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HomeMy WebLinkAboutInterwest Construction for Contract of Phase 2 - 011624 or-7 . 2/f / '- PCt) SECTION 005100 - AGREEMENT BETWEEN OWNER AND CONTRACTOR FOR CONSTRUCTION CONTRACT STIPULATED PRICE) This Agreement is by and between Jefferson County ("Owner") and Interwest Construction,Inc. ("Contractor"). Some words used in this this Agreement are defined below or in either the General Conditions (Section 7000)or the Supplementary Conditions(Section 8000).Words not defined in this Agreement or the General Conditions (Section 7000) or the Supplementary Conditions (Section 8000) are meant to have their usual and ordinary meaning in the context used and as defined in the Dictionary by Merriam-Webster (https://www.merriam-webster.com/). Owner and Contractor hereby agree as follows: ARTICLE 1—WORK 1.01 Contractor shall complete all Work as specified or indicated in the Contract Documents (listed in Article 7, below). Contractor agrees to furnish all labor and equipment and do certain Work, to- wit: That Contractor shall undertake and complete to the generally described Work as follows: The construction of a new max month 90,000 gpd Membrane Bioreactor Wastewater Treatment Plant("MBR WWTP"),included but not limited to site Work: stormwater,lighting,site piping and electrical; administration and chemical buildings; MBR WWTP canopy building; equalization tank; odor control;standby generator and other Work,all in accordance with the attached Contract Plans,the terms and conditions in this Agreement Contract Provisions, Supplementary Conditions and the General Conditions. ARTICLE 2—THE PROJECT 2.01 The Project, of which the Work under the Contract Documents is a part, is generally described as follows:Phase 2—Membrane Bioreactor Wastewater Treatment Plant for Port Hadlock UGA ARTICLE 3—ENGINEER 3.02 The part of the Project that pertains to the Work has been designed by Tetra Tech located at 2003 Western Avenue, Suite 700, Seattle,WA 98121. ARTICLE 4—CONTRACT TIMES 4.01 Time is of the Essence A. All time limits for Milestones, if any, Substantial Completion, and completion and readiness for final payment as stated in the Contract Documents are of the essence of in this Agreement. 4.03 Contract Times:Days A. The Work shall be substantially complete within 502 days after the date when the Contract Times commence to run as provided in Paragraph 4.01 of the General Conditions, and completed and ready for final payment in accordance with Paragraph 15.06 of the General Conditions within 30 days after the date when the Contract Times commence to run. AGREEMENT 005100- 1 4.05 Liquidated Damages A. Contractor and Owner recognize that time is of the essence as stated in Paragraph 4.01 above and that Owner will suffer financial and other losses if the Work is not completed and Milestones not achieved within the Contract Times, as duly modified. The parties also recognize the delays, expense, and difficulties involved in proving, in a legal or arbitration proceeding, the actual loss suffered by Owner if the Work is not completed on time. Accordingly, instead of requiring any such proof, Owner and Contractor agree that as liquidated damages for delay(but not as a penalty): 1. Substantial Completion: Accordingly, Contractor agrees: 1) To pay(according to the following formula)liquidated damages for each working day beyond the number of working days established for Substantial Completion, and 2) To authorize the Owner to deduct these liquidated damages from any money due or coming due to Contractor. Liquidated Damages Formula LD=0.15C/T Where: LD=liquidated damages per working day(rounded to the nearest dollar) C=original Contract amount T=original time for Substantial Completion 2. Completion of Remaining Work:After Substantial Completion,if Contractor shall neglect, refuse,or fail to complete the remaining Work within the Contract Times(as duly adjusted pursuant to the Contract)for completion and readiness for final payment, Contractor shall pay Owner per Article 4.06.B until the Work is completed and ready for final payment. B. If Owner recovers liquidated damages for a delay in completion by Contractor, then such liquidated damages are Owner's sole and exclusive remedy for such delay, and Owner is precluded from recovering any other damages,whether actual,direct,excess,or consequential, for such delay, except for special damages(if any)specified in this Agreement. 4.06 Special Damages A. Contractor shall reimburse Owner(1)for any fines or penalties imposed on Owner as a direct result of Contractor's failure to attain Substantial Completion according to the Contract Times, and (2)for the actual costs reasonably incurred by Owner for engineering, construction observation, inspection, and administrative services needed after the time specified in Paragraph 4.02 for Substantial Completion (as duly adjusted pursuant to the Contract), until the Work is substantially complete. B. After Contractor achieves Substantial Completion,if Contractor shall neglect,refuse,or fail to complete the remaining Work within the Contract Times, Contractor shall reimburse Owner for the actual costs reasonably incurred by Owner for engineering, construction observation, inspection, and administrative services needed after the time specified in Paragraph 4.02 for Work to be completed and ready for final payment(as duly adjusted pursuant to the Contract), until the Work is completed and ready for final payment. AGREEMENT 005100-2 C. The special damages imposed in this paragraph are supplemental to any liquidated damages for delayed completion established in this Agreement. ARTICLE 5—CONTRACT PRICE A. For all Work, at the prices stated in Contractor's Bid,attached hereto as Exhibit B. B. Contractor shall provide and bear the expense of all equipment, Work, and labor of any sort whatsoever that may be required for the transfer of materials and for constructing and completing the Work provided for this contract and every part therefore. ARTICLE 6—PAYMENT PROCEDURES 6.01 Submittal and Processing of Payments A. Contractor shall submit Applications for Payment in accordance with Article 15 of the General Conditions. Applications for Payment shall be processed by Engineer as provided in the General Conditions. 6.02 Progress Payments;Retainage A. Owner shall make progress payments on the basis of Contractor's Applications for Payment monthly during performance of the Work as provided in Paragraph 6.02.A.1 below, provided that such Applications for Payment have been submitted in a timely manner and otherwise meet the requirements of the Contract. All such payments shall be measured by the Schedule of Values established as provided in the General Conditions (and in the case of Unit Price Work based on the number of units completed) or, in the event there is no Schedule of Values, as provided elsewhere in this Agreement. 1. Progress payments shall be made in an amount equal to the percentage indicated below but, in each case, less the aggregate of payments previously made and less such amounts as Owner may withhold, including but not limited to liquidated damages, in accordance with this Agreement. a. 95 percent of the value of the Work completed(with the balance being retainage). b. Retainage shall be releases as outline in Paragraph 7-20.D of the Supplemental Conditions 2. Contractor will declare a management option of the statutory percentage on Exhibit A. 6.03 Final Payment A. Upon final completion and acceptance of the Work, Owner shall pay the remainder of the Contract Price in accordance with Paragraph 15.06 of the General Conditions. ARTICLE 7—CONTRACT DOCUMENTS 7.01 Contents A. The Contract Documents consist of all of the following documents: 1. This Agreement. 2. Addenda(numbers 1 to 4 inclusive). 2. Bonds: AGREEMENT 005100- 3 a. Performance bond(together with power of attorney). b. Payment bond(together with power of attorney). 3. Conditions: a. General Conditions. b. Supplementary Conditions. 4. Drawings (not attached but incorporated by reference) for the: Phase 2 — Membrane Bioreactor Wastewater Treatment Plant for Port Hadlock UGA. 5. Exhibits to this Agreement(enumerated as follows): a. Exhibit A-Management Option of the Statutory Percentage b. Exhibit B-Contractor's Bid Forms 6. Specifications as listed in the table of contents of the project manual(copy of list attached). 7. The following documents which may be delivered or issued on or after the Effective Date of this Agreement and are not attached hereto: a. Notice to Proceed. b. Work Change Directives. c. Change Orders. d. Field Orders. e. Warranty Bond, if any. B. The Contract Documents listed in Paragraph 7.01.A are attached to this Agreement(except as expressly noted otherwise above). C. There are no Contract Documents other than those listed above in this Article 7. D. The Contract Documents may only be amended,modified,or supplemented as provided in this Agreement. E. Contractor shall perform any alteration in or addition to the Work provided in this Agreement and every part thereof. ARTICLE 8—INDEMNIFICATION,INSURANCE, OTHER TERMS 8.01 Indemnification A. Contractor shall defend, indemnify and hold the County, its officers, officials, employees, agents, and volunteers (and their marital communities) harmless from any and all claims, injuries,damages, losses or suits including attorney fees,arising out of our resulting from the acts,error or omissions of Contractor's in performance of this Agreement, except for injuries and damages caused by the sole negligence of the County. B. 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 Contractor and the County, its officers, officials, employee, agents and volunteers (and their marital AGREEMENT 005100-4 communities)Contractor's liability, including the duty and cost to defend,hereunder shall be only to the extent of Contractor's negligence. C. Claims against the County shall include, but not be limited to assertions that the use and transfer of any software,book,document,report,film,tape,or sound reproduction of material of any kind delivered hereunder, constitutes an infringement of any copyright, patent, trademark,trade name, or otherwise results in an unfair trade practice or an unlawful restraint of competition. D. Contractor specifically assumes potential liability for actions brought against the County by Contractor's employees, including all other persons engages in the performance of any Work or service required of Contractor under this Agreement and, solely for the purpose of this indemnification and defense, Contractor specifically waives any immunity under the state industrial insurance law, Title 51 R.C.W. Contractor recognizes that this waiver was specifically entered into pursuant to provisions of R.C.W.4.24.115 and was subject of mutual negotiation. E. The provision of this section shall survive the expiration or termination of this Agreement. 8.02 Insurance A. Prior to commencing Work, Contractor shall obtain at its own cost and expense insurance required in Section 6.02 Insurance-General Provisions of the Supplemental Conditions. 8.03 Other terms A. Contractor's relation to the County shall be at all times as an independent Contractor, and noting herein contained shall be construed to create a relationship of employer-employee or master-servant,and any and all employees of Contractor or other persons engaged in the performance of any Work or services required of Contractor under this Agreement shall be considered employees of Contractor only and any claims that may arise on behalf of or against said employees shall be the sole obligation and responsibility of Contractor. B. Contractor shall not sublet or assign any of the services covered by this contract without the express written consent of the County or its authorized representatives. Assignment does not include printing or other customary reimbursable expenses that may be provided in an agreement. AGREEMENT 005100- 5 IN WITNESS WHEREOF,Contractor has executed this instrument on the day and year first below written, and the Board of County Commissioners has caused this instrument to be executed by and I the name of said County of Jefferson the day and year first above written. JEFFERSON COUNTY WASHINGTON CONTRACTOR Board of County Commissioners Jefferson Cou ty, Washington AIL By: t '/((/'2 `� By: pi�eT "1'rrr Gre rotherton, Chair Date Signature rt C rr''�h By: 1ii ,...�.-- /�(' Z 41 Name: Eben Twaddle , ~� AL s Kate Ian, Commissioner Date ti, rflgl _ _ Title: President ���''"�����""`��O'� A� — rr� IPJG�,, By: -` Date: _January 4. 2024 1. Heidi Eisenhour, Commissioner Date _owns tttttttttt SEAL: 1.0 V'oN C'0Gti'•,. =r>:o t� tiF,p. �,.% LcsEAf::z ATTEST: '',�c�''•• ......-,,.. 0 4. OF VVAS�\..... kk 6( ie 1-4 1//IP/Z V CarolynCalloway, CMC/ Date Clerk of the Board Approved as to form only: .; November 6,2023 Philip C. Hunsucker, Date Chief C. ' uty Prosecuting Attorney 7 .2 emders, P.E., Date Public Works Director/County Engineer AGREEMENT 005100-6 SECTION 006100 - PERFORMANCE BOND Bond No. 107939031 Contractor Surety Name: lnterwest Construction,Inc. Name: Address(principal place of business): Travelers Casualty and Surety Company of America 609 North Hill Blvd. Address(principal place of business): Burlington,WA 98233 1501 4th Ave.,Suite 1000 Seattle,WA 98101 Owner Contract Name: Jefferson County Public Works Description(name and location): Mailing address(principal place of business): Phase 2—Water Reclamation Plant for Port Hadlock 623 Sheridan Street UGA Port Townsend,WA 98368 236 Lopeman Rd. Port Hadlock,WA 98339 Contract Price: $10,020,835.00 Effective Date of Contract: Bond Bond Amount: $10,020.835.00 Date of Bond: January 4, 2024 (Date of Bond cannot be earlier than Effective Date of Contract) Modifications to this Bond form: IN None❑ See Paragraph 16 Surety and Contractor, intending to be legally bound hereby,subject to the terms set forth in this Performance Bond, do each cause this Performance Bond to be duly executed by an authorized officer,agent,or representative. Contractor as Principal Surety Interwest Construction, Inc. Travelers Casualty and Surety Company of America (Full formal n m of Contras (Full formal name of Surety) (corpora seal) • 44, "Os,"��i, � V''"� By: ji�41"c:_L,c• , - -'�L� 1613 (Signature) (Signature)(Attach Power of Attorney) ►- 0 s� SE 1 s s Eben Twaddle Name: Theresa A. Lamb (Printed or typed) (Printed or typed) , ti4e`� 0 Pr e s d e n t Title: Attorney-in-Fact Ohl tl'+'/S ~`1� ING;4 ^11 est: °"`�-# '" Attest: .1, l wed, (Signature) (Signature) Name: Michaela Smith Name: Jim S.Kuich (Printed or typed) (Printed or typed) Title: Contracts Assistant Title: Witness PERFORMANCE BOND 006100- 1 Notes: (1)Provide supplemental execution by any additional parties,such as joint venturers. (2)Any singular reference to Contractor,Surety, Owner, or other party is considered plural where applicable. The Contractor and Surety,jointly and severally,bind themselves,their heirs,executors,administrators, successors,and assigns to the Owner for the performance of the Construction Contract,which is incorporated herein by reference. 1. If the Contractor performs the Construction Contract, the Surety and the Contractor shall have no obligation under this Bond, except when applicable to participate in a conference as provided in Paragraph 3. 2. If there is no Owner Default under the Construction Contract,the Surety's obligation under this Bond will arise after: 2.1. The Owner first provides notice to the Contractor and the Surety that the Owner is considering declaring a Contractor Default. Such notice may indicate whether the Owner is requesting a conference among the Owner,Contractor,and Surety to discuss the Contractor's performance.If the Owner does not request a conference, the Surety may, within five (5) business days after receipt of the Owner's notice, request such a conference. If the Surety timely requests a conference,the Owner shall attend.Unless the Owner agrees otherwise,any conference requested under this Paragraph 3.1 will be held within ten(10)business days of the Surety's receipt of the Owner's notice. If the Owner, the Contractor, and the Surety agree, the Contractor shall be allowed a reasonable time to perform the Construction Contract,but such an agreement does not waive the Owner's right, if any, subsequently to declare a Contractor Default; 2.2. The Owner declares a Contractor Default,terminates the Construction Contract and notifies the Surety;and 2.3. The Owner has agreed to pay the Balance of the Contract Price in accordance with the terms of the Construction Contract to the Surety or to a contractor selected to perform the Construction Contract. 3. Failure on the part of the Owner to comply with the notice requirement in Paragraph 3.1 does not constitute a failure to comply with a condition precedent to the Surety's obligations, or release the Surety from its obligations,except to the extent the Surety demonstrates actual prejudice. 4. When the Owner has satisfied the conditions of Paragraph 3, the Surety shall promptly and at the. Surety's expense take one of the following actions: 4.1. Arrange for the Contractor, with the consent of the Owner, to perform and complete the Construction Contract; 4.2. Undertake to perform and complete the Construction Contract itself, through its agents or independent contractors; 4.3. Obtain bids or negotiated proposals from qualified contractors acceptable to the Owner for a contract for performance and completion of the Construction Contract,arrange for a contract to be prepared for execution by the Owner and a contractor selected with the Owners concurrence, to be secured with performance and payment bonds executed by a qualified surety equivalent to the bonds issued on the Construction Contract,and pay to the Owner the amount of damages as described in Paragraph 7 in excess of the Balance of the Contract Price incurred by the Owner as a result of the Contractor Default;or 4.4. Waive its right to perform and complete,arrange for completion,or obtain a new contractor,and with reasonable promptness under the circumstances: PERFORMANCE BOND 006100-2 5.4.1 After investigation,determine the amount for which it may be liable to the Owner and, as soon as practicable after the amount is determined,make payment to the Owner;or 5.4.2 Deny liability in whole or in part and notify the Owner,citing the reasons for denial. 5. If the Surety does not proceed as provided in Paragraph 5 with reasonable promptness,the Surety shall be deemed to be in default on this Bond seven days after receipt of an additional written notice from the Owner to the Surety demanding that the Surety perform its obligations under this Bond, and the Owner shall be entitled to enforce any remedy available to the Owner. If the Surety proceeds as provided in Paragraph 5.4, and the Owner refuses the payment, or the Surety has denied liability, in whole or in part,without further notice,the Owner shall be entitled to enforce any remedy available to the Owner. 