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HomeMy WebLinkAbout6776 Docusign Envelope ID: 1A368197-388A-4796-A2D7-65BBF72E5A2D PROFESSIONAL SERVICES AGREEMENT Pacific Forest Resources 2000 Road Pipeline Crossing Design Work The City of Bremerton ("City") and Pacific Forest Resources ("Consultant"), referred to collectively as the "Parties," enter into the following Agreement for professional services: L Scope: The Consultant agrees to perform the services more specifically described in the Scope of Work, dated October 21st, 2024, including any attachments thereto , attached hereto as Exhibit A, which is incorporated by reference herein. The Scope of Work may be modified only pursuant to Section VII.H of this Agreement. If the Scope of Work provides for unspecified additional services such services shall only be performed upon the express written request of the City. Consultant further represents that the services furnished under this Agreement will be performed in accordance with generally accepted professional practices in effect at the time such services are performed. IL Term: The City and the Consultant agree that work will begin on the tasks described in Exhibit A immediately upon execution of this Agreement. The parties agree that the work described in Exhibit A is to be completed as provided for in the work schedule attached hereto as Exhibit B;provided however,that additional time shall be granted by the City for excusable delays or extra work as provided for in Section X.A of this agreement. III. Compensation: In consideration of the services provided pursuant to this Agreement,the City shall pay Consultant in an amount not to exceed $35.000. Consultant's charges and bills shall conform to the fee schedule attached hereto as Exhibit C and incorporated herein by this reference. The Consultant shall submit regular billing statements detailing work performed and amount charged on each task or portion thereof The descriptions shall conform to and fall within the categories set out in the Scope of Work and/or Fee Schedule. Upon receipt of a conforming billing statement, the City shall promptly process payment. PROVIDED, HOWEVER, the City reserves the right to prioritize scoped work and accelerate and/or delay work tasks under the time frame set forth in Section II herein. The Consultant's labor rates and billing fees shall be as delineated in Exhibit C. Consultant shall not perform work beyond the Scope of Work, nor shall be compensated for such work, unless the Scope of Work or amount of compensation is modified pursuant to this Agreement. Consultant shall only be compensated for additional services if requested pursuant to Section I and, if not otherwise provided, such compensation shall be in accordance with Exhibit C. If a billing statement does not conform to this Agreement,the City may withhold payment until the statement is brought into compliance. Such withholding does not relieve Consultant of its obligations under this Agreement. IV. Relationship of Parties: Consultant represents that it is skilled in the matters addressed in the Scope of Work and is performing independent functions and responsibilities within its field Page 1 of 10 Bremerton/Pacific Forest Resources Inc [2000 Road Pipeline Crossing Engineering Assistance Rev. 09/2021 Docusign Envelope ID: 1A368197-388A-4796-A2D7-65BBF72E5A2D of expertise. Consultant and its personnel are independent Consultants and not employees of the City. Consultant and its personnel have no authority to bind the City or to control the City's employees and other Consultants. None of the benefits provided by the City to its employees, including, but not limited to, compensation, insurance, and unemployment insurance are available from the City to the employees, agents, representatives, or sub-consultants of the Consultant. Consultant will be solely and entirely responsible for its acts and for the acts of Consultant's agents, employees, representatives and sub-consultants during the performance of this Agreement. The City may, during the term of this Agreement, engage other independent Consultants to perform the same or similar work. As an independent Consultant, Consultant is responsible for its own management. The City's administration and enforcement of this Agreement shall not be deemed an exercise of managerial control over Consultant or its personnel. As an independent Consultant, Consultant is responsible for payment of all taxes and licensing fees necessary to perform its obligations under this Agreement. These taxes and fees include but are not limited to State industrial insurance, Business & Occupation, State professional licensing, and City business licensing. If any taxes or fees due the City have been declared delinquent,the City may withhold the delinquent amount,plus any additional charges arising from the delinquency,from any payments due Consultant. V. Indemnification: A. Consultant 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 except for that portion of the injuries and damages caused by the City's sole negligence, unless Consultant is conducting work pursuant to Subsection B below. The City's review or acceptance of any of the work when completed shall not be grounds to avoid any of these covenants of indemnification. B. Architects, Engineers and Any Other Professional Listed In and Performing Services Defined in RCW 4.24.115. Should a court of competent jurisdiction determine that Consultant's services provided pursuant to 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 Consultant and the City, its officers, officials, employees, agents and volunteers, the Consultant's liability hereunder shall be only to the extent of the Consultant's negligence. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONSULTANT'S WAIVER OF IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER. Page 2 of 10 Bremerton/Pacific Forest Resources Inc [2000 Road Pipeline Crossing Engineering Assistance Rev. 09/2021 Docusign Envelope ID: 1A368197-388A-4796-A2D7-65BBF72E5A2D The provisions of this section shall survive the expiration or termination of this Agreement. VI. Insurance: The Consultant shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Consultant, its agents, representatives, employees, sub-consultants or sub-contractors. Before beginning work on the project described in this Agreement, the Consultant shall provide a Certificate of Insurance evidencing: 1. Automobile Liability insurance with limits no less than $1,000,000 combined single limit per accident for bodily injury and property damage; and 2. Commercial General Liability insurance written on an occurrence basis with limits no less than $1,000,000 combined single limit per occurrence and general 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; explosion, collapse and underground (XCU) if applicable; and 3. Excess Liability insurance with limits not less than $1,000,000 limit per occurrence and aggregate; and 4. Professional Liability insurance with limits no less than $1,000,000 limit per occurrence/claim; and Any payment of deductible or self-insured retention shall be the sole responsibility of the Consultant. All required policies shall be provided on an "occurrence" basis except professional liability insurance (if required), which may 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 Consultant and a copy of an endorsement that is acceptable to the City, which names the City as an 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 and endorsements. The City further reserves the right to reject any unacceptable policies and/or endorsements. The Consultant'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 Consultant'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 Consultant 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 Page 3 of 10 Bremerton/Pacific Forest Resources Inc [2000 Road Pipeline Crossing Engineering Assistance Rev. 09/2021 Docusign Envelope ID: 1A368197-388A-4796-A2D7-65BBF72E5A2D substantive change of any insurance policy set out 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. In the event that the Consultant employs other consultants or contractors (sub-consultants or sub-contractors) as part of the work covered by this Agreement, it shall be the Consultant's responsibility to require and confirm that each sub-consultant or sub-contractor meets the minimum insurance requirements specified above. The Consultant