for any insured any person or organization or others for the handling, stor- that is not a Named In- age, disposal, processing or sured. However, this para- treatment of waste; graph does not apply if the "bodily injury" is caused by (c) Which are or were at any time vapors produced by or transported, handled, stored, originating from equipment treated, disposed of, or proc- that is used to heat, cool or essed as waste by or for: dehumidify the building, or 1) Any insured; or equipment that is used to heat water for personal use, 2) Any person or organization by the building's occupants for whom you may be le- or their guests. gaily responsible; For the purpose of the ex- (d) At or from any premises, site or ception granted in Para- location on which any insured or graph 1) only, vapors any contractors or subcontrac- means any gaseous or air- tors working directly or indirectly borne irritant or airborne on any insured's behalf are contaminant, including performing operations if the smoke, fumes, vapor or "pollutants" are brought on or to soot, but excluding asbes- the premises, site or location in tos, which is discharged, connection with such operations dispersed, emitted, re- by such insured, contractor or leased or escapes from subcontractor. However, Para- materials, machinery or graph (d)does not apply to: equipment used in the service or maintenance of 1) "Bodily injury" or "property the premises. Vapors does damage" arising out of the not mean any gaseous or discharge, dispersal, seep- age, migration, release, es- Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 3 of 22 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 cape or emission of fuels, erations are to test for, monitor, lubricants or other operating clean up, remove, contain, treat, fluids, or exhaust gases, detoxify or neutralize, or in any which are needed to per- way respond to, or assess the form, or are the result of, effects of, "pollutants". the normal electrical, hy- draulic or mechanical func- (2) Any loss, cost or expense arising out tions necessary for the op- of any: eration of "mobile equip- (a) Request, demand, order or ment" or its parts, if such statutory or regulatory require- fuels, lubricants or other ment that any insured or others operating fluids, or exhaust test for, monitor, clean up, re- gases, escape, seep or mi- move, contain, treat, detoxify or grate, or are discharged, neutralize, or in any way re- dispersed, released or spond to, or assess the effects emitted from a vehicle part of, "pollutants"; or designed to hold, store or receive them. This excep- (b) Claim or suit by or on behalf of a tion does not apply if the fu- governmental authority for dam- els, lubricants or other op- ages because of testing for, erating fluids, or exhaust monitoring, cleaning up, remov- gases, escape, seep or mi- ing, containing, treating, detoxi- grate, or are discharged, fying or neutralizing, or in any dispersed, released or way responding to, or assessing emitted with the intent to the effects of, "pollutants". cause "bodily injury" or "property damage" or with However, Paragraphs (2)(a) and (b) the knowledge that "bodily do not apply to liability for damages injury" or "property damage" because of "property damage" that is substantially certain to the insured would have in the ab- occur, or if such fuels, lubri- sence of such request, demand, or- cants or other operating der or statutory or regulatory re- fluids, or exhaust gases, quirement, or such claim or "suit" by are brought on or to the or on behalf of a governmental premises, site or location authority. with such intent to escape, g. Aircraft,Auto or Watercraft seep or migrate, or be dis- charged, dispersed, re- "Bodily injury" or "property damage" aris- leased or emitted as part of ing out of the ownership, maintenance, the operations being per- use or entrustment to others of any air- formed by such insured, craft, "auto" or watercraft owned or oper- contractor or subcontractor; ated by or rented or loaned to any in- sured. Use includes operation and 2) "Bodily injury" or "property "loading or unloading". damage" sustained within a building and caused by the This exclusion applies even if the claims release of gases, fumes or against any insured allege negligence or vapors from materials other wrongdoing in the supervision, hir- brought into that building in ing, employment, training or monitoring of connection with operations others by that insured, if the "occurrence" being performed by you or which caused the "bodily injury" or "prop- on your behalf by a con- erty damage" involved the ownership, tractor or subcontractor; or maintenance, use or entrustment to oth- ers of any aircraft, "auto" or watercraft 3) "Bodily injury" or "property that is owned or operated by or rented or damage" arising out of heat, loaned to any insured. smoke or fumes from a "hostile fire"; or This exclusion does not apply to: (e) At or from any premises, site or (1) A watercraft while ashore on prem- location on which any insured or ises you own or rent; any contractors or subcontrac- tors working directly or indirectly (2) A watercraft you do not own that is: on any insured's behalf are (a) Less than 51 feet long; and performing operations if the op- Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 4 of 22 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 (b) Not being used to carry persons governmental authority in hindering or property for a charge; or defending against any of these. (3) Parking an "auto" on, or on the ways j. Damage to Property next to, premises you own or rent, provided the "auto" is not owned by "Property damage" to: or rented or loaned to you or the in- (1) Property you own, rent or occupy, sured; including any costs or expenses in- (4) Liability assumed under any "insured curred by you, or any other person, contract" for the ownership, mainte- organization or entity, for repair, re- nance or use of aircraft or watercraft; placement, enhancement, restora- or tion or maintenance of such property for any reason, including prevention (5) "Bodily injury" or "property damage" of injury to a person or damage to arising out of: another's property; (a) The operation of machinery or (2) Premises you sell, give away or equipment that is on, attached abandon, if the "property damage" to, or part of, a land vehicle that arises out of any part of those prem- would qualify under the defini- ises; tion of "mobile equipment" if it were not subject to a compul- (3) Property loaned to you; sory or financial responsibility (4) Personal property in the care, cus- law or other motor vehicle insur- tody or control of an insured; ance law in the state where it is licensed or principally garaged; (5) That particular part of real property or on which you or any contractors or subcontractors working directly or (b) The operation of any of the ma- indirectly on your behalf are per- chinery or equipment listed in forming operations, if the "property Paragraph f.(2) or f.(3) of the damage" arises out of those opera- definition of "mobile equipment". tions; or h. Mobile Equipment (6) That particular part of any property "Bodily injury" or "property damage" aris- that must be restored, repaired or ing out of: replaced because "your work" was incorrectly performed on it. (1) The transportation of "mobile equip- ment" by an "auto" owned or oper- Paragraphs (1), (3) and (4) of this exclu- ated by or rented or loaned to any sion do not apply to "property damage" insured; or (other than damage by fire or explosion) to premises, including the contents of (2) The use of "mobile equipment" in, or such premises, rented to you for a period while in practice for, or while being of 7 or fewer consecutive days, for which prepared for, any prearranged rac- the amount we will pay is limited to the ing, speed, demolition, or stunting Damage To Premises Rented To You activity. Limit as described in SECTION III - LIM- i. War ITS OF INSURANCE. Paragraph (2) of this exclusion does not "Bodily injury" or "property damage", apply if the premises are "your work" and however caused, arising, directly or indi- were never occupied, rented or held for rectly, out of: rental by you. (1) War, including undeclared or civil Paragraphs (3), (4), (5) and (6) of this ex- war; clusion do not apply to liability assumed (2) Warlike action by a military force, in- under a sidetrack agreement. cluding action in hindering or de- Paragraph (6) of this exclusion does not fending against an actual or ex- apply to "property damage" included in pected attack, by any government, the "products-completed operations haz- sovereign or other authority using ard". military personnel or other agents; or k. Damage to Your Product (3) Insurrection, rebellion, revolution, usurped power, or action taken by "Property damage" to "your product" arising out of it or any part of it. Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 5 of 22 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 I. Damage to Your Work q. Employment-Related Practices "Property damage" to "your work" arising "Bodily injury"to: out of it or any part of it and included in the "products-completed operations haz- (1) A person arising out of any: ard". (a) Refusal to employ that person; This exclusion does not apply if the dam- (b) Termination of that person's aged work or the work out of which the employment; or damage arises was performed on your behalf by a subcontractor. (c) Other employment-related prac- m. Damage to Impaired Property or Prop- prac- tices,includingpol but actsflimited omissions tcoer- erty Not Physically Injured but not to o ion, cion, criticism, demotion, "Property damage" to "impaired property" evaluation, failure to promote, or property that has not been physically reassignment, discipline, defa- injured, arising out of: mation, harassment, humiliation or discrimination directed at that (1) A defect, deficiency, inadequacy or person; or dangerous condition in "your prod- uct" or "your work"; or (2) The spouse, child, parent, brother or sister of that person as a conse- (2) A delay or failure by you or anyone quence of "bodily injury" to that per- acting on your behalf to perform a son at whom any of the employment- contract or agreement in accordance related practices described in Para- with its terms. graphs (a), (b) or (c) above is di- rected. This exclusion does not apply to the loss of use of other property arising out of This exclusion applies: sudden and accidental physical injury to "your product" or "your work" after it has (1) Whether the insured may be liable been put to its intended use. as an employer or in any other ca- pacity; and n. Recall of Products, Work or Impaired Property (2) To any obligation to share damages with or repay someone else who Any liability or damages claimed for any must pay damages because of the loss, cost or expense incurred by you or injury. others for the loss of use, withdrawal, re- call, inspection, repair, replacement, ad- r. Additional Insured Prior Knowledge justment, removal or disposal of: An additional insured added by attach- (1) "Your product"; ment of an endorsement to this Coverage Part that is seeking coverage for a claim (2) "Your work"; or or "suit", if that additional insured knew, (3) "Impaired property"; per the following paragraph, that "bodily injury" or "property damage" had oc- if such product, work