6. If the Surety elects to act under Paragraph 5.1, 5.2,or 5.3,then the responsibilities of the Surety to the Owner will not be greater than those of the Contractor under the Construction Contract, and the responsibilities of the Owner to the Surety will not be greater than those of the Owner under the Construction Contract. Subject to the commitment by the Owner to pay the Balance of the Contract Price,the Surety is obligated,without duplication for: 6.1. the responsibilities of the Contractor for correction of defective work and completion of the Construction Contract; 6.2. additional legal,design professional,and delay costs resulting from the Contractor's Default,and resulting from the actions or failure to act of the Surety under Paragraph 5;and 6.3. liquidated damages,or if no liquidated damages are specified in the Construction Contract,actual damages caused by delayed performance or non-performance of the Contractor. 7. If the Surety elects to act under Paragraph 5.1,5.3,or 5.4,the Surety's liability is limited to the amount of this Bond. 8. The Surety shall not be liable to the Owner or others for obligations of the Contractor that are unrelated to the Construction Contract, and the Balance of the Contract Price will not be reduced or set off on account of any such unrelated obligations.No right of action will accrue on this Bond to any person or entity other than the Owner or its heirs,executors,administrators,successors,and assigns. 9. The Surety hereby waives notice of any change,including changes of time,to the Construction Contract or to related subcontracts,purchase orders,and other obligations. 10. Any proceeding, legal or equitable, under this Bond must be instituted in any court of competent jurisdiction in the location in which the work or part of the work is located and must be instituted within two years after a declaration of Contractor Default or within two years after the Contractor ceased working or within two years after the Surety refuses or fails to perform its obligations under this Bond, whichever occurs first.If the provisions of this paragraph are void or prohibited by law,the minimum periods of limitations available to sureties as a defense in the jurisdiction of the suit will be applicable. 11. Notice to the Surety,the Owner,or the Contractor must be mailed or delivered to the address shown on the page on which their signature appears. 12. When this Bond has been furnished to comply with a statutory or other legal requirement in the location where the construction was to be performed,any provision in this Bond conflicting with said statutory or legal requirement will be deemed deleted therefrom and provisions conforming to such statutory or other legal requirement will be deemed incorporated herein. When so furnished,the intent is that this Bond will be construed as a statutory bond and not as a common law bond. 13. Definitions PERFORMANCE BOND 006100-3 r 13.1. Balance of the Contract Price—The total amount payable by the Owner to the Contractor under the Construction Contract after all proper adjustments have been made including allowance for the Contractor for any amounts received or to be received by the Owner in settlement of insurance or other claims for damages to which the Contractor is entitled,reduced by all valid and proper payments made to or on behalf of the Contractor under the Construction Contract. 13.2. Construction Contract—The agreement between the Owner and Contractor identified on the cover page, including all Contract Documents and changes made to the agreement and the Contract Documents. 13.3. Contractor Default—Failure of the Contractor, which has not been remedied or waived, to perform or otherwise to comply with a material term of the Construction Contract. 13.4. Owner Default—Failure of the Owner, which has not been remedied or waived, to pay the Contractor as required under the Construction Contract or to perform and complete or comply with the other material terms of the Construction Contract. 13.5. Contract Documents—All the documents that comprise the agreement between the Owner and Contractor. 14. If this Bond is issued for an agreement between a contractor and subcontractor,the term Contractor in this Bond will be deemed to be Subcontractor and the term Owner will be deemed to be Contractor. 15. Modifications to this Bond are as follows:None PERFORMANCE BOND 006100-4 SECTION 006200 - PAYMENT BOND Bond No. 107939031 Contractor Surety Name: lnterwest Construction, Inc. Name:Travelers Casualty and Surety Company of America Address(principal place of business): Address(principal place of business): 609 North Hill Blvd. 1501 4th Ave., Suite 1000 Burlington, WA 98233 Seattle, WA 98101 Owner Contract Name: Jefferson County Public Works Description (name and location): Mailing address(principal place of business): Phase 2—Water Reclamation Plant for Port 623 Sheridan Street Hadlock UGA Port Townsend,WA 98368 236 Lopeman Rd. Port Hadlock,WA 98339 Contract Price: $10,020,835.00 Effective Date of Contract: Bond Bond Amount: $10,020.835.00 Date of Bond: January 4, 2024 (Date of Bond cannot be earlier than Effective Date of Contract) Modifications to this Bond form: iN None D See Paragraph 18 Surety and Contractor, intending to be legally bound hereby, subject to the terms set forth in this Payment Bond,do each cause this Payment Bond to be duly executed by an authorized officer,agent, or representative. Contractor as Principal Surety Interwest Construction, Inc. Travelers Casualty and Surety Company of America (Full form name of Contr ctor) (Full formal me of Surety)(corporate seal By� c L4— By: .�./w lil • fltUC�tit+ttt (Signature) (Signature)(Attach Power of Attorney) Go*I• /" �,\Ahlflgle'Oy`�ti Eben Twaddle Name: Theresa A.Lamb YOR , g_�l�L / � (Printed or typed) (Printed or typed) U ,,, Ti$e '% President Title: Attorney-in-Fact SEAL dwIts_r 2 Attest: l l l n � (Signature) (Signature) ,'114)�.l .'p —.. Michaela Smith Name: "Jim S. Kuich iA (Printed or typed) (Printed or typed) Title: Contracts Assistant Title: Witness Notes:(1)Provide supplemental execution by any additional parties,such as joint venturers. (2)Any singular reference to Contractor,Surety, Owner, or other party is considered plural where applicable. PAYMENT BOND 006200- 1 The Contractor and Surety,jointly and severally,bind themselves,their heirs,executors,administrators, successors,and assigns to the Owner to pay for labor,materials,and equipment furnished for use in the performance of the Construction Contract,which is incorporated herein by reference,subject to the following terms. 1. If the Contractor promptly makes payment of all sums due to Claimants,and defends,indemnifies,and holds harmless the Owner from claims,demands,liens,or suits by any person or entity seeking payment for labor, materials, or equipment furnished for use in the performance of the Construction Contract, then the Surety and the Contractor shall have no obligation under this Bond. 2. If there is no Owner Default under the Construction Contract, the Surety's obligation to the Owner under this Bond will arise after the Owner has promptly notified the Contractor and the Surety(at the address described in Paragraph 13)of claims,demands,liens,or suits against the Owner or the Owner's property by any person or entity seeking payment for labor, materials, or equipment furnished for use in the performance of the Construction Contract,and tendered defense of such claims,demands,liens, or suits to the Contractor and the Surety. 3. When the Owner has satisfied the conditions in Paragraph 3, the Surety shall promptly and at the Surety's expense defend, indemnify, and hold harmless the Owner against a duly tendered claim, demand,lien,or suit. 4. The Surety's obligations to a Claimant under this Bond will arise after the following: 4.1. Claimants who do not have a direct contract with the Contractor 4.1.1. have furnished a written notice of non-payment to the Contractor,stating with substantial accuracy the amount claimed and the name of the party to whom the materials were, or equipment was, furnished or supplied or for whom the labor was done or performed, within ninety(90) days after having last performed labor or last furnished materials or equipment included in the Claim;and 4.1.2. have sent a Claim to the Surety(at the address described in Paragraph 13). 4.2. Claimants who are by employed or have a direct contract with the Contractor have sent a Claim to the Surety(at the address described in Paragraph 13 . �P ) 5. If a notice of non-payment required by Paragraph 5.1.1 is given by the Owner to the Contractor,that is sufficient to satisfy a Claimant's obligation to furnish a written notice of non-payment under Paragraph 5.1.1. 6. When a Claimant has satisfied the conditions of Paragraph 5.1 or 5.2, whichever is applicable, the Surety shall promptly and at the Surety's expense take the following actions: 6.1. Send an answer to the Claimant,with a copy to the Owner,within sixty(60)days after receipt of the Claim,stating the amounts that are undisputed and the basis for challenging any amounts that are disputed;and 6.2. Pay or arrange for payment of any undisputed amounts. 6.3. The Surety's failure to discharge its obligations under Paragraph 7.1 or 7.2 will not be deemed to constitute a waiver of defenses the Surety or Contractor may have or acquire as to a Claim, except as to undisputed amounts for which the Surety and Claimant have reached agreement.If, however,the Surety fails to discharge its obligations under Paragraph 7.1 or 7.2,the Surety shall indemnify the Claimant for the reasonable attorney's fees the Claimant incurs thereafter to recover any sums found to be due and owing to the Claimant. PAYMENT BOND 006200-2 7. The Surety's total obligation will not exceed the amount of this Bond, plus the amount of reasonable attomey's fees provided under Paragraph 7.3, and the amount of this Bond will be credited for any payments made in good faith by the Surety. 8. Amounts owed by the Owner to the Contractor under the Construction Contract will be used for the performance of the Construction Contract and to satisfy claims, if any, under any construction performance bond.By the Contractor furnishing and the Owner accepting this Bond,they agree that all funds earned by the Contractor in the performance of the Construction Contract are dedicated to satisfying obligations of the Contractor and Surety under this Bond, subject to the Owner's priority to use the funds for the completion of the work. 9. The Surety shall not be liable to the Owner,Claimants,or others for obligations of the Contractor that are unrelated to the Construction Contract. The Owner shall not be liable for the payment of any costs or expenses of any Claimant under this Bond, and shall have under this Bond no obligation to make payments to or give notice on behalf of Claimants, or otherwise have any obligations to Claimants under this Bond. 10. The Surety hereby waives notice of any change,including changes of time,to the Construction Contract or to related subcontracts,purchase orders,and other obligations. 11. No suit or action will be commenced by a Claimant under this Bond other than in a court of competent jurisdiction in the state in which the project that is the subject of the Construction Contract is located or after the expiration of one year from the date(1)on which the Claimant sent a Claim to the Surety pursuant to Paragraph 5.1.2 or 5.2, or(2)on which the last labor or service was performed by anyone or the last materials or equipment were furnished by anyone under the Construction Contract, whichever of(1)or(2)first occurs. If the provisions of this paragraph are void or prohibited by law, the minimum period of limitation available to sureties as a defense in the jurisdiction of the suit will be applicable. 12. Notice and Claims to the Surety,the Owner,or the Contractor must be mailed or delivered to the address shown on the page on which their signature appears. Actual receipt of notice or Claims, however accomplished,will be sufficient compliance as of the date received. 13. When this Bond has been furnished to comply with a statutory or other legal requirement in the location where the construction was to be performed,any provision in this Bond conflicting with said statutory or legal requirement will be deemed deleted here from and provisions conforming to such statutory or other legal requirement will be deemed incorporated herein. When so furnished,the intent is that this Bond will be construed as a statutory bond and not as a common law bond. 14. Upon requests by any person or entity appearing to be a potential beneficiary of this Bond, the Contractor and Owner shall promptly furnish a copy of this Bond or shall permit a copy to be made. 15. Definitions 15.1. Claim—A written statement by the Claimant including at a minimum: 15.1.1. The name of the Claimant; 15.1.2. The name of the person for whom the labor was done, or materials or equipment furnished; 15.1.3. A copy of the agreement or purchase order pursuant to which labor, materials, or equipment was furnished for use in the performance of the Construction Contract; 15.1.4. A brief description of the labor,materials,or equipment furnished; 15.1.5. The date on which the Claimant last performed labor or last furnished materials or equipment for use in the performance of the Construction Contract; PAYMENT BOND 006200-3 15.1.6. The total amount earned by the Claimant for labor,materials,or equipment furnished as of the date of the Claim; 15.1.7. The total amount of previous payments received by the Claimant;and 15.1.8. The total amount due and unpaid to the Claimant for labor, materials, or equipment furnished as of the date of the Claim. 15.2. Claimant—An individual or entity having a direct contract with the Contractor or with a subcontractor of the Contractor to furnish labor, materials, or equipment for use in the performance of the Construction Contract. The term Claimant also includes any individual or entity that has rightfully asserted a claim under an applicable mechanic's lien or similar statute against the real property upon which the Project is located. The intent of this Bond is to include without limitation in the terms of"labor, materials, or equipment" that part of the water, gas, power, light,heat, oil,gasoline,telephone service, or rental equipment used in the Construction Contract, architectural and engineering services required for performance of the work of the Contractor and the Contractor's subcontractors, and all other items for which a mechanic's lien may be asserted in the jurisdiction where the labor,materials,or equipment were furnished. 15.3. Construction Contract—The agreement between the Owner and Contractor identified on the cover page, including all Contract Documents and all changes made to the agreement and the Contract Documents. 15.4. Owner Default—Failure of the Owner, which has not been remedied or waived, to pay the Contractor as required under the Construction Contract or to perform and complete or comply with the other material terms of the Construction Contract. 15.5. Contract Documents—All the documents that comprise the agreement between the Owner and Contractor. 16. If this Bond is issued for an agreement between a contractor and subcontractor,the term Contractor in this Bond will be deemed to be Subcontractor and the term Owner will be deemed to be Contractor. 17. Modifications to this Bond are as follows:None PAYMENT BOND 006200-4 Travelers Casualty and Surety Company of America Travelers Casualty and Surety Company TRAVELERS .. St. Paul Fire and Marine Insurance Company POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS:That Travelers Casualty and Surety Company of America,Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein collectively called the "Companies"),and that the Companies do hereby make,constitute and appoint Heather L.Allen,Dana Brown,Emma C.Doleshel,Jim W.Doyle, Natalie C.Chau,Chad M.Epple,Jim S.Kuich,Theresa A.Lamb,Maxwell Martin,Michael A.Murphy,Andy D.Prill,S.M.Scott,and Steve Wagner of Bothell,Washington,their true and lawful Attomey(s)-in-Fact to sign,execute, seal and acknowledge any and all bonds,recognizances,conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF,the Companies have caused this instrument to be signed,and their corporate seals to be hereto affixed,this 21st day of April, 2021. yh4. .nM1v„i,,,, 40( &''. --six ii.-------tt. .? *Nit .:„.: e [HARTFORD, 2=a HARiFDRD,j i � c_,* N CONN. :o_=w:, CONN. n 1 r, fX yo.„M u,n mtl60.rS 1 .�f+�T �� State of Connecticut 1,2 " By: City of Hartford ss. Robert . Raney,Senior Vice President On this the 21st day of April,2021,before me personally appeared Robert L.Raney,who acknowledged himself to be the Senior Vice President of each of the Companies,and that he,as such, being authorized so to do,executed the foregoing instrument for the purposes therein contained by signing on behalf of said Companies by himself as a duly authorized officer. IN WITNESS WHEREOF, I hereunto set my hand and official seal. hPMp,,wo.\ a" �,� �++x'� My Commission expires the 30th day of June,2026 = +WOTATTY .; vu.ic ;My�0 Anna P.Nowik,Notary Public S This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of each of the Companies, which resolutions are now in full force and effect,reading as follows: RESOLVED,that the Chairman,the President,any Vice Chairman,any Executive Vice President,any Senior Vice President,any Vice President,any Second Vice President,the Treasurer,any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds,recognizances,contracts of indemnity,and other writings obligatory in the nature of a bond,recognizance, or conditional undertaking,and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her,and it is FURTHER RESOLVED,that the Chairman,the President, any Vice Chairman,any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company,provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary;and it is FURTHER RESOLVED,that any bond, recognizance,contract of indemnity,or writing obligatory in the nature of a bond, recognizance,or conditional undertaking shall be valid and binding upon the Company when (a)signed by the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary; or(b)duly executed(under seal, if required)by one or more Attorneys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority;and it is FURTHER RESOLVED,that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President,any Assistant Vice President,any Secretary,any Assistant Secretary,and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof,and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached. I,Kevin E.Hughes,the undersigned,Assistant Secretary of each of the Companies,do hereby certify that the above and foregoing is a true and correct copy of the Powerl of Attorney executed by said Companies,which remains in full force and effect.