shall,upon demand of the City, deliver to the City copies of such policy or policies of insurance and the receipts for payment of premiums thereon. VII. General Conditions: A. Reports and Information: When requested by the City, Consultant shall furnish periodic reports and documents on matters covered by this Agreement. The reports and documents shall be furnished in the time and form requested. Consultant shall maintain accounting records in accordance with Generally Accepted Accounting Principles ("GAAP")to substantiate all billed amounts. B. Ownership and Use of Records and Documents: Original documents, drawings, designs and reports, including those in electronic format, developed under this Agreement are the property of the City. All written information submitted by the City to the Consultant in connection with the services performed by the Consultant under this Agreement will be safeguarded by the Consultant to at least the same extent as the Consultant safeguards like information relating to its own business. If such information is publicly available or is already in Consultant's possession or known to it, or is rightfully obtained by the Consultant from third parties, Consultant shall bear no responsibility for its disclosure, inadvertent or otherwise. All data, documents and files created by Consultant under this Agreement may be stored at Consultant's office in Enumclaw Washington. Consultant shall make such data, documents, and files available to the City upon its request at all reasonable times for the purpose of editing, modifying and updating as necessary until such time as the City is capable of storing such information in the City's offices. Duplicate copies of this information shall be provided to the City upon its request, and at reasonable cost. All documents, including all reports, drawings, specifications, computer software or other items prepared or furnished by Consultant pursuant to this Agreement, are instruments of service with respect to the project and are the property of the City. Any reuse by the City for other than the specific purpose intended will be at City's sole risk. C. Use of Photographs and Images. Consultant shall not use or distribute photographs or images depicting City officials, personnel, property, or equipment whether prepared by Page 4 of 10 Bremerton/Pacific Forest Resources Inc [2000 Road Pipeline Crossing Engineering Assistance Rev. 09/2021 Docusign Envelope ID: 1A368197-388A-4796-A2D7-65BBF72E5A2D Consultant or provided by City without prior written consent of the City. The City will not unreasonably withhold its consent. D. Work Performed at Consultant's Risk: Consultant shall take all precautions necessary and shall be responsible for the safety of its employees, agents, and sub-consultants in the performance of the work hereunder and shall utilize all protection necessary for that purpose. All work shall be done at Consultant's own risk, and Consultant 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. E. Place of Work: The Consultant shall perform the work authorized under this Agreement at its offices in Enumclaw, Washington. Meetings with the City staff as described in Exhibit A, Scope of Work, shall take place at the City's offices, or at locations mutually agreed upon by the parties. F. Entire Agreement: This Agreement and its Exhibits constitutes the entire agreement between the Parties, and the Parties acknowledge that there are no other agreements, written or oral, that have not been set forth in the text of this Agreement. G. Severability: Should any part of this Agreement be found void, the balance of the Agreement shall remain in full force and effect. H. Modification: This Agreement may only be modified by written instrument signed by both Parties. L Written Notices: All communications regarding this Agreement shall be sent to the parties at the addresses listed below by registered or 1st class mail, or by personal service, and shall be deemed sufficiently given if sent to the addressee at the address stated in this Agreement or such other address as may be hereafter specified in writing. Notices to be sent to: Notices to be sent to: CITY: CONSULTANT: Attn: Sean Walsh Attn: Steve Faulkner ,PE Forestry Manager President City of Bremerton Pacific Forest Resources 345 6th Street, Suite 100 P.O Box 395 Bremerton, WA 98337-1891 Enumclaw, WA 98022 J. Waiver: Failure to enforce any provision of this Agreement shall not be deemed a waiver of that provision. Waiver of any right or power arising out of this Agreement shall not be deemed waiver of any other right or power. K. Non-Waiver of Breach: The failure of the City to insist upon strict performance of any of the covenants and agreements contained herein, or to exercise any option herein conferred Page 5 of 10 Bremerton/Pacific Forest Resources Inc [2000 Road Pipeline Crossing Engineering Assistance Rev. 09/2021 Docusign Envelope ID: 1A368197-388A-4796-A2D7-65BBF72E5A2D in one or more instances shall not be construed to be a waiver or relinquishment of said covenants, agreements or options, and the same shall be and remain in full force and effect. L. Compliance with Laws: Consultant shall comply with all applicable Federal, State, and local laws in performing its obligations under this Agreement. M. Choice of Law and Venue: This Agreement shall be interpreted according to the laws of the State of Washington. Any judicial action to resolve disputes arising out of this Agreement shall be brought in Kitsap County Superior Court. N. Attorneys' Fees: In the event of litigation to enforce any of the terms or provisions herein, each party shall pay all its own costs and attorney's fees. O. Assignment: Any assignment of this agreement by the Contractor without the written consent of the City shall be void. VIII. Equal Employment Opportunity Statement: In the hiring of employees for the performance of work under this Agreement, the Consultant, its subcontractors, or any person acting on behalf of Consultant 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. IX. 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. X. Termination: This Agreement shall remain in force until completion and acceptance of the services, terminated by written instrument upon mutual consent, or by the City of Bremerton for convenience. This Agreement may be immediately terminated for cause by a Party if the other Party substantially fails to perform through no fault of the terminating Party, and the non- performing Party does not commence correction of the failure of performance within thirty (30) days of the terminating Party's sending notice to the non-performing Party. Any Notice by Consultant shall include a report showing the status of all items listed in the Scope of Work current through the termination date. If the City receives reimbursement by any federal, state, or other source for work described in Section I herein, and that funding is withdrawn, reduced or limited in any way, or the project is cancelled or substantially reduced after the execution date of this Agreement and prior to the completion of the work,the City may summarily terminate this Agreement. A. Excusable Delays: The right of Consultant to proceed shall not be terminated nor shall Consultant be charged with liquidated damages for any delays in the completion of the work due to: 1)any acts of the federal government in controlling,restricting, or requisitioning materials, Page 6 of 10 Bremerton/Pacific Forest Resources Inc [2000 Road Pipeline Crossing Engineering Assistance Rev. 09/2021 Docusign Envelope ID: 1A368197-388A-4796-A2D7-65BBF72E5A2D equipment, tools, or labor by reason of war, national defense, or other national emergency; 2) any acts of the City, its consultants, or other public agencies causing such delay; and 3) causes not reasonably foreseeable by the parties at the time of the execution of the Agreement that are beyond the control and without the fault or negligence of the Consultant, including, but not restricted to, acts of God, fires, floods, strikes, or weather of unusual severity. PROVIDED, HOWEVER, that the Consultant must promptly notify the City within ten (10) calendar days in writing of the cause of the delay. If, on the basis of the facts and the terms of this Agreement, the delay is properly excusable, the City shall, in writing, extend the time for completing the work for a period of time commensurate with the period of