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HomeMy WebLinkAbout2019-120 20190438 Pacific Electrical Contractors • PERSONAL SERVICES AGREEMENT ($25,000.00 or less) CONSULTANT: Pacific Electrical Contractors CITY OF CONSULTANT'S CONTACT: Eric Summers �S H LAN D 20 East Main Street ADDRESS: 920 South Grape Street Ashland,Oregon 97520 Medford, OR 97501 Telephone: 541-488-5587 Fax: 541-488-5311 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 ("hereinafter "Consultant"), for Thinmanager and development. 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, 2019. 2. Scope of Work: Consultant shall provide Thinmanager and development, as more fully set forth in Consultant's Budget dated 02/20/2019 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$11,208.00 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$11,208.00 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. 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 Page 1 of 6: Personal Services Agreement with Pacific Electrical Contractors • 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 maybe 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 $1,000,000 (one 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.I 10. 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: Nromh • stug.Aar--- Signature Si; . , re P444 c.¢ c J J .rs Printed Name Pri wed Name I,Gc/ ,O/ VP Title Title 6 f -+2 so i 9 3/6/2019 Date Date (W-9 is to be submitted with this signed Agreement) ? ,)0 ( Page 6 of 6: Personal Services Agreement with Pacific Electrical Contractors I I i i f I Exhibit A • PACIFIC SYSTEMS ELECTRICAL CONTRACTORS I� VV A DIVISION OF I'ACIrIC ELECTRICAL CONTRACTORS • BUDGET TO: City of Ashland ATTN: Steve Burkhalter JOB NAME: Ashland Thinmanager software and development. JOB LOCATION: Ashland, Oregon. Pacific Electrical Contractors, Inc. along with ORPAC Systems,propose to furnish labor,and programming for the work described during a walk through with Steve Burkhalter.This proposal covers the work that was described,and detailed,dated 20 February 2019, and includes the following: THINMANAGER AND DEVELOPEMENT -Pricing to include Thinmanager licensing for 5 terminals, 1 yr platform maintenance,setup of Thinmanager software on existing Smart Glance server, software development for viewing of existing Wonderware SCADA application, installation and setup of WinTMC on (1)local workstation for SCADA viewing, required terminal development, and testing. In addition,(4)terminals will be available to be used for remote SCADA locations,or future Ethernet camera inputs. Price to be budgetary and handled on a time and material basis. Total Material: $7,008 Total Labor: $4,200 Total: $11,208 EXCLUSIONS:Premium time. 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'tees and costs incurred whether or not litigation is tiled;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 20 Feb 19 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. wale. $15.12 per hour, effective June 30, 2018. 1/1111 June 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 $21,127.46. part-time employees, the Ashland if the contract Living Wage does not apply exceeds$21,127.46 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. INotice 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. gA�I' il:.!_ Consul!. is ;TA 3/6/2019 Date Accuzo® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 3/6/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. -THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Kim Schnetzky Ward Insurance Agency Inc. PHONE FAX PO Box 10167 (A/C.No.EMI:541-687-1117 (NC.No):541-342-8280 Eugene OR 97440 ADDRESS: kim @wardinsurance.net INSURER(S)AFFORDING COVERAGE NAIC q 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:986992228 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 W ADDLSUBR POLICY EFF POLICY EXP LIMITS LTR INSD VD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY Y Y EPP 0488739 7/1/2018 7/1/2019 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE © 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 NEC LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: Limited Pollution $1,000,000 A AUTOMOBILE LIABILITY Y Y EBA 0488739 7/112018 7/1/2019 CO MaBwlernSINGLE LIMIT $1,000,000 X ANY AUTO BODILY INJURY(Per 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 UMBRELLA LIAB X OCCUR Y Y EPP 0488739 7/1/2018 7/1/2019 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED RETENTIONS $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUOED7 