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HomeMy WebLinkAbout2019-090 20190213 Pacific Electrical Contractors, Inc PERSONAL SERVICES AGREEMENT ($25,000.00 or less) CONSULTANT: Pacific Electrical Contractors CITY OF CONSULTANT'S CONTACT: Eric Summers ASHLAND 20 East Main Street ADDRESS: 920 S. Grape Street Ashland,Oregon 97520 Medford, OR 97501 Telephone: 541-488-5587 Fax: 541-488-6006 TELEPHONE: 541-773-7751 EMAIL: eric @pacificelectrical.com This Personal Services Agreement (hereinafter"Agreement") is entered into by and between the City of Ashland, an Oregon municipal corporation (hereinafter "City") and Pacific Electrical Contractors, a domestic business corporation, ("hereinafter "Consultant"), for instrumentation and control integration services as necessary for water distribution and treatment. NOW THEREFORE,in consideration of the mutual covenants contained herein,the City and Consultant hereby agree as follows: 1. Effective Date and Term: This Agreement shall become effective on the date of execution on behalf of the City, as set forth below(the"Effective Date"), and unless sooner terminated as specifically provided in Section 11, shall terminate upon the City's affirmative acceptance of Consultant's Work as complete and Consultant's acceptance of the City's final payment therefore,but not later than June 30, 2018. 2. Scope of Work: Consultant shall provide instrumentation and control integration services as necessary for water distribution and treatment as more fully set forth in Consultant's Proposal dated August 15, 2018 which is attached hereto as"Exhibit A" and incorporated herein by this reference. Consultant's services are collectively referred to herein as the"Work." 3. Compensation: City shall pay Consultant the sum of$25,000 as full compensation for Consultant's performance of all Work under this Agreement. In no event shall Consultant's total of all compensation and reimbursement under this Agreement exceed the sum of$25,000 without the express,written approval from the City official whose signature appears below, or such official's successor in office. Payments shall be made within thirty(30) days of the date of receipt by the City of Consultant's invoice. Should this Agreement be terminated prior to completion of all Work,payments will be made for any phase of the Work completed and accepted as of the date of termination. 4. Supporting Documents/Conflicting Provisions: This Agreement and any exhibits or other supporting documents shall be construed to be mutually complimentary and supplementary wherever possible. In the event of a conflict between this Agreement and the supporting documents which cannot be resolved, the provisions of this Agreement shall control over any conflicting provisions in any of the exhibits or other supporting documents. Page 1 of 6: Personal Services Agreement with Pacific Electrical Contractors 5. All Costs Borne By Consultant: Consultant shall, at its own risk and expense, perform the Work described above and, unless otherwise specified in this Agreement, furnish all labor, equipment, and materials required for the proper performance of such Work. 6. Qualifications: Consultant has represented, and by entering into this Agreement now represents, that all personnel assigned to the Work to be performed under this Agreement are fully qualified to perform the service to which they will be assigned in a skilled and worker-like manner and, if required to be registered, licensed, or bonded by the State of Oregon, are so registered, licensed, and bonded. 7. Ownership of Work/Documents: All Work product or documents produced in furtherance of this Agreement belong to the City, and any copyright,patent, trademark proprietary or any other protected intellectual property right shall vest in and is hereby assigned to the City. 8. Statutory Requirements: The following laws of the State of Oregon are hereby incorporated by reference into this Agreement: ORS 279B.220, 279B.230 and 279B.235. 9. Living Wage Requirements: If the amount of this Agreement is$21,127.46 or more, Consultant is required to comply with Chapter 3.12 of the Ashland Municipal Code by paying a living wage, as defined in that chapter,to all employees performing Work under this Agreement and to any Subcontractor who performs 50% or more of the Work under this Agreement. Consultant is also required to post the notice attached hereto as "Exhibit B"predominantly in areas where it will be seen by all employees. 10. Indemnification: Consultant shall defend, save, hold harmless and indemnify the City and its officers, employees, and agents from and against any and all claims, suits, actions, losses, damages, liabilities, costs, and expenses of any nature resulting from or arising out of, or relating to the performance of any Work pursuant to this Agreement by Consultant(including but not limited to, Consultant's employees, agents, and others designated by Consultant to perform Work or services under this Agreement). However, Consultant shall not be held responsible for any losses, expenses, claims, subrogations, actions, costs,judgments, or other damages, caused solely by the negligence of City. 11. Termination: a. Mutual Consent. This Agreement may be terminated at any time by the mutual consent of both parties. b. City's Convenience. This Agreement may be terminated by City at any time upon not less than 30 days' prior written notice delivered by certified mail or in person. c. For Cause. The City may terminate this Agreement, in whole or in part, effective upon delivery of written notice to Consultant, or at such later date as may be established by City under any of the following conditions: i. If City funding from federal, state, county or other sources is not obtained and continued at levels sufficient to allow for the purchase of the indicated quantity of services; ii. If federal or state regulations or guidelines are modified, changed, or interpreted in such a way that the services are no longer allowable or appropriate for purchase under this Agreement or are no longer eligible for the funding proposed for payments authorized by this Agreement; or Page 2 of 6: Personal Services Agreement with Pacific Electrical Contractors iii. If any license or certificate required by law or regulation to be held by Consultant to provide the services required by this Agreement is for any reason denied, revoked, suspended, or not renewed. d. For Default or Breach. i. Either City or Consultant may terminate this Agreement in the event of a breach of the Agreement by the other. Prior to such termination the party seeking termination shall give to the other party written notice of the breach and its intent to terminate. If the party committing the breach has not entirely cured the breach within fifteen (15) days of the date of the notice, or within such other period as the party giving the notice may authorize in writing, then the Agreement may be terminated at any time thereafter by a written notice of termination by the party giving notice. ii. Time is of the essence for Consultant's performance of each and every obligation and duty under this Agreement. City by written notice to Consultant of default or breach may at any time terminate the whole or any part of this Agreement if Consultant fails to provide services called for by this Agreement within the time specified herein or within any extension thereof. iii. The rights and remedies of City provided in this subsection(d)are not exclusive and are in addition to any other rights and remedies provided by law or under this Agreement. e. Obligation/Liability of Parties. Termination or modification of this Agreement pursuant to subsections a, b, or c above shall be without prejudice to any obligations or liabilities of either party already accrued prior to such termination or modification. However, upon receiving a notice of termination(regardless whether such notice is given pursuant to Subsection a, b, c, or d of this section, Consultant shall immediately cease all activities under this Agreement,unless expressly directed otherwise by City in the notice of termination. Further, upon termination, Consultant shall deliver to City all Agreement documents, information,works-in-progress and other property that are or would be deliverables had the Agreement been completed. City shall pay Consultant for Work performed prior to the termination date if such Work was performed in accordance with this Agreement. 12. Independent Contractor Status: Consultant is an independent contractor and not an employee of the City for any purpose. Consultant shall have the complete responsibility for the performance of this Agreement. Consultant shall provide workers' compensation coverage as required in ORS Chapter 656 for all persons employed to perform Work pursuant to this Agreement. 13. Assignment: Consultant shall not assign this Agreement or subcontract any portion of the Work without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be void. Consultant shall be fully responsible for the acts or omissions of any assigns or subcontractors and of all persons employed by them, and the approval by City of any assignment or subcontract of the Work shall not create any contractual relation between the assignee or subcontractor and City. 14. Default. The Consultant shall be in default of this Agreement if Consultant: commits any material breach or default of any covenant,warranty, certification, or obligation under the Agreement; institutes an action for relief in bankruptcy or has instituted against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing business on a regular basis of the type identified in its obligations under the Agreement; or attempts to assign rights in, or delegate duties under,this Agreement. Page 3 of 6: Personal Services Agreement with Pacific Electrical Contractors 15. Insurance. Consultant shall, at its own expense, maintain the following insurance: a. Worker's Compensation insurance in compliance with ORS 656.017, which requires subject employers to provide Oregon workers' compensation coverage for all their subject workers b. Professional Liability insurance with a combined single limit, or the equivalent, of not less than $2,000,000 (two million dollars) per occurrence. This is to cover any damages caused by error, omission or negligent acts related to the professional services to be provided under this Agreement. c. General Liability insurance with a combined single limit, or the equivalent, of not less than $2,000,000 (two million dollars)per occurrence for Bodily Injury, Death, and Property Damage. d. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than $1,000,000 (one million dollars) for each accident for Bodily Injury and Property Damage, including coverage for owned, hired or non-owned vehicles, as applicable. e. Notice of cancellation or change. There shall be no cancellation, material change, reduction of limits or intent not to renew the insurance coverage(s)without 30 days' prior written notice from the Consultant or its insurer(s)to the City. f. Additional Insured/Certificates of Insurance. Consultant shall name the City of Ashland, Oregon, and its elected officials, officers, and employees as Additional Insureds on any insurance policies, excluding Professional Liability and Workers' Compensation, required herein, but only with respect to Consultant's services to be provided under this Agreement. The consultant's insurance is primary and non-contributory. As evidence of the insurance coverages required by this Agreement, the Consultant shall furnish acceptable insurance certificates prior to commencing the Work under this Agreement. The certificate will specify all of the parties who are Additional Insureds. Insuring companies or entities are subject to the City's acceptance. If requested, complete copies of insurance policies; trust agreements, etc. shall be provided to the City. The Consultant shall be financially responsible for all pertinent deductibles, self-insured retentions, and/or self-insurance. 