excusable delay. B. Rights Upon Termination: In the event of termination, the City shall pay for all services performed by the Consultant to the effective date of termination, as described on a final invoice submitted to the City. After termination, the City may take possession of all records and data within the Consultant's possession pertaining to this project which may be used by the City without restriction. Any such use not related to the project which Consultant was contracted to perform shall be without liability or legal exposure to the Consultant. XI. Suspension & Debarment. For contracts involving Federal funding, Consultant hereby certifies, by signing this agreement, that neither it nor its principals are presently debarred, suspended,proposed for debarment,declared ineligible,or voluntarily excluded from participation in this transaction by any Federal department or agency. Consultant shall provide immediate written notice to the City if at any time it learns that it is or has become ineligible for certification. Should Consultant enter into a covered transaction with another firm, Consultant agrees by signing this agreement that it will verify that the firm with whom it intends to do business is not debarred, suspended, ineligible, excluded or disqualified. IN WITNESS WHEREOF, the parties below have executed this Agreement. CITY: CONSULTANT: CITY O gBJEyEMERTON Pacific ForoestgResources 4,2-€12,eA, guxt. FtuatALie By: By: i3,�CM095 ' 7B... .Err6ETE'i3ZE6... Print Name: Greg Wheeler Print Name: Steve Faulkner, PE Its: Mawr Its: President /17/2024 10/17/2024 Date: Date: Signed by: Signed by: APPRO p O FORM: ATT ST4dix NOV-a'By: �' By: b2ACbE8381B04b1... 4ED5ED5 � Kylie J. Finnell, Bremerton City Attorney Angela I-oove4Er,4 Ci1Fty Clerk R:\Legal\Legal\Forms\FORMS ON COBWEB\Professional Services Agreement Rev.09 2021.docx Page 7 of 10 Bremerton/Pacific Forest Resources Inc [2000 Road Pipeline Crossing Engineering Assistance 1 Rev. 09/2021 Docusign Envelope ID: 1A368197-388A-4796-A2D7-65BBF 72E5A.2D Exhibit A PF R Pacific Forest Resources, Inc. Engineering and Forest Management City of Bremerton, Public Works & Utilities September 23, 2024 Attn: Sean Walsh 100 Oyster bay Ave N Bremerton,WA 98312 RE: Bremerton Watershed 2024-25 Engineering Assistance — 2000 Rd "Pipeline Crossing" Project Approach Outline & Cost Estimate The following is a brief description of the perceived engineering and/or design assistance required for various services associated with the proposed new crossing on 2000 Road near the intersection of the Navy railroad that includes both the City's waterline and a gas pipeline as requested by the City of Bremerton Watershed along with an estimated cost of the proposed services. Site Survey & Preliminary Site Review Pacific Forest Resources (PFR) will sub-contract with a licensed surveyor to provide the necessary topographic survey for the design of the road/pipeline crossing and associated bridge structures. An initial field visit to the site (as well as any other joint site visits with the WDFW and WDNR to analyze potential options and concerns as well as to jointly determine the bankfull-width of the crossing). This joint meeting will also serve as the "pre-FP/HPA" review and can be made with the City's representative. Preliminary Plans, FPIHPA Preparation & Cost Estimate Based on the site survey and Water/gas pipeline requirements, PFR shall utilize best engineering practices to develop `permit-ready"plans and specifications needed to obtain the FP/HPA. PFR shall work with City(and gas-line) engineers to satisfy their needs for working in and around their respective pipelines. PFR will also prepare a complete Forest Practice Application package ready for the City's submittal to the WDNR. Following development of the preliminary plans, PFR will provide the City with a cost estimate for the completed project. Bridge Bid Specifications & Bid Packages Pacific Forest Resources will provide all necessary bridge specifications needed to assist the City in preparing the bid package for the purchase of the needed structure (including any assistance in evaluating the bids). Page 8 of 10 Bremerton/Pacific Forest Resources Inc [2000 Road Pipeline Crossing Engineering Assistance] Rev. 09/2021 Docusign Envelope ID: 1A368197-388A-4796-A2D7-65BBF72E5A2D Construction Plans & Bid Specifications Once the bridge manufacture have been selected, a"stand-alone" set of"construction- grade" plans for the complete bridge project will be developed for the sites. These plans shall be stamped by a licensed engineer and will be suitable for construction and inclusion into the City's Construction Bid package. PFR will offer whatever assistance is needed to the City the in preparation and evaluation of the construction bid package/contractor selection. PFR will be available at the City's request to attend any Pre-Bid site meetings in order to answer any potential contractor questions. Construction Staking PFR shall work with the City's forestry staff to stake the bridge location so that the "office design" can be verified in the field. A single site visit will be required to accomplish this item and it is recommended that this site visit be combined with the construction pre-bid site meeting so the PFR can answer any potential contractor questions. Construction Supervision It is expected that that much of the construction supervision will be done by the City's Forester, however a provision is included for this item as there may be some specialized construction issue that require closer inspection. If requested by the City, PFR will develop a set of As-Built plans for the projects that depict any significant deviations from the original construction plans. Estimated Engineering Costs Pacific Forest Resources (PFR) proposes to charge for professional services on a time and material basis as with similar municipal contracts. The basic engineering rate will be One Hundred Seventy Dollars ($170)per hour plus vehicle cost per the accepted IRS rate. Direct expenses (sub-consultants) and/or materials will charged based on the actual cost incurred plus 12%. The cost estimate shown below should be somewhat conservative and also anticipates that much of the construction supervision is to be supplied by the City's Forester. Page 9 of 10 Bremerton/Pacific Forest Resources Inc f 2000 Road Pipeline Crossing Engineering Assistance Rev. 09/2021 Docusign Envelope ID:1A368197-388A-4796-A2D7-65BBF72E5A2D Road "Pipeline Crossing" Project Cost Estimate Item Estimated Time Estimated Cost Preliminary Site Review 1±day w/travel $1,500± Topographic Survey Est$5500± $5,500± Prelim Design,FPA& Cost Estimate 7±days $9,300± Bridge Specs &Bid Package 11/z± day $2,000± Construction Plans&Bid Specs 3±days $4,000± Construction Staking 1±day w/travel $1,500± Construction Supervision 3±days w/travel $4,500± As-Built plans(if requested) 1± day $1,300± Total Estimated Engineering Cost $29,600± As noted above,these costs are expected to be somewhat conservative,however all work is to be invoiced on an "actual time"basis,therefore if the project is simpler than expected or if more site work can be accomplished by the City, the final cost will obviously be reflective of that. Throughout the design process, status reports for the project will be coordinated with the City's contracting officer so that any decisions as to additions (or deletions)to the project scope may be made in a timely manner. It is also requested that the City locate and "pothole" both the water and gas pipelines in selected areas so that their respective locations (and elevations) can be tied to the topographic survey to facilitate proper design. Please feel free to contact me if you wish to discuss any of this in more detail. Respectfully submitted— Steve Faulkner, PE President Page 10 of 10 Bremerton/Pacific Forest Resources Inc 12000 Road Pipeline Crossing Engineering Assistance l Rev. 0912021 Docusign Envelope ID: 1A368197-388A-4796-A2D7-65BBF72E5A2D A�OR DATE(MMfDOIYWY) CERTIFICATE OF LIABILITY INSURANCE 09/24/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT If the certificate holder Is an ADDITIONAL INSURED,the policy(Ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NMIc 1E G7 Dianne Dairies Totem Agencies,Inc MOW Ern (360)829-9400 fax Nol: (360)829-9405 rect,P 0 Box 1554 ADDRESS: ddainesratotemagencies.corn INSURERES)AFFORDING COVERAGE NAIC if , Buckley WA 98321 INSURERA: Ohio Casualty Insurance Company 24074 INSURED — --- INSURERS: _ Pacific Forest Resources Inc INSURERC: PO Box 395 INSURER D: INSURER E: Enumclaw WA 98022 INSURER F: COVERAGES CERTIFICATE NUMBER: CL242525353 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 WTH 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, PIER TYPE OF INSURANCE NS• *ND POLICY NUMBER LIMenN fYYYYYI IMILV IWYYYYl rTs uM COMMERCIAL GENERAL WIDILrTY EACH OCCURRENCE S 1.000.000 i1 CLAIMS-MADE ®OCCUR PROEM SE S O J (RSI S 1,000,000 1 3'C Log Broad Form PD MED E%P sAruy one�+eraml $ 15,000 _ A BK080493787 02/21/2024 02/21/2025 pERSONALSAovlruum, S 1,000,000 GEM AGGREGATE 11MR APPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICY n EC I '�I LOC PRODUCTS-COMPIOPAGG S 2,000,000 OTHER: CSCHD a AUTOMOBILE LIABILITY r CparBINED SINGLE LIMIT S 1,000,000 ANY AUTO BODILY INJURY(Per person) S A '— OWNED —SCHEDULED BA060493767 02/21/2024 02/21/2025 BODILY INJURY(Per.c denI) S AUTOS ONLY AUTOS HIRED NON.OWNED PROPERTY DAMAGE S AUTOS ONLY AUTOS ONLY iPer sod4lnrl Underinsured motorist a 1,000,000 14 UMBRELLA UAB I ' ,,•,,,"•,••••'", "' ,,, 1,000,000 OCCUR EACH OCWRR � S A ~ Excess LAB CLAIMS-MADE ES080493787 02/21R024 02/21/2025 AGGREGATE s 1,000,000 CEO I RETENTIONS _ - --- - _ S WORK ERS COMPENSATION PEA O AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N f A E.L.EACH ACCIDENT I OFFICER/MEMBER EXCLUDED? (Mandatary In NH} E.L DISEASE-EA EMPLOYEE S If yes,describe under r DESCRIPTION Of OPERATIONS beim E.L DISEASE-POLICY LIMIT S I I ~ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACOR)101,Additional Remarks Schedule.may beeifeciled If more epees le required) Certificate holder is named additional insured as respects operations of the named insured.Additional insured is primary per the attached endorsement CG881 D-0413. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Bremerton Attn: Risk Management ACCORDANCE WITH THE POLICY PROVISIONS. 345 6th Street#600 - AUTHORIZED RIPRIISF.A\va Bremerton WA 98337 ' r a 11. ID 1988-2010 AC s- r •-I•'•'-44113Prili rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Docusign Envelope ID: 1A368197-388A-4796-A2D7-65BBF72E5A2D COMMERCIAL GENERAL LIABIUTY , CG 88 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL UABILITY COVERAGE PART MAGI PAGE NON-OWNED AIRCRAFT 2 NON-OWNED WATERCRAFT 2 PROPERTY DAMAGE LIABILITY—ELEVATORS 2 EXTENDED DAMAGE TO PROPERTY RENTED TO YOU(Tenant's Property Damage) 2 MEDICAL PAYMENTS EXTENSION 3 EXTENSION OF SUPPLEMENTARY PAYMENTS—COVERAGES A AND B 3 ADDITIONAL INSUREDS—BY CONTRACT,AGREEMENT OR PERMIT 3 PRIMARY AND NON-CONTRIBUTORY—ADDITIONAL INSURED EXTENSION 5 ADDITIONAL INSUREDS—EXTENDED PROTECTION OF YOUR"UNITS OF INSURANCE" 8 WHO IS AN INSURED—INCIDENTAL MEDICAL ERRORSIMALPRACTICE AND WHO IS AN INSURED— 6 FELLOW EMPLOYEE EXTENSION—MANAGEMENT EMPLOYEES NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES 7 FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES 7 KNOWLEDGE OF OCCURRENCE,OFFENSE,CLAIM OR SUIT 7 LIBERALIZATION CLAUSE 7 BODILY INJURY REDEFINED 7 EXTENDED PROPERTY DAMAGE 8 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US— 8 WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU O 2013 Uberty Mutual Insurance CG 88 10 0413 Includes copyrighted material of Insurance servloes Office,Inc..with Its permission Page 1 of 8 Docusign Envelope ID: 1A368197-388A-4796-A2D7-65BBF72E5A2D With respect to coverage afforded by this endorsement,the provisions of the policy apply unless modified by the endorsement. A. NON-OWNED AIRCRAFT Under Paragraph 2.Exclusions of Section I—Coverage A-Bodily Injury And Property Damage Liability, exclusion g.Aircraft,Auto Or Watercraft does not apply to an aircraft provided: 1. It is not owned by any insured; 2. It is hired,chartered or loaned with a trained paid crew; 3. The pilot in command holds a currently effective certificate,Issued by the duly constituted authority of the United States of America or Canada,designating her or him a commercial or airline pilot;and 4. It is not being used to carry persons or property for a charge. However,the insurance afforded by this provision does not apply if there is available to the insured other valid and collectible insurance,whether primary,excess(other than insurance written to apply specifically in excess of this policy),contingent or on any other basis,that would also apply to the loss covered under this provision. B. NON-OWNED WATERCRAFT Under Paragraph 2.Exclusions of Section I—Coverage A—Bodily Injury And Property Damage Liability, Subparagraph(2)of exclusion g.Aircraft,Auto Or Watercraft is replaced by the following: This exclusion does not apply to: (2) A watercraft you do not own that is: (a) Less than 52 feet long;and (b) Not being used to carry persons or property for a charge. C. PROPERTY DAMAGE LIABILITY—ELEVATORS 1. Under Paragraph 2.Exclusions of Section I—Coverage A—Bodily Injury And Property Damage Liability,Subparagraphs(3),(4)and(6)of exclusion j.Damage To Property do not apply if such "property damage"results from the use of elevators. For the purpose of this provision,elevators do not include vehicle rifts. Vehicle kits are lifts or hoists used in automobile service or repair operations. 2. The following is added to Section IV—Commercial General Liability Conditions,Condition 4.Other Insurance,Paragraph b.Excess Insurance: The insurance afforded by this provision of this endorsement is excess over any property insurance. whether primary,excess,contingent or on any other basis. D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU(Tenant's Property Damage) If Damage To Premises Rented To You is not otherwise excluded from this Coverage Part: 1. Under Paragraph 2.Exclusions of Section I-Coverage A-Bodily Injury and Property Damage Liability: a. The fourth from the last paragraph of exclusion j.Damage To Property is replaced by the following: Paragraphs(1),(3)and(4)of this exclusion do not apply to"property damage"(other than damage by fire,lightning,explosion.smoke.or leakage from an automatic fire protection system) to: (I) Premises rented to you for a period of 7 or fewer consecutive days;or (II) Contents that you rent or lease as part of a premises rental or lease agreement for a period of more than 7 days. Paragraphs(1),(3)and(4)of this exclusion do not apply to"property damage"to contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described in Section III—Limits of Insurance. o 2013 liberty Mutual Insurance CG 8810 0413 Includes copyrighted material of Inatome*Services Office,Inc.,with ins permission. Page 2 of 8 Docusign Envelope ID: 1A368197-388A-4796-A2D7-65BBF72E5A2D b. The last paragraph of subsection 2.Exclusions is replaced by the following: Exclusions c.through n.do not apply to damage by fire,lightning,explosion,smoke or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner.A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III—Limits Of Insurance. 2. Paragraph 6.under Section III—Limits Of Insurance is replaced by the following: 6. Subject to Paragraph 5.above,the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of"property damage"to: a. Any one premise: (1) While rented to you;or (2) While rented to you or temporarily occupied by you with permission of the owner for damage by fire,lightning,explosion,smoke or leakage from automatic protection systems;or b. Contents that you rent or lease as part of a premises rental or lease agreement. 3. As regards coverage provided by this provision D.EXTENDED DAMAGE TO PROPERTY RENTED TO YOU(Tenant's Property Damage)-Paragraph 9.a.of Definitions is replaced with the following: 9.s. A contract for a lease of premises.However,that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire,lightning,explosion,smoke,or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner,or for damage to contents of such premises that are included in your premises rental or lease agreement, is not an"insured contract". E. MEDICAL PAYMENTS EXTENSION If Coverage C Medical Payments is not otherwise excluded,the Medical Payments provided by this policy are amended as follows: Under Paragraph 1.Insuring Agreement of Section I—Coverage C—Medical Payments, Subparagraph(b)of Paragraph a.is replaced by the following: (b) The expenses are incurred and reported within three years of the date of the accident;and F. EXTENSION OF SUPPLEMENTARY PAYMENTS—COVERAGES A AND 13 1. Under Supplementary Payments—Coverages A and f3,Paragraph 1.b.is replaced by the following: b. Up to$3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies.We do not have to furnish these bonds. 