—`Dated this ' day of3OY LAc 1 u , 2OZ41 • em�u++...,,,:� J N 1sttt,,1„..,. HART-ORD, 1_ ¢i HARTFORo). t :,,�:: . . ;To CON... 8 ,,•��'• ��aF �y�.,� r ai lac-- 7' Kevin E.Hughe Assistant Secretary To verify the authenticity of this Power of Attorney,please call us at 1-800-421-3880. Please refer to the above-named Attorney(s)-in-Fact and the details of the bond to which this Power of Attorney is attached. EXHIBIT A CONTRACTOR'S DECLARATION OF OPTION FOR MANAGEMENT OF STATUTORY RETAINED PERCENTAGE A. I hereby elect to have the retained percentage of this contract held in a fund by the Owner until (30) days following final acceptance of the Work. Date Signed B. I hereby elect to have the Owner deposit the retained percentage of this contract in an interest bearing account, not subject to withdrawal until after final acceptance of the Work. Date Signed C. I hereby elect to have the Owner invest the retained percentage of this contract from time to time as such retained percentage accrues. I hereby designate as the repository for the escrow of said funds. I hereby further agree to be fully responsible for payment of all costs or fees incurred as a result of placing said retained percentage in escrow and investing it as authorized by statute. The owner shall not be liable in any way of any costs or fees in connection therewith. Date Signed D. I hereby elect to provide a Retainage Bond in accordance with R.C.W. 60.28.01 1. Date January 4, 2 0 2 4 Signed AGREEMENT 005100- 7 RETAINAGE BOND Bond No. 107939032 KNOW ALL MEN BY THESE PRESENTS,that Interwest Construction,Inc. , as Principal authorized to do business in the State of Washington and Travelers Casualty and Surety Company of America as Surety, a corporation organized and existing under the laws of the State of Connecticut and authorized to transact business in the State of Washington as Surety, are jointly and severally held and bound unto Jefferson County Public Works as Obligee in the penal sum of Four Hundred Fifty-nine Thousand Two Hundred Fifty And No/100 Dollars($459,250.00 ),which is 5%of the Principal's bid. WHEREAS, on the day of , 20 ,the said Principal, herein, executed a contract with the Obligee, for Phase 2-Water Reclamation Plant for Port Hadlock UGA WHEREAS, said contract and RCW 60.28 require the Obligee to withhold from the Principal the sum of 5%from monies earned on estimates during the progress of the construction, hereinafter referred to as earned retained fund AND NOW WHEREAS, Principal has requested that the Obligee not retain any earned retained funds as allowed under RCW 60.28. NOW, THEREFORE, the condition of this obligation is such that the Principal and Surety are held and bound unto the beneficiaries of the trust fund created by RCW 60.28 in the penal sum of 5%of the final contract cost which shall include any increases due to change orders, increases in quantities of work or the addition of any new item of work. If the Principal shall use the earned retained funds,which will not be retained, for the trus fund purposes of RCW 60.28,then this obligation shall be null and void; otherwise, it shall remain in full force and effect. This bond and any proceeds therefrom shall be made subject to all claims and liens and in the same manner and priority as set forth for retained percentages in RCW 60.28. PROVIDED HOWEVER, that: 1. The liability of the Surety under this bond shall not exceed 5%of the total amount earned by the Principal if no monies are retained by the Obligee on estimates during the progress of construction. 2. Any suit under this bond must be instituted within the time period provided by applicable law. WITNESS our hands this 4th day of ,Ian iary , 2024. Interwest Co- n,Inc. c�l.�' By: Eben Twaddle, President Principal "� r .°\\\``" ‘ Iii1,,,,�r ,t CON R ` SuretyTravelers Casualty and Surety Company of America \\\\„„ '11/0. y��4 4/71,1ZV---- 6). F. 410 Attorney-in-Fact S s A m c� Theresa A. Lamb A.1`ii. Name and Address of Local Agentt,q987 HUB International P.O.Box 3018,Bothell WA 98041-3018 /'/`/tr� ;�� ` Travelers Casualty and Surety Company of America 411.1k. Travelers Casualty and Surety Company TRAVELERS' St. Paul Fire and Marine Insurance Company POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS:That Travelers Casualty and Surety Company of America,Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein collectively called the "Companies"),and that the Companies do hereby make,constitute and appoint Heather L.Allen,Dana Brown,Emma C.Doleshel,Jim W.Doyle, Natalie C.Chau,Chad M.Epple,Jim S.Kuich,Theresa A.Lamb,Maxwell Martin,Michael A.Murphy,Andy D.Prill,S.M.Scott,and Steve Wagner of Bothell,Washington,their true and lawful Attomey(s)-in-Fact to sign,execute, seal and acknowledge any and all bonds,recognizances,conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF,the Companies have caused this instrument to be signed,and their corporate seals to be hereto affixed,this 21st day of April, 2021. SUflfTyq, diw"'P`1 A,yi, .�11 • i d;HARTFORD,<_'a i HARTFORD, c caeca* 5 Nk coNN. io_%0 CONN. o tl n „, , 1. Ip yh a nn State of Connecticut By: City of Hartford ss. Robert .Raney,Senior Vice President On this the 21st day of April,2021,before me personally appeared Robert L.Raney,who acknowledged himself to be the Senior Vice President of each of the Companies, and that he,as such, being authorized so to do,executed the foregoing instrument for the purposes therein contained by signing on behalf of said Companies by himself as a duly authorized officer. %y�,�`� IN WITNESS WHEREOF, I hereunto set my hand and official seal. �PNOgi; /� �:oe My Commission expires the 30th day of June,2026 Anna P.Nowik, Notary Public This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of each of the Companies, which resolutions are now in full force and effect,reading as follows: RESOLVED,that the Chairman,the President,any Vice Chairman,any Executive Vice President, any Senior Vice President,any Vice President,any Second Vice President,the Treasurer,any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds,recognizances,contracts of indemnity,and other writings obligatory in the nature of a bond,recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her,and it is FURTHER RESOLVED,that the Chairman,the President, any Vice Chairman,any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company,provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary;and it is FURTHER RESOLVED,that any bond, recognizance,contract of indemnity,or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when(a)signed by the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary; or(b)duly executed(under seal, if required)by one or more Attorneys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority;and it is FURTHER RESOLVED,that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President,any Assistant Vice President,any Secretary, any Assistant Secretary,and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof,and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached. I,Kevin E.Hughes,the undersigned,Assistant Secretary of each of the Companies,do hereby certify that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies,which remains in full force and effect. Dated this y+h day of Taanwafy 2.02fsg;...;;;N, 4-7:74"Z- OININ gl HARTFORD,E.,itai kf1HARTFORD, �4CONN o zee-- Cy./ Kevin E.Hughes,Assistant Secretary To verify the authenticity of this Power of Attorney,please call us at 1-800-421-3880. Please refer to the above-named Attorney(s)-in-Fact and the details of the bond to which this Power of Attorney is attached. ____.---..„N INTECON-15 RBHASKAR .a�oRn, CERTIFICATE OF LIABILITY INSURANCE DATE D/YYYY) 1/2/2024 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 CONTACT NAME: Hub International Northwest LLC PHONE FAX PO Box 3018 (A/C,No,EXt):(425)489-4500 I(A/c,No):(425)485-8489 Bothell,WA 98041 ADORIEss:now.info@hubinternational.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:The Travelers Indemnity Company of America 25666 INSURED INSURER B:The Travelers Indemnity Company of Connecticut 25682 Interwest Construction Inc. INSURER C:Travelers Property Casualty Company of America 25674 609 North Hill Blvd INSURER D:St.Paul Surplus Lines Insurance Company 30481 Burlington,WA 98233 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR wVD IMM/DD/YYYYI IMM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR X X DTCO7N065015TIA23 7/1/2023 7/1/2024 DAMAGE PREMGETO(ERENTED NToccu ante) $ 300,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JECT X LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: WASHINGTON STOP $ 1,000,000 - B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ X ANY AUTO X X 8106P73016A2326G 7/1/2023 7/1/2024 BODILYINJURY(Perperson) $ AUTOSOWNED ONLY SCHEDULED SVUyLNED BODILY INJURY(Per accident) $ AUTOS ONLY AUOTOS ONLY PROPERTY accident DAMAGE $ $ C X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 EXCESS LIAB CLAIMS-MADE X X CUP7N0837522326 7/1/2023 7/1/2024 AGGREGATE $ 10,000,000 DED X RETENTION$ 10,000 A WORKERS ND EMPLOYERS COMPENSATION Y/N STATUTE X ERH- ANY PROPRIETOR/PARTNER/EXECUTIVE DTCO7N065015TIA23 7/1/2023 7/1/2024 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A (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 D Pollution x x ZCE-16P55245-23-SK 7/1/2023 7/1/2024 OCC/AGG: 5,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) RE:ICI Job#1442,Water Reclamation Plant,1442 Phase 2—Membrane Bioreactor Wastewater Treatment Plant for Port Hadlock UG Jefferson County Public Works,Owner and Engineer,and any individualsor entities include coverage for the respective officers,directors,members, partners,employees,and consultants are included as an additional insureds,Coverage is Primary and non-contributory and Waiver of Subrogation applies per the attached forms/endorsements.Per Project Aggregate applies to General Liability policy,per attached forms/endorsements. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE fferson County Public Works THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Je 623Sheridan St ACCORDANCE WITH THE POLICY PROVISIONS. Port Townsend,WA 98368 AUTHORIZED REPRESENTATIVE eitspiAlPeC ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID:INTECON-15 RBHASKAR LOC#: 0 ACCPR ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Hub International Northwest LLC Interwest Construction Inc. 609 North Hill Blvd POLICY NUMBER Burlington,WA 98233 EE PAGE 1 CARRIER NAIC CODE EE PAGE 1 SEE P 1 EFFECTIVE DATE:SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Pollution Liability This Contract is registered and delivered as a Surplus Lines coverage under the insurance code of the State of Washington,Title 48 RCW. It is not protected by any Washington State Guaranty Association Law ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. 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Nmm r Zc « E uCOLLHt F� yr Ilil_ < 4 a .5 a .c U Policy#DTCO7N065015'rIA23 COMMERCIAL GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY COVERAGE FORM the buiro beat,cod adehuby or to perform the normal electrical. the building,a produced by or hydraulic or mechanical functions originating from equipment that is necessary for the operation of used to heat water for personal "mobile equipment"or its parts,if Various provisions in this policy restrict coverer Read (1)The"bodily a' damage'is use by the building's occupants or open fuels. lubricants or notha gee y injury "property erg their guests: vehicle erid e part fluids escape from e the entire policy carefully to determine rights,duties and caused by "occurrence"that lakes place vehicle designed to hold.store what s and is not covered. n the"coverage territory"; lW"Bodily injury' r 'may rtybe or rece them.This exception damage"for which you may be Throughout this policy the wads'you"and"your"refer (2)The"bodily injury or"property damage" held liabe.if you are a contractor does not apply if the'bodily injury" to the Named Insured shown in the Declarations,and occurs during the pokey period:and and the owner or lessee of such or"property damage"apses out of any other person or organization qualifying as a Named premises,site or location has been the intentional discharge,dispersal Insured under this policy.The words"we',"us"and (3)Prior to tlIe policy period,no insured fisted added to your policy as an or release of the fuels,lubricants 'we"refer to the canproviding undo Paragraph 1.d Section II-Who Is additional insured with res ct to or other operatingfluids.or If such parry this insurance. An Insured and no'employee"authorized ce The word insured"means any person or organization by you to give or receive notice of an f r nthatgaddtionaloing a assured at that performed fled lace bn��oo oroperating he qualifying as such under Section It-Who Is An 'occurrence"or claim knew that the"bodily premises,site or location and such prams s.site or location with the Insured. injury'or"property damage"had occurred. premises.site or location is not intent that they be discharged, in whole or in part If such a fisted insured and never was owned or occupied dispersed or released as part of Other wads and phrases that appear in quotation or authorized"employed knew,prior to the p Pe marks have special meaning.Refer to Section V- mPoy by,or rented or loaned to,any the operations being performed by Definitions. policy period. that the"bodily ,injury'or insured,other than that additonal such insured. contractor or 'property damage" occurred then any insured;or subcontractor. SECTION I-COVERAGES continuation,change a resumption of such _ COVERAGE A-BODILY INJURY AND PROPERTY 'bodily injury'or"property damage"during toil"Bodily injury' or "property (id"Bodily injury' or "property or after the k daage" sing out d heat. der sustained within DAMAGE LIABILITYporky period will be deemed to smoke or fumes from a"hostile damage" `have been known prior to the policy period. building and caused by the release 1. Insuring Agreement fire, of gases,fumes or vapors from a "Bodily injury" or "property damage" which a. We will pay those sums that the insured (b)At or from any premises, site or materials brought into that building becomesobligated to damagesoccurs during the policy period and was nit, location which is or was at any time in connection with operations being legally g pay as opens ons because of"bodily injury or"property damage" Ana to the policy period. known to have used by or for any insured or others for performed by you or on your behalf to which this insurance applies.W e will have occurred by any insured fisted under Paragaph the handling. storage, disposal, by a contractor or subcontractor;a the right and duty to defend the insured against 1.of Section II-Who Is An Insured or any processing a treatment of waste: I or any"suit'seeking those damages.However, "employee"authorized by you to give or receive (c)If such"pollutants"are or were at any lii 1"Bodily injury' 'property notice of an"occurrence'or claim includes any damage" arising out d heat. we will have no duty to defend the insured time transported, handed. stored, smoke or fumes from a'hostile continuation, change or resumption of that against any"suit"seeking damages for"bodily "bodily injury"or'property damage'after the treated,disposed d.or processed as fire';or injury' or 'property damage" to which this endtbepolicyd. waste by or for:of insurance does not apply.We may,at our Pen (I) Any insured;or (a)At or from any premises, site or discretion.investigate any"occurrence"and d. "Bodily injury"or"property damage'will be location on which any insured or any (li)Any person a organisation for contractors or subcontractors working settle any claim or"suit"that may result.But: deemed to have been known to have occurred whom be legal) g (1)The amount we will pay for damages is at the earliest time when any insured listed responsible: may y directly or indirect&on any insured's limited as described n Section III-Limits under Paragraph 1.of Section II-Who Is An behalf are or were at any time Insured or any"employee"authorized by you to (d)At or front any premises, site or performing operations to test for. Of Insurance;and - give or receive notice of an"occurrence"or location on which any insured or any monitor, clean up• remove,contain. (2)Our right and duty to defend end when we claim: contractors or subcontractors working heal,detoxify or neutralize,or in any have used up the applicable limit of directly or indirectly on any nsured's way respond to.or assess the effects (1)Reports all, or any part d the"bodily behalf are performing operations if the of,"pollutants". insurance in the payment of judgments or injury"a"properly damage to us or any "pollutants"are brought on or to the settlements under Coverages A or B or other insurer; premises,site or location in connection ()Anype rising 2 loss.Cost or ez rise a' out d medical expenses under Coverage C. with such operations by such insured, any: (2)Receives a written or verbal demand a Request.demand.order or No obligation dlligati or liability to pay Sum a s contractor or subcontractor.HaHeaer, claim for damages because d the"badly (a) eq statutory or perform acts a services is covered unless this subparagraph does not apply to: tat t that an insured explicitly provided for under Supplementary injury*or'property damage":or or repo ay test fomen y Payments. (3)Becomes awareother means that (I) damage"g injury' 'property reor others test for.treat. clean up, by any arising out of the escape remove, contain. treat, detoxify a "bodily injury"or"property damage"has of fuels, lubricants or other neutralize,or in anyto.a b. This insurance applies to"bodily injury and occurred a has begun to occur. way respond "property damage"only it: �' operating fluids which are needed assess the effects of."polldans":a • CG T1 00 0219 o 2017 The Travelers Indemnity fights company. glts reserved. Page 1 d 21 CG T1 00 0219 O2017 The Travelers Indemnity •A.Cmen . rgha reserve. Page 3 d 21 I�', Includes copyrighted maeoal of Insurance Services Office.Inc.with its permission. Irclxles copyrighted manna of Insurance Services Office.Inc.with is permission. • COMMERCIAL GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY e. Damages because of"bodily injury'include (3)Any statute.ordinance or regulation relating (b)Claim or suit by or on behalf of any (bl The operation of any of the machinery damages claimed by any person or orgadzaton to the sale,gift, distributon or use of governmental authority or any other or equipment listed in Paragraph f.(2) for care,loss of services or death resulting at alcoholic beverages. person a organisation because of or f.