16. Nondiscrimination: Consultant agrees that no person shall, on the grounds of race, color, religion, creed, sex, marital status, familial status or domestic partnership,national origin, age, mental or physical disability, sexual orientation, gender identity or source of income, suffer discrimination in the performance of any Work under this Agreement when employed by Consultant. Consultant agrees to comply with all applicable requirements of federal and state civil rights and rehabilitation statutes, rules and regulations. Further, Consultant agrees not to discriminate against a disadvantaged business enterprise, minority-owned business, woman-owned business, a business that a service-disabled veteran owns or an emerging small business enterprise certified under ORS 200.055, in awarding subcontracts as required by ORS 279A.110. 17. Consultant's Compliance With Tax Laws: 17.1 Consultant represents and warrants to the City that: 17.1.1 Consultant shall,throughout the term of this Agreement, including any extensions hereof, comply with: (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS Chapters 316, 317, and 318; (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Consultant; and (iii) Any rules, regulations, charter provisions, or ordinances that implement or enforce any of the foregoing tax laws or provisions. Page 4 of 6: Personal Services Agreement with Pacific Electrical Contractors 17.1.2 Consultant, for a period of no fewer than six(6)calendar years preceding the Effective Date of this Agreement,has faithfully complied with: (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS Chapters 316, 317, and 318; (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Consultant; and (iii) Any rules, regulations,charter provisions, or ordinances that implement or enforce any of the foregoing tax laws or provisions. 18. Governing Law; Jurisdiction; Venue: This Agreement shall be governed and construed in accordance with the laws of the State of Oregon without resort to any jurisdiction's conflict of laws,rules or doctrines. Any claim, action, suit or proceeding(collectively, "the claim")between the City and the Consultant that arises from or relates to this Agreement shall be brought and conducted solely and exclusively within the Circuit Court of Jackson County for the State of Oregon. If, however,the claim must be brought in a federal forum,then it shall be brought and conducted solely and exclusively within the United States District Court for the District of Oregon filed in Jackson County, Oregon. Consultant, by its signature hereon of its authorized representative,hereby consents to the in personam jurisdiction of said courts. 19. THIS AGREEMENT AND THE ATTACHED EXHIBITS CONSTITUTE THE ENTIRE UNDERSTANDING AND AGREEMENT BETWEEN THE PARTIES. NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS AGREEMENT SHALL BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER, CONSENT, MODIFICATION OR CHANGE, IF MADE, SHALL BE EFFECTIVE ONLY IN THE SPECIFIC INSTANCE AND FOR THE SPECIFIC PURPOSE GIVEN. THERE ARE NO UNDERSTANDINGS, AGREEMENTS, OR REPRESENTATIONS, ORAL OR WRITTEN,NOT SPECIFIED HEREIN REGARDING THIS AGREEMENT. CONSULTANT, BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT HE/SHE HAS READ THIS AGREEMENT, UNDERSTANDS IT,AND AGREES TO BE BOUND BY ITS TERMS AND CONDITIONS. 20. Force Majeure. Neither party to this Agreement shall hold the other responsible for damages or delay in performance caused by acts of God, strikes, lockouts, accidents, or other events beyond the control of the other or the other's officers, employees or agents. 21. Amendments. This Agreement may be amended only by written instrument executed by both parties with the same formalities as this Agreement. 22. Nonappropriations Clause. Funds Available and Authorized: City has sufficient funds currently available and authorized for expenditure to finance the costs of this Agreement within the City's fiscal year budget. Consultant understands and agrees that City's payment of amounts under this Agreement attributable to Work performed after the last day of the current fiscal year is contingent on City appropriations, or other expenditure authority sufficient to allow City in the exercise of its reasonable administrative discretion,to continue to make payments under this Agreement. In the event City has insufficient appropriations, limitations or other expenditure authority, City may terminate this Agreement without penalty or liability to City, effective upon the delivery of written notice to Consultant,with no further liability to Consultant. Page 5 of 6: Personal Services Agreement with Pacific Electrical Contractors 23. Certification. Consultant shall execute the certification attached hereto as "Exhibit C"and incorporated herein by this reference. IN WITNESS WHEREOF the parties have caused this Agreement to be signed in their respective names by their duly authorized representatives as of the dates set forth below. THE CITY OF ASHLAND, OREGON: CONSULTANT: ` /1‘.\A k ignature Sig IaMir Q 1,,A . IV�Gt de r M ers 411.1)' Printed Name Pri d Name C� M014, -4 k VP Title Title 11111t 8/23/2018 Date Date (W-9 is to be submitted with this signed Agreement) Page 6 of 6: Personal Services Agreement with Pacific Electrical Contractors Exhibit A 7 PACIFIC Al ORPAC SYSTEMS ELECTRICAL CONTRACTORS V A OIVIS:ON OF PACIFIC ELECTRICAL CONTRACTORS PROPOSAL TO: City of Ashland ATTN: Kevin Caldwell JOB NAME: Ashland instrumentation and controls integrator. JOB LOCATION: Ashland, Oregon. Pacific Electrical Contractors, Inc. along with ORPAC Systems, propose to furnish labor, materials, and programming at a T&M rate set at the below values.This proposal covers the work that is required by the City of Ashland on an on call basis,24/7, dated 15 August 2018. ELECTRICIAN/CONTROLS TECHNICIAN - Description of duties to consist of conduit installation,wire pulling,installation of lighting fixtures,addition of circuits, wiring of electrical motors and apparatus, installation of control system equipment, installation of instrumentation devices,and troubleshooting of control system components. $90.00/HR $125.00/HR OT ➢ PROGRAMMING - Description of duties to consist of work requiring special software in order to troubleshoot,repair,design, or monitor specialty systems. Plc programming, SCADA programming, HMI programming,and programming of instrumentation devices. 5105.00/HR $144.00/HR OT ➢ MATERIAL MARKUP -Materials to be marked up from the integrator pricing extended to us from vendors. 15% MARGIN TOTAL NTE: $25,000 TERMS AND CONDITIONS: 1)All workmanship and materials are to comply with the requirements of the National Electrical Code;and the applicable local and state codes. 2)This proposal is based upon a lump sum unless otherwise noted. Contractor shall bill on a monthly basis. Payment is due within 10 days of the monthly invoice. Sums not paid within said time period shall accrue interest at the rate of 1.5%per month from the date of the invoice until paid. If there is a retainage option required by the owner,it will not exceed 5%withheld. In the event a party retains an attorney to enforce any of the terms of this proposal,or any other contract document executed in connection herewith,the prevailing party shall be entitled to recover attorneys'fees and costs incurred whether or not litigation is filed; and in the event litigation is filed, the prevailing party shall be entitled to recover attorneys'fees and costs incurred in said litigation at trial and on appeal. 3)Contractor shall not be liable for any charges for liquidated damages resulting from delay in completion of the work caused by factors beyond his/her control. Project schedule and completion to be mutually agreed upon prior to beginning work. 4)Notwithstanding any provision herein to the contrary,in the event that,during the performance of this agreement,the price of steel raceways, copper wire and/or any other necessary commodities significantly increases,through no fault of Pacific Electrical Contractors,the price of any materials,components,or goods to be furnished under this agreement shall be equitably adjusted by an amount reasonably necessary to cover any such significant price increases. PACIFIC ELECTRICAL CONTRACTORS, INC. CCB#3651 CA C10#299180 Control Systems By Title Project Manager Date 15 Aug 18 Eric.A. Summers This proposal is made for acceptance within 10 days. ACKNOWLEDGED AND ACCEPTED By Title Date Signator warrants that he/she is authorized to enter into contractual agreements. CAPABLE. COMPETITIVE. GUARANTEED. 920 South Grape Street • Medford, Oregon 97501 • Phone 541-773-7751 • Fax 541-779-2072 • www.PacificElectrical.com EXHIBIT B CITY OF ASHLAND, OREGON City of Ashland LIVING ALL employers described WAG E below must comply with City of Ashland laws regulating •a ment of a livin• wa•e. $14.81 per hour, effective June 30, 2017. The Living Wage is adjusted annually every June 30 by the Consumer Price Index. Employees must be paid a portion of business of their 401K and IRS eligible living wage: employer, if the employer has cafeteria plans(including ten or more employees, and childcare) benefits to the has received financial amount of wages received by assistance for the project or the employee. > For all hours worked under a business from the City of service contract between their Ashland in excess of ➢ Note: For temporary and employer and the City of $20,688.86. part-time employees,the Ashland if the contract Living Wage does not apply exceeds$20,688.86 or more. > If their employer is the City of to the first 1040 hours worked Ashland, including the Parks in any calendar year. For > For all hours worked in a and Recreation Department. more details, please see month if the employee spends Ashland Municipal Code 50%or more of the > In calculating the living wage, Section 3.12.020. employee's time in that month employers may add the value working on a project or of health care, retirement, For additional information: Call the Ashland City Administrator's office at 541-488-6002 or write to the City Administrator, City Hall, 20 East Main Street, Ashland, OR 97520, or visit the City's website at www.ashland.or.us. (Notice to Employers: This notice must be posted predominantly in areas where it can be seen by all employees. CITY OF ASHLAND Page 1 of 1: Exhibit B EXHIBIT C CERTIFICATIONS/REPRESENTATIONS: Consultant, by and through its authorized representative, under penalty of perjury, certifies that(a)the number shown on the attached W-9 form is its correct taxpayer ID (or is waiting for the number to be issued to it and(b) Consultant is not subject to backup withholding because: (i) it is exempt from backup withholding, or(ii) it has not been notified by the Internal Revenue Service(IRS)that it is subject to backup withholding as a result of a failure to report all interest or dividends, or(iii) the IRS has notified it that it is no longer subject to backup withholding. Consultant further represents and warrants to City that: (a) it has the power and authority to enter into this