or property is with- curred or had begun to occur, in whole or drawn or recalled from the market or from in part, prior to the "coverage term" in use by any person or organization be- which such "bodily injury" or "property cause of a known or suspected defect, damage" occurs or begins to occur. deficiency, inadequacy or dangerous An additional insured added by attach- condition in it. ment of an endorsement to this Coverage o. Personal and Advertising Injury Part will be deemed to have known that "bodily injury" or "property damage" has "Bodily injury" arising out of "personal and occurred or has begun to occur at the advertising injury". earliest time when that additional insured, or any one of its owners, members, part- p. Asbestos ners, managers, executive officers, "em- "Bodily injury" or "property damage" aris- ployees" assigned to manage that addl- ing out of, attributable to, or any way re- tional insured's insurance program, or lated to asbestos in any form or trans- "employees" assigned to give or receive miffed in any manner. notice of an "occurrence", "personal and advertising injury" offense, claim or"suit": Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 6 of 22 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 (1) Reports all, or any part, of the "bodily a. We will pay those sums that the insured injury" or "property damage" to us or becomes legally obligated to pay as any other insurer; damages because of "personal and ad- vertising injury" to which this insurance (2) Receives a written or verbal demand applies. We will have the right and duty or claim for damages because of the to defend the insured against any "suit" "bodily injury" or "property damage"; seeking those damages. However, we (3) First observes, or reasonably should will have no duty to defend the insured have first observed, the "bodily in- against any "suit" seeking damages for jury" or"property damage"; "personal and advertising injury" to which this insurance does not apply. We may, (4) Becomes aware, or reasonably at our discretion, investigate any offense should have become aware, by any and settle any claim or "suit" that may re- means other than as described in (3) suit. But: above, that "bodily injury" or "prop- erty damage" had occurred or had (1) The amount we will pay for damages begun to occur; or is limited as described in SECTION III- LIMITS OF INSURANCE; and (5) Becomes aware, or reasonably should have become aware, of a (2) Our right and duty to defend ends condition from which "bodily injury" when we have used up the applica- or "property damage" is substantially ble limit of insurance in the payment certain to occur. of judgments or settlements under SECTION I - COVERAGES, COV- s. Electronic Data ERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY; Damages arising out of the loss of, loss SECTION I - COVERAGES, COV- of use of, damage to, corruption of, in- ERAGE B. PERSONAL AND AD- ability to access, or inability to manipulate VERTISING INJURY LIABILITY; or "electronic data". medical expenses under SECTION I t. Distribution of Material in Violation of COVERAGES, COVERAGE C. Statutes MEDICAL PAYMENTS. "Bodily injury" or "property damage" aris- No other obligation or liability to pay sums ing directly or indirectly out of any action or perform acts or services is covered or omission that violates or is alleged to unless expressly provided for under violate: SUPPLEMENTARY PAYMENTS - COV- ERAGES A AND B. a. The Telephone Consumer Protection Act (TCPA), including any amend- b. This insurance applies to "personal and ment of or addition to such law; or advertising injury" only if: b. The CAN-SPAM Act of 2003, includ- (1) The "personal and advertising injury" ing any amendment of or addition to is caused by an offense arising out such law; or of your business; and c. Any statute, ordinance or regulation, (2) The "personal and advertising injury" other than the TCPA or CAN-SPAM offense was committed in the "cov- Act of 2003, that prohibits or limits the erage territory" during the policy pe- sending, transmitting, communicating riod; and or distribution of material or informs- (3) Prior to the "coverage term" in which tion. the "personal and advertising injury" Exclusions c. through q. do not apply to offense is committed, you did not "property damage" by fire or explosion to know, per Paragraph 1.d. below, that premises while rented to you or temporarily the offense had been committed or occupied by you with permission of the owner, had begun to be committed, in whole for which the amount we will pay is limited to or in part. the Damage to Premises Rented To You Limit c. "Personal and advertising injury" caused as described in SECTION III - LIMITS OF IN- by an offense which: SURANCE. COVERAGE B. PERSONAL AND ADVERTISING (1) Was committed during the "coverage term"; and INJURY LIABILITY 1. Insuring Agreement Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 7 of 22 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 (2) Was not, prior to the "coverage (1) The inception of this Coverage Part; term", known by you, per Paragraph or 1.d. below, to have been committed; (2) The "coverage term" in which insur- includes any continuation, change or re- ance coverage is sought. sumption of that offense after the end of the "coverage term" in which it first be- d. Criminal Acts came known by you. "Personal and advertising injury" arising d. You will be deemed to know that a "per- out of a criminal act committed by or at sonal and advertising injury" offense has the direction of the insured. been committed at the earliest time when e. Contractual Liability any "authorized representative": "Personal and advertising injury" for (1) Reports all, or any part, of the "per- which the insured is obligated to pay sonal and advertising injury" to us or damages by reason of the assumption of any other insurer; liability in a contract or agreement. This (2) Receives a written or verbal demand exclusion does not apply to liability for or claim for damages because of the damages: "personal and advertising injury"; (1) That the insured would have in the (3) First observes, or reasonably should absence of the contract or agree- have first observed, the offense that ment; or caused the "personal and adverbs- (2) Assumed in a contract or agreement ing injury"; that is an "insured contract", pro- (4) Becomes aware, or reasonably vided the "personal and advertising should have become aware, by any injury" is caused by or arises out of means, other than as described in an offense committed subsequent to (3) above, that the offense had been the execution of the contract or committed or had begun to be com- agreement. When a claim for such mitted; or "personal and advertising injury" is made, we will defend that claim, pro- (5) Becomes aware, or reasonably vided the insured has assumed the should have become aware, of a obligation to defend such claim in the condition from which "personal and "insured contract". Such defense advertising injury" is substantially payments will not reduce the limits of certain to occur. insurance. 2. Exclusions f. Breach of Contract This insurance does not apply to: "Personal and advertising injury" arising out of a breach of contract, except an im- a. Knowing Violation of Rights of Another plied contract to use another's advertising "Personal and advertising injury" caused idea in your "advertisement". by or at the direction of the insured with g. Quality or Performance of Goods - the knowledge that the act would violate Failure to Conform to Statements the rights of another and would inflict "personal and advertising injury". "Personal and advertising injury" arising b. out of the failure of goods, products or Material Published With Knowledge of services to conform with any statement of Falsity quality or performance made in your "ad- "Personal and advertising injury" arising vertisement". out of oral or written publication of mate- h. Wrong Description of Prices rial, if done by or at the direction of the in- sured with knowledge of its falsity. "Personal and advertising injury" arising c. Material Published Prior to Coverage out of the wrong description of the price Term of goods, products or services stated in your "advertisement". "Personal and advertising injury" arising i. Infringement of Copyright, Patent, out of oral or written publication of mate- Trademark or Trade Secret rial whose first publication took place be- fore the later of the following: "Personal and advertising injury" arising out of the infringement of copyright, pat- Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 8 of 22 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 ent, trademark, trade secret or other in- or discrimination directed at that tellectual property rights. person; or However, this exclusion does not apply to (2) The spouse, child, parent, brother or infringement, in your "advertisement", of sister of that person as a conse- copyright, trade dress or slogan. quence of "personal and advertising j. Insureds in Media and Internet Type injury" to that person at whom any of Businesses the employment-related practices described in Paragraphs (a), (b) or "Personal and advertising injury" com- (c) above is directed. mitted by an insured whose business is: This exclusion applies: (1) Advertising, broadcasting, publishing (1) Whether the insured may be liable or telecasting; as an employer or in any other ca- (2) Designing or determining content of pacity; and web-sites for others; or (2) To any obligation to share damages (3) An Internet search, access, content with or repay someone else who or service provider. must pay damages because of the injury. However, this exclusion does not apply to Paragraphs 17. a., b. and c. of "personal n. Pollutant and advertising injury" under SECTION V "Personal and advertising injury" arising -DEFINITIONS. out of the actual, alleged or threatened For the purposes of this exclusion, the discharge, dispersal, seepage, migration, placing of frames, borders or links, or ad- release, escape or emission of "pollut- vertising, for you or others anywhere on ants" at any time. the Internet is not, by itself, considered o. Pollutant-Related the business of advertising, broadcasting, publishing or telecasting. Any loss, cost or expense arising out of k. Electronic Chatrooms or Bulletin any: Boards (1) Request, demand, order or statutory or regulatory requirement that any "Personal and advertising injury" arising insured or others test for, monitor, out of an electronic chatroom or bulletin clean up, remove, contain, treat, board any insured hosts, owns, or over detoxify or neutralize, or in any way which any insured exercises control. respond to, or assess the effects of, I. Unauthorized Use of Anothert Name "pollutants"; or or Product (2) Claim or suit by or on behalf of a "Personal and advertising injury" arising governmental authority for damages out of the unauthorized use of another's because of testing for, monitoring, name or product in your e-mail address, cleaning up, removing, containing, domain name or metatag, or any other treating, detoxifying or neutralizing, similar tactics to mislead another's poten- or in any way responding to, or as- tial customers. sessing the effects of, "pollutants". m. Employment Related Practices p. Asbestos "Personal and advertising injury" to: "Personal