(3) d the defiretwe of"nubile any time from the'bodily injury'. testing for, monitoring. cleaning up, equipment":a This exclusion applies only if you are in the 2. Exclusions business of manufacturing,distributing,seling, removing, containing, treating. (6)An aircraft that is: This insurance does not a serving a famishing alcoholic beverages.For detoxifying a rl xifyng ed a inralizlrg, any (a)Chartered with a pilot to any insured: apply to: the purposes of this exclusion,permitting a respurdirg lo,a assessing the a. Expected Or Intended Injury person to bring alcoholic beverages on your effects of.'pollutants". (b)Not owned by any insured:and "Bodily injury"or"property damage"expected a premises,for consumption on your premises, g. AYcraft,Auto Or Watercraft (c)Not being used to carry any person or intended from the standpoint of the insured. whether or not a fee is charged or a license is "Bodily injury'or"property damage"arising out property for a charge. This exclusion does not apply to'bodily injury' required for such activity, is not by itself of the ownership, maintenance, use or h. Mobile Equipment or"property damage"resulting from the use of considered the business of selling.serving or entrustment to others of arry aircraft,'auto"or "Bodily injury"or"property damage"arising out reasonable force to protect persons or properly. furnishing alcoholic beverages. watercraft owned or operated by or rented or ot: b. Contractual Liability d. Workers'Compensation And Similar Laws loaned to any insured.Use includes operators (1)The transportation d"mobile equipment" 'Bododam for which Anyobligation of the insured under a workers' and loading or unloading'. &injury'or"property age" o 9a by an'auto"owned or operated by or the insured is obligated to pay damages by compensation. disability benefits or This exclusion applies even if the claims rented or loaned to any insured;or reason of the assumption of liability in a unemployment compensation law or any similar against any insured allege negligence or other (2)The use d'mll equipmen a bile t'in, while contract or agreement.This exclusion does rot law. wrongdoing in the supervision, hiring, apply to liability for damages: e. Employer's to er's Llabll' employment,training or monitoring of others by in practice for,a while being prepared for. (1)That the insured would have in the absence P y any prearranged racing.sped,demolition. that insured,if the"occurrence'which caused [prep 1 d the contract a agreement;a that injury'to: the"bodil or der e"involved g activity. y in injury" property nag (2)Assumed in a contract a agreement that is (1)An'emplace'of the insured arising out d the ownership, maintenance, use or 1. War as Insured contract'.provided that tt the and In the course d: enyustment to others of any aircraft"auto"a "Bodily Injury or'property damage"arising out la)Employment the insured.or watercraft that is owned or operated by or of: injuy or"property damage"occurs frented toa loanedany insured. subsequent to the eof executionthe contract gig Performing duties related to the r, This exclusion does not apply to (1)War,including undeclared a civil wa or agreement. Solely for the purposes of conduct or couct the insured's business; (2)Warlike action by a military force including liability assumed in an Insured contract, (1)A watercraft while ashore on premises you action in hinderingor defendin ainst an reasonable attorneys'fees and necessary (2)The spouse,child,parent brother a sister a rent, actual or expected attack. by litigation expenses incuned b fa a d that'employee"as a consequence of ownany 9a y°r pant Paragraph(1)above. (2)A watercraft you do not own that is: government.sovereign a other authority other than an insured will be deemed to be using military personnel a other agents:or damages because of"bodily injury' or This exclusion applies whether the insured may (a)50 feet long or less;and "property damage",provided that: be table as an employer or in any other capacity (b)Not being used to carry any person or (3)Insurrection.rebellion,revolution.usurped (a)Liability to such party for,or for the and to any ohigalion to share damages with a property far a charge; power,a lunidentaken k n�ongovernmenta l repay someone else who must pay damages Ity in g g again cost d.that partys defense has also (3)Parking an'auto"on,or on the ways next d these. because d the injury. any been assumed in the same"insured to, you own or rent,provided the contact'':and This exclusion does not apply to liability "auto'o"is rotr ownedby or rented or loaned d DamageTo Property (h)Such attorneys' fees and litigation assumed by the insured under an Insured to you or the insured: "Property damage"to: expenses are for defense d that party contract'. (4)Lability assumed under any "insured (1)Property you own, rent. a occupy, against a civil or alterative dispute f. Pnllufoon contract for the ownership,maintenance or ncludng any costs or expenses incurred resdtian proceeding which (1)"Bdiy injury'or"property damage"arising use d aircraft or watercraft: by you,or any other person,organisation or damages to which this I Insurance out of the actual,alleged or threatened (5)"Bodily injury or"property damage"arising entity, for repair. replacement. applies are alleged. discharge.dispersal.seepage.migration. out of: enhancement restoration a maintenance c. Liquor Liabilityrelease or escaped"polluans": (a)The operation of macho d such property for any reason.including "Bodily injury or*property damage"for which (a)At a from any premises. site a equipment that is attached to,a part to prevention drin property; a person a damage any insured may be held liable by reason of: location which Is a was at any time of,a land vehicle that would qualify as (1)Causingcontributingto the intoiicatioe owned or occupied by,or rented or 'mobile equipment"under the definition (2)Premises you sell,give away or abandon,if or loaned to,any insured.However,thisothe"properly damage"arises out of any of any person: bee does notto vehicle'mobile w equipment" 'b tch land part of those premises: s P agreph apply were not subject to a (2)The furnishing of alcoholic beverages to a p) "Bodily ijuy if sustained within a compulsory or financial responsibility (3)Property loaned to you: person under the legal drinking age or building and caused by smoke. law,or other motor vehicle insurance (4)Personal property in the care,custody a under the influence of alcohol;or fumes,vapor or soot produced by law.where it is licensed or principally timed al No insured; or originating from equipment that garaged:or Page 2 of 21 o zol T The Travelers idemrey company.N rights reurvea. CG T1 00 0219 Page 4 of 21 o Xn)The Travelers Indemnity company.NI rig.reserved. CG T1 00 0219 Includes copyrighted maeral of Insurance Services Office.Inc.with in permission. Includes copyrighted material of Insurance services Office,Inc.with is permission. COMMERCIAL GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY (5)That particular part of real property on accidental physical injury to"your product"or This exclusion does not apply to"personal against a civil or alternative dispute which you or any contractors or "your work"after it has been put to its intended injury"caused by malicious prosecution. resolution proceeding in which subcontractors working directly or indirectly Use. b. Material Published With Knowledge Of damages to which this insurance on your behalf are performing operations,if n. Recall Of Products,Work Or Impaired Falsity apples are alleged. the"property damage"arises out of those Property "Personalandadvertising adise out of f. Breach Of Contract operations:orrg injury arising (6)That particular part of anypropertythat Damages claimed for any loss,cost or expense oral or written publication.including publication "Advertising injury'arising out of a breach of incurred by you or others for the loss of use by electronic means,of material.if done by or at C«liracL must be restored, repaired or replaced withdrawal, recall, inspection, repair. the direction of the insured with knowledge of g- Quality Or Performance Of Goods-Failure because "your work" was incorrectly replacement adjustment.removal or disposal its falsity. To Conform To Statements performed on it. ct c. Material Published Or Used Prior To Policy Paragraphs(1),(3)and(4)of this exclusion do (1)"Your product"; Period "Advertising goods.products or seniors failurerising out of the services to conformwith not apply to"premises damage".A separate (2)"Yore work";or (1)"Personal and advertising irjuy arising out any statement of quality or performance made limit of insurance applies to"premises damage" of oral or written publication, including in your"advertisement". as described in Paragraph 6.of Section III- (3)"Impaired property: of Limits Of Insurance. if suchproduct work,or propertypublication by blicaonic means,c material h. Wrong Description Of Prices is withdrawn whose first publication lode place before Paragraph(2)of this exclusion does not apply if or recalled from the market or from use by any the beginning of the policy period;or "Advertising injury arising out of the wrong the premises are"your work"and were never person or organization because of a known or (2)"Advertisingarising out of description of the price d gtisems.product or occupied,rented Of for rental suspected defect, deficiency. inadequacy« n injuy g services stated in your"advertisement". p by you in your "dcopyright."title"«"slogan Paragraphs (3). (4). (5) and (6) of this ^ °�condition in it. in your "advertisement"' whose first I. Intellectual Property exclusion do not apply to liability assumed o. Personal And Advertising Injury infringement in your advertisement"was "Persona and advertising injury'arising out of under a sidetrack agreement "Bodily injury arising out of'personal and committed before thee beginning of the any actual or alleged infringement or violation of Paragraph(6)of this exclusion does not applyadvertising injury. policy period. any of the following rights or laws,or any other d. Criminal Acts "personal and advertising injury alleged in any to"property damage"included in the"products- p. Electronic Data claim or "suit" that also alleges any such completed operations hazard'. "Personal and advertising injry arising out d ainfringement«violation: d Pe Damages arising out of the loss d.loss of use criminal act committed by or at the direction of k. Damage To Your Product of,damage to,corruption of,inability to access, the inured. (1)Copyright: "Property damage"to"your product"arising out of inability to manipulate"electronic data". e. Contractual Liability (2)Patent of it orany part d i. However, this exclusion does notto I. Damage To Your Work liability for damages because of"bodily injuy, "Personal and advertising injury"for which the (3)Trade tress: insured has assumed lability in a contract or (4)Trade name; "Property damage"to"your work"arising out of q. Unsolicited Communication agreement.This exclusion does not apply to (5)Trademark it or any part of it and included in the"products- liability for damages: completed operations hazard". "Bodily injury'or'property damage"arising out 1 (6)Trade secret or of any actual or alleged visation of any law that ()That the insured would have in the absence nte (7)Other intellectual e rights or laws. This exclusion does not apply if the damaged restricts Of prohibits the sending,transmitting of the contract or agreement or property work or the work out of which the damage or distributing of"unsolicited communication". (2)Because of"personal injury"assumed by This exclusion does not apply to arises was performed on your behalf by a you in a contract or t that is an subcontractor. r. Access Or Disclosure Of Confidential Oragreement (1)or alleged injury arising out of allyon of Personal Information "insured contract", provided that the « alleged Inking,"title" or violation d m.Damage To Impaired Property Or Property "personal injury"is caused by an offense another's copyright."title"or"slogan"in Not Physically Injured "Bally injury or"property damage"arising out subsequent to the execution of your"advertisement":or "Property damage"to property or of any access to«disclosure d any person' the contract or agreement.Solely for the 2 property Ibar has not been"impaired physically injured, Organizalion's confidential or personal purposes of tract",assumed by you in an ()Any other"personal and advertising injury' arising out d information. "insured contract", reasonable attorneys' alleged es anyn any such infringement entr«that also violation s. Asbestos fees and necessary litigation expenses alleges gem (1)A defect, deficiency, inadequacy or incurred by or for a party other than an of another's copyright,"Idle"or"slogan"in dangerous condition in"your product"or (1)"Bodily injury'or"property damage"arising insured will be deemed to be damages your"advertisement". "your work";or out of the actual or alleged presence or because of"personal injury,provided that j. Insureds In Media And Internet Type (2)A delayor failure byor anyone acting actual,alleged or threatened dispersal of you yo rig (a)Liability to such party for,or for the Businesses on your behalf to perform a contract or asbestos, asbestos fibers or products cost of,that partys defense has also "Personal and advertising injury"caused by an agreement in accordance with its terms. containing asbestos, provided that the been assumed by you in the sane offense committal by an insured whose "bodily injury or "property damage is "insured contract";and This exclusion does not apply to the loss of use caused or contributed to by the hazardous business is: of other property arising out of sudden and properties of ey asbestos. (b)Such attorneys' fees and litigation (1)Advertising,"broadcasting"«publishing; expenses are for defense of that party CG T1 00 0219 02017 The Travelers Indemnity company.N rights reserved. Page 5 of 21 CG T1 00 0219 02017 The Travelers Indemnity Company.AI rights reserved. Page 7 of 21 Includes copyrighted material of Insurance Services Once.Inc.with its permission. Includes copyrighted materiel of Insurance services Once.Inc.with is permission. COMMERCIAL GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY (2)"Bodily injury'or"property damage'arising employment-related practices described in (2)Designing or determining content of neutralizing.or in any way responding to,or out of the actual or alleged presence or Paagaph(a),(b),or(c)above is directed. websites for others;or assessing the effects of."pollutants". actual,afeged or threatened dispersal of This exclusion applies whether the insured may (3)An Internet search, access.content or o. War any solid,liquid,gaseous or hermal irritant be fable as an employe or in any other capacity service provider. "Personal and advertising injury arising out of: or contaminant including smoke,vapors, and to any obligation to share damages with or However, this exclusion does not apply to sod n ,fumes,acids,alkalis,chemicals and repay sonee else who must pay damages (1)War.including undeclared or civil war; waste,and that are pan of any claim or because of the"troll injury'. Paragraphsa.(1).(2)and(3)of the definition of age of y jury Y i 1 ry'. (2)Warlike action by a military force.including "suit"'which also alleges a "bodily "Personal injury'. Exclusions<.through n.do not apply to`premises action in hindering or defending against an or "property damage" described in damage".A separate limit of insurance a For the purposes of this exclusion: actual or ex Paragraph(1)above. Pea applies to expected attach, by any 'premises tlamage'as described in Paragraph 6.of (1)Creating and producing correspondence government.sovereign or other authority (3)Any loss,cost or expense arising out of Sectlonlll-Limits Of Insurance. written in the conduct of your business. using miliay personnel or other agents:or any COVERAGE B-PERSONAL AND ADVERTISING bulletins.financial or annual reports,or (3)Insurrection,rebelfon,revolution,usurped INJURY LIABILITY newsletters about your goods.products Of Request,demand,order or statutory or INJURY will not be considered the Power,or action taken ggovernmentalgovernmentalregulatory requirement that any insured 1. Insuring Agreement authority in hindering or defending against or others lest for,monitor,clean up, a. We willbusiness of publishing:and anyof these. p pay those sums that the insured remove. contain, treat, detoxify or becomes legally obligated to pay as damages (2)The placing of frames.borders or links,or p. Unsolicited Communication neutralize,or in any way respond to,or because of"personal and advertising injury'to advertising,for you or others anywhere on d d injury"arise out of the effects of, asbestos, which this insurance applies.We will have the the Internet will not,by itsett,be considered "personal an advertising t du y arising the business of advertise "broadcasting" any actual or alleged violation of any law that asbestos fibers or products containing right and duty t^defend ag insured against any ^9' restricts« bits the sends transmitting asbestos;a "suit"seeking those damages.However,we oil or publishing. prohibits g, g (b)Claim or suit by or on behalf of any have no duty to defend the insured against any k. Electronic Chatrooms Or Bulletin Boards or dstributirg of"unsolicited communication". governmental authority or any other "suit" seeking damages for "personal and q. Access Or Disclosure Of Confidential Or person or organization because of advertising injury to which this insurance does "Personal and advertising injury'arising out of Personal Information testing for, monitoring, cleaning up, not apply. We may, at our discretion an electronic chatroom or bulletin board the "Personal and advertising injury arising out of investigate anyoffense and settle anyclaim or insured hosts or owns, or over which the removing. containing, treating. g exercises control. any access to or disclosure of any person's or detoxifying or rtentral¢bg,or in any "suit"that may result But: insuredorganisation's confidential or personal way responding to,or assessing the (1)The amount we will pay for damages is I. Unauthorized Use Of Another's Name Or information. effects of,asbestos,asbestos fibers or fmiled as described in Section III-Limits Product r Asbestos containing asbestos. Of Insurance and "Personal and advertising injury arising out of t Employment-Related Practices (2)Our right and duty to defend end whet we the unauthorized use of anotheOs name or 11) t actualct and or alleged p injury"arising out "Bodiy injury"to: have used up the applicable toil of product in your e-mail address,domain name or of the a alleged presence or actual, stos, (1)A person arising out d any insurance in the payment of judgnnerts or melaag,or any other similar tactics to mislead allegedt s threatened dispersal of containing (a)Refusal to eon thatsettlements under Coverages A or B or anothKs potential customers. asbestos fibers or products sonai andng poy person; medicalasbestos.provided that the"personal (bl Termination of that person's expenses under Coverage C. m.Pollution advertise Is caused or contdbuted employment or No other obligation or liability to pay sums or advertising injury' "Personal and advertise n arising to by the hazardous properties of asbestos. (xl Employment-related practice, policy. perform acts or services is oared unless advertising jury dout of act or