Agreement and perform the Work, (b)the Agreement,when executed and delivered, shall be a valid and binding obligation of Consultant enforceable in accordance with its terms, (c)the work under the Agreement shall be performed in accordance with the highest professional standards, and(d) Consultant is qualified,professionally competent, and duly licensed(if applicable)to perform the Work. Consultant also certifies under penalty of perjury that its business is not in violation of any Oregon tax laws, it is an independent contractor as defined in the Agreement, it is authorized to do business in the State of Oregon,and Consultant has checked four or more of the following criteria that apply to its business. X (1) Consultant carries out the work or services at a location separate from a private residence or is in a specific portion of a private residence, set aside as the location of the business. X (2) Commercial advertising or business cards or a trade association membership are purchased for the business. X (3)Telephone listing is used for the business separate from the personal residence listing. (4)Labor or services are performed only pursuant to written contracts. X (5)Labor or services are performed for two or more different persons within a period of one year. (6) Consultant assumes financial responsibility for defective workmanship or for service not provided as evidenced by the ownership of performance bonds, warranties, errors and omission(professional liability) insurance or liability insurance relating to the Work or services to be provided. kid i Con. ' si• azure 8/ 2018 Date www.saif.com Oregon Workers' Compensation Work. Certificate of Insurance sail Oregon. Certificate holder: CITY OF ASHLAND 20 EAST MAIN STREET ASHLAND, OR 97520 The policy of insurance listed below has been issued to the insured named below for the policy period indicated.The insurance afforded by this policy is subject to all the terms, exclusions and conditions of such policy;this policy is subject to change or cancellation at any time. Insured Producer/contact Pacific Electrical Contractors Inc Ward Insurance Agency Inc 920 S Grape St Mike Godfrey Medford, Or 97501-3631 541.687.1117 mike @wardinsurance.net Issued 08/01/2018 Limits of liability Policy 811124 Bodily Injury by Accident $1,000,000 each accident Period 10/01/2017 to 10/01/2018 Bodily Injury by Disease $1,000,000 each employee Body Injury by Disease $1,000,000 policy limit Description of operations/locations/special items RE: all operations performed by the named insured in accordance with the policy terms and conditions Important This certificate is issued as a matter of information only and confers no rights to the certificate holder.This certificate does not amend, extend or alter the coverage afforded by the policies above. This certificate does not constitute a contract between the issuing insurer, authorized representative or producer and the certificate holder. CANCELLATION: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED TO THE POLICYHOLDER AND CERTIFICATE HOLDER IN ACCORDANCE WITH THE POLICY PROVISIONS AND OREGON LAW. SAIF WILL ENDEAVOR TO PROVIDE WRITTEN NOTICE WITHIN 30 DAYS WHENEVER POSSIBLE. Authorized representative Kerry Barnett President and CEO 400 High Street SE Salem,OR 97312 P:800.285.8525 F:503.584.9812 Policy_OLCA_CertificateOf I n su rance A� M' CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDY1) 8/2/2018 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 NAME CONTACT Klm Schnetzky Ward Insurance Agency Inc. PHONE FAX PO Box 10167 (A/C No Extr 541-687-1117 (A/c,No):541-342-8280 Eugene OR 97440 ADDRess: kim©wardinsurance.net INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Cincinnati Casualty 28665 INSURED PACIELE-01 INSURER B:Columbia Casualty Insurance Company 31127 Pacific Electrical Contractors Inc 920 S. Grape Street INSURER C: Medford OR 97501 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1068455612 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 SUER POLICY EFF POLICY EXP MM/D LIMITS INSD WVD POLICY NUMBER (MWDD/YYYY) ( DrrAm A X COMMERCIAL GENERAL LIABILITY Y V EPP0488739 7112018 7/12019 EACH OCCURRENCE $1,000,000 i TO RENTED CLAIMS-MADE X I OCCUR PREMISES Ea occurrence) $500,000 MED EXP(Any one person) $10,000 PERSONAL 8 ADV INJURY $1,000,000 ' GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,000 POLICY X JEGT LOC PRODUCTS-COMP/OPAGG $2,000,000 - OTHER: Limited Pollution $1,000,000 A AUTOMOBILE LIABILITY Y V EBA0488739 7/1/2018 7/1/2019 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Par person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) $ A X UMBRELLALIAB X OCCUR EPP0488739 7/12018 7/1/2019 EACH OCCURRENCE $5,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $5,000,000 _ DED I RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY PER EERH - ANYPROPRIETOR/PARTNER/EXECUTIVE Y7 N/A E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? I (Mandatory In NI-I) E.L.DISEASE-EA EMPLOYEE $ • If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S A Installation Floater EPP 0488739 7/1/2018 7/1/2019 Umit$500,000 Ded:$1,000 B Professional Liability 02088371577 7/12018 7/1/2019 Umit$2,000,000 Ded:$10,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate holder and all entities required by written contract are included as additional insureds on a primary and non-contributory basis with waiver of subrogation as respects to the general liability including completed operations and auto liability,including waiver of subrogation as required by written contract per attached endorsements.Umbrella follows form over General Liability,Auto Liability and Employers Liability.Subject to policy limits,terms,conditions and exclusions. Certificate Holder Includes:City of Ashland,Oregon,and its elected officials,officers,and employees. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland 20 E Main Street AUTHORIZEDREPRES{ENTATIVE Ashland OR 97520L JTV o- I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. However, any 'auto' that is leased, a. Is effective on the date of acquisition hired,rented or borrowed with a driver or formation,and is afforded for 180 CinciPlus® is not a covered'auto'. days after such date; ® E. Audio,Visual and Data Electronic Equip- b. Does not apply to'bodily injury or BUSINESS AUTO XC+® ment 'property damage'resulting from an EXPANDED COVERAGE PLUS) SECTION III - PHYSICAL DAMAGE COV- ERAGE, acquirenl' that occurred organization; you C. Limit of Insurance is amended acquired or formed the or ENDORSEMENT by adding the following: c. Does not apply to any newly acquired A The most we will pay for all loss'to au- or formed organization that is a joint dio,visual or data electronic equipment venture or partnership;and This endorsement modifies insurance provided by the following: and any accessories used with this d. Does not apply to an Insured under equipment as a result of any one 'ac& any other automobile liability policy, BUSINESS AUTO COVERAGE FORM dent'is the lesser ot. or would be an insured under such a a. The actual cash value of the dam- policy but for the termination of such a ed or stolen property policy or of exhaustion of such pole With respect to the coverage provided by this endorsement,the provisions of the Coverage Form apply unless 0 P party as of time cys limits of insurance. modified by this endorsement. of the'accident': b. The cost of repairing or replacing the 3. Any re 'auto'your 'employees"In ur while using r damaged or stolen property with ob- it. covered' 'N your business or your A Blanket Waiver of Subrogation This provision does not apply unless the valid er property of Pike kind and quality;or personal affairs,provided you do not own, written contract has been: hire or borrow that'auto'. SECTION IV - BUSINESS AUTO CONDI• C. $2.500. TIONS,A.Loss Conditions,5.Transfer of 1. Executed prior to the accident causing G. Liability Coverage Extensions - Supple. Rights of Recovery Against Others to Us is 'bodily injury'or'property damage`,and Provided the equipment.at the time of the mentary Payments-Higher Limits amended by the addition of the following: 2. Is still in force at the time of the'accident' loss'Is: SECTION II - LIABILITY COVERAGE, A We waive any right of recovery we may have causing'bodily injury or'property dam- a. Pennanenty Installed In or upon the Coverage,2.Coverage Extensions,a.Sup- against any person or organization because of age'. covered'auto'In a housing,opening plementary Payments Is amended by payments we make for 'bodily Injury' or or other location that is not normally 'property damage'arising out of the operation D. Employee Hired Auto used by the'auto'manufacturer for 1. Replacing bi the with$000 in of insurance of a covered'auto'when you have assumed 1. Changes In Liability Coverage the Installation of such equipment; for bat bonds with$4,000 in(2);and liability for such 'bodily Injury' or 'properly 2. Replacing the$250 Limit of Insurance for lo damage'under an'insured contract'.provid- The following H added to the Section ll- b. Removable from a permanently in- reasonable expenses with$500 in(4). ed the'bodily injury'or'property damage'oc- Liability Coverage, A Coverage, 1, stalled housing unit as described in curs subsequent to the execution or the'in- Who Is an Insured: Paragraph 2a,above;or H. Amended Fellow Employee Exclusion sured contract'. An'employee'of ay yours is an 'insured" c. An Integral part of such equipment. SECTION II•LIABILRV COVERAGE,B.Ex- B- Noncontributory Insurance while operating an'auto'hired or rented F. who Is an Insured•Amended elusions,5.Fellow Employee is modified as SECTION N - BUSINESS AUTO CONDI- under a contract or agreement in that follows: SECTI N.IV ' BUSINESS Conditions,T.Other I- 'employee's'name,with your permission, SECTION II - LIABILITY COVERAGE, A Exclusion 5.Fellow Employee is deleted. TIONS, aG General by the following: while performing duties related to the Coverage,1.Who is an Insured Is amended conduct of your business. by adding the following: L Hired Auto•Physical Damage c, Regardless of the provisions of Par- 2. Changes in General Conditions The following are'insureds': If hired'autos'are covered'autos'for Liability agraph a- above, this Coverage Form's Liability Coverage is primary SECTION IV-BUSINESS AUTO CON- 1. My subsidiary which is a legally Coverage,then Comprehensive and Collision legally incorpo- Physical Damage Comprehensive as provided un- and we will not seek contribution DRIONS, B. General Conditions, 5. rated entity of which you own a financial der SECTION III - PHYSICAL DAMAGE from any other insurance for any lia- Other Insurance is amended by repiac- interest of more than 50%of the voting COVERAGE of this Coverage Part are ex- bility assumed under an 'insured trig Paragraph 5.b.with the following: stock on the effective date of this cover- tended to'autos'you hire,subject to the fol- contract'that requires liability to be age form. assumed on a primary noncontributo- b. For Hired Auto Physical Damage lowing: ry basis Coverage the following are deemed However.the insurance afforded by this 1. The most we will pay for loss' to any to be covered'autos'you own: provision does not apply to any subsidiary hired'auto'is$50.000 or the actual cash C. Additional Insured by Contract that Is an'insured'under any other au- value or cost to repair or replace,Any covered 'auto'you lease, tunoble liabili poky, pa place,which- SECTION II - LIABILITY COVERAGE, A hire.rent or borrow:and ry ry. or would be an ever a the least,minus a deductible. Coverage,I.Who