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Installation Floater EPP 0488739 7/1/2018 7/1/2019 Limit$500,000 Ded:$1,000 B Professional Liability C2088371577 7/1/2018 7/1/2019 Limit:$2.000000 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,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 East Main Street AUTHORIZED REPRESENTATIVE Ashland OR 97520 .fo- ©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 ® is not a covered'auto'. days after such date; CinciPlus E. Audio, Visual and Data Electronic Equip" b. Does not apply to 'bodily injury' or BUSINESS AUTO XC+® ment 'property damage'resulting from an SECTION III - PHYSICAL DAMAGE COV• 'accident' that occurred before you (EXPANDED COVERAGE PLUS) ERAGE, C. Limit of Insurance is amended acquired or formed the organization; ENDORSEMENT by adding the following: c. Does not apply to any newly acquired 4. 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 'acci- any other automobile liability policy, BUSINESS AUTO COVERAGE FORM dent'is the lesser of: or would be an Insured under such a a. The actual cash value of the dam- policy but for the termination of such aged or stolen property as of the time policy or the exhaustion of such poli- With respect to the coverage provided by this endorsement,the provisions of the Coverage Form apply unless of ihe'accldent`, cys limits of Insurance. modified by this endorsement. 3. Any of your 'employees' while using a b. The cost of repairing or replacing the covered "auto' in your business or your damaged or stolen property with oth- A Blanket Waiver of Subrogation This provision does not apply unless the valid er property of Gke kind and quality,or personal affairs,provided you do not own, SECTION IV - BUSINESS AUTO CONDI• written contract has been: hire or borrow that'auto'. 4 $2,500. 'IONS,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. Permanently 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. for bail Replacing the$2,000 Limit 0 I 2)insurance of a covered'auto'when you have assumed 1. Changes In Liability Coverage the Installation of such equipment; for bail bonds with$4,000 In(2):and liability for such 'bodily Injury or "property 2. Replacing the$250 Limit of insurance for damage°under an °insured contract',provid- The following is added to the Section II- 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 2.a.above;or H. Amended Fellow Employee Exclusion cured contract". An 'employee' of yours is an 'insured' c. An Integral part of such equipment. SECTION II•LIABILITY 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 under a contract or agreement in that follows: SECTION IV - BUSINESS AUTO CONDI- 'employee's'name,with your permission, SECTION II • LIABILITY COVERAGE, A. Exclusion S.Fellow Employee is deleted. TIONS,B.General Conditions,5.Other In- while performing duties related to the Coverage,1.Who Is an Insured Is amended surance c.is replaced by the following: conduct of your business. by adding the following: I. 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 Coverage,then Comprehensive and Collision Form's Liability Coverage is primary SECTION IV-BUSINESS AUTO CON- 1. Any subsidiary which is a legally incorpo- Physical Damage Coverages as provided un- and we will not seek contribution DITIONS, 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 replan- interest of more than 50% of the voting COVERAGE of this Coverage Part are ex- bility assumed under an 'insured ing Paragraph S.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 b. For Hired Auto Physical Damage age form. lowing: assumed on a primary noncontributo- Coverage the following are deemed However, the insurance afforded by this ry y 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- (1) Any covered 'auto' you lease, tomobile liability policy, value or cost to repair or deductible. which- SEC ION II - LIABILITY COVERAGE, A hire,rent or borrow;and cry, or would be an ever is the least,minus a deductible. Coveage,I.Who Is an Insured is amended °Insured'under such policy but for termi- 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 nation 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" written contract to provide insurance as is af- a contract in that individual'em- 2. Any organization that is newly acquired or for that coverage,or$1,00D,whichever is forded by this policy. ployee's' name,with your per- less. y D y mission,while performing duties formed maby jority you and over which insurance you ranin- This provision is limited to the scope of the related to the