omission. such as coercion, explicitly provided for under covered the actual.alleged or threatened discharge, (2)"Personal and advertising injury arising out, demotion, evaluation reassignment. Payments. dispersal. seepage, migration. release « of the actual or alleged presence or actual, discipline, failure to promise or b. This insurance applies to "personal and escape of"pollutants"al any time alleged«threatened dispersal of any solid, advance, harassment, humiliation advertising injury causedan offense arisingn. Pollution-Related conliquitaminant. gaseous or thermal irritant, aor by sootaminant. including smoke, aapors, discrimination,libel,sander,vidalbn out of you business bid only if the offense was Any loss,cost or expense arising out of any: soot,fumes,acids.alkalis,chemicals and of the person's right of privacy, committed in the`coverage territory during the waste.and that are part of any claim or malicious prosecution or fake arrest, policy period. (1)Request. demand order or statutory or detention or impisonrned applied to or regulatory requirement that any insured« "suit"which also alleges any"personal and directed at that 2. Exclusions advertising injury'described in Paragraph person,regardless of others test tor,monitor,clean up,remove, 1 whether such practice Policy.actor This insurance does not apply to: contain,treat,detoriy or neutralise,or in ()above. omission occurs, is applied or is a. Knowing Violation Of Rights Of Another any way respond to.or assess the effects (3)Any loss.cost Of expense arising out of of."pollutants";or arty: time committed erore.during or after the at the and on of injury"caused by or time of that person's employment« (2)Claim or suit by or on behaR of any (a)Request,dement.order or sanatory or at the direction d the assured withr the (2)The spouse,child parent brother«sister knowledge that the act world violate the rights governmental authority or any other person regulatory requirement that any insured of that person as a consequence of"bodily of another and would inflict "personal and or organization because of testing for, or others test for,monitor,clean up, injury'to that person at whom any of the advertising injury'. monitoring. cleaning up. removing, remove. co treat, detoxify orcocontaining, treating, detoxifying or neutralize.or in in any way respond lo,or Page 6 of 21 c 2017 The Travelers Indemruy company.rat rides reserved. CG T1 00 02 19 Page 6 of 21 o 2017 The Travelers indemnity Company.xt rights reurvea. CG T1 00 0219 Includes copyrighted material of Ircuance services Office.Inc.wOr in permission. IncWw copyrighted materiel of...ace services Office.Inc.with to permission. COMMERCIAL GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY assess the effects of, asbestos. (3)Because of your operations; a. We have used up the applicable limit of workers" while performing duties asbestos fibers a products containing provided that insurance in the payment of judgments. related to the conduct of your asbestos;or settlements or medical expenses;or business: (b)Claim or suit by or on behalf of any (a)The accident takes place in the"coverage The cond itions ditions set forthove,or ab the tens of (b)To the spouse,child,parent,brother a territory"and during the poky period;governmental authority or sister of that co-employee"any other the agreement described in Paragraph I.above, Mee" or person or organization because of (b)The expenses are incurred and reported to are no longer mat. 'volunteer worker'as a consequence testing for. monitoring, cleaningus within one year of the date of the of Paragraph(1Na)ahove; rig, SECTION II-WHO IS AN INSURED removing, containing. treating, accident:and (e)For which there is any obligation to 1. If you are designated in the Declarations as: detoxifying or neutralizing.or in any (c)The injured person submits to examination, share damages with or repay someone a An individual, you and your spouse are way responding to,or assessing the at our expense,by physicians of our choice nsureds.but only with respect to the conduct else who must pay damages because effects of,asbestos,asbestos fibers or as often as we reasonably require. of a business of welch you are the sate owner. of the injury described in Paragraph products containing asbestos. (1)(a)or(b)above a b. We will make these payments regardless of s. Employment-Related Practices fault. These payments will not exceed the b. A partnership a joint venture.you are an (d)Arising out of his or her providing or "personali applicable limit of insurance. We will Insured.Your members.your partners,and failing to provide professional health tinny'to: pay their spouses are also insureds.but only with reasonable expenses for: respect to the conduct of business. care services. (1)A person arising out of any Pe your Unless you are in the business a (a)Refusal to eon (1)First ad administered at the time of an c. A limited liability company.you are an insured. ploy that person: occupation d providing professional heath accident; Your members are also insureds,but only with (b)Ternenatbn of that persm's (2)Necessary medical.surgical, X-ray and respect to the conduct of your business.Yoa care services,Paragraphs(1Na),(b).(c) employment:or and(d)above do not apply to"bodily iNuy dental services, including prosthetic managers are insureds,but only with respect to arising out of providing or failing to provide (c)Employment-related practice, policy, devices:and their duties as your managers. first aid or"Good Samaritan services"by act or omission, such as coercion. (3)Necessary ambulance, hospital, d. An organization other than a partnership.joint any of your "employees or "volunteer demotion, evaluation reassignment professional nursing and funeral services. venture or limited liability company,you are an workers", other than an employed or discipline, (ailure to promote or 2 Exclusions insured.Your"executive officers"and directors volunteer doctor.Any such"employees"or advance, harassment, humiliation, are insureds.but only with respect to their "volunteer workers"providing or failing to discrimination,libel,slander,vidation We will not pay expenses for"bodily injury: duties as your officers or directors. Van provide first aid or "Good Samaritan of the persais right of privacy, a. Any Insured stockholders are also insureds.but only with services"during their work hours for you malicious prosecution or fate arrest, To any insured.excepl"volunteer ovorkers". respect to their lability as stockholders. wit be deemed to be acting within the detention a imprisonment applied to or directed at that person,regardless of b. Hired Person e. A bust,you are an insured.Your trustees are scope of their employment by you or whether such practice policy,act or To aalso insureds,but only with respect to lined performing duties related to line conduct of person hired to do work for or on behalf of duties as trustees. your business. omission occurs, is applied or is any insured or a tenant of any insured. 2. Each of the fdlavh alsoinsured: (2)"Property damage"to property: comrriq�before.during a after the c. Injury On Normally Occupied Premises g s an time of that person's employment;a a. Your"volunteer workers'only whale performing la)Owned,occupied a used by To a person injured on that part of premises duties related to the conduct of your business. (b)Rented to, in the care.custody or (2)The spouse,child parent,brother or sister you own a rent that the person normally or your"employees",other than eithercontrol d, or over which physical of that person as a consequence of occupies. your "personal injury to that person at wham 'executive officers"(if you are an organtzation control is bang exercised for any any of the employment-related practices d. Workers'Compensation And Similar Laws other than a partnership,joint venture or(nured purpose by described in Paragraph(a),(b),or(o) To a person,whether or not an"employee"of liability company)or your managers(if you are a you,any of your"employees","volunteer above is directed any insured.if benefits for the"bodly injury'are limited liabiity company), but only for acts workers",any partner or member(if you are This exclusion applies whether the insured may payable or must be provided under a workers' within the scope of their employment by you or a partnership or joint venture). or any be liable as an employer a in any other capacity compensation a disability benefits law or a while performing duties related to the conduct member (if you are a limited liability and to any obligation to share damages with or similar law. of your business. However, none of these company) "employees" a 'volunteer eskers" are repay someone else who must pay damages e. Athletics Activities b. Any person(other than your"employee'or insureds fa: "volunteer worker).or because of the"personal injury. To a person injured while practicing.instructing any organization,while COVERAGE C-MEDICAL PAYMENTS or participating in any physical exercises or (1)"Bodily injury"or"personal irquy: acting as your real estate manager. 1. Insuring Agreement games,sports,or athletic contests. (a)To you,to your partners or members(if c. Any person or organization having proper 1. Products-Completed you area partnership or joint venture), temporary custody of your property if you die, a. We writ pay medical expenses as described pl Operations Hazard to your members(if you area limited but only below for"bodily injury"caused by an accident: Included within the "products-completed lability company),to a co-"employee" (1)With respect to liability ailing out of the On premises you awn or rent operations hazard". while in the course d his or her (2)On ways next to premises you own or rent: & Coverage A Exclusions employment a performing duties Unilyour maintenance or use of that property,and related to the conduct of your (2)Until your legal representative has been or Excluded under Coverage A. business,a to your other"volunteer appointed. CG T1 00 0219 0 2017 The Travelers Indemnity Canpary a rights reserved. Page 9 of 21 CG T1 00 0219 0 2012 Tee Travelers Indemnity Company'_All rights reserved. Page 11 of 21 Includes coprnghted material of Insurance services Office.Inc.with its permission. Includes ceme ghted material of Insurance Services Office.kx.over is permission. COMMERCIAL GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY SUPPLEMENTARY PAYMENTS assumed by the insured in the same"insured d. Your legal representative if you die,but only b. Arises out of the ownership,maintenance or 1. We will pay, with respect to any claim we contract"; with respect to duties as such. That use of that part of any premises leased to you. investigate or settle,or any"suit"against an insured d. The allegations in the"suit'and the information representative will have all your rights and The insurance provided to such premises owner. we defend we know about the"occurrence"or offense are duties under this Coverage Pan. manager or lessor is subject to the following a. All expenses we incur. such that no conflict appears to exist between e. Any person or organization that, with your provisions: the interests of the insured and the interests of express a implied consent,either uses or is a. The imits of insurance provided to such b. Up to$2,500 for the cost of bail bonds required the indemnitee: responsible for 01e use of a watercraft that you premises owner,manager or lessor will be the because of accidents or traffic law violations e. The indemnitee and the insured ask us to do not own that is: minimum limits that you agreed to provide in the arising out of the use of any vehicle to which conduct and control the defense of That (1)50 feet long or less:and written contract Of agreement. or the limits the Bodily Injury Liability Coverage applies.We indemnitee against such"suit"and agree that (2)Not being used to carry any person Of shown in the Declaration.whichever are less. do not have lofumish these bonds. we can assign the same counsel to defend the property for a charge b. The insurance provided to such premises e. The cost of bonds to release attachments,but insured and the indemneee:and 3. Any organization you newly form,other owner,manager or lessor does not apply to, y acquire or only for bond amounts within the applicable limit f. The indemnitee: than a partnership,joint venture or limited liability (1)Any'buddy injury"or"property damage of insurance We do not have to furnish these (1)Agrees in writing to: company,and of which you are the sole owner or in that occurs.or'personal and advertising bonds. which you maintain an ownership interest of more injury" caused by an offense that is (a)Cooperate with us in the investigation. than 50%,will qualify as a Named Insured a there is committed,after you cease to be a tenant in d. All reasonable expenses incurred by the settlement or defense of Me"suit": no other similar insurance available to that that premises:or insured at our request to assist us in the (b)Immediatelysend us c investigation or defense of the clam a'suit". open of any ogan¢ation.However: (2)Structural alterations.new construction or including actual lens of earnings demands.notices,summonses a legal a. Coverer der this o s on is afforded onlydemdition operationsperformed on g ac rigs up to SSog a get under pr vi by or day because of time off from work. papers received in connection with the until the 180th day after you acquire or form the behalf of such premises°wren,manager or ^suit"; organization or the end of the policy period, lessor. e. All court costs taxed against the insured in the (c) Notify any other insurer whose whichever is earlier, 5. Any person a organization that is an equipment "suit".However,these payments do not include coverage is available to the indemnitee: b. Coverage A does not apply to"bodily injuy or lessor and that you have agreed in a written contract anomeys'fees or attorneys'expenses taxed and "propertydamage"that occurred beforeagreement to include as an additional insured on against the insured. fired you orsCoverage Cooperate with us with respect to acquired or famed the organization;and this Coverage Part is an insured,but only with f. Prejudgment interest awarded against the coordinating other applicable insurance c. Coverage B does not appy to"personal and respect to liability for "bodily injury'. "property insured on that part of the judgment we pay.If available to the indemnitee and advertising injury'arising out of an offense damage".or"personal and advertising injury'that we make an offer to pay the applicable limit of (2)Provides is with written authorization to committed before you acquired or formed the a. Is "bodily injury'or"property damage'that insurance,we will not pay any prejudgment organisation. occurs,or is"personal and advertising injury" interest based on that period of time after the (a)Obtain records and other information caused by an offense that is committed, offer related to the"suit":any For the purposes of Paragraph 1.of Section II- subsequent to the signing of that contract or All interest on the full amount of anyjudgmentWho Is An Insured,each such organisation will be (b)Conduct and control the defense of the agreement:and g. j gonerdeemed to be designated in the Declarations as: that accrues after a indemnitee nary of the judgment and b. Iso caused,in whole or in part,p your acts e before we have paid, offered to pay, or So long as the above conditions are met,attorneys' a. An organisation.oMer than a partnership.joint omissions in the maintenance.operation a use deposited in court the part of the judgment that fees incurred by us in the defense of that venture or limited liability company,or of equpment leased to you by such egupment is within the applicable imit of insurance indemnitee,necessary litigation expenses incurred b. A trust. lessor. These payments will not reduce the limits of by us and necessary litigation expenses incurred by a The insurance provided to such equipment lessor is the indemnitee at our request will be d as s indicated in its name or the documents that provisions: insurance Da subject to the following Supplementary Payments. Notwithstanding the govern its structure. 2. If we defend an insured against a'suit"and an provisions of Paragraph 2.b.