Is an Insured is amended 'insureC under such policy but for tertni to include as an insured any person or organi' (2) Any covered 'auto' hired or nation of such policy or the exhaustion of 2. The deductible will be equal to the largest ration with which you have agreed in a valid rented by your'employee'under such policy's limits of Insurance. deductible applicable to any owned'auto' a contract in that individual for that coverage-or$1,000,whichever is written contract to provide insurance as Is af- 2, Any formed by organization that is newly acquired or less, forded this li ployee's' name, with your per- by policy. loaned jo you and over which The insurance main-mission.ato the performing duties rain majority ownership. The insurance 3. Hired Auto over any other Damage coverage This provision t limited to the scope of the business. to [he conduct of your provided by this provision: is excess over any other colettible inzur- valdwritten contract. business. once. Includes copyrighted material of 150 Includes copyrighted material of ISO AA 288 01 16 Properties,Inc.,with its permission. Page 1 of 4 AA 288 01 16 Properties,Inc.,with its permission. Page 2 of 4 4. Subject to the above limit deductible,and K. Transportation Expense-Higher Limits 2. SECTION V-DEFINITIONS is amended P. Unintentional Failure to Disclose Hazards excess provisions we win provide cover- SECTION III- PHYSICAL DAMAGE COY- by adding the following.but only for the SECTION IV - BUSINESS AUTO CONDI- ageequaltothebroadestcoverageappl4 purposes of this Loan or Lease Gap cable to any covered'auto'you own in- ERAGE,A.Coverage,4. Coverage Exten• Coverage: TONS,B.General Conditions,2.Conceal- slons is amended replacing per day g surer under this policy. by p maxi rda amended Misrepresentation adding or Fraud is with$1,500 per um I and $600 maximum with costal loss'means the loss' ly in value the amended by adding the following: t Coverage includes i loss from use an that hired au- to ion maximum in Extension a.Transpor cost s the actual l plus thv value. value ex- However,if you unintentionally fail to disclose which ch you provided it legally from an as'accident'for ration Expenses. users the actual cash value. Y IIY which you are legally loss and as a result of any hazards existing Frm,oe the effective d date of a monetary loss Is sustained by the L Airbag Coverage N. Glass Repair-Waiver of Deductible this Coverage Form.we will not deny cover- leasing or rental concern. The most we will SECTION ill- PHYSICAL DAMAGE COV- SECTION Ill - PHYSICAL DAMAGE COV- age under this Coverage Form because of pay for any one'accident'is 53,000. ERAGE,B.Exclusions,3.a.is amended by ERAGE,D.Deductible is amended by adding such failure. adding the following: If a limit for Hired Auto-Physical Damage is 0 9: the}snowing: Q. Mental Anguish Resulting from Bodily IRK:- shown in the Schedule,then that limit replac- However. the mechanical and electrical No deductible applies to glass damage if the ry es,and is not added to,the$50,000 limit indi- breakdown portion of this exclusion does not glass is repaired in a manner acceptable to us SECTION V-DEFINITIONS,C."Bodily!nit:- rated above. apply to the accidental discharge of an airbag. rather than replaced. ry"is deleted in its entirety and replaced by J. Rental Reimbursement This coverage for airbags is excess over any the following: other coilecbble insurance or warranty O. Duties In the Event of an Accident,Claim, SECTION ill - PHYSICAL DAMAGE is Suit or Loss•Amended 'Bodily injury means bodily injury,sickness or amended by adding the following: M. Loan or Lease Gap Coverage SECTION IV - BUSINESS AUTO CONDI• disease sustained by a person,including men- 1. SECTION ill - PHYSICAL DAMAGE TIONS,A.Loss Conditions,2.Duties In the tat anguish and death sustained o the same 1. We will pay for rental reimbursement ex- person that results from such bodily injury, noes incurred ou for the rental of COVERAGE, C. Limit of Insurance is Event of Accident Claim,Suitor Loss,a.k sickness or disease.Rode Pe you deleted in its entirety and replaced by the amended by adding the following: N injury'does not 'auto'.to'.Payment ymt because applies s in addition to a covered to Y 9 9: include mental anguish or death that does not an'auto'.Payment applies in addition to the following,but only for private passenger This condition apples only when the 'acct result from bodily injury.sickness or disease. otherwise applicable amount of each coy- type'autos'with an original loan or lease, and only in the event of a'total loss'to dent'or loss'is known to: R. Coverage for Certain Operations In Con- drage you have on a covered'auto'.No such a private passenger type'auto`. nection with Railroads P deductible applies to this coverage. D 9 tyD 1. You,A you are an individual: 2. We will pay only for those expenses in- a. The most we win pay for loss'in any 2. A partner,if you are a partnership; With respect to the use of a covered'auto'in carted during the poky period beginning one'accident'is the greater of operations for or affecting a railroad: 24 hours after the'loss'and ending.re- (1) The amount due under the terms 3. An executive officer or Insurance manag- ( ) er,If are 1. Section V-Definitions,H.'Insured con- gardless of the policy's expiration. with of the lease or loan to which you corporation;or tract',1.c.is amended to read: the lesser of the following number of your covered private passenger 4. A member or manager.If you are a lim- days: type'auto'is subject.but will not iced Labiaty company. c. An easement or license agreement; a. The number of days reasonably re- include: 2. Section V-Definitions,H.'Insured con- quired to repair the covered'auto'.If (a) Overdue lease or loan pay- tract",2.a.is deleted. 'loss'is caused by theft.this number menns: of days is added to the number of days it takes to locate the covered (b) Financial penalties imposed 'auto'and return it to you:or under the lease due to high b. 30 tla mileage, excessive use or Ys. abnormal wear and tear, 3. Our payment is limited to the lesser of the (c) Security deposits not re- following amounts: funded by the lessor, a. Necessary and actual expenses in- (d) Costs for extended warran- cured;or ties. Credit Life Insurance. b. $50 per day. Health,Accident or Disabt- ity Insurance purchased 4. This coverage does not apply while there with the loan or lease;and are spare or reserve'autos'available to you foryouroperations. (e) Carty-over balances from previous loans or leases,or 5. We will pay under this coverage only that amount of your rental reimbursement ex- (2) Actual cash value of the stolen penses which is not already provided for or damaged property. under SECTION III - PHYSICAL DAM- b. An adjustment for depreciation and AGE COVERAGE, A. Coverage, 4. physical condition will be made in de- Coverage Extensions. termining actual cash value at the time of loss'. Includes copyrighted material of ISO Includes copyrighted material of ISO AA 268 01 16 Properties,Inc.,with its permission. Page 3 of 4 AA 288 01 16 Properties,Inc.,with its permission. Page 4 of 4 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. 6. Voluntary Property Damage(Coverage a.)and Care.Custody orControl Liability Coverage (Coverage b.) OREGON CONTRACTORS'COMMERCIAL GENERAL LIABILITY Limits of Insurance(Each Occurrence) BROADENED ENDORSEMENT Coverage Coverage 500 unless otherwise stated $ Deductibles(Each Occurrence) TVs endorsement modifies Insurance provided under the following: Coverage a.$250 COMMERCIAL b.$250 unless otherwise stated $ OMMERCIAL GENERAL LIABILITY COVERAGE PART A Endorsement-Table of Contents: COVERAGE PREMIUM BASIS RATE ADVANCE PREMIUM 0 Area (For Limits h Excess of (For Limits I Ernes of Coves°e: Begln9 on Peoe; b Payroll $5,000) $5,000) 1. Employee Benefit Liability Cole raga...._..._..._..._..._...__..._..._..._..._..._..._....._..._..._..._..._...__.2 d Units Sales 2. Unintentional Failure to Disclose Hazards...._............................................._..._..._..._..._....B a Other 3. Damage to Premises Rented to You...._..._..._..._..._...__..._..._...... .._..._................._...-..._..._.B b. Cara. Custody 4. Supplementary Pauments...._..._........................................._..._..._..._..._..._..._....._..........9 or Control $ 5. Medical Payments........................._..._..._..._..._..._..__...__._..._..._..._...__..._..._...__._..._..10 6. Voluntary Property Damage(Coverage a)an Care,Custody or Control TOTAL ANNUAL PREMIUM $ Liability Coverage(Coverage b.)................_..._...__..._..._..._..._..._...__.._..._..._..._..._..._ 10 11. Property Damage to Borrowed Equipment 7. 160 Day Coverage for Newly Formed or Acquired Organizations.. 10 8. Waiver of Su&ogatlon...._..._........_..._...-_..._..._..._..._..._...__..._..._.................................10 Eerh Occurrence Unit $ 10,000 9. Autnnatic Additional Insured-Specified Relationsrps:...._..._...............__..._..._..._..._..._..._..11 Deductible: $ 250 x Managers or Lessors of Premises: x Lessor of Leased Equipment; x Vendors; C. Coverages: it State or Political Subdlvsions-Permits Relating to Premiss 2)2) Our right and duty to it State or Political Subdvislons-Permits;and 1. Employee Benefit Liability Coverage defend ends when we it Contactors'Operations have used up the appt- 10. Broadened Conlradual Liability-Work Within 50'of Railroad Property .........................16 a. The fo0aNng is added to SECTION I Cable limit of insurance 11. Property Damage to BarowedEqulpment................................_..._..._...__.__..._..._..._..._.16 -COVERAGES:Employee Benefit in the payment of 12. Employees as Insureds-Sped Health Care Services........................._..._.._..._..._..._...16 Liability Coverage. judgments a' settle- ✓ Nurses; (1) Insuring Agreement ments. Technicians;• Emergency Maral Tenicians;and No other obligation or Iiabi- x Paramedics (a) We will pay those sums that 8 13. Broadened Nolte of Occurence...._..._..._..._..._...__..._..._..._..._..._................._.._..._...