conduct of your pain provided by swprorship. The in 3. Hired Auto over any of Damage coverage insur- valid valid written contract. business. provided by lNs provision: is excess over any other collectible insur- ance. Includes copyrighted material of ISO 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 will provide cover- by adding the following, but only for the age equal to the broadest coverage appli- SECTION III - PHYSICAL DAMAGE COV- purposes of this Loan or Lease Gap SECTION IV - BUSINESS AUTO CONDI- cable to any covered "auto"you own in- ERAGE, A. Coverage, 4. Coverage Exten- Coverage: TIONS,B. General Conditions,2. Conceal- sured under this policy. sions is amended by replacing $20 per day ment, Misrepresentation or Fraud is with $50 per day, and $600 maximum with "Total loss" means a "loss" in which the amended by adding the following: Coverage includes loss of use of that hired au- $1,500 maximum in Extension a. Transpor- cost of repairs plus the salvage value ex- to, provided it results from an "accident" for tation Expenses. ceeds the actual cash value. However,if you unintentionally fail to disclose which you are legally liable and as a result of any hazards existing on the effective date of which 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 age under this Coverage Form because of pay for any one"accident"is$3,000. SECTION .II - PHYSICAL 3.a. is amended by DAMAGE CO SECTION III - PHYSICAL DAMAGE COV- such failure. ERAGE, B. Exclusions,3.a. s amended by ERAGE,D.Deductible is amended by adding If a limit for Hired Auto-Physical Damage is adding the following: i the following: Q. Mental Anguish Resulting from Bodily Inju- 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 inju- cated above. apply to the accidental discharge of an airbag. rather than replaced. Ty" is deleted in its entirety and replaced by J. Rental Reimbursement This coverage for airbags is excess over any the following: other collectible insurance or warranty. O. Duties in the Event of an Accident,Claim, SECTION III - 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 disease sustained by a person,including men- tal IV - BUSINESS AUTO CONDI- tal anguish and death sustained by the same 1. We will pay for rental reimbursement ex- 1. SECTION III - PHYSICAL DAMAGE TIONS,A.Loss Conditions,2.Duties in the p y person that results from such bodily injury, of i i COVERAGE, C. Limit o Insurance is Event of Accident,Claim,Suit or Loss,a.is penses incurred by you for the rental of sickness or disease. "Bodily injury" does not an"auto"because of a"loss"to a covered deleted in its entirety and replaced by the amended by adding the following: include mental anguish or death that does not "auto".Payment applies in addition to the following, but only for private passenger result from bodily injury,sickness or disease. otherwise applicable amount of each cov- type"autos'with an original loan or lease. This condition applies only when the "acci_ Y dent"or"loss"is known to: erage you have on a covered "auto". No and only in the event of a "total loss"to R. Coverage for Certain Operations in Con- deductible applies to this coverage. such a private passenger type"auto': 1. You,if you are an individual; nection with Railroads 2. We will pay only for those expenses in- a. The most we will pay for"loss"in any 2. A partner,if you are a partnership; With respect to the use of a covered"auto"in curred during the policy period beginning one"accident"is the greater of: operations for or affecting a railroad: 24 hours after the"loss" and ending, re- (1) 3. An executive officer or insurance manag- The amount due under the terms 1. Section V-Definitions,H."Insured con- gardless of the policy's expiration, with er,if you are a corporation;or of the lease or loan to which 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 lirn- days: type"auto"is subject,but will not ited liability 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 ments; 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 mileage, excessive use or b. 30 days. abnormal wear and tear; I 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- curred;or ties, Credit Life Insurance, b. $50 per day. Health, Accident or Disabil- ity Insurance purchased 4. This coverage does not apply while there with the loan or lease;and are spare or reserve"autos" available to you for your operations. (e) Carry-over balances from previous loans or leases,or 5. We will pay under this coverage only that amount of your rental reimbursement ex- (2) Actual cash value of the stolen penses which is not already provided for or damaged property. under SECTION III - PHYSICAL DAM- b. An adjustment for depreciation and AGE COVERAGE, A. Coverage, 4. physical condition will be made in de- Coverage Extensions. termining actual cash value at the time of"loss". Includes copyrighted material of ISO Includes copyrighted material of ISO AA 288 01 16 Properties,Inc.,with its permission. Page 3 of 4 1 AA 288 01 16 Properties,Inc.,with its permission. Page 4 of 4 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ R CAREFULLY. 