(2)of Section 1 - a. The limits of insurance provided to such Pre. An person or organization that is ales indemnitee of the insured is also named as a parry Cove y pet got a pre equipment lessor will be the minimum lirrils That Coverages -Coverage A-Bodily Injury And owner,manager or lessor and that you have agreed • to the'suit',we will defend that indemnitee if al of p Da Liability or Par you agreed to provide in Me written contract a Property merge tY Paragraph rave.d in a written contractor agreement to include as an line following cottons are met Section I-Coverages-Coverage B-Personalagreement a the limits shown n the a. The 'suit against the indemnitee seeks And Advertising Injury Liability,such payments will additional insured on this Coverage Part is an Declarations,whichever are less. • damages • for which the insured has assumed not be deemed to be damagesfor"bodily et.but only with respect to liability for"bodily y injury'. injuy, 'property damage' or "personal are b. The insurance prodded to such equipment the liability of the indemnitee in a contract or "property damage"or"personal injury",and will not lessor does not apply to any'bodily injury'or reduce the limits of insurance aNertising injury'that: •property dam that occurs,or"personal • agreement that is an"insured contract"': age' b. This insurance apples to such liability assumed Our obligation to defend an insureds indemnitee a. Is "bodily injury"or"property damage'that and advertising injury"caused by an offense by the insured: and to pay for attorneys' fees and necessary occurs,or is'personal and advertising injury" that is committed,after the equipment lease e. The obligation to defend, expenses the cost of the litigation as Supplementary Payments caused by an net Mal is committed, expires. • defense of,that indemnitee,has also been ends when: subsequent to Mea sit signng of that contract or No person or organization is an insured with respect to agreement;and the conduct of any current or past partnership.joint Page 10 of 21 a 2017 The revelers Indemnity Company.All riges reserved. CG T1 00 0219 Page 12 of 21 0 2012 The Travelers Indemnity Cnnparw.Al votes reserved. CG T1 00 02 19 Includes copyrighted material of Insurance services Office,Inc.oar its permission. includes copyrighted material of Insurance services office,Mc.with as permission. COMMERCIAL GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY venture or limited liability company that is not shown as a. The amount shown for the Damage To 4. Other Insurance (f0 That is insurance for"premises a Named Insured in the Declarations.This paragraph Premises Rented To You Limit in the If valid and collectible other insurance is available to damage"; does not apply to any such partnership,joint venture en Declarations of this Coverage Part;or the insured fora loss we cover under Coverages A (iii)If the loss arises out of the limited liabiliy company that otherwise qualifies as an b. $300,000 if no amount is dawn for the or B of this Coverage Part our obligations are maintenance or use of aircraft, insured under Section It-Who Is An Insured. Damage To Premises Rented To You Limit in limited as described in Paragraphs a.and b.below. "autos"or watercraft to the extent SECTION III-LIMITS OF INSURANCE the Declarations of this Coverage Part. not subject to any exclusion in this As used anywhere in this Coverage Part,other 1. The Limits of Insurance shown in the Declarations 7. Subject to Paragraph S. above, the Medcal in Coverage Part that applies to insurance meansoinsurance hr g the tuning of and the rules below fix the most we will pay Expense Limit is the most we will pay under losses.that is provided by,through or on behalf of: aircraft,is insurance c watercrble regardless of the number of: Coverage r for all ed byyal yexpenses because of (iv)That is inso available to a "bodily injury'sustained a oneperson. (i) Another assurance canpany, a. Insureds; t ^y premises oto owner, manager a The Limits of Insurance of this Coverage Part apply (ii)Us a aryl our affiliated insurance companies, lessor that qualifies as an insured b. Claims made or"suits"brought;or separately to each consecutive annual period and to any except when the Non cumulation of Each under Paragraph 4.of Section II- c. Persons or organizations making claims or remaining period of less than 12 months.starting with Occurrence Limit provision of Paragraph S.of Who Is An Insured,except when bringing"suits". the beginning of the policy period shown in the Section III-Limits Of Insurance or the Nov Paragraph d.below applies:or 2. The General Aggregate Limit is the most we will pay Declarations.unless the policy penal is extended after cumulation of Personal and Advertising Injury (v)That is insurance available to an for the sum d: issuance for an additional penal of less than 12 Limit provision ofParagraph 4.of Section III- equipment lessor that goatees as Coveragemonths. In that case, the additional period will be Limits of Insurance applies because the an insured under Pa Pdeemed part of the last precedng period for Amendment purposes of Amement - Non Cumulation Of Each Section II-Who Is Aa n a. Medical expenses under C: Insured, b. Damages under Coverage A.except damages determining the Limits of Insurance. Occurrence Limit Of Liability And Non except when Paragraph d.below because of"both injury damage" Cumulation Of Personal And Advertising Injury"bodily ucts co"property erg SECTIONONDITIIV-COMMERCIAL GENERAL LIABILRV applies. included in the"products-completed operations CONDITIONS Limit endorsement is included in this policy. hazard';and (iii)Any a group:risk retention (b)Any of the other insurance,whither 1. Bankruptcy p primary.excess,contingent or on any c. Damages under Coverage B. (in)Any self-insurance method en program, in other basis.that is available to the 3. The Products-Completed O insureds estate or insolvency of the insured or of the which case the insured will be deemed to be insured when the insured s an p Operations ra Aggregate for Insureds will not relieve us of our obligations n Limit is the most we will pay under Coverage A far under this Coverage Part. the provider of other insurance. additional insured, a is any other damages because of"bodily injury and"property Other insurance does not Include umbrella insured that does not qualify as a damage" included in the 'products-completed 2• Duties In The Event Of Occurrence,Offense named insured. under Such other 9" insurance.or excess insurance,that was bought operations hazard". Claim Or Suit specifically to apply in sexcess of the Limits of insurance. 4. Subject to Paragraph 2.above,the Personal And a. You must see to it that we are notified as soon Insurance shown in the Declarations of this (2)When this insurance is excess.we will Advertising Injury Limit is the most we wit pay as practicable of an"occurrence'or an offense Coverage part. have nodutyunder Coverages A or B to under Coverage B for the sum of all der which may result in a claim.To the extent defend the insured against any"suit"if any g s use possible,notice should include: As anywhere n this Coverage the r other insurer has a duty to defend the because d all"personal injury'and"advertising insurer means a provider of other insurance.As injury'sustained by any one person a organization. (1)Haw,when and where the"occurrence•or used in Pa insured egad, tel 'suit If no other offense lock place: Paragraph c. below. insurer means a insurer defends,we will undertake to do so. 5. Subject to Paragraph 2.or 3.above,whichever prvvioer d insurance but we will he entitled o the insureds rights applies,the Each Occurrence Limit is the most we (2)The names and addresses of any injured a primary Insurance against all those other insurers. will pay for the sum of: persons and witnesses;and (3)When this insurance is excess over other a. This insurance a primary except when nonce we will m our share of the Damages under Coverage A;and (3)The nature and location d any injury a Paragraph h.belay applies.If this insurance is insurance pay y b. Medical expenses under Coverage C: damage rising out of the'occurrence a amount of the loss,if any.that exceeds the offense.a primary,our obligations are not affected unless sum of: because of all"bodily injury"and"property damage" any of the other insurance is also primary. i arising oil d any one"occurrence". b. If claim is made a sail s brought against Then,we will share with all that other insurance (a)The total amount that all such other any insured.you must: bythe method described in Paragraphpay for the loss in the For the purposes of determining the applicabe except agrp c.below. insurance would Each Occurrence Limit, all related acts or (1)Immediately record the specifics of the when Paragraph d.below apples. absence of this insurance:and claim or'suit"and the date received and (b)The total of all deductible and self- omissions committed in providing or failing to It. Excess Insurance provide first aid or"Good Samaritan services"to (2)Notify us as soon as practicable. insured amounts under all that other airy one person will be deemed to be one You must see to it that we receive written notice (1)This insurance is excess over insurance. "occurrence". of the claim or"suit"as soon as practicable. (a)Any of the other insurance whether (4)We wit share the remaining loss,if any. 6. Subject to Paragraph 5.above.the Damage To c. You and any other involved insured must: primary,excess,contingent a on any with any other insurance that is not Premises Rented To You Limit is the most we will other basis: described in this Excess Insurance pay under Coverage A for damages because of a Ill Immediately send us copies of any provision and was not bought specifically to "premses damage" to any one premises. The demands, notices, summonses or legal (i) That is Fire,Extended Coverage apply in excess of the Limits of Insurance Damage To Premises Rented To You Limit will be: Builders Risk.Installation Risk a shown papers received in connection with the similar coverage for"your work': in the Declarations of this Coverage claim or"suit": Part. CG 71 00 02 19 0 2017 The Travelers Indemnity company.ass rights reserved. Page 13 of 21 CG 71 00 02 19 o 2017 The Travelers Indemnity Canpe o.u riyas reserved. Page 15.121 Includes copyrighted material of Insurance services Office.Inc.etc its permission. Imhdes copyrghlea material of Insurance services Office.Inc.edits permission COMMERCIAL GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY (2)Authorize us to obtain records and other (lift An executive officer or director of e. Method Of Shadng e. The statements in the Declarations are information; any other organization:or If all of the other insurance permits contribution accurate and complete (3)Cooperate with us in the investigation or (iv)A trustee of any trust: by equal shares,we will follow tNs method also. b. Those statements are based upon settlement of the claim or defense against Under this approach each insurer contributes representations you made to us;and the"suit";and that is your partner, joint venture equal amounts until it has paid its applicable c. We have issued this policy in reliance upon member,manager or trustee or limit d insurance or none of the loss remains. your representations. (4)Assist us, upon our request in the whichever comes first enforcement of any right against any (b)Any employee authorized by such The unintentional omission of,or unintentional error person or organization which may be liable partnership. joint venture. limited If any of the other insurance does not permit in.any information provided by you which we relied to the insured because of injury or damage liabilitycompany, trust or other contribution by equal shares.we wit contribute upon in issuing this policy will not prejudice your to which this insurance may also apply. organization to give notice of an by limits.Under this method,each insurer's rights under this insuranceHowever,this provision "occurrence"or offense share is based on the ratio of its applicable limit does not affect our right to collect additional d. No insured will,except at that insureds own of insurance to the total applicable limits of premium or to exercise our rights of cancellation or (3)Notice to us of such "occurrence'or insurance of all insurers. cost.voluntarily make a payment,assume any n^nrenewal in accordance with applicable insurance offense will be deemed to be given as son obligation,or incur arty expense other than for d. Primary And Non-Contributory Insurance If laws or regulations. first aid.without our consent as practicable if it is given in good faith asRequired By Written Contract 7. Separation Of Insureds oon as practicable to your workers' e. The following provisions apply to Paragraph a. compensation insurer.This applies only if If you specifically agree in a written contract or Except with respect to the Limits of Insurance.and above.but only or purposes of the insurance you subsequently give notice to us of the agreement that the insurance afforded to an any rights or duties specifically assigned in this provided under this Coverage Part to you or any "occurrence' or offense as soon as insured under this Coverage Part must appy on Coverage Part to the first Named Insured,this insured listed in Paragraph 1.or 2.of Section II practicable after any of the persons a primary bass. ora primary and non insurance applies: contribute basis,thi insurances to only Wla 15 An Insured: described in Paragraph e.(1)a(2)above other insurance that is available to such a. As if each Named Insured were the discovers that Me whichnce"a offenseNamed Insured:and (1)Notice to us of such "occurrence"a may result in sums to the insurance which coverssuch insured as a named insured. offense must be given as soon as provided under this Coverage Part may and we will not share with that other insurance, b. Separately to each insured against wham claim practicable only after the'occurrence"or aPPN provided that s made a"suit"is brought. offense is known to you(if you are an (1)The"bodily In" damage"for It. Transfer Of Rights Of Recovery Against Others individual), any of your partners or However,s this policy includes an endorsementwhich coverage sought occurs;rs;and To Us members who is an individual(lf you are a that provides limited coverage for"bodily injury partnership or joint venture),a of or"property damage"or leaspollution costs arising (2)The'persona and advertising injury for If the insured has rights o recover all a part of any p Ip der try your out of a dscharge. release or escape of which coverage is sought is caused by an payment we have made under this Coverage Part. managers who is an individual(if you area those rights are transferred to us.The insured must limited liability tom the discharge, "pollutants'which contains a requirement that offense that is committed; try pany), any of your the release or escaped''pollutants" subsequent do nothing after loss to impair them.At our request Pr u equent to the signing of that contract or "executive officers"a directors(d you areMe insured will brit suit"or transfer those rights an organization other than a partnership, must be reported to us within a specific number agreement by you to us and help us enforce then. g joint venture,a limited liability company), of days after its abrupt commencement.this does not affect that requirement. S. Premium Audit Paragraph e. 9. When We Do Not Renew any of your trustees who is an indvisual(4 a. We will compute al premiums for this Coverage If we decide not to renew this Coverage Part,we will you are a ,us, or any "employee" 3. Legal Action Against UaccordancePartin accordance with our Nos and rates. nail or deliver to the first Named Insured shown in authorized by you to give notice of an No persona organization has a right under tits b. Premium shown in this Coverage Part as enewal "occurrence'or offense. Coverage Part: advance premium s a depositMe Declarations days b relive x the nndate, premium only.At not less than 30 before the expiration doe. (2) If you are a partnership,,joint verdure, a. To join us as a party a otherwise bang us into the close of each audit period we will compute a"suit"askingfor damages from an insured;or the earned premium or that nod and send If ratite is mailed.prod of mailing will be sufficient limited lability rs joint or trust,and none 9 a Pe proof of notice. of your partners,joint venture members. b. To sue us on this Coverage Part unless all of notice to the first Named Insured.The due date onagers or trustees are individuals.notice its toms have been fully complied with. for audit and retrospective premiums is dse date SECTION V-neon means a to us of such"occurrence'a offense must A person a organization may sue us to recover on shown as the due date on the bill.If the sum of 1. •Adve to the means a notice that is broadcast or be given as soon as practicable only after an agreed settlement or on a final judgment against the advance and audit premiums paid forted published about general public a productsspe or market the"occurrence"of offense is known policy period is turner than the alined segments your goads. t services M: an insured:but we will not be Fable for damages premium,we will return the excess to the first for the purpose of attracting customers or (a)Any individual who is: that are not payable under the terms of this Named Insured. supporters.For the purposes of this definition: Coverage Part or that are in excess of the - The first Named Insured must k records of a. Notices that are published include material (f) A partner or member of any applicable limit of insurance.An agreed settlement a keep partnership orjoint venture; means a settlement and release of liability signed by the information we need for premium placed on the Intemet or on similar electronic us,the insured,and the claimant or the claimants omputation.and send us copies at such times means of communication:and OD A manager of any limited liabilityas we may request b. Regarding ebsites,m that part of a websbe company: legal representative. that is 9 w N 6. Representations is about your goods,products or services By accepting this policy,you agree: for the purposes of attracting customers or supporters is considered an advertisement. Page14 of 21 a 2017 The Travelers Indemnity Compaex.ANN.reserved. CG T1 00 02 19 Page 16 of 21 o 2017 The revelers Irdemrae Company.Al rights reserved. CG T1 00 0219 Includes copyrighted manorial of Insurance services Office.Inc.with its permission. Incldes copyrighted mate.of Insuaa.e services office Inc.web as permission. COMMERCIAL GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY 2. "Advertising injury': b. In.by or with any other electronic means of d. Vehicles, whether self-propelled or not, b. An act or omission committed in providing or a. Means injury caused by one or more of the communication,such as the Internet,0 that maintained primarily to provide mobility to failing to provide first aid or"Good Samaritan following offenses: material is part of: permanently mounted: services'to a person.unless you are in the (1)Oral or written publication, including (1)Radio or television programming being (1)Power cranes,shovels.loaders.diggers or business a occupation of providing publication by electronic means,of material transmitted; drills:Or professional health care services. in your"advertisement"That slanders or (2)Road construction or resurfacing 18."Personal and advertising injury'means"personal libels organization or person or or (3)Other entertainment. educational.instructional,musk a news programming equipment such as graders,scrapers or injury'or"advertising injury".or disparages a person'sorganizalion's roles; goods,products or services,provided that bring transmitted;a 19.'Personal injury: the e. Vehicles ab not hat are inlf-Paragraph a..b.,c. the claim is made a the"suit"is brought by (3)Advertising transmitted with any of such or d.above that are not self-propelled and are a. Means injury,other Than'advertising injury, a person or organization that claims to have programming. maintained primarily to provide mobility to caused by one or more of the following been slandered or libeled,or that claims to offenses: have had its goods,products a services 6. "Coverage territory means: permanently attached equipment of the disparaged: a. The United States of America(including its following types: (1)False arrest.detention a imprisonment; (2)Oral or written publication. including territories and possessions).Puerto Rico and (11 Air compressors,pumps and generators.building (2)Malicious prosecution; ubfication byelectronic means,of material Canada; cleaning,eLdg prhysic doiati bWdirg P nd well geophysi cal me t;or fighting (3)The wrongfulinvasion eviction fremr wrongful entry in your"advertisement"that: B. International waters or airspace,but only if the and well servicing equipment;or into,or invasion of the right d private (a)Appropriates a person's name,voice, injury or damage occurs in the course of travel (2)Cherry pickers and similar deuces used to occupancy of a room,dwelling or premises photograph or likeness;or or transportation between any places included raise or lower workers: that a person occupies,provided that the (h)Unreasonably places a person in a in Paragraph a.above:or f. Vehicles not described in Paragraph a.,b.,c. wrongful eviction.wrongful entry a invasion false Ight;or c. All other parts of the word if the injury or orof the right of private occupancy is above maintained primarily for purposes committed by or on behalf of the owner, (3)Infringement of copyright"title"or"slogan" damage arises out of: other than the Iranspatation of persons or in your"advertisement'.provided that the (1)Goods or products made or sold by you in cargo. landlord or lessor of that room,dwelling a claim is made or the"suit'is brought by a the territory described in Paragraph a. However. self-propelled vehicles with the premises: person or organization that claims above; following types of permanently attached (4)Oral or written publication. including ownership of such copyright. "tale" or aces d a person ane equipment are not"mobile equipment"but will publication by electronic means,d material 'slogan'. (2)ThewhosetivitiK is in be considered"autos": that slanders or libels a person or b. Includes"bob n' by the territory described in Paragraph a. y i gray caused one or more organization a disparages a person's o of the offenses described in Paragraph a. above but is away for a shoo lime on your (1)Equipment designed primarily for: organization's goods,products or services. above. business;or (a)Snow removalprovided that theclaim is made a the"suit" 3. "Add means: (3)"Personal and advertising injury offenses (b)Road maintenance, but not is brought by a person or organization that that take place through the Internet or construction or resurfacing:or claims to have been slandered or libeled,or a. A land motor vehicle, trailer or semaraier similar imilar electronic means of communication; that claims to have had its goods,products designed for travel on public roads.including (c)Street cleating; or s any attached machinery a equipment;on Provided the lnsured's responsibility to pay (2)Cherry pickers and similar devices erncaz disparaged:or b. A other and vehicle that is subject to a damages is determined in a"suit'on the merits in mounted on automobile or truck chassis (5)Oral a written publication, including Any 1 the territory described in Paragraph a.above-or in a and used compulsory or financial responsibility law,or settlement we agree to. to raise a laver workers:and publication by electrons means.of material that other motor vehicle insurance law,where it is (3)Air compressors.pumps and generators, licensed or principally garaged. 