2. Paragraph 1.d.is replaced by the following: d. All reasonable expenses Incurred by the insured at our request to assist us in the investigation or defense of the claim or'suit',including actual loss of earnings up to$500 a day because of time off from work. G. ADDITIONAL INSUREDS-SY CONTRACT,AGREEMENT OR PERMIT 1. Paragraph 2.under Section II—Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract,written agreement or permit. Such person or organization is an additional insured but only with respect to lability for`bodily injury'.'property damage'or"personal and advertising injury" caused in whole or in part by a. Your acts or omissions,or the acts or omissions of those acting on your behalf,in the performance of your on going operations for the additional insured that are the subject of the written contract or written agreement provided that the."bodily injury'or"property damage'occurs, or the'personal and advertising injury'is committed,subsequent to the signing of such written contract or written agreement;or 0 2013 Liberty Mutual Insurance CO 88 10 0413 Includes copyrighted material of Insurance Senoes Office.Inc.,nith its permission. Page 3 of 8 Docusign Envelope ID: 1A368197-388A-4796-A2D7-65BBF72E5A2D b. Premises or facilities rented by you or used by you;or c. The maintenance,operation or use by you of equipment rented or leased to you by such person or organization; or d. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit subject to the following additional provisions: (1) This insurance does not apply to'bodily injury','property damage',or'personal and advertising injury'arising out of the operations performed for the state or political subdivision; (2) This insurance does not apply to'bodily injury'or'property damage'included within the 'completed operations hazard'. (3) insurance applies to premises you own,rent,or control but only with respect to the folowing hazards: a) The existence,maintenance,repair,construction,erection,or removal of advertising signs,awnings,canopies,cellar entrances,coal holes,driveways, manholes,marquees,hoist away openings,sidewalk vaults,street banners,or decorations and similar exposures;or (b) The construction,erection,or removal of elevators;or (c) The ownership,maintenance,or use of any elevators covered by this insurance. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law;and 2. If coverage provided to the additional insured is required by a contract or agreement,the Insurance afforded to such additional insured wilt not be broader than that which you are required by the contract or agreement to provide for such additional insured. With respect to Paragraph 1.a.above,a person's or organization's status as an additional insured under this endorsement ends when: (1) All work,including materials.parts or equipment furnished in connection with such work, on the project(other than service,maintenance or repairs)to be performed by or on behalf of the additional insured(s)at the location of the covered operations has been completed,or (2) That portion of'your work"out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project With respect to Paragraph 1.b.above,a person's or organization's status as an additional insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends. With respects to Paragraph 1.c.above,this insurance does not apply to any'occurrence'which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the'toddy injury"or"property damage". We have no duty to defend an additional insured under this endorsement until we receive written notice of a"suit' by the additional insured as required in Paragraph b.of Condition 2.Duties In the Event Of Occurrence, Offense,Claim Or Suit under Section IV—Commercial General Liability Conditions. 0 2013 Liberty Mutual Nuurance CO BS 10 0413 Includes copyrighted materlal of Insurance Services Office,Inc..with Its penniulon. Page 4 of 8 Docusign Envelope ID: 1A368197-388A-4796-A2D7-65BBF72E5A2D 2. With respect to the insurance provided by this endorsement,the following are added to Paragraph 2. Exclusions under Section I-Coverage A-Bodily Injury And Property Damage Liability: This Insurance does not apply to: a. 'Bodily injury or"property damage'arising from the sole negligence of the additional insured. b. "Roddy injury"or'property damage'that occurs prior to you commencing operations at the location where such'bodily Injury'or'property damage'occurs. c. "Bodily injury","property damage"or"personal and advertising injury"arising out of the rendering of,or the failure to render,any professional architectural,engineering or surveying services, including: (1) The preparing.approving,or failing to prepare or approve,maps,shop drawings. opinions,reports,surveys,field orders,change orders or drawings and specifications;or (2) Supervisory,inspection,architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing In the supervision,hiring,employment,training or monitoring of others by that insured,if the'occurrence'which caused the'bodily injury'or'property damage',or the offense which caused the'personal and advertising injury,involved the rendering of,or the failure to render,any professional architectural,engineering or surveying services. d. "Bodily injury"or"property damage"occurring after: (1) Al work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed;or (2) That portion of"your work"out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. a. My person or organization specifically designated as an additional insured for ongoing operations by a separate ADDITIONAL INSURED—OWNERS.LESSEES OR CONTRACTORS endorsement issued by us and made a part of this policy. 3. With respect to the insurance afforded to these additional insureds,the following is added to Section III— Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement the most we will pay on behalf of the additional insured is the amount of Insurance: a. Required by the contract or agreement;or b. Available under the applicable Limits of Insurance shown in the Declarations; whichever is leas. 411101 This endorsement shallnot increase the applicable Limits of Insurance shown in the Declarations. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. Condition 4.Other Insurance of SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as folowa: a. The following is added to Paragraph a.Primary Insurance: If an additional insureds policy has an Other Insurance provision making is policy excess,and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis,this policy shall be primary and we will not seek contribution from the additional insureds policy for damages we cover. O 2013 Liberty lAutual Insurance CO 8810 0413 includes copyrighted material or Insurance Services Office,Inc..with its permission. Page 5 of 8 Docusign Envelope ID: 1A368197-388A-4796-A2D7-65BBF72E5A2D b. The following is added to Paragraph b.Excess Insurance: When a written contract or written agreement,other than a premises lease,facilities rental contract or agreement,an equipment rental or lease contract or agreement, or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non-contributory,this insurance is excess over any other insurance for which the additional insured is designated as a Named Insured. Regardless of the written agreement between you and an additional insured,this insurance is excess over any other insurance whether primary,excess,contingent or on any other basis for which the additional insured has been added as an additional insured on other policies. I. ADDITIONAL INSUREDS-EXTENDED PROTECTION OF YOUR"UMITS OF INSURANCE" This provision applies to any person or organization who quartiles as an additional insured under any form or endorsement under this policy. 1. The following is added to Condition 2.Duties In The Event Of Occurrence,Offense,Claim or Suit: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an"occurrence"or an offense that may resuk in a claim or'suit'under this insurance to us; b. Tender the defense and indemnity of any claim or'suit"to all insurers whom also have insurance available to the additional insured;and c. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. d. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a"sur by the additional insured. 