__....16 the Insured becomes legally Ity to pay sums or perform obligated to pay as dam- ads or services Is covered ages caused by any act,cr- unless explicitly provided for B. Limits of Insurance: ror or omission of the in- under Supplementary Pay. sired,or of any other per- merits. The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorsement, son for whose ads the in- (b) This Insurance applies to except as provided below: aired Is legally liable, to damages only if the act,er- 1. Employee Benefit Liability Coverage plies.We will have the right roc gently omission, Is neg0. and duly to defend the in- 9enlly cemrtti0etl In the in- Each Employee Limit: $ 7,000,000 sued against any •suit' 'administration"mploy b of your Aggregate Limit $ 3,000,000 seeking those damages. "employee benefit Deductible: $ 1,000 and However, we will have no 3. Damage to Premises Rented to You duty to defend against any 1) Occurs during the pd- The lesser of: which Vise i insurance does icy period;or a. The Each Occurrence Limit shown in the Declarations;or not apply We may.at our 2) Occurred prior to the discretion, Investigate any effective date of the b. $500,000 unless otherwise stated$ report of an ad, error or endorsement provided: 4. Supplementary Payments claim omission•auk'that may�re- a) You std not of a suit.But: knowledge of e a. Bail bons: $ 1.000 claim or•suir on the ea b. Loss of earnings $ 350 1) The amount i wit pay or date of this for damages is limited 6. Medical Payments TI N described ill-LIMITS I SEC- endorsement. TISN le -E and OF You will be Medical Expense Unlit $ 10,000 INSURANCE;erhd deemed to have Includes copyrighted material of Insurance Includes cepydghied material of Insranee GA 233 OR 09 10 Services Office,Inc,with its permission. Page 1 of 16 GA233 OR 09 10 SeMces Office,Inc,with Its permission. Page 2 of 16 knowledge of a 1) Failure of any invest- (3) Coercion, demotion, tors are insureds, but only claim or "suit" ment to perform; evaluation, reassign- with respect to their duties when any"author- ment, discipline, defa- as your officers or directors. ized represents- 2) Errors in providing in- mation, harassment, Your stockholders are also formation on past per- five", humiliation, discrimina- insureds, but only with re- formance of investment tion or other employ- I) Reports all, or vehicles;or ment-related practices, stockholders. kholders.e1r liability as any part,of the ad, error or 3) Advice given to any ads or omissions;or person with respect to (e) A trust,you are are insured. omission to us (4) Consequential liability Your trustees are also in- or any other that person's decision as a result of(1),(2)or sureds,but only with respect insurer; to participate or not to (3)above. to their duties as trustees. participate in any plan II) Receives a included in the "em- This exclusion applies (2) Each of the following is also an written or ver- ployee benefit pro- whether the insured may be insured: bal demand or gram". held liable as an employer claim for dam- or in any other capacity and (a) Each of your "employees" ages because (f) Workers' Compensation to any obligation to share who is or was authorized to I of the ad,error and Similar Laws damages with or repay administer your "employee I or omission: Any claim arising out of your someone else who must benefit program". i and failure to comply with the pay damages because of Ph (b) Any persons, organizations b) There is no other mandatory provisions of any the injury. or "employees" having applicable inuu- workers'compensation, un- (3) Supplementary Payments proper temporary authorize- ance. employment compensation Lion to administer your"em- insurance,soda)security or SECTION I - COVERAGES. ployee benefit program" if (2) Exclusions disability benefits law or any SUPPLEMENTARY PAY- you die, but only until your similar law. MENTS-COVERAGES A AND legal representative is ap- This insurance does not apply to B also apply to this Coverage. pointed. (g) ERISA (a) Bodily Injury,ry, Pro a rt y b. Who is an Insured (c) Your legal representative if Damage or Personal and Damages for which any in- you die, but only with re- Advertising Injury sured is liable because of Ii- As respects Employee Benefit Liabil- sped to duties as such "Bodily injury', "property ability imposed on a fdud- ity Coverage,SECTION II-WHO IS ary by the Employee Re- AN INSURED is deleted in its entirety have representative ur rihtand will damage" or "personal and tirement Income Security and replaced by the following: have all your rights and du- advertising injury/'. Act of 1974, as now or ties under this Coverage Dishonest, Fraudulent, hereafter amended, or by (1) If you are designated in the Dec- (b) Part. larations or Malicious Act any similar federal,state or (3) Any organization you newly ace local laws. (a) An individual,you and your quire or form,other than a pert- Damages arising out of any spouse are insureds, but nership,joint venture or limited intentional, dishonest, (h) Available Benefits only liability company,ony with respect to the con- ty n M.and over which fraudulent,criminal or mali- Any claim for benefits to the dud of a business of which you maintain ownership or ma- cious act,error or omission, extent that such benefits are you are the sole owner. jority interest, will qualify as a committed by any insured, available, with reasonable Named Insured if no other simi- including the willful or reck- effort and cooperation of the (b) A partnership or joint wen- lar insurance applies to that or- less violation of any statute. insured,from the applicable ture, you are an insured. ganization. However, coverage c Failure to Perform a Con- funds accrued or other col- Your members, your part- under this provision: (c) lectible insurance. Hers,and their spouses are tract also insureds but only with (a) Is afforded only until the ' Damages arising out of fad- (I) Taxes,Fines or Penalties respect to the condud of 180th day after you acquire or form the ure of performance of con- Taxes, fines or penalties, your business. thee d of the organization policy ipenod, tract by any insurer. including those imposed (c) A limited liability company, whichever is earlier,,and (d) Insufficiency of Funds under the Internal Revenue you are an insured. Your (b) Does not apply to any ad, Code or any similar state or members are also insureds, ( ) pPY Y Damages arising out of an local law. but only with respect to the error or omission that was insufficiency of funds to conduct of your business. committed before you ac- meet any obligations under (j) Employment-Related Your managers are inuryr- quired or formed the agani- any plan included in the Practices eds,but only with respect to zation. "employee benefit program". Any liability arising out of their duties as your manag- c. Limits of Insurance ers. (e) Inadequacy of Perform- any. As respects Employee Benefit Liabil- ance of Investment/Ad- (1) Refusal to employ; (d) An organization other than a ity Coverage,SECTION III-LIMITS vice Given With Respect partnership,joint venture or OF INSURANCE is deleted in its en- to Participation (2) Termination of em- limited liability company,you tirety and replaced by the following: ploy Any daim based upon: ment; ecutive officers" and direr- Includes copyrighted material of Insurance Includes copyrighted material of Insurance GA 233 OR 09 10 Services Office,Inc.,with its permission. Page 3 of 16 GA 233 OR 09 10 Services Office,Inc.,with its permission. Page 4 of 16 • (1) The Limits of Insurance shown in amount stated in the Della- may result in a dam surance may also Section B.Limits of Insurance, rations as applicable to To the extent possible, apply. 1. Employee Benefit Liability Each Employee.The Gmts notice should halide: Coverage and the rules below of Insurance shall not be re- d. No insured will,except fix the most we will pay regard- duced by the amount of this (1) What the act,error at that Insureds own less of the number of deducible. or omission was cost,voluntarily make a end when it or, payment, assume any (a) Insureds; (b) The deMdit1a amount coned;and obligation,or Incur any (b) Claims made or 'suits stated in the Declarations expense without our ( ) applies to all damages sus- (2) The names and consent. brought: Mined by any one 'em- addresses of any- (c) Persons or organizations plowe', including such one who may suf- (2) Item 5.Other Insurance Is de- making claims or bringing 'bmpbyee5" dependents fer damages as a leted In Its entirety and replaced "suite; and benefidades, because result of the ad, by the following: of Cons ads, errors or orals- claim Is omission.made(d) Acts,errors or omissions;or sions to which this incur- 5. Other Insurance ance applies. b. If a deice Is made or (e) Benefits Included In your you against If other valid and ble to le "suit's brought an "employee benefit program". (c) The terms of this Insurance, any Irarad,you must: insured is loss we to the Insdrrd hoc a loss we cover including those with respell (1) Immediately (2) The on B.Aggregate imi Limit shown e, to: ( ) dY re- our o this Coverage Pad, '1. Employee to Limits s of Benefit Li2nce, old the sail or esr loligalfons ere 0mted Coverage e oft odor extent Is 1) Our d and dory to "e of the dais to as blows: most wef this pay endorsement Is defend the Insured received;and date a the most we will f ay s,for errors rs dam-or against any "suits- ceased,antl a. Primary Insurance ages because of ads,errors or seeking those dam- (2) Notiy us as soon This insurance Is pro omissions negligently committed ages and as practicable. mary except when c. In the "administration" of your below apples.If this in- "empbyee benefit program". 2) Your &Mrs, and the You must see to It that surance is primary,our duties of any other In. we receive written no- obligations are not et- (3) Subject to the Emit desoibed in volved Insured, In the li(2) above, the Each Employee event of an act,error or lice as the claim or felled unless any of the mit shown In Section B.Limits omission,or clam, cable. primary.soon as pmctl- other insurance Is also of Insurance, 1. Employee ale• primary.'Then, we will Benefit liability Coverage of apply Irrespective of the sip. share with all that other ttY g c. vol and Insured must:In- this endorsement Is the most we amounn of the deducible method by the will pay for all damages amount voNed hsured must: methotl desoibetl in b. sus- tained by any one 'employee', (d) We may pay any part or all (1) Immediately send below. including damages sustained by of the deductible amount to us copies of any b. Method of Sharing such 'employee's dependents effect settlement of any demands, notices, and benefidades,as a result of: claim or'suit'and,upon no- summonses or le- If all of the other insur- e An a: error or omission;or tifiraben of the action taken, gel papers re- ante permits centribu- ( ) t' you anal promptly rein~ arrived in canner, lion by equal shares, lion with the claim we will follow this (b) A series of related ads,er- bursa us for such part of the or"suit"; method also.Under this rors or omissions, regard- deductible amount as we less of the amount of time have paid. (2) Authorize us to al- approach each Insurer that lapses between such twin records and contributes equal ads,errors or omissions, d. Additional CondMons other Information; amounts until it has negligently committed in the As respects Employee Benefit U- Cooperate with us paid Its nce or none limit of your ability Coverage, SECTION N - In the Investigatbn of insurance or none of plate°benefit" gr r 'em- COMMERCIAL UAB6.- (3) p the loss remains,of ployee benefit progrem'. or serain or of whichever canes first. low CONDITIONS is errondetl as for- the dam or de- Nowaver,the amount paid under lows: If any of the other in- this endorsement shall per- med, ex- tense against the surance does not per- ed,and will be subject to the (1) Item 2.Duties In the Event of 'suit`,and mit contribution by limits and restrictions that apply Occurrence,Offense.Claim or (4) Assist us, upon equal shares, we will to the payment of benefits in any Suit Is deleted in its entirety and our request,in the contribute by limits. plan Included In the"employee replaced by tie folowbg: enforcement of Under this method, benefit program". 