and advertising injury" arising out of, attributable to, or any way related (1) A person arising out of any: to asbestos in any form or transmitted in (a) Refusal to employ that person; any manner. q. Additional Insured Prior Knowledge (b) Termination of that person's employment; or An additional insured added by attach- ment of an endorsement to this Coverage (c) Other employment-related prac- Part that is seeking coverage for a claim tices, policies, acts or omissions or "suit", if that additional insured knew, including but not limited to coer- per the following paragraph, that a "per- cion, criticism, demotion, sonal and advertising injury" offense had evaluation, failure to promote, been committed or had begun to be reassignment, discipline, defa- committed, in whole or in part, prior to the mation, harassment, humiliation "coverage term" in which such offense Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 9 of 22 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 was committed or began to be commit- "Personal and advertising injury" arising ted. directly or indirectly out of any action or omission that violates or is alleged to An additional insured added by attach- violate: ment of an endorsement to this Coverage Part will be deemed to have known that a a. The Telephone Consumer Protection "personal and advertising injury" offense Act (TCPA), including any amend- has been committed or has begun to be ment of or addition to such law; or committed at the earliest time when that additional insured, or any one of its own- b. The CAN-SPAM Act of 2003, includ- ers, members, partners, managers, ex- ing any amendment of or addition to ecutive officers, "employees" assigned to such law; or manage that additional insured's insur- c. Any statute, ordinance or regulation, ance program, or "employees" assigned other than the TCPA or CAN-SPAM to give or receive notice of an "occur- Act of 2003, that prohibits or limits the rence", "personal and advertising injury" sending, transmitting, communicating offense, claim or"suit": or distribution of material or informa- (1) Reports all, or any part, of the "per- tion. sonal and advertising injury" to us or COVERAGE C. MEDICAL PAYMENTS any other insurer; (2) Receives a written or verbal demand 1. Insuring Agreement or claim for damages because of the a. We will pay medical expenses as de- "personal and advertising injury"; scribed below for "bodily injury" caused (3) First observes, or reasonably should by an accident: have first observed, the offense that (1) On premises you own or rent; caused the "personal and advertis- ing injury"; (2) On ways next to premises you own or rent; or (4) Becomes aware, or reasonably should have become aware, by any (3) Because of your operations; means other than as described in (3) provided that: above, that the "personal and adver- tising injury" offense had been com- (1) The accident takes place in the mitted or had begun to be commit- "coverage territory" and during the ted; or policy period; (5) Becomes aware, or reasonably (2) The expenses are incurred and re- should have become aware, of a ported to us within three years of the condition from which "personal and date of the accident; and advertising injury" is substantially certain to occur. (3) The injured person submits to ex- amination, at our expense, by physi- r. War cians of our choice as often as we "Personal and advertising injury", how- reasonably require. ever caused, arising, directly or indirectly, b. We will make these payments regardless out of: of fault. These payments will not exceed the applicable limit of insurance. We will (1) War, including undeclared or civil pay reasonable expenses for: war; (1) First aid administered at the time of (2) Warlike action by a military force, in- an accident; cluding action in hindering or de- fending against an actual or ex- (2) Necessary medical, surgical, x-ray pected attack, by any government, and dental services, including pros- sovereign or other authority using thetic devices; and military personnel or other agents; or (3) Necessary ambulance, hospital, (3) Insurrection, rebellion, revolution, professional nursing and funeral usurped power, or action taken by services. governmental authority in hindering or defending against any of these. 2. Exclusions s. Distribution of Material in Violation of We will not pay expenses for "bodily injury": Statutes Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 10 of 22 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 a. Any Insured cluding actual loss of earnings up to $250 a To any insured, except "volunteer work- day because of time off from work. ers". 5. All costs taxed against the insured in the "suit". b. Hired Person 6. Prejudgment interest awarded against the To a person hired to do work for or on insured on that part of the judgment we be- behalf of any insured or a tenant of any come obligated to pay and which falls within insured. the applicable limit of insurance. If we make c. Injury on Normally Occupied Premises an offer to pay the applicable limit of insur- ance, we will not pay any prejudgment interest To a person injured on that part of prem- based on that period of time after the offer. ises you own or rent that the person nor- mally occupies. 7. All interest on the full amount of any judgment that accrues after entry of the judgment and d. Workers' Compensation and Similar before we have paid, offered to pay, or de- Laws posited in court the part of the judgment that is within the applicable limit of insurance. To a person, whether or not an "em- ployee" of any insured, if benefits for the These payments will not reduce the limits of insur- "bodily injury" are payable or must be ance. provided under a workers' compensation or disability benefits law or a similar law. SECTION II-WHO IS AN INSURED e. Athletic Activities 1. If you are designated in the Declarations as: To any person injured while officiating, a. An individual, you and your spouse are coaching, practicing for, instructing or insureds, but only with respect to the participating in any physical exercises or conduct of a business of which you are games, sports, or athletic contests or ex- the sole owner. hibitions of an athletic or sports nature. b. A partnership or joint venture, you are an f. Products-Completed Operations Haz- insured. Your members, your partners, and and their spouses are also insureds, but only with respect to the conduct of your Included within the "products-completed business. operations hazard". c. A limited liability company, you are an in- g. Coverage A Exclusions sured. Your members are also insureds, Excluded under COVERAGE A. BODILY but only with respect to the conduct of yours, bueon. Your spect to are in- INJURY AND PROPERTY DAMAGE LI- sured but only with respect to their du- ABILITY. ties as your managers. SUPPLEMENTARY PAYMENTS - COVERAGES d. An organization other than a partnership, A AND B joint venture or limited liability company, We will pay, with respect to any claim we investi- you are an insured. Your "executive offi- gate or settle, or any "suit" against an insured we cers" and directors are insureds, but only defend: with respect to their duties as your offi- cers or directors. Your stockholders are 1. All expenses we incur. also insureds, but only with respect to their liability as stockholders. 2. Up to $250 for cost of bail bonds required be- cause of accidents or traffic law violations e. A trust, you are an insured. Your trustees arising out of the use of any vehicle to which are also insureds, but only with respect to the Bodily Injury Liability Coverage applies. their duties as trustees. We do not have to furnish these bonds. 2. Each of the following is also an insured: 3. The cost of bonds to release attachments, but only for bond amounts within the applicable a. Your "volunteer workers" only while per- limit of insurance. We do not have to furnish forming duties related to the conduct of these bonds. your business, or your "employees", other than either your "executive officers" 4. All reasonable expenses incurred by the in- (if you are an organization other than a sured at our request to assist us in the inves- partnership, joint venture or limited liability tigation or defense of the claim or "suit", in- company) or your managers (if you are a limited liability company), but only for acts within the scope of their employment by Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 11 of 22 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 you or while performing duties related to d. Your legal representative if you die, but the conduct of your business. However, only with respect to duties as such. That none of these "employees" or "volunteer representative will have all your rights workers" are insureds for: and duties under this Coverage Part. (1) "Bodily injury" or "personal and ad- 3. Any organization you newly acquire or form, vertising injury": other than a partnership, joint venture or lim- ited liability company, and over which you (a) To you, to your partners or maintain ownership or majority interest, will members (if you are a partner- qualify as a Named Insured if there is no other ship or joint venture), to your similar insurance available to that organiza- members (if you are a limited li- tion. However: ability company), to a co- "employee" while in the course a. Insurance under this provision is afforded of his or her employment or only until the 90th day after you acquire performing duties related to the or form the organization or the end of the conduct of your business, or to policy period, whichever is earlier; your other "volunteer workers" b. COVERAGE A. BODILY INJURY AND to the conduct of your business;ouries related while performing PROPERTY DAMAGE LIABILITY does not apply to "bodily injury" or "property (b) To the spouse, child, parent, damage" that occurred before you ac- brother or sister of that co- quired or formed the organization; and "employee" or "volunteer c. COVERAGE B. PERSONAL AND AD- worker" as a consequence o of Paragraph (1)(a) above; VERTISING INJURY LIABILITY does not apply to "personal and advertising injury" (c) For which there is any obligation arising out of an offense committed be- to share damages with or repay fore you acquired or formed the organi- someone else who must pay zation. damages because of the injury described in Paragraphs (1)(a) No person or organization is an insured with re- or(b) above; or spect to the conduct of any current or past part- nership, joint venture or limited liability company (d) Arising out of his or her provid- that is not shown as a Named Insured in the Dec- ing or failing to provide profes- larations. sional health care services. SECTION III- LIMITS OF INSURANCE (2) "Property damage" to property: 1. The Limits of Insurance shown in the Declara- (a) Owned, occupied or used by; or tions and the rules below fix the most we will (b) Rented to, in the care, custody pay regardless of the number of: or control of, or over which a. Insureds; physical control is being exer- cised for any purpose by, b. Claims made or "suits" brought; or you, any of your "employees", "vol- c. Persons or organizations making claims unteer workers", any partner or or bringing "suits". member (if you are a partnership or 2. a. The General Aggregate Limit is the most joint venture), or any member (if