7. "Electronic data" means information, facts or including spraying, welding. building programs stored as a on.created or used on.or cleaning, (a)photograph a person's name.voice. geophysical exploration.fighting d a orlikerness:or However, "auto" does not include "mobile Ph ogr Ph equipment'. transmitted to or from computer software(including and well servicing equipment. systems and apdica ions software),hard or floppy (b)Unreasonably places a person in a 4. "Bodily injury'means: disks. CD-ROMs, apes. drives, cells, data However,"mobile equipment"does not include any false light. processing devices or anyother media which are and vehicle that is subject to a compulsory a a. Physical harm,including sickness a disease, W 9 financial responsibility law,or other motor vehicle b. Includes"bodily injury"caused by one or more sustained bya persona used with electronically controlled equipment. insurance law,where it is licensed on principally of the offenses described in Paragraph a. b. Mental anguish,injury a illness.or emotional 8. "Employee"includes a'leased worker.'Employee" garaged. Such and vehicles are considered above. distress, resulting at any time from such does not include a"temporary worker. "autos". physical harm,sickness a disease. 17."Occurrence"means: 20."Pollutants' mean any solid,ligdd. gaseous or 9. "Executive officer means a person holding any of thermal irritant or cmtamiranl.including smoke. 5. 'Broadcasting"means transmitting any audio or the officer positions created by your charter, a. An accident,including continuous or repeated vapor,soot,fumes.acids,alkalis,chemicals and visual material for ay purpose: constitution,bylaws or any other similar governing exposure to substantially the same general waste.Waste includes materials to be recycled. a. By radio or television:a document. harmful conditions;or reconditioned or reclaimed. CG T1 00 0219 0 2017 The Travelers Indemnity Company.AI rides reserved Page 17 of 21 CS T1 00 02 19 0 2017 The Travelers Indemnity Company.All rights reserved. Page 19 of 21 IrrcWes copyfiylxed material of Insurance Services Office.Inc.with its permission. Includes copynaked material of Insurance Services Office Inc.with is permission. COMMERCIAL GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY 10.'Good Samaritan services"means any emergency tracks. roadbeds. tunnel, underpass or 21."Premises damage"means: contract calls for work at more than medical services for which no compensation is crossing: one site. demanded or received. a. With respect to the first paragraph n the (2)That indemnifies an architect.sing out f, Coverage exceptions in Exclusion J. of Section I - (c)When that part the work done atd a 11."Hostile fire" means a fire which becomes surveyor for injury on damage arising out of: Coverage A - Bodily Injury And Property job site has been put to its intended uncontrollable or breaks out hum where a was s approving, a ailing to Damage Lability,"property damage"to any usebyanyoro anaation other intended to be. (a)Preparing, person g prepare a approve, maps, shop premises while rented to you fora period of than another contractor or 12.'Impaired property means tangible property,other drawings, opinions.reports.surveys, seven or fewer consecutive days,inducing the subcontractor working on the same than"your product"or"your work",that cannot be fidd orders,change orders or drawings contents of such premises;or projecL used or is less useful because: and specifications;or b. With respect to the exception to Exclusions c. Work that may need service maintenance, a. It incorporates"your product"or"your work" (b)Giving directions orinstructions. or through n.in the last paragraph of Paragraph 2. convection,repair or replacement but which that is known or thought to be defective, failing to of Section I-Coverage A-Bodily Injury And otu9 a give them.if that is the is otherwise complete,will be treated as deficient,inadequate or dangerous;or primary cause of the injury or damage; Property Damage Liability."property damage"to canpletdo any premises rented to you for a period of of b. You have failed to fulfill the terms of a contract or more than sevenne consecutive days,or while b. Does not Include'bodily injury or"property or agreement (3)Under which the insured,if an architect, temporarily occupied by you with permission of damage"arising out of: it such property can be restored to use by the engineer or surveyor,assumes liability for the owner,caused by (1)The transportation of property,unless the repair,replacement.adjustment or removal of"your an injury a damage arising out of theinjurya9 Insureds rendering or failure to render (1)Fire; or damage arises out of a operated in product"or"your wok"or your fulfilling the terms of professional services,including those listed (2)Explosion; oryou,and on a vehicle not owned or by by the the contract a agreement. (3)Lightning; ladng or unloading"ring'of that v condition was rsinicle by any 13.'Insured contract'means: in Paragraph chi above and engineering Inspection. architectural a engineering insured. a. A contract for a lease of premises.However. activities. (q Smoke resulting from fire, explosion or that portion of the contract for a lease of 14."Leased wakeon abandoned a unused"means a person leased to you bya lightning or (2)The ez'ste Inds, rai ed premises that indemnifies any person or labor leasing firm under an agreement between you (5)Water. equipment a abandoned a cation for"premises damage"is not an and the labor leasingfirm,toperform duties related But"remises damage" materials;a gam p under this Paragraph (3)Products or operations for which the "insured contract": to the conduct of your business."Leased worker" b.does not include"property damage"to any classification.listed in the Declarations or b. A sidetrack agreement: does not include a"temporary worker'. premises caused by c. Any easement or license agreement,except in 15."Loading or unloading" means the handlingof (1)Rupture,bursting,a - in a policy operations sates that products- c. to - g, operation of pressure inc a p policy eted Schedule, are subject to the connection wfh construction or demotion Property relief devices; General Aggregate Limit. operations on or within 50 feet of a railroad a. After it is moved from the place where it is (2)Rupture a bursting due to expansion a 23."Propertydams means; I d. An obligation,as required by ordnance,to accepted for movement into or onto an aircraft, swelling d the contents d any buildng a 9e a.Physical injury to tangible property.inclalir indemnity a muricipalay,except in connection watercraft or"auto"; structure caused by a resulting from water; s all with work for a municipality, B. While it is in or on an aircraft.watercraft or a resulting loss of use of that property.All such loss of use will be deemed to occur at the time of e. An elevator maintenance agreement; "auto":or (3)Explosion of steam boilers.steam pipes, the physical injury that caused it:or f. That part of any other contract or agreement c. While it is being moved horn an arcraft, steam engines or steam turbines. b.Loss of use of tangible that is not watercraft or'auto"to thelpropertye pertaining to your business (including an place where it is 22."Products-completed operations hazard": physically injured.All such loss of use wit be indemnification of a municipality n connection finally delivered; Pa ry i deemed to occur at the rime on the"occurrence" li Includes all "bodily injury and 'property with work performed for a municipally)undert but'leering of or unloading"tybetas not include ha the athat caused it which you assume the tort liability of another movement property by means of a mechanical damage"occurring away from premises you party to pay for "bodily injury. 'property device other than a hand truck that is not attached own or rent and arising out of"your product"or For the purposes of this insurance,'electronic data' damage or'personal injury toa third person to the aircraft,watercraft or"auto". "your work'except: is not tangible property III or organization Tat liability means a liability24."Slogan': that would be imposed by law in the absence of 16."Mobile equipment"means, including any g the attached (1)Products that are still in your physical any contract a agreement. types of land vehicles, inclW irg any attached possession:or a. Means a phrase that others use for the purpose machinery or equipment: (2)Work that has riot yet been completed or of attracting attention in their advertising. Paragraph f.does not include that part of any a. Bulldozers.farm machinery,forklifts and other abandoned.However."your work"will be b. Does not include a phrase used as.or in,the contractor agreement: vehicles designed fa use principally off public deemed completed at the earliest of the name on (1)That indemnifies a railroad for "bodily roads; following times: (1)Any person a organization.other than you: injury or"property damage arising out of b. Vehicles maintained for use solely on or next to (a)When all of the work caned for in your or construction or demolition operions, premises you own or rent; contract has been completed. within 50 feed any raikoad propertyy and W (2)Any business.or any of the premises. affect any railroad bridgeor trestle, C. Vehicles that travel on crawler treads; goods,products,services a work.of any n9 Ib)When all of the work to be done at the job site has been completed if your person aagan¢atim.other than you. Page 18 of 21 0 21117 The Travelers Indemnity Company...II ride:reerved. CG T1 00 0219 Page 20 of 21 02017 The Travelers Indemnity camps,a nights rssewed. CG T1 00 02 19 inheres copyruMM maenad of Insurance services Orion,Inc.rii its pemn,ssion. Includes copyrighted material or Insurance Services Office,Inc.with is permission. COMMERCIAL GENERAL LIABILITY 25."Suit"means a civil proceeding in which damages (a)You; because of"bodily injury,"property damage"or (b)Others trading under your name:or "personal and adamtising injury' to which this (c)A person or organization whose insurance applies are alleged."Suit"includes: business or assets you have acquired: a. An arbitration proceeding in which such and damages are claimed and to which the insured (2)Containers(other than vehicles).materials. must submi or does submit with our consent; parts or equipment furnished in connection or wih such goods or products. b. Any other alternative dispute resolution b. Includes: proceeding in which such damages are claimed (1)Warranties or representations made at any and to which the insured submits with an time wih respect to the fitness,quality. consent. durability, performance or use of'your 26."Temporary worker means a person who is product";and funished to you to substitute for a permanent (2)The providing of or failure to provide "employee"on leave or to meet seasonal or short- warnings or instructions. term workload conditions. 27."Title"means a name of a Fterary or artistic work. c. Does not include vending rnas or other property rented to or locateded for for the use of 28."Unsolicited communication" means any others but not sold. communication,in any form.that the recipient of 31 ,Your vork': such communication did not specifically request to receive. a. Means: 29."Volunteer worker means a person who is not your (1)Work or operations performed by you or on "employee".and who donates his or her work and your behalf.and acts at the direction of and within the scope of (2)Materials,parts or equipment furnished in duties determined by you.and is not paid a fee, connection with such work or operators. salary or other compensation by you or anyone else b. Includes: for their work performed for you. 30."Your product": (1)Warranties or representations made at any time with respect to the fitness,quality. a. Means: durability, performance or use of'your (1)Any goods or products.other than real work";and property, manufactured. sold handled. (2)The providing of or failure to provide distributed or disposed of by warnings or instructions. CG T1 00 0219 02017 The Travelers Irdemrrrn company.Ai riN+s reserved. page 21 of 21 Includes copyrighted male rial or Insurance Services Office.Inc.nth 25 permission. Policy#DTCO7N065015TIA23 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. XTEND ENDORSEMENT FOR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE —This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general coverage description only. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. Who Is An Insured—Unnamed Subsidiaries C. Incidental Medical Malpractice B. Blanket Additional Insured — Governmental D. Blanket Waiver Of Subrogation Entities — Permits Or Authorizations Relating To E. Contractual Liability—Railroads Operations F. Damage To Premises Rented To You PROVISIONS a. An organization other than a partnership, joint A. WHO IS AN INSURED — UNNAMED venture or limited liability company; or SUBSIDIARIES b. A trust; The following is added to SECTION II —WHO IS as indicated in its name or the documents that AN INSURED: govern its structure. Any of your subsidiaries, other than a partnership, B. BLANKET ADDITIONAL INSURED — joint venture or limited liability company, that is GOVERNMENTAL ENTITIES — PERMITS OR not shown as a Named Insured in the AUTHORIZATIONS RELATING TO OPERATIONS Declarations is a Named Insured if: The following is added to SECTION II — WHO IS a. You are the sole owner of, or maintain an AN INSURED: ownership interest of more than 50% in, such subsidiary on the first day of the policy period; Any governmental entity that has issued a permit and or authorization with respect to operations b. Such subsidiary is not an insured under performed by you or on your behalf and that you similar other insurance. are required by any ordinance, law, building code or written contract or agreement to include as an No such subsidiary is an insured for"bodily injury" additional insured on this Coverage Part is an or "property damage" that occurred, or "personal insured, but only with respect to liability for "bodily and advertising injury" caused by an offense injury", "property damage" or "personal and committed: advertising injury" arising out of such operations. a. Before you maintained an ownership interest The insurance provided to such governmental of more than 50% in such subsidiary; or entity does not apply to: b. After the date, if any, during the policy period a. Any "bodily injury", "property damage" or that you no longer maintain an ownership "personal and advertising injury" arising out of interest of more than 50% in such subsidiary. operations performed for the governmental entity; or For purposes of Paragraph 1. of Section II —Who Is An Insured, each such subsidiary will be b. Any "bodily injury" or "property damage" deemed to be designated in the Declarations as: included in the "products completed operations hazard". CG D3 16 02 19 ©2017 The Travelers Indemnity Company.All rights reserved. Page 1 of 3 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. COMMERCIAL GENERAL LIABILITY C. INCIDENTAL MEDICAL MALPRACTICE pharmaceuticals committed by, or with the 1. The following replaces Paragraph b. of the knowledge or consent of,the insured. definition of "occurrence" in the 5. The following is added to the DEFINITIONS DEFINITIONS Section: Section: b. An act or omission committed in providing "Incidental medical services" means: or failing to provide "incidental medical services", first aid or "Good Samaritan a. Medical, surgical, dental, laboratory, x-ray services" to a person, unless you are in or nursing service or treatment, advice or the business or occupation of providing instruction, or the related furnishing of professional health care services. food or beverages; or 2. The following replaces the last paragraph of b. The furnishing or dispensing of drugs or Paragraph 2.a.(1) of SECTION II — WHO IS medical, dental, or surgical supplies or AN INSURED: appliances. Unless you are in the business or occupation 6. The following is added to Paragraph 4.b., of providing professional health care services, Excess Insurance, of SECTION IV — Paragraphs (1)(a), (b), (c) and (d) above do COMMERCIAL GENERAL LIABILITY not apply to "bodily injury" arising out of CONDITIONS: providing or failing to provide: This insurance is excess over any valid and (a) "Incidental medical services" by any of collectible other insurance, whether primary, your "employees" who is a nurse, nurse excess, contingent or on any other basis, that assistant, emergency medical technician is available to any of your "employees" for or paramedic; or "bodily injury" that arises out of providing or (b) First aid or "Good Samaritan services" by failing to provide "incidental medical services" any of your "employees" or "volunteer to any person to the extent not subject to workers", other than an employed or Paragraph 2.a.