2. Out/es In the Event of an any right against each insurers share Is (4) Deductible Amount Act,Error or Omission,or any person or a- based on the ratio of its ( ) Claim or Sult ganizaton which applicable limit of in- (a) Our obligation to pay dam- may be lable to suranne to the total ap- ages on behalf of the In- a. You must see to It that the insured be- pliable limits of Insur- sured applies only to the we are notified as soon cause of an ad, ance of al insurers. amount of damages In ex- as predicable of an ad, error or omission c, No Coverage cess of the deducible error or omission which to which this In- Indudes copyrighted material of Insurance Includes copyrighted material of Insurance GA 233 OR0910 SeMCes Office,Inc,with its permission. Page6 of 16 GA 233 OR 0910 Services Office,Inc,will its permission. Page 6 of 16 V ibis insuranoa shall not providing some or all of the ages are claimed and The exclusions under SECTION ' cover any loss for following benefits to 'em- to which the Insured I-COVERAGES, COVERAGE which the Insured Is en- ployeee, whether provided must submit or does A. BODILY INJURY AND titled to recovery under through a"cafeteria plan"or submit with our con- PROPERTY DAMAGE LIABIL- any other insurance in otherwise: sent; ITT.2.Exclusions,other than I. force previous to the ef- War and the Nuclear Energy fective date of this a. Group life Insurance; b. Any other alternative Liability Exclusion,are deleted Coverage Pal. group accident or dispute resolution Pro- and the following are added: health insurance; den- seeding in which such e. Additional Definitions tai,vision and hearing damages are claimed This Insurance does not apply to: In- As respects Employee Benefit LI- plans and flexible and to which the In- P spending a punts; sized submits with our (a) 'Properly damage: ability Coverage, SECTION V - provided that no one consent;or DEFINITIONS is amended as fol- other than an 'tam- 1) Assumed or in any coo- lows ployee' may subsdba C. An appeal of a civil pro- tract;or (1) The folloMng definitions are to such tenets and Oeeding. 2) Loss caused by or re- added: such benefits are made 8. 'Employee"means a person suiting from any of the generally available to actively employed. formerly following: 1. "Administration"means those'employees"who employed, on leave of er- a. Provitli information to satisfy the plan's Obi- a) Wear end bar, n9 billy regdrements; tire. or"Employee In d re- "employeeS, including tired.'EmPloyee'ntlWes a b) Rust, corrosion, their dependents and b. Profit sharing plans leased worker'.'Employee" fungus,decay,de- benefitlariea, with re- employee savings does not Include a tempo- federation, hidden sped to etigib0ry for or plans, employee stork rerY worker'. or latent defect or scope of "employee ownership plans, pen- any quality n benefit programs", sion plans and stork 2. anldlsnlentional Failure to Disclose Haz- property that subscription plans Po- causes it to darn- b. Interpreting the "am- vided that no one other SECTION IV-COMMERCIAL GENERAL age or destroy it- ployee benefit pro- than an "employee" LIABILITY CONDITIONS. 7.Represen- self grams", may subsoil=to suds tatbns is hereby amended by the add- c) Smog; e. Handing renxds in benefits and such Lion of the following connection with the benefits are made gen- d) Mechanical break- connection ema0y avertable to all Based on ow dependence upon your rep- down including "employee benefit "empbyeee who are resentations as to existing hazards,if un- ru ture or bursting grams";or �hced by �g eligible under the plan Intentionally you should fall to disdose all d. Effecting,continuing or for such benefits policy,hazards at the inception date of your trifu I force; terminating any "em- c. we will not reject solely on under ployee'S partitlpetbn c. Unemployment burr- Its Coverage Pad based solely on such e) Setnnng, or ex- in in any benefit included once, social security failure. shrinking or ex- tn the'employee bens- berets,workers'con- pension;or fit program' pensaticn and disability 3. Damage to Premises Rented to You benefits aid a. The last Subparagraph of Paragraph f) Nesting or infesta- tion,"administration' d. Vacation plans, Indud- 2. SECTION I - COVERAGES, or discharge does not include: ins buy and sell pro- COVERAGE A. -BODILY INJURY or release of waste AND PROPERTY DAMAGE. 2. U- lions, or sects, a. Handling payrol claque- grams; leave of ea birds, by insects, bons;or Bence programs, in- ABILITY Exclusions is hereby de- birds, rodents or b. The failure to effect or during military,mater- feted and replaced by the following: other animals. pity, family, and civil Exclusions C.through q.do not apply maintain any instance leave;tuition assistance (b) Loss caused directly or Ind- or adequate links of tans transportation to damage by fie,explosion, light- redly by any of the follow coverage of Insurance, and health club subsi- dug, smoke or soot to premises ing: including but not lmited dies. wtale rented to you or temporarily oe- to unemployment n- copied by Sou with permission of the 1) Earthquake, volcanic in- surance, a security (2) The following definitions are de- owner. eruption, landslide or benefits,workers'con- let= in their entirety aid re- any other earth move- pensation end disability placed by the following: D. The I-COVERAGES,provided under SEC- ment; benefits. TION I-COVERAGES,COVERAGE 21. 'Suit' means a tlW pro- A BODILY INJURY AND PROP- 2) Water that Darks up or 2. 'Cafeteria plans" means ceeding in which money ERTY DAMAGE LIABILITY applies overflows from a sewer, plan authorized by applica- damages because of an act, to'property damage arising out of drain or sump; ble law to alloy'employees' error or omission to which water damage to premises that are to elect to pay for certain this insurance apples ere both rented to w and oocpied by y . 3) Water under the ground surface pressing on,or with pre-tax dollas. aleged.'Sue Includes (1) As respects Water Damage La- flowing or seeping 3. 'Employee benefit pro- a. An arbitration proceed- gal Liability,as provided in Para- through: grams" means a program ing In With sod,dam- graph 3.b.above: Includes copyriglted material of Insurance Includes copyrighted materiel of Insrmnce GA233 OR 0910 Services OMre,Ine,with Its permission. Pagelof16 GA233 OR0910 Services Office,Inc.,with its permission. Page 8 of 16 a) Foundations one "occurrence" to which b. Care,Custody or Control Liability deductible amount as has been walls, floors or this Inman®applies. Coverage paid by us. paved srfaces; (3) The amount we will pay is limited SECTION I -COVERAGES. COV- 7. 180 Day Coverage for Newly Formed or b) Basements, as desabed in Section B.Lim- ERAGE A BODILY INJURY AND Acquired Organizations whether paved or Its of Insurance,3.Damage to PROPERTY DAMAGE LIABILITY,2. not or Premises Rented to You of this Exclusions,J.Damage to Property, SECTION II-WHO IS AN INSURED is c) Doors,windows or endorsement. Subparagraphs(3),(4)and(5)do not amended as follows other Doors,wrongs 4. Supplementary Payments apply to 'property damage" to the Subparagraph a. of Paragraph 4. is p property of others described therein. hereby deleted and replaced by the fol- (e) Loss caused by or resulting Under SECTION I-COVERAGE. SUP- With respell to the insurance provided by lowing: fran water that leaks or PLEMENTARY PAYMENTS - COVER- this sedbn of the endorsement,the Id- flows Iran plumbing, heat- AGES AAND @ a. Insurance under this 180th day Is ter Ink. air conditioning,or fire lowing additional provisions apply: forded only until the 780th day after protection systems caused a. Paragraph 2.is replaced by the fd- a. The Limits of Insurance shown In the you acquire or form the organization by or resulting from freezing, lowing: Declarations are replaced by the lien- or the end of the policy period, unless: its designated in Section B.Limits of whichever is earlier; Up it Na nsu shown.e Ball on BoB.nds Insurance. 6. Voluntary 1) You del your best to Limits of Insurance,b.a.Ball Bonds ry Custody 8. Walvero/SUbroga0on maintain heat in the of this endorsement for and of bat Control L hgl C Coverage of or building or structure;a' bonds required because of eaddents Liability Coverage of this SECTION IV-COMMERCIAL GENERAL or traffic law violations arising out of endorsement with rasped to cover- LIABILITY CONDITIONS.9.Transfer of 2) You drained the equip-. the use of any vehicle to whdi the age provided by this endorsemenL Rights of Recovery Against Others to ment and shut off the Bodily Injury Uabdey Coverage ap- These limits are inclusive of and not Us is hereby amended by the addition of water supply if the heat pies We do rot have to furnish in ndtlition to the limits being re- the ltllowing: was not maintained. these bonds. placed. The Limits of Insurance shown In Section B.Limits of Insur- We waive any right of recovery we may (d) Loss to or damage to: b. Paragraph 4.Is replaced by the id- ante, 6.Voluntary Property Dam- have because of payments we make for 1 Plumbing, heating, air lowing: age and Cam,Custody or Control injury or damage arising out of your sego- g. Liability Coverage of this endorse- ing operations or'your work"dale under conditioning, fire pro- All reasonable expenses Named by ment fa the most we will pay in any a written centred requiring sudn waiver tedlon systems, or the Insured at arr request to assist us one "acosrence'regardless of the with that person or organization and in- other equipment or ap- in the Investigation or defense of the number of chided in the'products-completed opera pliances;or claim or'stir,including actual loss of lions haired'. However, cur rights may 2) The Interior of any earnings up to the knit shown in Sec- (1) Insureds; only be waived prior to the'occurrence" ny lion B. Limits of Insurance, 4.b. giving rise to the injury or damage for bullring or structure,or Loss of Earnings of this endorsement (2) Claims made or'suits'brought which we make payment under this Coy- to personal properly In per day because of time off from or the bullring or structure p erage Part.The insured must.do nothing r re caused by or resulting waif. (1) Persons or ingenireeore making alter loss i s to red icurng'suiAootars- from rain, mow, sleet 5. Medical Payments claims or tlingirg'sultY. quest,the ensured wl06dng'suir'or trorce far those rights to us and help us enforce or ice, whether driven The Medical F�yense Limit of Any One b. Deductible Clause those rights. by ulna or not Person as staled in the Declarations Is e. Limit of Insurance amended to the knit shown In Sedan B. (1) on Our o'behaf tppaynamo the e. fled Relainshipional Insuretl-Speci- Limits of Insurance, 5. Medical P amour eofhaamages oforfothe fled Relationships The Damage to Premises Rented to meets of this endorsement. amount of damages in each You Limit as shown in the Dedara of the drraa'tible Brain excess a. The following is hereby added to Lions is amended as follows 6. Voluntary Property Damage and Care, of the deductible amount dated SECTION II-WHO IS AN INSURED. (2) Paragraph 6. of SECTION III- Custody or Control Liability Coverage m Section B.Limits of Insur- Custody (1) Any person or organization de- ante, 6. Voluntary Property sated in Paragraph 8.e.