6. Voluntary Property Damage(Coverage a.)and Care,Custody or Control Liability Coverage (Coverage b.) OREGON CONTRACTORS' COMMERCIAL GENERAL LIABILITY Limits of Insurance(Each Occurrence) BROADENED ENDORSEMENT Coverage .$ 00b $ 00unlessotherwisestated $ _ Deductibles(Each Omnrence) This endorsement modifies insurance provided under the following: Coverage a.$250 COMMERCIAL GENERAL LIABILT'COVERAGE PART Coverage b.$250 unless otherwise stated $ A. Endoaemerd-Table of Contents: COVERAGE PREMIUM BASIS I RATE ADVANCE PREMIUM a Area (For Limits In Excess of (For Limits in Excess of Pitman: Begins on Papa: �b Payroll $5,000) $5,000) c Gross Sales 1. Employee Benefit Liability Covarege...._..._..._..._..._...__..._..._......._..._..._....._..._............_...._.2 d Units 2. Unintentional Failure to Disclose Hazards...._..._..._..._..._...__..._..._..._..._..._...__......._..._..._....B a Other 3. Damage to Premises Rented to You .........................................._...__..._..._..._..._........._8 b. Care, Custody 4. Supplementary Perments...._..._..._..._..._...__..._........_..._..._..._............_..._............._........_..9 or Control $ 6. Medical Payments...._..._........_..._..._....._..._..._..._..._...__..._..._..._..._..._...__........_...............10 6. Voluntary Property Damage(Coverage a.)and Care,Custody or Control TOTAL ANNUAL PREMIUM $ Liability Coverage(Coverage b.)...._..._..._..._...............................................................10 11. Properly Damage to Borrowed Equipment 7. 180 Day Coverage for Nally Formed or Acquired Organizations...._..._..._..._..._...__..._..._..._...10 8. Waiver of Sub rogation........._................._...._..._........_........__........_..._..._..._...__..._..._........_10 Each Omzrence Limit $ 10,000 9. Automatic Addtional Insured-Specified RdationsNps•...._..._..._........_...__..._..._..._........_..._..11 Deductible: $ 250 x Managers or Lessors of Premises; x Lessor of Leased Equipment; x Vendors; C. Coverages: x State or Political Subdivisions-Permits Relating to Premises; 2) Our right and duty to x State or Political Subdivisions-Permits;and 1. Employee Benefit Liability Coverage defend ends when we x Contactors'Operations have used up the appl- 10. Broadened Contractual Liability-Work Within 50'of Railroad Property...._........_........_..._....._....16 a. The folleMng is added to SECTION I cable limit of Insurance 11. Property Damage to Ba'rowed Equipment...._....................._........_..._..._..._...__..._..._..._..._.16 -COVERAGES: Employee Benefit in the payment of 12. Employees as Insureds-Specified Health Care Services:........_................_..._......._........_...16 Liability Coverage. Judgments or settle- s Nurses; (1) Insuring Agreement manta. x Emergency Medical Technicians;and No other obligation or liabd- x Paramedics (a) We will pay those sums that 13. Broadened Notice of Occurrenm...._..._..._..._....................................................................16 the!nand becomes legally Ity to pay sums or perform obligated to pay as den- ads or services is covered ages caused by any act,er- unless explicitly provided for B. Limits of Insurance: ror or omission of the In- ^nderr Supplementary Pay. sued, or of any other per- The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorsement, son for whose acts the th- (b) This Insurance applies to except as provided below. sued Is legally liable, to damages only if the ad,er- e. Employee Benefit Liability Coverage plis. this insurance rap- ror or omission, is negli- gently tY 9 plies.We will have the right and dui to defend the h- Each mmmidetl in the Each Employee Limit: $ 1,000,000 y "administration" of your sued against a °suit' Aggregate Limit: $ 3,000,000 seeking gthose damages. a ePbvae benefit program°; Deductible: $ 1,000 However, we will have no 3. Damage to Premises Rented to You duty to defend against any 1) Occurs during the pd- "suit seeking damages to icy