(1) of Section II — Who Is An volunteer doctor. Any such "employees" Insured. or "volunteer workers" providing or failing D. BLANKET WAIVER OF SUBROGATION to provide first aid or "Good Samaritan services" during their work hours for you The following is added to Paragraph 8., Transfer will be deemed to be acting within the Of Rights Of Recovery Against Others To Us, scope of their employment by you or of SECTION IV — COMMERCIAL GENERAL performing duties related to the conduct LIABILITY CONDITIONS: of your business. If the insured has agreed in a contract or 3. The following replaces the last sentence of agreement to waive that insured's right of Paragraph 5. of SECTION III — LIMITS OF recovery against any person or organization, we INSURANCE: waive our right of recovery against such person or For the purposes of determining the organization, but only for payments we make applicable Each Occurrence Limit, all related because of: acts or omissions committed in providing or a. "Bodily injury" or "property damage" that failing to provide "incidental medical occurs; or services", first aid or "Good Samaritan services" to any one person will be deemed to b. "Personal and advertising injury" caused by be one "occurrence". an offense that is committed; 4. The following exclusion is added to subsequent to the execution of the contract or Paragraph 2., Exclusions, of SECTION I — agreement. COVERAGES — COVERAGE A — BODILY E. CONTRACTUAL LIABILITY—RAILROADS INJURY AND PROPERTY DAMAGE LIABILITY: 1. The following replaces Paragraph c. of the Sale Of Pharmaceuticals definition of "insured contract" in the "Bodily injury" or "property damage" arising DEFINITIONS Section: out of the violation of a penal statute or c. Any easement or license agreement; ordinance relating to the sale of Page 2 of 3 ©2017 The Travelers Indemnity Company.All rights reserved. CG D3 16 02 19 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. COMMERCIAL GENERAL LIABILITY 2. Paragraph f.(1) of the definition of "insured a. Any premises while rented to you or contract" in the DEFINITIONS Section is temporarily occupied by you with permission deleted. of the owner; or F. DAMAGE TO PREMISES RENTED TO YOU b. The contents of any premises while such The following replaces the definition of "premises premises is rented to you, if you rent such damage" in the DEFINITIONS Section: premises for a period of seven or fewer consecutive days. "Premises damage" means "property damage"to: CG D3 16 02 19 ©2017 The Travelers Indemnity Company.All rights reserved. Page 3 of 3 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Policy#8106P73016A2326G COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE - CONTRACTORS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM PROVISIONS 2. The following is added to Paragraph B.5., Other 1. The following is added to Paragraph c. in A.1., Insurance of SECTION IV — BUSINESS AUTO Who Is An Insured, of SECTION II — COVERED CONDITIONS: AUTOS LIABILITY COVERAGE: Regardless of the provisions of paragraph a. and paragraph d. of this part 5. Other Insurance, this This includes any person or organization who you are required under a written contract or insurance is primary to and non-contributory with agreement, that is signed by you before the applicable other insurance under which an "bodily injury" or "property damage" occurs and additional insured person or organization is a that is in effect during the policy period, to name named insured when a written contract or as an additional insured for Covered Autos agreement with you, that is signed by you before Liability Coverage, but only for damages to which the "bodily injury" or "property damage" occurs this insurance applies and only to the extent of and that is in effect during the policy period, that person's or organization's liability for the requires this insurance to be primary and non conduct of another"insured". contributory. CA T4 99 02 16 ©2016 The Travelers Indemnity Company.All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office,Inc.with its permission. Policy t8106P73016.A2326G COMMERCIAL AUTO COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. You agree to maintain all required or (2)In or on your covered"auto". compulsory insurance in arty such coon- This coverage applies only in the event of a total try up to the minimum limits required by theft of your covered'auto". BUSINESS AUTO EXTENSION ENDORSEMENT local law. Your failure to comply with No deductibles apply to this Personal compulsory insurance requirements will Y Property not invalidate the coverage afforded by coverage. This endorsement modifies insurance provided under the following: this policy,but we will only be liable to the K. AIRBAGS BUSINESS AUTO COVERAGE FORM same extent we would have been liable The following is added to Paragraph 8.3..Exclu- had you complied with the compulsory in sions.of SECTION III-PHYSICAL DAMAGE GENERAL DESCRIPTION OF COVERAGE-This endorsement broadens coverage.However,coverage for any surance requirements. COVERAGE: injury,damage or medical expenses described in any of the provisions of this endorsement may be excluded or (d)It is understood that we are not an admit- Exclusion 3.a.does not apply to'loss"to one or limited by another endorsement to the Coverage Part,and these coverage broadening provisions do not apply to ted or authorized insurer outside the more airbags in a covered"auto"you own that in- the extent that coverage is excluded or limited by such an endorsement.The following listing is a general cover- United States of America,its territories Bate due to a cause other than a cause of'loss" age description only.Limitations and exclusions may apply to these coverages.Read all the provisions of this en- and possessions,Puerto Rico and Can- set forth in Paragraphs A.1.b.and A.1.c,but dorsement and the rest of your policy carefully to determine rights.duties,and what is and is not covered. ada.We assume no responsibility for the only: A BROAD FORM NAMED INSURED H. HIRED AUTO PHYSICAL DAMAGE-LOSS OF furnishing of certificates of insurance,or a. If that'auto"is a covered"auto"for Compre- B. BLANKET ADDITIONAL INSURED USE-INCREASED LIMIT for compliance In any way with the laws hensive Coverage under This policy: I. PHYSICAL DAMAGE - TRANSPORTATION of other countries relating to insurance. gsany C. EMPLOYEE HIRED AUTOb. The airbags are not covered under war- EXPENSES-INCREASED LIMIT G. WAIVER OF DEDUCTIBLE-GLASS runty;and D. EMPLOYEES AS INSURED J. PERSONAL PROPERTY The following is added to Paragraph D..Deducti- c. The airbags were not intentionally inflated. E. SUPPLEMENTARY PAYMENTS-INCREASED K. AIRBAGS ble. of SECTION III -PHYSICAL DAMAGE We will pay up to a maximum of$1,000 for any LIMITS COVERAGE: one-loss". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR No deductible for a covered-auto'will applyto L NOTICE AND KNOWLEDGE OF ACCIDENT OR F. HIRED AUTO-LIMITED WORLDWIDE COV- LOSS ERAGE-INDEMNITY BASIS glass damage 4 the glass is repaired rathererthan LOSS G. WAIVER OF DEDUCTIBLE-GLASS M. BLANKET WAIVER OF SUBROGATION replaced. following Paragraphof N. UNINTENTIONAL ERRORS OR OMISSIONS SheSECTIONIVis added to Para N A.2.a., : H. HIRED AUTO PHYSICAL DAMAGE-LOSS OF -BUSINESS AUTO CONDITIONS: PROVISIONS USE-INCREASED LIMIT Your duty to give us or our authorized representa- A. BROAD FORM NAMED INSURED this insurance applies and onlyto the extent that The following replaces the last sentence of Para- live pp prompt notice of the"accident"or'loss'ap- The following is added to Paragraph Al.,Who Is person or organization qualifies as an insured graph A4.6.,Loss Of Use Expenses.of SEC- plies onlywhen the'accident'or loss"is known An Insured,of SECTION II-COVERED AUTOS under the Who Is An Insured provision contained TION III-PHYSICAL DAMAGE COVERAGE: to: mostLIABILITY COVERAGE: in Section II. However,the we will pay for any expenses (a)You(if you are an individual); Any organization you newly acquire or form dun- C. EMPLOYEE HIRED AUTO for loss of use is$65 per day,to a maximum of (h)A partner(if you are a partnership): ing the policy period over which you maintain 1. The following is added to Paragraph A1.. $750 for any one'accldent. (c)A member(if you are a limited liability com- 50%or more ownership interest and that is not Who Is An Insured,of SECTION II-COY- I. PHYSICAL DAMAGE - TRANSPORTATION puny): separately insured for Business Auto Coverage. ERED AUTOS LIABILITY COVERAGE: EXPENSES-INCREASED LIMIT (d)An executive officer, director or insurance Coverage under this provision is afforded only un- An"employee"of yours is an"insured"while The following replaces the first sentence in Para- manager(if you are a corporation or other or- til the 180th day after you acquire or form the or- operating an"auto'hired or rented under a graph A.4.a., Transportation Expenses, of ganization);or ganization or the end of the policy period,which- contract or agreement in an 'employee's" SECTION III-PHYSICAL DAMAGE COVER- My ever is earlier. name,with your permission,while performing AGE: (e)tice of the"" authorized accident or by you to give no- dufie B. BLANKET ADDITIONAL INSURED nesss related to the conduct of your busi- pay up $50per dayto a maximum of We will to M. BLANKET WAIVER OF SUBROGATION $1,500 for temporary transportation expense in The followingreplaces Paragraph AS..Transfer The following is added to Paragraph c.in Al., 2. The following replaces Paragraph b,in B.5.. cuffed by you because of the total theft of a cov- r p Who Is An Insured,of SECTION II-COVERED Other Insurance.of SECTION IV-BUSI- Bred"auto"of the private passenger type. Of Sights NO IV-Recovery BUSINESSAgE AUTOTs To Us. AUTOS LIABILITY COVERAGE: NESS AUTO CONDITIONS: of SECTION IV- CONDO Any person of organization who is required under b. For Hired Auto Physical Damage Cover- J. PERSONAL PROPERTY TIONS a written contract or agreement between you and age,the following are deemed to be cov- The following is added to Paragraph A.4.,Cover- 5. Transfer Of Rights Of Recovery Against that person or organization,that is signed and ered"autos"you own: age Extensions,of SECTION III-PHYSICAL Others To Us executed by you before the"bodilyinjury"orDAMAGE COVERAGE: We waive any right of recovery we may have o damage" (1)Any covered"auto"you lease,hire, against any person or organization to the ex- pr pertly g"occurs and that Is in effect rent or borrow;and Personal Property tent required of you b a written contract during the policy period,to be named as an addi Qw Y Y tional insured is an"insured for Covered Autos (2)Any covered"auto hired or rented by We will pay up to$400 for"loss"to wearing ap- signed and executed prior to any'accident" Liability Coverage,but only for damages to which your'employee'under a contract in pare)and other personal property which is: or'IosS".provided that the'accident"or'loss' an "employee's" name, with your (1)Owned by an"insured";and arises out of operations contemplated by CA T3 53 02 15 O aotS The Travelers Indemnify Company.All rights reserved. Page 1 of 4 CA T3 53 02 15 o IgrS The Tsvalers Indemnity company.All rights reserved Page 3 of 4 Includes copyaghtea material of Insurance Services arms.Inc.xelh as rermnown. Inckidas copyrighted material of Insurance Services Moe.Inc.xerr Is permission. COMMERCIAL AUTO COMMERCIAL AUTO permission. while performing duties (a)With respect to any claim made or'suit" such contract.The waiver applies only to the The unintentional omission of,or unintentional related to the conduct of your busi- brought outside the United States of person or organization designated in such error in,any information given by you shall not ness. America,the territories and possessions contract. prejudice your rights under this insurance.How- However,any"auto"that is leased.hired, of the United States of America.Puerto N. UNINTENTIONAL ERRORS OR OMISSIONS ever this provision does not affect our right to col- rented or borrowed with a driver is not a Rico and Canada: The following is added to Paragraph 8.2.,Con- tact additional premium or exercise our right of covered"auto". (I) You must arrange to defend the"i cealment, Misrepresentation, Or Fraud, of cancellation or non-renewal. steed"against.and investigate SECTION IV-BUSINESS AUTO CONDITIONS: D. EMPLOYEES AS INSUREDgel a or set- tle any such claim or proceedings and keep The followingsure is added to II-ParagraphO Al..ED Who Ss us advised of all proceedings and do- An Insured,of SECTION II-COVERED AUTOS bons. LIABILITY COVERAGE: My"employee"of yours is an'insured while us- Oh Neither you nor any other involved ing a covered"auto"you don't own,hire or borrow Insured will make any settlement in your business or your personal affairs. without our consent. E. SUPPLEMENTARY PAYMENTS-INCREASED OM We may.al our discretion,participate LIMITS in defending the'insured"against,or in the settlement of, any claim or 1. The following replaces Paragraph A2.a.(2), 'suit-. of SECTION II-COVERED AUTOS LABIL- ITY COVERAGE: (iv)We will reimburse the"insured"for sums that the Insured'legally must (2)Up to$3,000 for cost of bail bonds(in- cluding bonds for related traffic law viola- pay injury" "propertydamoer bde t'which u ance damage"to "in- h bons)required because of an"accident" this insurance applies,that the'in- we cover. We do not have to furnish sured pays with our consent. but these bonds. only up to the limit described in Para- 2. The following replaces Paragraph A.2.a.(4), graph C.. Limits Of Insurance, of of SECTION II-COVERED AUTOS UABIL- SECTION II -COVERED AUTOS ITY COVERAGE: LIABILITY COVERAGE. (4)All reasonable expenses incurred by the (v)We will reimburse the'insured'for 'insured at our request.including actual the reasonable expenses incurred loss of earnings up to$500 a day be- with our consent for your investiga- cause of time off from work. lion of such claims and your defense of the "insured against any such F. HIRED AUTO-LIMITED WORLDWIDE COV- 'suit",but only up to and included ERAGE-INDEMNITY BASIS within the limit described in Para- The following replaces Subparagraph(5)in Para- graph C.. Limits Of Insurance, of graph B.7..Policy Period,Coverage Territory. SECTION II -COVERED AUTOS of SECTION IV-BUSINESS AUTO CONDI- LIABILITY COVERAGE,and not in TIONS: addition to such limit.Our duty to (5)Anywhere in the world,except any country or make such payments ends when we jurisdiction while any trade sanction, em- have used up the applicable limit of bergo,or similar regulation imposed by the insurance in payments for damages, settlements or defense expenses. United Stales of America apples to and pro- hibits the Transaction of business with or (b)This insurance is excess over any valid within such country or jurisdiction.for Cov- and collectible other insurance available ered Autos Liability Coverage for any covered to the'insured whether primary,excess. "auto"that you lease,hire,rent or borrow contingent or on any other basis. without a driver for a period of 30 days or less (c)This insurance is not a substitute for re- and that is not an"auto"you lease.hire.rent quired or compulsory insurance in any or borrow from any of your 'employees'. country outside the United States,its ter- partners(if you are a partnership).members ritories and possessions.Puerto Rico and (if you are a limited liability company) or Canada. members of their households. Page 2 of 4 o xors The Travelers Indemnity company.AI rights reserves. CA T3 53 0215 Page 4 of 4 o Sots The Travelers Indemnity Coupe my.All rights reserves CA T3 53 02 15 Includes copyrighted material of Insurance Services Silica.Inc.with M permission. Includes copyrighted malarial of!moron.Services Office.Inc.wrath Is permissron. Department of Public Works O Consent Agenda Page 1 of 1 Jefferson County Board of Commissioners Agenda Request To: Board of Commissioners Mark McCauley, County Administrator From: Monte Reinders, P.E., Public Works Director/County Engineer Agenda Date: January 16, 2024 Subject: Execution of Contract with Interwest Construction, Inc. for Award of Contract for Phase 2 — MBR Wastewater Treatment Plant for Port Hadlock UGA, Project No. 40521140, Commerce Project No. 22-96515- 026 Statement of Issue: Execution of Contract with Interwest Construction, Inc. for the award of contract for Phase 2— MBR Wastewater Treatment Plant for Port Hadlock UGA, Project No. 40521140, Commerce Project No. 22-96515-026. Analysis/Strategic Goals/Pro's & Con's: The Board awarded this construction contract to Interwest Construction, Inc. on January 2, 2024. The contractor has provided the required Performance Bond, Payment Bond and Insurance and the Contract is ready for final signature. This work will be performed over the course of 502 calendar days and is expected to be completed in July 2025. Fiscal Impact/Cost Benefit Analysis: The bid amount is $10,020,835.00, including 9.1% Washington State Sales Tax (WSST). This project is fully funded with an appropriation from the State of Washington received in the 2021 Capital Budget utilizing Coronavirus State and Local Fiscal Recovery Funds (SLFRF) from the federal American Rescue Plan Act (ARPA). Recommendation: Public Works recommends that the Board execute all two (2) originals of the Contract with Interwest Construction, Inc. and return one (1) original to Public Works for further processing. Department Contact: Samantha Harper, P.E., Project Manager, 385-9175. Reviewed By: ///0/9-7/ Mark McCauley, C ty Administrator Dat CONTRACT REVIEW FORM I Clear Form I (INSTRUCTIONS ARE ON THE NEXT PAGE) CONTRACT WITH: TBD Contract No:gA 3 rii,7 Contract For: Phase 2-MBR Wastewater Treatment Plant for Port Hadlock UGA Term: COUNTY DEPARTMENT: Public Works Contact Person: Samantha Harper Contact Phone: 360-385-9160 ext 175 Contact email: sharper@co.jetferson.wa.0 AMOUNT: $7,000,000 PROCESS: Exempt from Bid Process AP Revenue: 00,000.0o(plus WSST) Cooperative Purchase Expenditure: , 000,000 00(plus WSST) Competitive Sealed Bid Matching Funds Required: S Small Works Roster Sources(s) of Matching Funds so Vendor List Bid Fund# aos RFP or RFQ Munis Org/Obj if Other: Review Prior to Award APPROVAL STEPS: STEP 1: DEPARTMENT CERTIFIES CO PLIANCE W T 3.55.080 AND CHA TER 42.23 RCW. CERTIFIED: p N/A:f - (O 3 Signatu c Date STEP 2: DEPARTMENT CERTIFIES THE PERSON PROPOSED FOR CONTRACTING WITH THE COUNTY (CONTRACTOR) HAS NOT BEEN DEBARRED BY ANY FEDERAL, STATE, OR LOCAL AGENCY. CERTIFIED: i l N/A: ! — ( (/ co ?/3 Signature j ate STEP 3: RISK MANAGEMENT REVIEW (will be added electronically through Laserfiche): Electronically approved by Risk Management on 11/9/2023. STEP 4: PROSECUTING ATTORNEY REVIEW (will be added electronically through Laserfiche): ctronically approved as to form by PAO on 11/6/2023. \/71L hanks for providing the entire contract for the risk/legal review required by County Resolution 81-96. PAO' detailed comments on a draft contract were provided on 10/18/2023 in an email sent at 5:30 a.m. Not sure all the suggested edits got made. STEP 5: DEPARTMENT MAKES REVISIONS & RESUBMITS TO RISK MANAGEMENT AND PROSECUTING ATTORNEY(IF REQUIRED). STEP 6: CONTRACTOR SIGNS STEP 7: SUBMIT TO BOCC FOR APPROVAL I