2. The limits of insurance applicable to the additional insured are those specified in a written contract or written agreement or the limits of insurance as stated in the Declarations of this policy and defined in Section III—Limits of Insurance of this policy,whichever are less.These limits are inclusive of and not in addition to the limits of insurance available under this policy. J. WHO 13 AN INSURED-INCIDENTAL MEDICAL ERRORS I MALPRACTICE WHO IS AN INSURED-FELLOW EMPLOYEE EXTENSION-MANAGEMENT EMPLOYEES Paragraph 2.a.(1)of Section II-Who Is An Insured is replaced with the following: (1) "Bodily injury"or"personal and advertising injury": (a) To you,to your partners or members(if you are a partnership or joint venture),to your members (if you are a limited liability company),to a co=employee"while in the course of his or her employment or performing duties related to the conduct of your business,or to your other "volunteer workers"while performing duties related to the conduct of your business; (b) To the spouse,child,parent,brother or sister of that co-"employee"or"volunteer worker"as a consequence of Paragraph(1)(a)above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs(1)(a)or(b)above;or (d) Arising out of his or her providing or fading to provide professional health care services.However, if you are not in the business of providing professional health care services or providing professional health care personnel to others,or if coverage for providing professional health care services is not otherwise excluded by separate endorsement,this provision(Paragraph(d))does not apply. C 2013 Liberty Mutual Insurance CG 88 10 0413 Includes copyrIghled material of Insurance Services Oteoe.Inc..with its permission. Page 6 of 8 Docusign Envelope ID: 1A368197-388A-4796-A2D7-65BBF72E5A2D Paragraphs(a)and(b)above do not apply to"bodily injury'or"personal and advertising injury'caused by an 'employee"who is acting in a supervisory capacity for you.Supervisory capacity as used herein means the 'employee's'job responsibilities assigned by you,includes the direct supervision of other'employees'of yours. However,none of these'employees'are insureds for'bodily injury'or'personal and advertising injury'arising out of their willful conduct,which is defined as the purposeful or willful intent to cause"bodily injury'or'personal and advertising injury',or caused in whole or in part by their Intoxication by liquor or controlled substances. The coverage provided by provision J.is excess over any other valid and collectable insurance available to your "employee". K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITLES Paragraph 3.of Section II-Who Is An Insured is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b. Coverage A does not apply to"body injury"or"property damage"that occurred before you acquired or formed the organization;and c. Coverage B does not apply to"personal and advertising injury"arising out of an offense committed before you acquired or formed the organization. d. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership,joint venture or limited liability company that is not shown as a Named Insured in the Declarations or qualifies as an Insured under this provision. L FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES Under Section IV—Commercial General Liability Condition%the following is added to Condition tl. Representations: Your failure to disclose as hazards or prior'occurrences'existing as of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior"occurrences'is not intentional. M. KNOWLEDGE OF OCCURRENCE,OFFENSE.CLAIM OR SUIT Under Section IV—Commercial General Liability Conditions,the following is added to Condition 2.Duties in The Event of Occurrence,Offense,Claim Or Suit: Knowledge of an'occurrence',offense,claim or'suit'by an agent, servant or'employee'of any insured shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph 1.of Section II—Who Is An Insured or a person who has been designated by them to receive reports of 'occurrences',offenses,claims or'suits"shall have received such notice from the agent,servant or 'employee'. N. UBERALIZAT1ON CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge,your policy will automatically provide the coverage as of the day the revision is effective in your state. O. BODILY INJURY REDEFINED Under Section V—Definitions,Definition 3.is replaced by the following: 3. 'Bodily Injury"means physical injury,sickness or disease sustained by a person.This includes mental anguish, mental injury.shock,fright or death that results from such physical injury,sickness or disease. 0 2013 Ubery MMus)insurance CG 8810 04 43 includes copyrighted material or insurance Services office.Inc..with Its permission. Page 7 of 8 Docusign Envelope ID: 1A368197-388A-4796-A2D7-65BBF72E5A2D P. EXTENDED PROPERTY DAMAGE Exclusion s.of COVERAGE A.BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following: a. Expected Or Intended Injury "Bodily injury"or"property damage"expected or intended from the standpoint of the insured.This exclusion does not apply to"body injury'or'property damage"resulting from the use of reasonable force to protect persons or property. Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US—WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU Under Section IV—Commercial General Liability Conditions, the following is added to Condition 8.Transfer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against a person or organization because of payments we make for injury or damage arising out of your ongoing operations or"your work"done under a contract with that person or organization and included in the"products-completed operations hazard"provided: 1. You and that person or organization have agreed in writing in a contract or agreement that you waive such rights against that person or organization:and 2. The injury or damage occurs subsequent to the execution of the written contract or written agreement. O 2013 Ll6efly Idutual Insurance CO 88 10 0413 includes copyrighted material of insurance Services olllce,Inc.,nth its permission. Page 8 of 8 AC'OR 1 0 CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 02/09/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Dianne Dames NAME: Totem Agencies, Inc PHONE (360) 829-9400 FAX (360) 829-9405 A/C No Ext : ACNo E-MAIL ddaines@totemagencies.com ADDRESS: P O Box 1554 INSURER(S) AFFORDING COVERAGE NAIC q INSURERA: Ohio Casualty Insurance Company 24074 Buckley WA 98321 INSURED INSURER B : INSURER C : Pacific Forest Resources Inc INSURER D : PO Box 395 INSURER E : INSURER F Enumclaw WA 98022 COVERAGES CERTIFICATE NUMBER: CL252926759 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. NO] WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE AUULSUBK INSD WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE RENTED PREMISES Ea occurrence $ 1,000,000 X MED EXP (Any one person) $ 15,000 Log Broad Form PD PERSONAL BADVINJURY S 1,000,000 A BK060493787 02/21/2025 02/21/2026 GEN'LAGGREGATELIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ❑ PRO ❑ LOC JECT PRODUCTS - COMP/OP AGO $ 2,000,000 CSCHD $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANYAUTO A OWNED SCHEDULED AUTOS ONLY AUTOS BA060493787 02/21/2025 02/21/2026 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Underinsured motorist $ 1,000.000 UMBRELLA LIAB OCCUR v�"'�"'MWEII V F EACH OCCURRENCE $ 1,000.000 AGGREGATE $ 1,000,000 A EXCESS LIAB CLAIMS -MADE ES060493787 02/21/2025 02/21/2026 DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? NIA E.L. EACH ACCIDENT S (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) orsement Certificate holder is named additional insured as respects operations of the named insured. Additional insured is primLFEB CG8810-0413. % c 02mn CERTIFICATE HOLDER CANCELLATION City of Bremerton Attn: Risk Management 345 6th Street #600 Bremerton WA 98337 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Docusign Envelope ID: 1A368197-388A-4796-A2D7-65BBF72E5A2D ACORD (I "' CERTIFICATE OF LIABILITY INSURANCE DATE °°" "Y ' 9/24/2024 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(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCERDianne Daines ~ Totem Agencies, Inc i ONE ECM 360-829-9400 �). 