you we will pay for the sum of: are a limited liability company). (1) Medical expenses under COVER- b. Any person (other than your "employee" AGE C. MEDICAL PAYMENTS; or "volunteer worker"), or any organiza- tion while acting as your real estate man- (2) Damages under COVERAGE A. ager. BODILY INJURY AND PROPERTY dam- c. Any person or organization having proper DAMAGE LIABILITY, except r temporary custody of your property if you ages because of "bodily injury"dne die, but only: "property damage" included in the "products-completed operations (1) With respect to liability arising out of hazard"; and the maintenance or use of that prop- (3) Damages under COVERAGE B. erty; and PERSONAL AND ADVERTISING (2) Until your legal representative has INJURY LIABILITY. been appointed. This General Aggregate Limit will not ap- ply if either the Location General Aggre- Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 12 of 22 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 gate Limit of Insurance, Paragraph 2.b., your behalf at the same location for or the Construction Project General Ag- the same persons or organizations, gregate Limit of Insurance, Paragraph no matter how often or under how 2.c. applies. many different contracts, will be deemed to be a single construction b. A separate Location General Aggregate project. Limit of Insurance, equal to the amount of the General Aggregate Limit shown in the 3. The Products-Completed Operations Aggre- Declarations, shall apply to each location gate Limit is the most we will pay under COV- owned by, or rented or leased to you and ERAGE A. BODILY INJURY AND PROP- is the most we will pay for the sum of: ERTY DAMAGE LIABILITY for damages be- cause of "bodily injury" and "property dam- (1) Damages under COVERAGE A. age" included in the "products-completed op- BODILY INJURY AND PROPERTY erations hazard". DAMAGE LIABILITY, except dam- ages because of "bodily injury" or 4. Subject to 2.a. above, the Personal and Ad- "property damage" included in the vertising Injury Limit is the most we will pay "products-completed operations under COVERAGE B. PERSONAL AND AD- hazard"; and VERTISING INJURY LIABILITY for the sum of all damages because of all "personal and ad- (2) Medical expenses under COVER- vertising injury" sustained by any one person AGE C. MEDICAL PAYMENTS, or organization. which can be attributed to operations at 5. Subject to 2. or 3. above, whichever applies, only a single location owned by, or rented the Each Occurrence Limit is the most we will or leased to you. pay for the sum of: c. A separate Construction Project General a. Damages under COVERAGE A. BODILY Aggregate Limit of Insurance, equal to INJURY AND PROPERTY DAMAGE Li- the amount of the General Aggregate ABILITY; and Limit shown in the Declarations, shall ap- ply to each construction project and is the b. Medical expenses under COVERAGE C. most we will pay for the sum of: MEDICAL PAYMENTS; (1) Damages under COVERAGE A. because of all "bodily injury" and "property BODILY INJURY AND PROPERTY damage" arising out of any one "occurrence". DAMAGE LIABILITY, except dam- ages because of "bodily injury" or 6. Subject to 5. above, the Damage to Premises "property damage" included in the Rented to You Limit is the most we will pay "products-completed operations under COVERAGE A. BODILY INJURY AND hazard"; and PROPERTY DAMAGE LIABILITY for dam- ages because of "property damage" to any (2) Medical expenses under COVER- one premises, while rented to you, or in the AGE C. MEDICAL PAYMENTS; case of damage by fire or explosion, while rented to you or temporarily occupied by you which can be attributed only to ongoing with permission of the owner. operations and only at a single construc- tion project. 7. Subject to 5. above, the Medical Expense Limit is the most we will pay under COVER- d. Only for the purpose of determining which AGE C. MEDICAL PAYMENTS for all medical General Aggregate Limit of Insurance, expenses because of "bodily injury" sustained 2.a., 2.b., or 2.c., applies: by any one person. (1) Location means premises involving The Limits of Insurance of this Coverage Part ap- the same or connecting lots, or ply separately to each "coverage term". premises, whose connection is inter- rupted only by a street, roadway, SECTION IV - COMMERCIAL GENERAL LI- waterway or right-of-way of a rail- ABILITY CONDITIONS road. 1. Bankruptcy (2) Construction project means a loca- tion you do not own, rent or lease Bankruptcy or insolvency of the insured or of where ongoing improvements, al- the insured's estate will not relieve us of our terations, installation, demolition or obligations under this Coverage Part. maintenance work is performed by 2. Duties in the Event of Occurrence, Offense, you or on your behalf. All connected Claim or Suit ongoing improvements, alterations, installation, demolition or mainte- a. You must see to it that we are notified as nance work performed by you or on soon as practicable of an "occurrence" or Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 13 of 22 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 a "personal and advertising injury" of- under the terms of this Coverage Part or that fense which may result in a claim. To the are in excess of the applicable limit of insur- extent possible, notice should include: ance. An agreed settlement means a settle- ment and release of liability signed by us, the (1) How, when and where the "occur- insured and the claimant or the claimant's le- rence" or offense took place; gal representative. (2) The names and addresses of any 4. Liberalization injured persons and witnesses; and If, within 60 days prior to the beginning of this (3) The nature and location of any injury Coverage Part or during the policy period, we or damage arising out of the "occur- make any changes to any forms or endorse- rence" or offense. ments of this Coverage Part for which there is b. If a claim is made or "suit" is brought currently no separate premium charge, and against any insured, you must: that change provides more coverage than this Coverage Part, the change will automatically (1) Immediately record the specifics of apply to this Coverage Part as of the latter of: the claim or "suit" and the date re- a. The date we implemented the change in ceived; and your state; or (2) Notify us as soon as practicable. b. The date this Coverage Part became ef- You must see to it that we receive written fective; and notice of the claim or "suit" as soon as practicable. will be considered as included until the end of the current policy period. We will make no c. You and any other involved insured must: additional premium charge for this additional coverage during the interim. (1) Immediately send us copies of any demands, notices, summonses or 5. Other Insurance legal papers received in connection with the claim or "suit"; If other valid and collectible insurance is available to the insured for a loss we cover (2) Authorize us to obtain records and under COVERAGE A. BODILY INJURY AND other information; PROPERTY DAMAGE LIABILITY or erate with us in the investiga- COV- ERAGE B. PERSONAL AND ADVERTISING (3) Cooperate 9 INJURY LIABILITY of this Coverage Part, our Lion or settlement of the claim or de- obligations are limited as follows: fense against the "suit"; and a. Primary Insurance (4) Assist us, upon our request, in the enforcement of any right against any This insurance is primary except when b. person or organization which may be below applies. If this insurance is pri- liable to the insured because of in- mary, our obligations are not affected jury or damage to which this insur- unless any of the other insurance is also ance may also apply. primary. Then, we will share with all that other insurance by the method described d. No insured will, except at that insured's in c.below. own cost, voluntarily make a payment, assume any obligation, or incur any ex- b. Excess Insurance pense, other than for first aid, without our consent. This insurance is excess over: 3. Legal Action Against Us (1) Any of the other insurance, whether primary, excess, contingent or on No person or organization has a right under any other basis: this Coverage Part: (a) That is Fire, Extended Cover- a. To join us as a party or otherwise bring age, Builder's Risk, Installation us into a "suit" asking for damages from Risk or similar insurance for an insured; or "your work"; b. To sue us on this Coverage Part unless (b) That is Fire or Explosion insur- all of its terms have been fully complied ance for premises rented to you with. or temporarily occupied by you with permission of the owner; A person or organization may sue us to re- cover on an agreed settlement or on a final (c) That is insurance purchased by judgment against an insured; but we will not you to cover your liability as a be liable for damages that are not payable tenant for "property damage" to Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 14 of 22 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 premises rented to you or tem- shown in the Declarations of this Cover- porarily occupied by you with age Part. permission of the owner; or c. Method of Sharing (d) If the loss arises out of the maintenance or use of aircraft, If all of the other insurance permits con- "autos" or watercraft to the ex- tribution by equal shares, we will follow tent not subject to SECTION I - this method also. Under this approach COVERAGES, COVERAGE A. each insurer contributes equal amounts BODILY INJURY AND PROP- until it has paid its applicable limit of in- ERTY DAMAGE LIABILITY, 2. surance or none of the loss remains, Exclusions, g.Aircraft,Auto or whichever comes first. Watercraft. If any of the other insurance does not (2) Any other primary insurance avail- permit contribution by equal shares, we able to the insured covering liability will contribute by limits. Under this for damages arising out of the method, each insurer's share is based on premises or operations, or the prod- the ratio of its applicable limit of insurance ucts and completed operations, for to the total applicable limits of insurance which the insured has been added of all insurers. as an additional insured by attach- 6. Premium Audit ment of an endorsement. (3) Any other insurance: a. We will compute all premiums for this Coverage Part in accordance with our (a) Whether primary, excess, con- rules and rates. tingent or on any other basis, b. Premium shown in this Coverage Part as except when such insurance is advance premium is a deposit premium written specifically to be excess only. At the close of each audit period we over this insurance; and will compute the earned premium for that (b) That is a consolidated (wrap-up) period and send notice to the first Named insurance program which has Insured. The due date for audit and ret- been provided by the prime rospective premiums is the date shown contractor/project manager or as the due date on the bill. If: owner of the consolidated proj- (1) The earned premium is less than the ect in which you are involved. deposit premium, we will return the When this insurance is excess, we will excess to the first Named Insured; or have no duty under COVERAGE A. (2) The earned premium is greater than BODILY INJURY AND PROPERTY the deposit premium, the difference DAMAGE LIABILITY or COVERAGE B. will be due and payable to us by the PERSONAL AND ADVERTISING IN- first Named Insured upon notice from JURY LIABILITY to defend the insured us. against any "suit" if any other insurer has a duty to defend the insured against that c. The first Named Insured must keep rec- "suit". If no other insurer defends, we will ords of the information we need for pre- undertake to do so, but we will be entitled mium computation, and send us copies at to the insured's rights against all those such times as we may request. other insurers. 