period;or The lesser of: Mich this insurance does a. The Ea Occurrence Limit shown in the Declarations;or not apply. We may,at our 2) effective date of the b. $500,000 unless otherwise stated$ report of an ad, error or endorsement provided: omission and settle any a) You did not have 4. Supplementary Payments claim or"suit"that may re- ImovAedge of a a. Bail bonds: $ 1,000 silt.But: deim or "suit on b. Loss of earnings: $ 350 1) for edamagewe vlim d fedive date of this 5. Medical Payments as described In SEC- endorsement. TION ID - LIMITS OF You will be Medical Expense Limit $ 10,000 INSURANCE;and deemed to have Includes copyrighted material of Insurance Includes copyrighted material of Insurance GA 233 OR 0910 SeMces Office,Inc.,with its permission. Page 1 of 16 GA 233 OR 0910 Services Office,Inc,with its permission. Page 2 of 16 I knowedge 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, data- as your officers or dredorm. ized represents- 2) Errors in providing n- mason, harassment, Your stodthdders are also five, formation on Past per- humiliallon, dscrlmna- insureds, but only with re- formance of investment Lion or other employ. sped to their liability as I) Reports at, or eehides;or mentelated practices, stockholders. any part,of the ads or omissions;or ad, error or 3) Advice given to any persist with reseed to (e) A trust,you are an Insured omission to us that person's decision (4) Consequential It:bitty Your trustees are also in- or nsurer other to participate or not to (3)above. to(2)or to their duties as respect participate in any plan II) Receives a included in the 'bon- This exclusion applies written or vet- ployee benefit pro- whether the Insured may be (2) the following Is also an insured: bal demand or gram'. held liable as an employer claim for dam- or In any other cepacity and (a) Each of your "employees" ages because (f) Workers' Compensation to any obligation to share who is or was authorized to of the ad,error and Similar Laws damages with or repay administer your "employee or omission; My claim arising out of your someone else wno must benefit program". and failure to comply with the pay damages because of b) There is no other mandatory provisions of any the injury. (b) or persons, having applicable nsur- waters'compensation, in- (3) Supplementary Payments proper temporary authorize- once. employment compensation tion to administer your'em- insurance,social security or SECTION I • COVERAGES, ployee benefit program" if (2) Exclusions disatifiry benefits law or any SUPPLEMENTARY PAY- you die, but only until your TNSirevanm does not apply to: similar law. MENTS-COVERAGES A AND legal representative is ep- (g) ERISA B also apply to this Coverage. pointed. (a) Bodily Injury, Property b. Who Is an Insured (c) Your le Damage or Personal and Damages for which any in- you legal representative I( Advertising Injury sued is liable because of I- As respects Employee Benefit Liabil- spe tli to duties only with re. spell a duties es such. ability imposed on a fiWe- Ay INSURE,SECTION n-WHD IS That reour rNas and wifl injury',"personal and my en the Employee Re- AN WpUREDy deleted inits entirety du- damage' or ury. and Act oft Income Security and replaced by the Miming: have all your rights and du- advenising tjury. ties under this Coverage Act of 19 T4, de now or as (b) Dishonest, Fraudulent, hereafter amended, or by (1) If you are designated in the Dec- Part. ( ) any similar federal,state or laratims as; Criminal or Malicious Act (3) quire or form,iother than newly local laws. (a) M individual,you and your quire part- Damages arising out o!any, (h) Available Benefits spouse nership,joint intentional, dishonest, ( ) o us° era insureds,to the bt- P.1 pl venture or which fraudulent,criminal or mat- onlywith business of cat- youlimcompnwnersoparnia- Any claim for such benefits to the dud of a bsol eon e. you maintain s osill gratify ownership or as a- co minted boroy omission,su extent table, with bea on are nary interest,Insured will o other es e committed by any insured, you are the side owner. jority the willful or reek- mailable, with reasonable (b) A partnership or joint vet- et ins trance applies to that or- less velationof any statute. insured,d,fom the applicable ( ) P P 1 wpl funds a from the other s- tore, members,are an insurer- and rthis. However, coverage you (e) Failure to Perform a Con- funds amura or other ml- Ymr members, your part- under this provision: tract lechtleinrence, aars,and their spouses are also is to the but only with (a) Is afforded