36D-e2e-9405 rror.P 0 Box 1554 ADDREas:ddainea9toteaagencies.com INSURfRISl AFFORDING COVERAGE NAIL/ Buckley WA 98321 IN>Jm art:Continental Casualty Company SISURED INSURER a: Pacific Forest Resources, Inc. PRIMER C: P. 0. Box 395 NSURER0: INSURER E: Enumclaw WA 98022 INSURER F: COVERAGES CERTIFICATE NUMBER:prof limb 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'NTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR t!I ra BER POLICY EFF POUCY sip LASTS OOYTY) JDYYY1�TR' TYPE OF INSURANCE 1 ---- -- COMMERCIAL GENERALI.IABUTY I EACH OCCURRENCE $ _CLAIMS-MADEOCCUR DAMAGE TO RENTED r PREMISES lEa cmxeto6l S MED EXP(Arty one person) S _ t PERSONAL a ADV INJURY S GEN'LAGGREGATE UNIT APPIJESPER: GENERAL AGGREGATE S POUCY❑JECT 0 LOC PRODUCTS-COMPIOPAOG $ - OTHER: S 1 COMBINED SINGE LIMIT $ AUTOMOBILELIABMJTY {Easaci0ernl ANY AUTO BODILY INJURY(Per person) S - .--'ALL MANED -SCHEDULED BODILY INJURY(Per scedenl) S AUTOS AUTOS • - HIRE AUTOS _ AU OS [Per RTY DAMAGE- $ t I ,UMBRELLA LIAR OCCUR EACH OCCURRENCE I EXCESS UM CLAIMS-MADE ,AGGREGATE I - DEA) 1 RETENTIONS S WORKERS COMPENSATION PER !+ J ER AND EMPLOYERS'LUBN.RIEAITY YIN STATIC I ANY PROFRIETOALRTNEECUTNE plink E.L.EACH ACCIDENT $ OFRCERnsEMBER EXCLUDED? (Mendatery In NM E.L.DISEASE.EA EMPLOYEE i If yes,describe under DE CRIPnON 09 qPf RATIOr15 two. EL DISEASE.POLICY LIMIT S A Professional Liability u76254039004 5/1/2024 5/1/2025 $2.000.000 per mamma $1,000 did $2.000.000 sown, I DESCRIPTION OF OPERARCOS I LOCATIONS I VEHICLES(ACORD 101,Additional Rema.R.SchadW",nay be attached I mere space N required) As respects operation of the named insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Bremerton THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Attu: Risk Management ACCORDANCE THE POLICY PROVISIONS. 345 6th Street 8600 Bremerton, to 98337 AUTHORIZED REPREa 1 C 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INSO25(201401) COMMERCIAL GENERAL LIABILITY CIS 88100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX SUBJECT NON -OWNED AIRCRAFT NON -OWNED WATERCRAFT PROPERTY DAMAGE LIABILITY — ELEVATORS EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) MEDICAL PAYMENTS EXTENSION EXTENSION OF SUPPLEMENTARY PAYMENTS — COVERAGES A AND B ADDITIONAL INSUREDS — BY CONTRACT, AGREEMENT OR PERMIT PRIMARY AND NON-CONTRIBUTORY — ADDITIONAL INSURED EXTENSION ADDITIONAL INSUREDS — EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" WHO 1S AN INSURED — INCIDENTAL MEDICAL ERRORS/MALPRACTICE AND WHO IS AN INSURED — FELLOW EMPLOYEE EXTENSION — MANAGEMENT EMPLOYEES NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT LIBERALIZATION CLAUSE BODILY INJURY REDEFINED EXTENDED PROPERTY DAMAGE WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US — WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU ® 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PAGE 2 2 2 2 3 3 3 5 6 6 7 7 7 7 7 8 8 Page 1 of 8 With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. A. NON -OWNED AIRCRAFT Under Paragraph 2. Exclusions of Section I — Coverage A - Bodily Injury And Property Damage Liability, exclusion g. Aircraft, Auto Or Watercraft does not apply to an aircraft provided: 1. It is not owned by any insured; 2. It is hired, chartered or loaned with a trained paid crew; 3. The pilot in command holds a currently effective certificate, issued by the duly constituted authority of the United States of America or Canada, designating her or him a commercial or airline pilot; and 4. It is not being used to carry persons or property for a charge. However, the insurance afforded by this provision does not apply if there is available to the insured other valid and collectible insurance, whether primary, excess (other than insurance written to apply specifically in excess of this policy), contingent or on any other basis, that would also apply to the loss covered under this provision. B. NON -OWNED WATERCRAFT Under Paragraph 2. Exclusions of Section I — Coverage A — Bodily Injury And Property Damage Liability, Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by the following: This exclusion does not apply to: (2) A watercraft you do not own that is: (a) Less than 52 feet long; and (b) Not being used to carry persons or property for a charge. C. PROPERTY DAMAGE LIABILITY — ELEVATORS 1. Under Paragraph 2. Exclusions of Section I — Coverage A — Bodily Injury And Property Damage Liability, Subparagraphs (3), (4) and (6) of exclusion j. Damage To Property do not apply if such "property damage" results from the use of elevators. For the purpose of this provision, elevators do not include vehicle lifts. Vehicle lifts are lifts or hoists used in automobile service or repair operations. 2. The following is added to Section IV — Commercial General Liability Conditions, Condition 4. Other Insurance, Paragraph b. Excess Insurance: The insurance afforded by this provision of this endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis. D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) If Damage To Premises Rented To You is not otherwise excluded from this Coverage Part: 1. Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury and Property Damage Liability: a. The fourth from the last paragraph of exclusion J. Damage To Property is replaced by the following: Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire, lightning, explosion, smoke, or leakage from an automatic fire protection system) to: (1) Premises rented to you for a period of 7 or fewer consecutive days; or (ii) Contents that you rent or lease as part of a premises rental or lease agreement for a period of more than 7 days. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described in Section tit — Limits of Insurance. 0 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with Its permission. Page 2 of 8 b. The last paragraph of subsection 2. Exclusions is replaced by the following; Exclusions c. through In. do not apply to damage by fire, lightning, explosion, smoke or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III — Limits Of Insurance. 2. Paragraph 6. under Section III — Limits Of Insurance is replaced by the following: Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to: a. Any one premise: (1) While rented to you; or (2) While rented to you or temporarily occupied by you with permission of the owner for damage by fire, lightning, explosion, smoke or leakage from automatic protection systems; or b. Contents that you rent or lease as part of a premises rental or lease agreement. 3. As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) - Paragraph 9.a. of Definitions is replaced with the following: 9.a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such premises that are included in your premises rental or lease agreement, is not an "insured contract". E. MEDICAL PAYMENTS EXTENSION If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this policy are amended as follows: Under Paragraph 1, Insuring Agreement of Section I — Coverage C — Medical Payments, Subparagraph (b) of Paragraph a. is replaced by the following: (b) The expenses are incurred and reported within three years of the date of the accident; and F. EXTENSION OF SUPPLEMENTARY PAYMENTS — COVERAGES A AND B 1. Under Supplementary Payments — Coverages A and B, Paragraph 1.b. is replaced by the following: b. Up to $3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. Paragraph 1.d, is replaced by the following: All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. G. ADDITIONAL INSUREDS - BY CONTRACT, AGREEMENT OR PERMIT 1. Paragraph 2. under Section II — Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract, written agreement or permit, Such person or organization is an additional insured but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by: a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your on going operations for the additional insured that are the subject of the written contract or written agreement provided that the "bodily injury" or "property damage" occurs, or the "personal and advertising injury" is committed, subsequent to the signing of such written contract or written agreement; or ® 2013 Liberty Mutual Insurance CG 88 10 0413 Indudes copyrighted material of Insurance Services Orrice, Inc„ with its permission. Page 3 of 8 b. Premises or facilities rented by you or used by you; or C. The maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or d. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit subject to the following additional provisions: (1) This insurance does not apply to "bodily injury", "property damage", or "personal and advertising injury" arising out of the operations performed for the state or political subdivision; (2) This insurance does not apply to "bodily injury" or "property damage" included within the "completed operations hazard". (3) Insurance applies to premises you own, rent, or control but only with respect to the following hazards: a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar exposures; or (b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elevators covered by this insurance. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. With respect to Paragraph 1.a. above, a person's or organization's status as an additional insured under this endorsement ends when: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. With respect to Paragraph 1.b. above, a person's or organization's status as an additional insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends. With respects to Paragraph 1.c. above, this insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage". We have no duty to defend an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured as required in Paragraph b, of Condition 2. Duties In the Event Of Occurrence, Offense, Claim Or Suit under Section IV — Commercial General Liability Conditions. ® 2013 Liberty Mutual Insurance CG 88 10 0413 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 8 2. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section 1 - Coverage A - Bodily Injury And Property Damage Liability: This insurance does not apply to: a. "Bodily injury" or "property damage" arising from the sole negligence of the additional insured. b. "Bodily injury" or "property damage" that occurs prior to you commencing operations at the location where such "bodily injury" or "property damage" occurs. C. "Bodily injury', "property damage" or "personal and advertising injury' arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising Injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. d. "Bodily injury' or "property damage" occurring after, (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. e. Any person or organization specifically designated as an additional insured for ongoing operations by a separate ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS endorsement issued by us and made a part of this policy, 3. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: a. Required by the contract or agreement; or b. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. H. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. Condition 4.Other Insurance of SECTION IV— COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: a. The following is added to Paragraph a. Primary Insurance: If an additional insured's policy has an Other Insurance provision making its policy excess, and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional insured's policy for damages we cover. ® 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with Its permission. Page 6 of 8 b. The following is added to Paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non-contributory, this insurance is excess over any other insurance for which the additional insured is designated as a Named Insured. Regardless of the written agreement between you and an additional insured, this insurance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies, ADDITIONAL INSUREDS - EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy, 1. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim or Suit: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence" or an offense that may result in a claim or "suit" under this insurance to us; b. Tender the defense and indemnity of any claim or "suit" to all insurers whom also have insurance available to the additional insured; and c. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured. 2. The limits of insurance applicable to the additional insured are those specified in a written contract or written agreement or the limits of insurance as stated in the Declarations of this policy and defined in Section III — Limits of Insurance of this policy, whichever are less. These limits are inclusive of and not in addition to the limits of insurance available under this policy. J. WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORS / MALPRACTICE WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES Paragraph 2.a.(1) of Section II - Who Is An Insured is replaced with the following: (1) "Bodily injury" or "personal and advertising injury": (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co -"employee" while in the course of his or her employment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co -"employee" or "volunteer worker" as a consequence of Paragraph (1) (a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1) (a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. However, if you are not in the business of providing professional health care services or providing professional health care personnel to others, or if coverage for providing professional health care services is not otherwise excluded by separate endorsement, this provision (Paragraph (d)) does not apply. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material or Insurance Services Office, Inc., with Its permission. Page 6 of 8 Paragraphs (a) and (b) above do not apply to "bodily injury" or "personal and advertising injury" caused by an "employee" who is acting in a supervisory capacity for you. Supervisory capacity as used herein means the "employee's" job responsibilities assigned by you, includes the direct supervision of other "employees" of yours. However, none of these "employees" are insureds for "bodily injury" or "personal and advertising injury" arising out of their willful conduct, which is defined as the purposeful or willful intent to cause "bodily injury" or "personal and advertising injury", or caused in whole or in part by their intoxication by liquor or controlled substances. The coverage provided by provision J. is excess over any other valid and collectable insurance available to your "employee". K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES Paragraph 3. of Section 11 - Who Is An Insured is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and C. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. d. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations or qualifies as an insured under this provision. L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES Under Section IV — Commercial General Liability Conditions, the following is added to Condition 6. Representations: Your failure to disclose all hazards or prior "occurrences" existing as of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior "occurrences" is not intentional. M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT Under Section IV — Commercial General Liability Conditions, the following is added to Condition 2. Duties In The Event of Occurrence, Offense, Claim Or Suit: Knowledge of an "occurrence', offense, claim or "suit" by an agent, servant or "employee" of any insured shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph 1. of Section II — Who Is An Insured or a person who has been designated by them to receive reports of "occurrences", offenses, claims or "suits" shall have received such notice from the agent, servant or "employee". N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the day the revision is effective in your state. O. BODILY INJURY REDEFINED Under Section V — Definitions, Definition 3. is replaced by the following: 3. "Bodily Injury" means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physical injury, sickness or disease. ® 2013 Liberty Mutual Insurance CG 88 10 0413 Includes copyrighted material of Insurance Services Office, Inc., with its permission, Page 7 of 8 P. EXTENDED PROPERTY DAMAGE Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured, This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US —WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU Under Section IV — Commercial General Liability Conditions, the following is added to Condition 8. Transfer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against a person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard" provided: 1. You and that person or organization have agreed in writing in a contract or agreement that you waive such rights against that person or organization; and 2. The injury or damage occurs subsequent to the execution of the written contract or written agreement. ® 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 8 of 8