7. Representations When this insurance is excess over other insurance, we will pay only our share of By accepting this Coverage Part, you agree: the amount of the loss, if any, that ex- a. The statements in the Declarations are ceeds the sum of: accurate and complete; (1) The total amount that all such other b. Those statements are based upon repre- insurance would pay for the loss in sentations you made to us; and the absence of this insurance; and (2) The total of all deductible and self- c. We have issued this Coverage Part in re- insured amounts under all that other Hance upon your representations. insurance. 8. Separation of Insureds We will share the remaining loss, if any, Except with respect to the Limits of Insurance, with any other insurance that is not de- and any rights or duties specifically assigned scribed in this Excess Insurance provi- in this Coverage Part to the first Named In- sion and was not bought specifically to sured, this insurance applies: apply in excess of the Limits of Insurance Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 15 of 22 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 a. As if each Named Insured were the only (1) An individual, you and your spouse Named Insured; and are "authorized representatives". b. Separately to each insured against whom (2) A partnership or joint venture, your claim is made or "suit" is brought. members, your partners, and their spouses are "authorized representa- 9. Transfer of Rights of Recovery Against Lives". Others to Us (3) A limited liability company, your If the insured has rights to recover all or part members and your managers are of any payment we have made under this "authorized representatives". Coverage Part, those rights are transferred to us. The insured must do nothing after loss to (4) An organization other than a part- impair them. At our request, the insured will nership, joint venture or limited liabil- bring "suit" or transfer those rights to us and ity company, your "executive offi- help us enforce them. cers" and directors are "authorized representatives". Provided you are 10. Two or More Coverage Forms or Policies not a publicly traded organization, Issued by Us your stockholders are also "author- If this Coverage Part and any other Coverage ized representatives". Form, Coverage Part or policy issued to you (5) A trust, your trustees are "authorized by us or any company affiliated with us apply representatives". to the same "occurrence" or "personal and advertising injury" offense, the aggregate b. Your"employees": maximum limit of insurance under all the Cov- erage Forms, Coverage Parts or policies shall (1) Assigned to manage your insurance not exceed the highest applicable limit of in- program; or surance under any one Coverage Form, Coy- (2) Responsible for giving or receiving erage Part or policy. This condition does not notice of an "occurrence", "personal apply to any Coverage Form, Coverage Part and advertising injury" offense, claim or policy issued by us or an affiliated company or "suit"; specifically to apply as excess insurance over this Coverage Part. are also "authorized representatives". 11. When We Do Not Renew 3. "Auto" means: If we decide not to renew this Coverage Part, a. A land motor vehicle, trailer or semitrailer we will mail or deliver to the first Named In- designed for travel on public roads, in- sured shown in the Declarations written notice cluding any attached machinery or of the nonrenewal not less than 30 days be- equipment; or fore the expiration date. b. Any other land vehicle that is subject to a If notice is mailed, proof of mailing will be suf- compulsory or financial responsibility law ficient proof of notice. or other motor vehicle insurance law in SECTION V- DEFINITIONS the state where it is licensed or principally garaged. 1. "Advertisement" means a notice that is broad- However, "auto" does not include "mobile cast, telecast or published to the general pub- equipment". lic or specific market segments about your goods, products or services for the purpose of 4. "Bodily injury" means bodily injury, sickness or attracting customers or supporters. "Adver- disease sustained by a person, including tisement" includes a publicity article. For pur- death resulting from any of these at any time. poses of this definition: 5. "Coverage term" means the following individ- a. Notices that are published include mate- ual increment, or if a multi-year policy period, rial placed on the Internet or on similar increments, of time, which comprise the policy electronic means of communication; and period of this Coverage Part: b. Regarding web-sites, only that part of a a. The year commencing on the Effective web-site that is about your goods, prod- Date of this Coverage Part at 12:01 AM ucts or services for the purposes of at- standard time at your mailing address tracting customers or supporters is con- shown in the Declarations, and if a multi- sidered an "advertisement". year policy period, each consecutive t. "Authorized representative" means: an- nual period thereafter, or portion thereof if any period is for a period of less than 12 a. If you are designated in the Declarations months, constitute individual "coverage as: terms". The last "coverage term" ends at Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 16 of 22 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 12:00 AM standard time at your mailing 10. "Hostile fire" means one which becomes un- address shown in the Declarations on the controllable or breaks out from where it was earlier of: intended to be. (1) The day the policy period shown in 11. "Impaired property" means tangible property, the Declarations ends; or other than "your product" or "your work", that cannot be used or is less useful because: (2) The day the policy to which this Cov- erage Part is attached is terminated a. It incorporates "your product" or "your or cancelled. work" that is known or thought to be de- fective, deficient, inadequate or danger- b. However, if after the issuance of this ous; or Coverage Part, any "coverage term" is extended for an additional period of less b. You have failed to fulfill the terms of a than 12 months, that additional period of contract or agreement; time will be deemed to be part of the last preceding "coverage term". if such property can be restored to use by: 6. "Coverage territory" means: a. The repair, replacement, adjustment or removal of "your product" or "your work"; a. The United States of America (including or its territories and possessions), Puerto Rico and Canada; b. Your fulfilling the terms of the contract or agreement. b. International waters or airspace, but only if the injury or damage occurs in the 12. "Insured contract" means: course of travel or transportation between a. A contract for a lease of premises. How- any places included in a.above; or ever, that portion of the contract for a c. All other parts of the world if the injury or lease of premises that indemnifies any damage arises out of: person or organization for "property damage" by fire or explosion to premises (1) Goods or products made or sold by while rented to you or temporarily occu- you in the territory described in a. pied by you with permission of the owner above; is not an "insured contract"; (2) The activities of a person whose b. A sidetrack agreement; home is in the territory described in a. above, but is away for a short time c. Any easement or license agreement, ex- on your business; or cept in connection with construction or demolition operations on or within 50 feet (3) "Personal and advertising injury" of- of a railroad; Tenses that take place through the Internet or similar electronic means d. An obligation, as required by ordinance, of communication, to indemnify a municipality, except in connection with work for a municipality; provided the insured's responsibility to pay damages is determined in a "suit" on e. An elevator maintenance agreement; the merits, in the territory described in a. f. That part of any other contract or agree- above or in a settlement to which we ment pertaining to your business (includ- agree. ing an indemnification of a municipality in 7. "Electronic data" means information, facts or connection with work performed for a programs stored as or on, created or used on, municipality) under which you assume or transmitted to or from computer software, the tort liability of another party to pay for including systems and applications software, "bodily injury", "property damage" or hard or floppy disks, CD-ROMs, tapes, drives, "personal and advertising injury"to a third cells, data processing devices or any other person or organization. Tort liability media which are used with electronically con- means a liability that would be imposed trolled equipment. by law in the absence of any contract or agreement. 8. "Employee" includes a "leased worker". "Em- ployee" does not include a "temporary Paragraph f. does not include that part of worker". any contract or agreement: 9. "Executive officer" means a person holding (1) That indemnifies a railroad for "bodily any of the officer positions created by your injury", "property damage" or "per- charter, constitution, by-laws or any other sonal and advertising injury" arising similar governing document. out of construction or demolition op- erations, within 50 feet of any rail- Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 17 of 22 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 road property and affecting any rail- engines; marketing analysis; and road bridge or trestle, tracks, road- providing access to the Internet or beds, tunnel, underpass or crossing; other similar networks; or (2) That indemnifies an architect, engi- (7) Under which the insured, if a web- neer or surveyor for injury or damage site designer or content provider, or arising out of: Internet search, access, content or service provider, assumes liability for (a) Preparing, approving, or failing injury or damage arising out of the to prepare or approve, maps, insured's rendering or failure to ren- shop drawings, opinions, re- der Internet services, including those ports, surveys, field orders, listed in Paragraph (6), above. change orders or drawings and specifications; or 13. "Leased worker" means a person leased to you by a labor leasing firm under an agree- (b) Giving directions or instructions, ment between you and the labor leasing firm, or failing to give them, if that is to perform duties related to the conduct of the primary cause of the injury your business. "Leased worker" includes su- or damage; pervisors furnished to you by the labor leasing (3) Under which the insured, if an archi- firm. "Leased worker" does not include a tect, engineer or surveyor, assumes "temporary worker". liability for an injury or damage aris- 14. "Loading or unloading" means the handling of ing out of the insured's rendering or property: failure to render