only until the Damages arising out of fad- (I) Taxes,Fines or Penalties respect to the mrWud of or form day after you ea0ire ure of performance of ore- Taxer fines or ties, your business, or form the the ganizatim or tract by any insurer. R penalties, the end of the policy period, inducing those imposed (c) A limited liability company, whichever Is earlier;and (d) Insufficiency of Funds under the Internal Revenue u are an Insured. Your m Code or any similar state m a or members are also hatreds, (b) Does not apply to any ad, Damages arising out of an to local law. but only with respect to the error or omission that was meet insufficiency o of funds nunder to Your conduct managers of rsr r rose . ccrnmior f heed t you so- meet airy includ d under Q) Practices �telated Ydsr wit ere e ins to rated or formed the ageN- any plan included in the Practices ads,but only with respect to ratan. "employee benefit program". My liability arising out of their duties as your manag- Y N g ers e. Limits of Insurance (e) Inadequacy of Perform- any: ante of Investment I Ad- (1) Refusal to employ; (d) M organization other than a As respects,Employee Benefit-LIMITS vice Given With Respect ( ) p°y' partnership,joint venture or icy Coverage,SECTION III i LIMITS to Participation (2) Termination of em- limited liability company,you OF INSURANCE is the deleted in its: ployment are en Insured. Your 'ex- lively and replaced by the fdlowing: Any claim based upon: endive officers" and direc- Includes copyrighted material of Insurance Includes copyrighted material of Insurance GA233 OR0910 Services Office,Inc.,with its permission. Page 3 of 16 GA233 OR 0910 Services Office,Inc,with its permission. Page 4 of 16 (1) The Limits of Insurance shown in amount stated in the Deda- may result in a claim. surance may also Section B.Limits of Insurance, rations as appicable to To the cadent possible, apply. 1. Employee Benefit Liability Each Employee.The limits notice should Fdude: Coverage and the rules below of insurance shall not be re- d. No insured v.111,except fix the most we will pay regard- duced by the amount of this (1) What the ad,error at that insureds own less of the number t deduc5bie. or omission was cost,voluntarily make a and when it co- payment, assume any (a) Insureds; (h) The deductible amount cared;and obligation,or Incur any (b) Claims made or "suits" slated in the Declarations expense without our ( ) applies to all damages sus- (2) The names and consent brought; tarred by any one 'em- addresses of any (c) Persons or organizations Moyer, including suds one who may suf- (2) Item 6.Other Insurance is de- making claims or bringing "employeeE" dependems fer damages as a kited in its entirety end replaced 'suits', and beneficiaries, bemuse result of the ad, by the following: of all ads, errors or orris- error a omission. (d) Acts,errors or omissions;or done to which this incur- S. Other Insurance once applies. b. If a claim is made or (e) Benefits included in your "suit'Is brought against If other valid and collectible "employee benefit program". (c) The terms of this insurance, any insured,you must: Insurance Is available to the including those with respect Insured for a loss we cover (2) The Aggregate Limit shown N to: (1) Immediately re- under this Coverage Part, Section B.Limits of Insurance. cad the speedos our obligations are limbed 1. Employee Benefit Liability 1) Our right and duty to of the dawn or as follows Coverage of this endorsement is defend the Insured "stir and the date the most we will pay for all dam- against any 'suits" received;and a. Primary Insurance ages because of ads,errors or seeldng those darn- (2) Notify us as soon This Insurance is pri- omissions negligently committed ages;and as practicable many except when c. in the "administration" of your below applies.If this in- "employeebenefit program-. 