(2)be- LIMITS OF INSURANCE is a. Voluntary Property Damage Coy Damage and Care.Custody or low (hereinafter referred to as hereby deleted and replaced by erage Control Liability Coverage of additional insured)whom you are the fdlowing: We WO for a damage"to this endorsement The limits of required to add as an additional pay 'TteP M g Insurance will not be reduced by 6. Subject to 5. above, the property of others arising all of cp- insured under this Coverage Part the amount. of such deduct- by reason of Damage Yto ou Pit is the orations when: to the Insured's we amount. y Rented wto e Vou Limit u the business when: Co COVERAGE A will pay under (2) of Occur 2.Duties Os In the Event (a) A written contract or agree INJURY GE A BODILY (1) Damage Is caused by the in- of Occurrence,Offense,Claim ment;a' INJURY AND PROPERTY saes;or or Sult,applies to each claim or (b) An oral agreement or can- DAMAGE LIABIUTV, roc (2) Damage oars wide In the Iry "suit irrespective of the amount. tract where a certificate of • damages because of'prop- sured's possession. insurance showing that per- arty damage' to premises (3) We may pay or all of the son or organization as an while rented to you or tern- With your coned, we wit make deductible amount i effect set- attritional insured has been poranly asupied by you these payments regardless offaulL Dement of any claim or "suit' issued • and. with permission of the upon notification of o- the s owner, arising out of any lion taken,you shall promptly re- is an Insured,provided: imburse us for such part of the Includes mpyrigited material of Insurance Includes copyrigned material of insurance GA233 OR 0910 Services Office,inn,with its permission. Page 9 of 16 GA233 OR0910 Services Office,Inc.,with its permission. Page 10 of 16 C. (a) The written or oral contract or use of equipment leased e) Any failure to Part with respect or agreement is: to you by such person(s)or make such inspec- to such products. Currently in effect or organizations(s). However, tions,adjustments, 1) y this insurance does not ap- tests or servicing (d) Any state or political subdi- becomes effective dur- ply to any "occurrence" as the vendor has vision with which you have ing the policy period; which takes place after the agreed to make or agreed per Paragraph and equipment lease expires. normally under- 9.a.(1)above to provide in- 2) Executed prior to an c Any person or organization takes to make in surance,subject to the fd- "occumence"or offense an ( ) y p g the usual course of lowing additional provision: (referred to below as wen- business, in con- to which this insurance dor) with whom you have This insurance applies only • would apply;and dectibn with the agreed per Paragraph with respect to the following b They are not specifically ( ) provide distribution or sale 9.a.1 above to ovide in- hazards for which the state ( ) y dp y of the products; surance, but only with re- or political subdivision has named as r additional in- b sired under any other pro- sped to "bodily injury" or f) Demonstration, in- issued a permit in connec- vision of, or endorsement "property damage" arising stallation,servicng Lion with premises you own, added to, this Coverage out of your products"which or repair opera- rent or control and to which Part, are distributed or sold in the Lions,except such this insurance applies: regular course of the ven- operations per- 1) The existence, mainte- (2) Only the following persons or or- dor's business, subject to formed at the yen- Hance,repair,construc- ganizations are additional insur- the following additional ex- dor's premises in lion, erection, or re- eds under this endorsement,and clusions: connection with moval of advertising insurance coverage provided to the sale of the such additional insureds is lim- 1) The insurance afforded product; signs, awnings, cano- ited as provided herein: the vendor does not pies, cellar entrances, apply to: g) Products which, coal holes, driveways, (a) The manager or lessor of a after distribution or manholes, marquees, premises leased to you with a) "Bodily injury" or sale by you, have hoist away openings, whom you have agreed per "property damage" been labeled or re- sidewalk vaults, street Paragraph 9.a.(1)above to for which the wen- labeled or used as banners,or decorations provide insurance, but only dor is obligated to a container,part or and similar exposures; with respect to liability aris- pay damages by ingredient of any or Mg out of the ownership, reason of the as- other thing or sub- maintenance or use of that sumption of liability stance by or for 2) The construction,ereo- part of a premises leased to in a contract or the vendor;or lion,or removal of ele- you,subject to the following agreement. This vators;or additional exclusions: exclusion does not h) 'Bodily injury" or apply to liability for "property damage" 3) The ownership, main- This insurance does not ap- damages that the arising out of the tenance,or use of any ply to: vendor would have negligence,acts or elevators covered by 1) Any"occurrence"which in the absence of omissions of the this insurance. y the contract or vendor, its em- (e) Any state or political subdi- takes place after you agreement; (e) visa state or political shade cease to be a tenant in g else acting or anyone vision with which you have that premises. b) Any express war- else acting on its agreed per Paragraph ranty unauthorized behalf. 9.a.(1)above to provide in- g Structural alterations, surance,subject to the fd- new construction or by you; 2) This insurance does not lowing provisions: apply to any insured demolition operations c) Any physical or person or organization: 1) This insurance applies performed by or on be- chemical change half of such additional in the product a) From whom you only with respect to op- insured, made intentionally have acquired erations performed by b Any person or organization by the vendor; such products, or for which your behalf or (b) y P g any ingredient, from which you lease d) Repackaging, ex- part or container, political subdivision has equipment with whom you kept when un- issued a permit. ac- have agreed per Paragraph packed solely for entering into, ao- 9.a.(1)above to provide in- the purpose of in- companying such 2) This insurance does not surance.Such person(s)or spection, demon- croducsg suds "property rt "bodily ie" o organizatim(s)are insureds, stration,testing,or products;or "property damage" or but only to the extent that the substitution of b) When liability in- "personal and advertis- the liability for"bodily injury", parts under in- eluded withn the e ing injury"arising out of operations performed"property damage" or"per- structions from the "products- for the state or political sonal and advertising injury" manufacturer, and completed opera- subdivision. is caused by your negli- then repackaged Lions hazard" has gence,acts or omissions in in the original con- been excluded un- (f) For "your work" performed • the maintenance, operation tamer; der this Coverage in Oregon, any person or Includes copyrighted material of Insurance Includes copyrighted material of Insurance GA 233 OR 09 10 Services Office,Inc.,with its permission. Page 11 of 16 GA 233 OR 09 10 Services Office,Inc.,with its permission. Page 12 of 16 organization with which you (a) Subparagraphs (e', (I)and Wtecdael or engi- primary to other insurance have agreed per Paragraph (g)do not apply to bodily in- neering activities available to the additional 9.a.(1)above to provide In- juy or'property damage' insured except: seance,but only to the ex- included within the 'prod- 3) Professional services tent that the liability is udscenryleted operations do not Indude services 1) As otherwise provided cased by'your work°per- herd: within mnstrudbn In SECTION IV - formed for that additional in- means, methods,tech- COMMERCIAL GEN- sured and only to the extent (b) Subparagraphs(a),(4(e) niques,sequences and ERAL LIABILITY that such liability Is caused and(g)do not apply to-bon- procedures employed CONDITIONS. 5. by your negligence or the ily Injury, 'property dam- by you In cornedbn Other Insurance, b. negligence of those acting age" or"personal and ad- with censtruc0on work Excess Insurance;or on your behalf.A person or vertlsing Injury arising out you perform. organization's status as an of the see negligence or 2) For any other valid and Insured under this provision willful mismndtid of the ad- (d) Subparagraphs (1) and (g) collectible insurance of this endorsement rants- ditibnal Insured or its'em- do not apply to'bodily In- available to the addd- ues for only the period of hawse;or jury or'properly damage" tionel insured esanad- time requtretl by the wrilien easing out of yourwort°for ditional inmred by at- time or required by the but (c) Subparagraph(f)and(g)do which a consolidated(wrap- taehment of an en- contract apply to'bodily injury, up) Insurance program has dorsement to another In no event berand the expt- 'property damage"or'per- been provided by the prime insurance policy that Is ration date of this Coverage sonar and advertising injury' contractor/project manager written on an excess Part. If there is no written arising out ot or oozier of the mnstrudion basis.In such case,the contract or agreement,or If project in which you are In- coverage provided un- no period of time is required 1) The rendering of, or vdved. der this endorsement by the written contrail or failure to render, any shall also be excess. agreement,a person or or- professional services b. Only with regard to Insurance pro- geNZaton's status as an in- by yon or on your be- vided to an additional Insured desig- (2) Condi0on 11.Conformance to shred under this endorse- half, but only with re- noted under Paragraph 9.a(2)Sub- Specific Written Contract or ment ends when your op- sped to either or both paragraphs(I)and(g)above,SEC- Agreement Is hereby added: eratlors for that insured are of the following opera- TION III-LI TS OF INSURANCE is completed tens: amended to Include: 11. Conformance to Specific pecific Written Contract or (g) For your work"performed a) Providing ergo The limits applicade to the additional Agreement in the "coverage territory neering, Bradlee- insured are those specified in the but not in Oregon,any per- tural or surveying written contract or agreement or In a. With respect to addi- son or organization with services to others; the Declarations of this Coverage tional insureds de- which you have agreed per and Part,whichever are less.If no limits sated in Paragraph Paragraph 9.a(1)above to are spedtad In the written contact or 9.a(2)(0 above only: provide Insurance, tot only b) Providing,or hiring agreement, or if there is no written with respect to liability arts- Independent pro- contract or agreement,the limits ep- If a written contract or ing out of your work-per- fessionals to pro- plirable to the additional insured are agreement between formed for that additional in- vide, engineering, those specified in the Declarations of you and the additional sired by you or on your be- architectural or this Coverage Part.The limits of In- Insured specifies that half.A person or organize- surveying services trance are inclusive of and not in coverage for the add- fon's stairs as an Insured In connection with addition to the limits of insurance tional insured: under this provision of this construction work shown in the Declarations. endorsement continues for you perform (1) Be provided by the Ser- ony the period of time m- e. SECTION IV-COMMERCIAL GEN- ERAL Insurance ad quire0 by the written rah- 2) Subjedm Paragraph 3) LIABILITY CONDITIONS is tract or agreement,but in no below, professional hereby amended as follows: number CG 3261 event beyond the expiration services Include: y (1) amended to 5.Other Is 32 32 62 or CG date of this Coverage contract Pact a) ag, or approv- amended to Include: 3263:or If gre is no agreement,o0Ifn centred ire, re f or to of time Is re required by y the prepare maps, ap- (a) centre required by a written (2) Include coverage o or of time is freci e r agree-the prove,maps,shop unbar or agreement, / r for ohs or completed op- written person or agree- ions,drawings, zips- noncontributory Is primary as and pests 'nettle coverage a person or insured ions, repddo, errs, anycother Inry as respecly (3) 'nettle cork, unde status as d issued change field or orders,or any issued for Insurance policy for your wolf; endsr this ur oprsement dr win oroers, d si d, to the such other b- ends at insured operations drawings and sued, and sudr other ex- and where the provided to or for that insured ere mrrF specifications;and cans /or shall be tit- the additional{alIndetl is plated. sass end/or oonclsriwd- the more restrictive Insured than is (3) insurance b) Supervnora or es this whichever applies,with wore rpecictive Nr- ( ) airy provided detl designated an perform activities Apart this hsuance was specifically re- und real insured 2esignamd of any rel as part co contract in that a written under Paragraph 9.a.