professional serv- ices, including those listed in Para- a. After it is moved from the place where it is graph (2) above and supervisory, in- accepted for movement into or onto an spection, architectural or engineering aircraft, watercraft or "auto"; activities; b. While it is in or on an aircraft, watercraft (4) That indemnifies an advertising, pub- or "auto"; or lic relations or media consulting firm for "personal and advertising injury" c. While it is being moved from an aircraft, arising out of the planning, execution watercraft or "auto" to the place where it or failure to execute marketing com- is finally delivered; munications programs. Marketing but "loading or unloading" does not include communications programs include the movement of property by means of a me- but are not limited to comprehensive chanical device, other than a hand truck, that marketing campaigns; consumer, is not attached to the aircraft, watercraft or trade and corporate advertising for "auto". all media; media planning, buying, monitoring and analysis; direct mail; 15. "Mobile equipment" means any of the follow- promotion; sales materials; design; ing types of land vehicles, including any at- presentations; point-of-sale materi- tached machinery or equipment: als; market research; public relations and new product development; a. Bulldozers, farm machinery, forklifts and other vehicles designed for use princi- (5) Under which the insured, if an adver- pally off public roads; tising, public relations or media con- sulting firm, assumes liability for b. Vehicles maintained for use solely on or "personal and advertising injury" next to premises you own or rent; arising out of the insured's rendering c. Vehicles that travel on crawler treads; or failure to render professional services, including those services d. Vehicles, whether self-propelled or not, listed in Paragraph (4), above; maintained primarily to provide mobility to (6) That indemnifies a web-site designer permanently mounted: or content provider, or Internet (1) Power cranes, shovels, loaders, dig- search, access, content or service gers or drills; or provider for injury or damage arising out of the planning, execution or fail- (2) Road construction or resurfacing ure to execute Internet services. equipment such as graders, scrap- Internet services include but are not ers or rollers; limited to design, production, distri- e. Vehicles not described in a., b., c. or d. bution, maintenance and administra- above that are not self-propelled and are Lion of web-sites and web-banners; maintained primarily to provide mobility to hosting web-sites; registering do- main names; registering with search Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 18 of 22 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 permanently attached equipment of the d. Oral or written publication, in any manner, following types: of material that slanders or libels a per- son or organization or disparages a per- (1) Air compressors, pumps and gen- son's or organization's goods, products or erators, including spraying, welding, services; building cleaning, geophysical explo- ration, lighting and well servicing e. Oral or written publication, in any manner, equipment; or of material that violates a person's right of privacy; (2) Cherry pickers and similar devices used to raise or lower workers; f. The use of another's advertising idea in f. Vehicles not described in a., b., c. or d. your "advertisement"; or above maintained primarily for purposes g. Infringing upon another's copyright, trade other than the transportation of persons dress or slogan in your"advertisement". or cargo. 18. "Pollutant" means any solid, liquid, gaseous or However, self-propelled vehicles with the thermal irritant or contaminant, including following types of permanently attached smoke, vapor, soot, fumes, acids, alkalis, equipment are not "mobile equipment" chemicals, petroleum, petroleum products but will be considered "autos": and petroleum by-products, and waste. Waste includes materials to be recycled, re- (1) Equipment designed primarily for: conditioned or reclaimed. "Pollutants" include (a) Snow removal; but are not limited to substances which are generally recognized in industry or govern- (b) Road maintenance, but not con- ment to be harmful or toxic to persons, prop- struction or resurfacing; or erty or the environment regardless of whether the injury or damage is caused directly or indi- (c) Street cleaning; rectly by the "pollutants" and whether: (2) Cherry pickers and similar devices a. The insured is regularly or otherwise en- mounted on automobile or truck gaged in activities which taint or degrade chassis and used to raise or lower the environment; or workers; and b. The insured uses, generates or produces (3) Air compressors, pumps and gen- the "pollutant". erators, including spraying, welding, building cleaning, geophysical explo- 19. "Products-completed operations hazard": ration, lighting and well servicing equipment. a. Includes all "bodily injury" and "property damage" occurring away from premises However, "mobile equipment" does not in- you own or rent and arising out of "your dude any land vehicles that are subject to a product" or "your work" except: compulsory or financial responsibility law or other motor vehicle insurance law in the state (1) Products that are still in your physical where it is licensed or principally garaged. possession; or Land vehicles subject to a compulsory or fi- (2) Work that has not yet been com- nancial responsibility law or other motor vehi- pleted or abandoned. However, cle insurance law are considered "autos". "your work" will be deemed com- 16. "Occurrence" means an accident, including pleted at the earliest of the following continuous or repeated exposure to substan- times: tially the same general harmful conditions. (a) When all of the work called for in 17. "Personal and advertising injury" means in- your contract has been com- jury, including consequential "bodily injury", pleted; or arising out of one or more of the following of- (b) When all of the work to be done fenses: at the job site has been com- a. False arrest, detention or imprisonment; pleted if your contract calls for work at more than one job site; b. Malicious prosecution; or C. The wrongful eviction from, wrongful entry (c) When that part of the work done into, or invasion of the right of private oc- at a job site has been put to its cupancy of a room, dwelling or premises intended use by any person or that a person occupies, committed by or organization other than another on behalf of its owner, landlord or lessor; contractor or subcontractor working on the same project. Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 19 of 22 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 Work that may need service, main- her work and acts at the direction of and tenance, correction, repair or re- within the scope of duties determined by you, placement, but which is otherwise and is not paid a fee, salary or other compen- complete, will be treated as com- sation by you or anyone else for their work pleted. performed for you. b. Does not include "bodily injury" or "prop- 24. "Workplace" means that place and during erty damage" arising out of: such hours to which the "employee" sustain- ing "bodily injury" was assigned by you, or (1) The transportation of property, un- any other person or entity acting on your be- less the injury or damage arises out half, to work on the date of "occurrence". of a condition in or on a vehicle not owned or operated by you, and that 25. "Your product": condition was created by the "load- ing or unloading" of that vehicle by a. Means: any insured; (1) Any goods or products, other than (2) The existence of tools, uninstalled real property, manufactured, sold, equipment or abandoned or unused handled, distributed or disposed of materials; or by: (3) Products or operations for which the (a) You; classification, listed in the Declara- (b) Others trading under your name; Lions or in a schedule, states that or products-completed operations are included. (c) A person or organization whose 20. "Property damage" means: business or assets you have acquired; and a. Physical injury to tangible property, in- (2) Containers (other than vehicles), cluding all resulting loss of use of that materials, parts or equipment fur- property. All such loss of use shall be nished in connection with such deemed to occur at the time of the physi- goods or products. cal injury that caused it; or b. Loss of use of tangible property that is b. Includes: not physically injured. All such loss of (1) Warranties or representations made use shall be deemed to occur at the time at any time with respect to the fit- of the "occurrence" that caused it. ness, quality, durability, performance or use of "your product"; and For the purposes of this insurance, "electronic data" is not tangible property. (2) The providing of or failure to provide 21. "Suit" means a civil proceeding in which warnings or instructions. money damages because of "bodily injury", c. Does not include vending machines or "property damage" or "personal and adverbs- other property rented to or located for the ing injury" to which this insurance applies are use of others but not sold. alleged. "Suit" includes: 26. "Your work": a. An arbitration proceeding in which such damages are claimed and to which the a. Means: insured must submit or does submit with (1) Work or operations performed by our consent; you or on your behalf; and b. Any other alternative dispute resolution (2) Materials, parts or equipment fur- proceeding in which such damages are nished in connection with such work claimed and to which the insured submits or operations. with our consent; or c. An appeal of a civil proceeding. b. Includes: 22. "Temporary worker" means a person who is (1) Warranties or representations made fit- furnished to you to substitute for a permanent ness,any time with respectpto mthe ce "employee" on leave or to meet seasonal or r ofqu "youro, work durability, performance short-term workload conditions. or use of work"; and 23. "Volunteer worker" means a person who is (2) The providing of or failure to provide not your "employee", and who donates his or warnings or instructions. Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 20 of 22 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 NUCLEAR ENERGY LIABILITY EXCLUSION (Broad Form) 1. The insurance does not apply: an insured of services, materials, parts or equipment in connection A. Under any Liability Coverage, to "bodily with the planning, construction, injury" or"property damage": maintenance, operation or use of (1) With respect to which an insured un- any "nuclear facility", but if such fa- der this Coverage Part is also an in- cility is located within the United sured under a nuclear energy liability States of America, its territories or policy issued by Nuclear Energy Li- possessions or Canada, this Exclu- ability Insurance Association, Mutual sion (3) applies only to "property Atomic Energy Liability Underwriters, damage" to such "nuclear facility" Nuclear Insurance Association of and any property thereat. Canada, or any of their successors, 2. As used in this exclusion: or would be an insured under any such policy but for its termination "Hazardous properties" includes radioactive, upon exhaustion of its limit of liability; toxic or explosive properties. or "Nuclear material" means "source material", (2) Resulting from the "hazardous prop- "special nuclear material" or "by-product ma- erties" of "nuclear material" and with terial". respect to which (a) any person or organization is required to maintain "Source material", "special nuclear material", financial protection pursuant to the and "by-product material" have the meanings Atomic Energy Act of 1954, or any given them in the Atomic Energy Act of 1954 law amendatory thereof, or (b) the or in any law amendatory thereof. insured is, or had this Coverage Part "Spent fuel" means any fuel element or fuel not been issued would be, entitled to component, solid or liquid, which has been indemnity from the United States of used or exposed to radiation in a "nuclear re- America, or any agency thereof, un- actor". der any agreement entered into by the United States of America, or any "Waste" means any waste material (a) con- agency thereof, with any person or taining "by-product material" other than the organization. tailings or wastes produced by the extraction or concentration of uranium or thorium from B. Under any Medical Payments coverage, any ore processed primarily for its "source to expenses incurred with respect to material" content, and (b) resulting from the "bodily injury" resulting from the "hazard- operation by any person or organization of ous properties" of "nuclear material" and any "nuclear facility" included under the first arising out of the operation of a "nuclear two paragraphs of the definition of "nuclear facility" by any person or organization. facility". C. Under any Liability Coverage, to "bodily "Nuclear facility" means: injury" or "property damage" resulting from the "hazardous properties" of "nu- A. Any "nuclear reactor"; clear material", if: B. Any equipment or device designed or (1) The "nuclear material" (a) is at any used for (1) separating the isotopes of "nuclear facility" owned by, or oper- uranium or plutonium, (2) processing or ated by or on behalf of, an insured, utilizing "spent fuel", or (3) handling, or (b) has been discharged or dis- processing or packaging "waste"; persed therefrom; C. Any equipment or device used for the (2) The "nuclear material" is contained in processing, fabricating or alloying of "spent fuel" or "waste" at any time "special nuclear material" if at any time possessed, handled, used, proc- the total amount of such material in the essed, stored, transported or dis- custody of the insured at the premises posed of, by or on behalf of an in- where such equipment or device is lo- sured; or cated consists of or contains more than 25 grams of plutonium or uranium 233 or (3) The "bodily injury" or "property dam- any combination thereof, or more than age" arises out of the furnishing by 250 grams of uranium 235; Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 21 of 22 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 D. Any structure, basin, excavation, prem- "Nuclear reactor" means any apparatus de- ises or place prepared or used for the signed or used to sustain nuclear fission in a storage or disposal of "waste"; self-supporting chain reaction or to contain a critical mass of fissionable material. and includes the site on which any of the foregoing is located, all operations conducted "Property damage" includes all forms of ra- on such site and all premises used for such dioactive contamination of property. operations. Includes copyrighted material of Insurance GA 101 12 04 Services Office, Inc., with its permission. Page 22 of 22 000umun Envelope|o 16*851o5f\5Ae'*ax* a702'2059600ea728 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ I][ CAREFULLY. »�U ��`nci" "�� U � BUSINESS AUTO XC+O �� i� �� ~��i-� �&� �� PLUS) ��~vvn ^ `/��~�� ~` v^ `��~ ��A�� ~o°��nv��~nn"�~nm . This endorsement modifies insurance provided by the following: BUSINESS AUTO COVERAGE FORM With respect to the coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified hy this endorsement. A. Blanket Waiver nfSubrogation This provision does not apply unless the valid wri8en�oo�ac� haoboeo� SECTION UV ~ BUSINESS AUTO C��ND|^ T|ON8, A. Loss Conditions, 5. Transfer of 1. Executed prior to the accident causing Rights of Recovery Against Others toUsio "bodily ioju?y'or"property danoage'', and amended hy the addition of the following: 2. |u still io force a1 the time uf the "accident" VVo waive any right of recovery mm may have causing "bodily injury'' or "property dam- against unypwrnonornryuniza\ionhecauswof age". payments we make for "bodily inju9'' nr "property damage"arising out uf the operation O. Employee Hired Auto ofacovered ''au\o'' when you have assumed 1. Changes in Liability Coverage liability for such "bodily injury" or "property damage" under un "insured onrk,uct'. p/nvk]- The following io added 1n the SECTION U ed the "bodily injury'ur"property damage" uu' ^ LIABILITY COVERAGE, ACoverage, curs subsequent to the execution or the "m- 1.Who isonInsured: *oreduoo|ract" An "employee" of yours is an "insured" B. Noncontributory Insurance while operating an '\au\o'' hired nrrented under o contract or agreement in that SECTION UV BUSINESS AUTO ��(�NO| ''~ ~ ennp|nyee's'' name, with your permission, T|ONS B. (�enenx| (��ndid�nn � Other |n ` � ` � ~ while performing duties related 1uthe surence c. is deleted in its entirety and re- conduct of your business. placed hy the following: c. Regard|e000ftheprovinionnofPa/- 2. Changes in General Conditions og/oph a. above, this Coverage SECTION |V ^ BUSINESS AUTO CON^ Foroo'uLiahi|ityCovera0eiuprinoary D|T|ONS. B. General Conditions, 5. and vw* will not seek contribution Other Insurance is deleted io its entirety from any other insurance for any |iu- and replaced hy the fh||ow/in0� hi|i\y unnunnzd under an "insured contract" that requires liability to be b. For Hired Auto Physical Damage assumed ona primary nonoon\ribu1o' Coverage the following are deemed rybasin. 1nhe covered ''ou<no''you nvxw C. Additional Insured hyContract (1) Any covered ''auto" you lease, hire, rent o/ borrow, and SECTION || ~ LIABILITY COVERAGE, A Coverage, 1. Who iaan Insured isamended (2) Any covered ''auto" hired or 10 include a*on insured any person nrorgaoi rented by your ''crnp|nyee'' under auun1ra'� in �ha1individua| ''eno zohon for v,hn/nyou have agreed inovalid w«i8onuontra(t tu provide insurance asaf- P|oyeo'o'' name, with your per- forded by1hinpo|icy mission, while performing duties related to the conduct of your This provision iu limited k) the scope ufthe business. valid mitten contract. Includes copyrighted material ofISO /\/\ 288O62U Properties, |nu. with its permission. Page 1of4 000umun Envelope|o 16*851o5f\5Ae'*ax* a702'2059600ea728 However, any '.autu'' that ioleased, a. |n effective nn the date ofacquisition hired, rented nr borrowed with adriver or formation, and is afforded for 1O0 io not e covered''au1o" days after such date, E. Audio, Visual and Data Electronic Equip- b. Does not apply to "bodily irjun/' ur nment "property damage" resulting from an "accident" that occurred before you SECTION ||| PHYSICAL O�0��E C��V ^ ^ acquired or formed the organization, ERAGE/ C. Limit uf Insurance io amended Uy adding the following: c. Does not apply 10 any newly acquired ur formed organization that inajoint 4. The most wowill pay for all '1ouo" 1uau- venture or partnership,and Uiu' visual or data electronic equipment and any accessories used with this d. Does not apply 1uan insured under equipment as a result of any one '\auoi any other automobile liability policy or dent"io the lesser nf would he an insured under such a policy but for the termination nfsuch a� The actual cash value of dam policy or the exhaustion uf such pu|i a0edurstu|enproportyaoufthe1inoe oy'o limits ufinsurance. of1he,,aooiden[` . 3� Any uf your '\enop|oyee�' while using a b. The cost uf repairing urrep|a�ngthe covered '\auto" in your business uryour damaged or stolen property with o1h' personal affairs, provided you du not own, er property uf like kind and quality, nr hire or borrow that'�au1o" c. $250O ' G. Liability Coverage Extensions ` Supple- Provided the equipment, at the time nfthe nnentary Payments ~Higher Limits loos�`in SECTION || ` LIABILITY COVERAGE, /L a. Permanently installed ino/ upon the Coverage, 2 Coverage Extensions, a. Sup- covered ''auto'' inahousing' opemng p|ennentary Payments io amended by: ur other location that io not normally 1� Rep|aungthe $2.O0O Limit ufInsurance used by the ''auto'' manufacturer for for bail bonds with $4'000in /2>, anU the installation nf such equipnoen1, ` ' %. Replacing the $Z5O Limit nf Insurance for b. Removablefroma permanently in reasonable expenses with$508in (4\ n1e||ed housing unit as described in ` ' Paragraph 2.m. above, nr H. Amended Fellow Employee Exclusion u. An integral part uf such equipment. SECTION || ` LIABILITY COVERAGE, B. Eu` c|uyions` 5. Fe||owvEmmp|oyeeinnooUifiedan F Who -Amended � ~ h)Unws� SECTION || L|��B|L|T`Y <��]VER/��E A.~ ' Exclusion 5. Fellow Employee indeleted. Coverage, 1. Who inan Insured ioamended Uy adding the fol|onin0� U. Hired Auto `Physical Damage The following are"|nsured,�' If hired "autus�'are covered "autos�'for Liability Coverage, then Comprehensive and Collision 1. Any suhsidiarywhich ina legally inonrPo Physical Damage Coverages ao provided un rateUonhtynfvvhiuhynuownafinanuia| der SECTION III ~ PHYSICAL DAMAGE interest nf more than 5OY6uf the voting COVERAGE of this Coverage Part are ex- stock on the effective date nf this cover- tended 1o ''autun" you hire, subject 1n the h)| a8efhrno. lowing: However, the insurance afforded by this 1� The most we will pay for "1000/' to any provision does not apply tn any nuh�diary hired ''auto" io $5O'O00or the actual cash that isan 'insured'' under any other au- value nr cost 1u repair or replace, vvhioh' 1nnx>bi|e |iabi|iLypu|icyor\,ouNbeen "in ever io the least, minus adeductible. nured" under such policy but for termina- tion nfnuohpu|ioynrtheoxhaunhonn[ 2. The deductible will be equal 1u the largest such pn|ioyo limits uf insurance. deductible applicable to any owned '\auto" for that coverage, or $1'8OO' whichever in 2. Any organization that io newly acquired ur less. formed by you and over which you main- tain noajorityowne/ohipThoinou/anoe 3. Hired Auto Physical Damage coverage provided by this provision in excess over any other collectible insur- ance. Includes copyrighted material ofISO /\/\ 288O62U Properties, |nu, with its permission. Page of 000umun Envelope|o 16*851o5f\5Ae'*ax* a702'2059600ea728 4. Subject k>the above limit,deductible, and K. Transportation Expense -Higher Limits excess provisions we will provide cover- age SE��T|��NU| PHYS|��\LO�K��EC��V equa| 1o1hebruadeo1unvenageepp|i ^ ^ nab|e 1n any covered `�au1u" you own in' ERAGE` A. Coverage, 4. Coverage Exten~ ouredunUerthinyn|ioy yionu is amended by replacing $20 per day with $58 per day' and $008 noaxinouno with Coverage includes loss of use of that hi"eUau' $1.5OU maximum in Extension a. Tronspor^ tn, provided it results from an ''aooiUen1" for tationExpenseo which you are legally liable and aoa result of which a monetary |000 is sustained by the L. Airbag Coverage leasing or rental concern. The most we will SECTION ||| ` PHYSICAL DAMAGE COV` yayfhranyune ''aooiUen1'' io$3.O00 EFW\GE, B. Exclusions, 3.a. in amended by |fa limit for Hired