(2): of any related err- (b) Any insurance m nto shall by this endorsement shall be conked or agreement, Na terms of Pare- Includes copyrighted material of Insurance Includes mpyrigited material of Insurance GA 233 OR 0910 Services Office,Inc,with its permission. Page 13 of 16 GA 233 OR 0910 Services Office,Inc.,with its permission. Page 14 of 16 • • 1 • • graphs 9.a.(3Xa)or 9.b. agreement specifies (2) Deductible Clause a. Nurses; above,or any combina- the Insurance Services tion thereof,shall be in- Office additional in- (a) Our obligation to pay dam- b. Emergency Medical Technicians;or terpreted as providing sured form number CG ages on your behalf applies the limits or coverage 20 10 but does not only to the amount of dam- c. Paramedics, required by the terms of specify which edition,or ages for each"occurrence" in the jurisdiction where an"occurrence" the written contract or spedfies an edition that which are in excess of the or offense to which this insurance applies agreement, but only to Deductible amount stated in takes place. does not exist, Para- Section B.Limits of Insur- its extent such that udr lim- graphs 9.a.3.b. and its or coverage is in- 9.b. of this endorse- ance. 11. of this endorse- 13. Broadened Notice of Occurrence eluded within the terms ment shall not apply ment. The limits of insur- of the Coverage Part to and Paragraph ance will not be reduced by Paragraph a. of Condition 2. Duties In which this endorsement 9.a.(3Xa) of this en- the application of such De- the Event of Occurrence, Offense, is attached. tlorsement shall apply. dudible amount. Claim or Suit(SECTION IV-COMMER- CIAL GENERAL LIABILITY CONDI- b. With respect to addi- 10. Broadened Contractual Liability-Work (b) Condition 2. Duties in the TIONS)is hereby deleted and replaced by tional insureds de- Within 50'of Railroad Property Event of Occurrence, Of- the following: scribed in Paragraph tense, Claim or Suit, ap- 9.a.(2xg)above only: It is hereby agreed that Paragraph f.(1)of plies to each daim or"suit" a. You must see to it that we are notified Definition 12. "Insured contrail" (SEC- irrespective of the amount. as soon as practicable of an"occur- If a written contract or TION V-DEFINITIONS)is deleted. rence"or an offense which may result agreement between (c) We may pay any part or all in a claim.To the extent possible,no- you and the additional 11. Property Damage to Borrowed Equip- of the deductible amount to lice should include: insured specifies that went effect settlement of any , coverage for the addi- claim or"suit"and,upon no- (1) How,when and where the"oc- coverage The following is hereby added to Ex- tificaticrm of the action taken, currence"or offense took place; tional insured: elusion J. Damage to Property of Paragraph you shall f promptly rf the a. Be provided by the a9 P 2., Exclusions of SEC- burse us for such part of the (2) The names and addresses of • Insurance Ser- TION I-COVERAGES,COVERAGE deductible amount as has any injured persons and wit- vices Office addi- A. BODILY INJURY AND PROP- been paid by us. messes;and tional insured form ERTY DAMAGE LIABILITY: number CG 20 10 12. Employees as Insureds - Specified (3) The nature and location of any or CG 20 37 Paragraphs(3)and(4)of this exdu- injury or damage arising out of Health Care Services sion do not apply to tools or equip- the"occurrence"or offense. (where edition ment loaned to you,provided they are It is hereby agreed that Paragraph specified);or This requirement applies only when not being used to perform operations 2.a.(1xd)of SECTION II-WHO IS AN b. Include coverage at the time of loss. INSURED, does not apply to your"em- the"occurrence"or offense is known to s'who provide professional health to an"authorized representative". for completed op- p Yee Pr P orations;or b. With respect to the insurance pro- care services on your behalf as duly li- vided by this section of the endorse- tensed: c. Include coverage went, the following additional provi- for"your work; sions apply • and where the limits or (1) The Limits of insurance shown in coverage provided to the Declarations are replaced by the additional insured is the limits designated in Section more restrictive than B. Limits of Insurance, 11.of was specifically re- this endorsement with respect to quired in that written coverage provided by this en- contract or agreement, dorsement.These limits are in- the terms of Para- elusive of and not in addition to graphs 9.a.(3Xa), the limits being replaced. The 9.a.(3Xb)or 9.b.above, Limits of Insurance shown in or any combination Section B.Limits of Insurance, thereof, shall be inter- 11.of this endorsement its the protect as providing the most we will pay in any one"oc- limits or coverage re- currence" regardless of the quired by the terms of number of: the written contract or (a) Insureds; agreement, but only to the extent that such lim- (b) Claims made or "suits" its or coverage is in- brought;or eluded within the terms of the Coverage Part to (c) Persons or organizations which this endorsement making claims or bring is attached.If,however, 'suits". the written contract or Includes copyrighted material of Insurance Includes copyrighted material of Insurance GA 233 OR 09 10 Services Office,Inc.,with its permission. Page 15 of 16 GA 233 OR 09 10 Services Office,Inc.,with its permission. Page 16 of 16 MI Purchase Order ,r W41 Fiscal Year 2019 Page: 1 of: 1 - =IOCUh7fEN B City of Ashland _ _ ______—=- I ATTN: Accounts Payable Purchase L AshlandaiOR 97520 Order# 20190213 T Phone: 541/552-2010 O Email: payable @ashland.or.us V H C/O Public Works Department E PACIFIC ELECTRICAL CONTRACTORS, INC I 51 Winburn Way N 920 S GRAPE STREET p Ashland, OR 97520 D MEDFORD, OR 97501 Phone: 541/488-5347 R T Fax: 541/488-6006 R O —1.1g[...=ug .orniii=1.1 '�=1,[= F_A0 a;7.1.1.7 z_Ia[e!i-:dii.ht-EITIO;I=10! e ilvt_1L.,A°i=ie=1_'=1s1 =- 541 773-7751 Paula Brown —Q(-7K—Jp-1g-B. .v t61dc-cei°I_ =@11n-st.t_1_1511e-7v-k =t=15_['1= -1 'i lag--1 28} ._r=F=�6 Bg1-16 p44=- -i[v1g-_ - _ 09/10/2018 489 FOB ASHLAND OR Cit Accounts Pa able �ia=3ia:i-A �=��= ����ja CeT __ �- tea= -giSl.!=F s�i-4UiC _ - 491zritE[ aM4iCk:,= On-call Instrumentation 1 On-call instrumentation and control integration services as 1 $25,000.0000 $25,000.00 necessary for water distribution and treatment. Personal Services Agreement ($25,000 or less) Completion date: 06/30/2018 (Typo on contract?) Project Account: Project Account: ............... GL SUMMARY ............... 081900-604100 $12,500.00 I I i J By. 1"� Date: i 1 L 1 ( l�` Authorized g ature tai. ___ $25,000.00 1 e /, 17( � FORM #3 CITY OF A request for a Purchase p r f ASHLAND e (7 ( 9 (9 , .- ( _J';'..e REQUISITION � Date of request: 08/23/2018 Vendor Name Pacific Electrical Contractors Address,City,State,Zip 920 South Grape Street Medford, Oregon 97501 Contact Name Eric Summers Telephone Number 541-773-7751 Email address SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Emergency ❑ Reason for exemption: ❑ Invitation to Bid (Copies on file) ❑ Form#13,Written findings and Authorization ❑ AMC 2.50 Date approved by Council: ❑ Written quote or proposal attached ❑ Written quote or proposal attached (Attach copy of council communication) (If council approval required,attach copy of CC) ❑ Small Procurement Cooperative Procurement Less than$5,000 ❑ Request for Proposal (Copies on file) ❑ State of Oregon ❑ Direct Award Date approved by Council: Contract# ❑ Verbal/Written quote(s)or proposal(s) —(Attach copy of council communication) ❑ State of Washington Intermediate Procurement ❑ Sole Source Contract# GOODS&SERVICES ❑ Applicable Form(#5,6,7 or 8) ❑ Other government agency contract $5,000 to$100,000 ❑ Written quote or proposal attached Agency ❑ (3)Written quotes and solicitation attached ❑ Form#4, Personal Services$5K to$75K Contract# PERSONAL SERVICES ❑ Special Procurement Intergovernmental Agreement $5,000 to$75,000 ❑ Form#9,Request for Approval ❑ Agency 12 Less than$35,000,by direct appointment ❑ Written quote or proposal attached Date original contract approved by Council: ae) t ❑ (3)Written proposals/written solicitation Date approved by Council: _(Attach copy of council communication) El Form#4, Personal Services$5K to$75K Valid until: (Date) Description of SERVICES Total Cost Instrumentation and control integration services as necessary for water distribution and treatment. $ 25,000.00 Item # Quantity Unit Description of MATERIALS Unit Price Total Cost ❑ Per attached quote/proposal TOTAL COST Expenditure must be charged to the appropriate account numbers for the financials to reflect the actual expenditures accurately. Project Number - _ — Account Number 081800 - 604100 $ 12500.00 - _ — Project Number -— _ — Account Number 081900 - 604100 $ 12500.00 — — - Project Number -_ — — Account Number - $_,_ _ _,_ _ _•_ _ IT Director in collaboration with department to approve all hardware and software purchases: By signing this requisition form,I certify that the thheCity's public contracting requirements have been satisfied. / IT Director Date Support-Yes/No p y VO C p ✓ 2.1(AO, Em to ee: Department Head: / (E / too reater than$000) Department Manager/Supervisor: City Administrator: v (Equal to or r I rthan$25,000) Funds appropriated for current fiscal year: NO C B)z e 1 l g nance Dire,,!Equal to or greater than$5,000) Date Comments: Form#3-Requisition CITY OF ASHLAND FORM #4 DETERMINATIONS TO PROCURE PERSONAL SERVICES $5,000 to $75,000 To: Kelly Madding, Public Contracting Officer From: Paula Brown-Director of Public Works Date: August 23, 2018 Re: DETERMINATIONS TO PROCURE PERSONAL SERVICES In accordance with AMC 2.50.120(A), for personal services contracts greater than $5,000, but less than $75,000, the Department Head shall make findings that City personnel are not available to perform the services, and that the City does not have the personnel or resources to perform the services required under the proposed contract. However, the City Attorney, the Public Contracting Officer, or Local Contract Review Board, can require a formal solicitation for bids to ensure that the purposes of this chapter are upheld. Background The Department of Public Works intent is to contract with a private consultant for the instrumentation and control integration services as necessary for water treatment and distribution. The scope of work for this project dictates that these services are to be requested on an as-needed basis. The work is expected to take place in fiscal year 2018 and 2019 with a not to exceed budget amount of $25,000.00. The amount appropriated in the current Council approved budget to perform this work is $100,000.00. Pursuant to AMC 2.50.120(A), has a reasonable inquiry been conducted as to the availability of City personnel to perform the services, and that the City does not have the personnel and resources to perform the services required under the proposed contract? The City of Ashland Engineering Division does not have the adequate staff or resources to provide the scope of service contemplated under this contract. In addition, no other Department in the City has the resources or technical knowledge to complete the work associated with this personal services contract. Form#4-Department Head Determinations to Procure Personal Services, Page 1 of 1,8/23/2018 1