Auto Physical Damage in adding the t>|ov/ing� shown in the Schedule, then that limit reP|ao- However, the mechanical and electrical es, and io not added to, the $50.000 limit inUi breakdown portion n[ this exclusion does not oated above and the deductibles shown inthe apply 10 the accidental discharge ofanairbag. Schedule are applicable. This coverage for airbags in excess over any J. Rental Reimbursement other collectible insurance orwarranty. SECTION ||| ^ PHYSICAL O/\0A8E C[>V. M. Loan mr Lease Gap Coverage ERAGEioan.endeUhy adding the hl||owing� 1 SECTION III ~ PHYSICAL DAMAGE ��i�VER�(�E �� Linmi� �f |nsuronueio 1. YVov�|| pay h)rrental reinoUuroenoentex- ' pen000 incurred by you for the rental uf deleted in its entirety and replaced Uythe an''au1o'' because ufa '1nsn'`1uacovered h)||w/vin8, but only for private passenger ''autn'' Payment applies in addition 1uthe type ''autoo''with an original loan orlease, otherwise applicable amount uf each ou»- and only in the event ufa "total loss" 1u erage you have ona covered ''autu'' No such a private passenger type''auto'`� deductible applies 1n this coverage. a. The most we will pay for'1oun'' inany 2. VVe will pay only for those expenses in- one ''anoiUent"in the greater of: nurreU during the policy period beginning (1> The anoountdue under the ternoo 24 hours after the '1oao'' and ending, re- ` ' uf the lease nr loan towhich garo|eno of the pn|icys expiration, with your onvereU private passenger the |0000r of the h)||nxving number of type ''auto'' io subject, but will not days: include a. The number cfdays reasonably re (m) Overdue lease nr loan pay- qu|reU1u repair the covered '`auto'` |t ` ' noen10 '1oss'' io caused Uy theft,this number ' of days is added to the number of (b) Financial penalties imposed days i1 takes 1u locate the covered under the lease due 1uhigh "auLo''and return it1u you, ur mileage, excessive use or b. 38Uayo. abnormal wear and tear, /c} 8euur�y deposits not re 3. Our payn�ontis |inoitedtu the lesser ufthe ` ' funded by the lessor, following amounts /d} Costs for extended vuanan- a. Necessary and actual expenses in- ` ' ties, Credit Life Insurance, ourrodur ' Health, Accident nrDisabi| b. $50 per day. i1y Insurance purchased with the loan urlease, and 4. This coverage does not apply while there are spare nrreserve '\autos!' available to (e) Carry-over balances from you for your operations. previous loans ur leases, ur A��ue| oenh value of the o1u|on�> G. YVowi|| pay under this coverage only that (` ' amount uf your rental reimbursement ex- ur damaged property. pennen which in not already provided for b� An adjustment for depreciation and under SECTION U|| PHYSICAL DAM-~ physical condition vj|| be made in de- AGE C(]VER/\<3E` A. Coveroge` 4. ternoining actual cash value atthe Coverage Extensions. time of'1noo" Includes copyrighted material ofISO /\/\ 288O62U Properties, |nu. with its permission. Page of 000umun Envelope|o 16*851o5f\5Ae'*ax* a702'2059600ea728 2. SECTION V ~ DEFINITIONS inamended P. Unintentional Failure ho Disclose Hazards by adding the fh |nwing' but only for the SECTION IV BUS|NEQS �U�D ��NO| o� this Loan or Lease Gap ~ ^ purposes T|��N�� B. ��enerm| <��nd�i�ny � Conceal- ment, ' � ' � ~ ment, Misrepresentation or Fraud is "Total |oss�' means a "1oss�' in which the amended by adding the hol|ovvin0� cost of repairs plus the salvage value ex- ceeds theao1ua| oanhva|ue However, if you unintentionally fail to disclose any hazards existing nn the effective date of N. Glass Repair-Waiver ofDeductible this Coverage Form, we will not deny cover- age under this Coverage Form because of SECTION III PHYSICAL - such failure. ERAGE` D. Deductible in amended Uyadding the following: Q. Mental Anguish Resulting from Bodily | ju~ NoUeUuoLib|eapp|ieotug|anndamageif1he ` glass in repaired ina manner acceptable tnuo SECTION V ~DEFINITIONS, C. "Bodily i rather1hanrep|aued n/ io deleted in its entirety and replaced by O. Duties in the Event nfan Accident, Claim, thehzUovving� Suit or Loss~Amended "Bodily injur\/' means bodily injury, sickness or disease sustained hya person, including men- SECTION UV BUSINESS ^ ta| anguish and death sustained Uy the same T|(]NS /� LmooCmnditiony 2 Dutieuinthe ` � ` person that results from such bodily injury, Event of&ccident <�|oirn Suit a in ` / ' � oioknono or disease. "Bodily injury' does not amended Uy adding the fn||owin0: include mental anguish or death that does not This condition applies only when the ''aooi result from bodily injury, sickness urdisease. dent"orinnn'` in known to R. Coverage for Certain Operations in Cmn` 1. You,if you are anindividual, nectiom with Railroads 2. A partner, if you are apartnership, With respect 1n the use cfe covered '.au1d" in operations for nr affecting a railroad � 3. Anexooutiveuffioororinouranoonoana0 1 SET|�)NV DEF|�|T|ONSH "Ins ured er. ifynuaroaourporadon, ur . ` ` � non1rar[' lz� in�e|eteUini�senLietyanU 4. A member nr manager, if you are a |ino- replaced by the k)|ov/ing� itod liability company. c. An easement nr license agreement, 3. SECTION V ` DEFINITIONS, H. "Insured non1rarL'", %.m. iodeleted. Includes copyrighted material ofISO A/\ 288O62U Properties, |nu, with its permission. Page 4of4 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 Public Works and Utilities Department 100 Oyster Bay Ave. N. • Bremerton,WA 98312 • (360)473-5920 • FAX(360)473-5360 DATE: January 20, 2023 TO: Procurement File FROM: Cami Apfelbeck,Water Utility Manager SUBJECT: Sole Source Determination In accordance with Bremerton Municipal Code 2.76.090, Sole Source Purchases, the purpose of this memorandum is to document the necessity of sole source procurement methodology for the purchase of Cla-Val maintenance and rebuild services. Reasoning: ® Compatibility to existing City standard or to existing equipment, inventory, systems, data, programs or service (see attached documentation). ® Other: Describe why this is the only company that can provide the sole source product or service. Provide the support document that explains why a particular product, manufacturer, or service is necessary and provide support for why the company you requested is the only available company (see attached documentation). Cost/Quote support: Per proposal letter dated January 9, 2023 at a total cost of $30,189.00 (attached), our staff believes this is a fair and reasonable price. Therefore, it is my determination that it is in the City's best interests to purchase the Cla-Val maintenance and rebuild services through direct negotiation, pursuant to BMC 2.76.090 and 2.76.010, and that sole source purchase of these services is justified for this procurement. Recommended by: if/WIY Cami Apfel ater Utility Manager Approved by: Tom Knuckey Digitally signed by Tom Knuckey Date:2023.01.24 07:25:33-08'00' Thomas Knuckey, Public Works and Utilities Director • Page 1 Cimco-GC Systems January 20, 2023 Rev. 09/2022 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 TO: THOMAS KNUCKEY, DIRECTOR PUBLIC WORKS AND UTILITIES FROM: CAMI APFELBECK, WATER UTILITY MANAGER DATE: JANUARY 20, 2023 CITY OF BREMERTOtNt RE: BUSINESS CASE FOR STANDARDIZATION — CLA VAL CONTROL VALVES AND CIMCO GC-SYSTEMS, INC. SERVICES (Updates original standardization and sole source approval dated June 10, 2012) BMC 2.76.090 allows for the Director to determine that requests for bids may be waived when equipment involves special facilities or services and a bid would not be in the City's best interests but rather a purchase may be best established by direct negotiation. Automatic control valves are critical components in the water system for maintaining adequate pressure and flows. Failure of a control valve can cause serious system disruption, water quality concerns, and customer complaints and claims. Water operators must be conscientious in the operation and maintenance of Bremerton's 64 control valves. Many of the valve installations have complex configurations. This memo outlines the reasons why we standardized our purchase of automatic control valves in the Bremerton water system to the Cla-Val brand in 2012. • All but a few of Bremerton's control valves are the Cla-Val brand. We have 62 Cla-Val control valves in the Bremerton water system, along with two from other manufacturers: one Bailey and one Ross (both of these are usually off-line— used only when primary facility is temporarily shut down for maintenance). • Control valves require many small parts to be kept on hand, making inventory a challenge. It is easiest and more efficient to keep stock to one brand of valve. Many parts are interchangeable from valve size to valve size enabling us to keep a smaller inventory. • All of the operator's control valve training has been with the Cla-Val representatives and that is where our knowledge and experience is the strongest. Cla-Val has an effective training program. • We have a good working relationship with GC Systems who is the local representative for Cla- Val. They have been very responsive to our needs for tech support, training, and the annual maintenance contract. They have made recommendations that have improved our operations, saving time and money. They have built trust with us. • There appears to be no local technical/sales representatives for any of these valves other than Cla-Val in our area. • As stipulated in a letter from the Cla-Val Company, Cimco GC-Services, Inc., appear to be the only Cla-Val authorized sales, engineering and service agency in the greater northwest area (see next page). With limited staffing of seven Water Operators, it is imperative to be as efficient as possible. Cutting down the time and costs associated with control valve maintenance through standardization of our automatic control valves is one way to increase both employee efficiency and water system reliability. DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 Liu Cla-Val Co. t1412o23 Subject:Authorized Sales,Engineering,and Service Agency please be advised that the company below is the only Authorized Sales,Engineering,and Service Agency set up in the Greater Northwest,including the states of Alaska.Idaho.Oregon,and Washington. They inventory parts,controls,accessories,and complete valve assemblies which are ready to service your every Automatic Control Valve requirements_Their Service Department is available for normal scheduled maintenance and.repairs. For additional details please contact: CIMCO-GC SYSTEMS.INC. PO BOX 848 SUMNER,WA 98390 (8° )525-94z5 Mr.Beau Swet Respectfully, Jake Corzine Western Regional Sales Manager 602-679-28i5 j corzinergcla-val.com F.O.Box 1325,Newport Beach,Ca 92659-0325 Phone:949-7a-4800 Fax:c ?-f'45-b5241 Page 1 DocuSign Envelope ID: 164851 D5-A5AE-4BA4-B702-20596DDEB728 Bremerton City Attorney Contract Review Sheet GENERAL CITY ATTORNEY TRACKING# 240096 Date Received: 2/21/24 Contractor: Cimco-GC Systems, Inc. Purpose: GSA - Control Valve Rebuild Services Contract Amount: $ 24,140.93 Contract Term: w/i 60d from NTP Originator/Department Contact: Larry/Water Resources Phone: X5492 Request Comments By: RISK MANAGER REVIEW 0 APPROVE ❑ NOT APPROVE Reviewer Initials: SNO Date: 2/28/24 Comments: CITY ATTORNEY CI APPROVE ❑ NOT APPROVE ❑ Needs to go to Council Reviewer Initials: MRR Date: 2.22.24 Comments: ROUTED TO R:\LEGAL\Contracts\FORMS\Contract Review Request.doc ****Attorney-Client Communication. Not for Dissemination****