2) Your duties, and the You must see to it that surane is primary,our duties of any other N- we receive written no- obligations are not af- (3) Subject to the limit desaibed in volved insured, in the tics of the claim or faded unless any of be (2) above, the Each Employee event of an ad,error or "suit as soon as cti- Lirrit shown in Section B.Limits omission,or daim, Pre other insurance is also of Insurance. t Employee cable. primary.Then, we will Benefit Llabll Coverage of apply irrespective of the ea share with all that other tlY g e. You and any must:hr- this endorsement is the most we amounn of the deducible volved Insured must: insurance by the will pay for all damages sus- amount. method described in b. tarred by any one °employee°, (1) Immediately send below. (d) of the may pay any Pao or all us copies of a such °e damages sustained is of me deduee amount to any b. Method of Sharing such °employee's dependents effect settlement r a d of any demands,uma notices,r le- end banetidaries,as eresult of: summonses or le- If all of the other insur- daim or-stir end,upon no- gal papers m- once permits conthbu- (a) An ad,error or anissioo;a Haitian of the action taken, salved in cannon- tion by equal shares, you shall promptly maim- lion with the claim we MI follow this (b) A series of related ads,a- burse us for such part of the a'suiT; method also.Under this rays or omissions, regard- deductible amount as we method each Tosser less of the amount of time have paid. (2) Authorize us to ob- contributes equal that lapses between such tern records end ads,errors or omissions, d. Additional Conditions other Itfords a; amounts until It has negligently committed in the Employee of in its insurance or none limit As ability Coverage,Em io ee Benefit - of insurance or none of (3) Cooperate with us "administration'benefit of your "em- COMMERCIAL RCIL SECTION IV - In the inementtbf the loss remains, ployee benefit program°. tTy NDillO GENERAL LIABIL- or settlement of whichever comes first TTY CONDITONB is amended as td- the claim or de- However,the amount paid under lows tense against the If any of the other in- this endorsement shall not ex- suaance does not per- need,and will m be misled to the (1) Item 2.Duties In the Event of fit`and nit corddbutim by limbs and restrictions that apply OCburranae,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 the following: enforcement of Under this method, benefit program'. 2. Duties In the Event of an any right against each insurer's share is Error or Omission,or any person or a- based on the ratio of its Deductible Amount Claim or Suit genlzafon which applicable limit of in- (a) Our obligation to pay darn- may be liable to surance to the total ep- ages on behalf of the in- a. You must see to it that the insured be- pliceble limbs of bear- sued applies only to the we are notled as soon cause of an ad, ante of al insurers. amount of damages in ex- as practicable of an ad, error or omission C. No Coverage Bess of the deductible error or omission which to which this in- Includes copyrighted material of Insurance Includes copyrighted material of Instance GA 213 OR 0910 SenAces Office,Ina,with its permission. Page 6 of 16 GA 233 OR 09 10 Services Office.Inc.,with its permission. Page 6 of 16 This insurance shall not predefine some or all of the ages are claimed and The exclusions under SECTION cover any loss for following bents to "em- to which the insured I -COVERAGES, COVERAGE which the insured is en- ployees', whether provided must submit or does A. BODILY INJURY AND titled to recovery under through a itefeteria plan"or submit with our cal- PROPERTY DAMAGE LIABIL- any other insurance in otherMSe: sent ITV,2.Exclusions,other than I. forte 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 Pert. group esident or dispute restlution pro- and the following are added: health insurance; den- ceeding in which such e. Additional Definitions tel, vision and hearing damages are claimed This insurance does not apply to: As respects Employee Benefit U- plans, and flexible and to which the m- P spending amounts; steed submits with our (a) 'Property damage": ability Coverage, SECTION V - provided that no one consent or DEFINITIONS is amended as fol- other than an "em- 1) Assumed in any con- low% ployee• may subscribe e. An appeal of a civil pm- tract;or (1) The following definitions are to such benefits and ceedng. 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, following: 1. "Administration"means: those"employees'who employed,on leave of aab e. Providing Information to satisfy the plan's eligi- sence or disabled, or re- a) Weer end bar, "employees", including ration t blity requirements; tired.'Employee"includes a b) Rust, corrosion, their dependents and b. Profit sharing plans, 'leased worker"."Employee" fungus,decay,de does not in beneficiaries, with re- employee savings Include a'tempo- led¢retion, hidden sped to eligibility for or plans, employee stock ray worker, or latent defect or scope of "employee ownership plans, pen- 2. Unintentional Failure to Disclose Hax- any quality in benefit programs^, don plans and stock suds property that subssiption plans,Pro- causes it to dem- b. Interpreting the "err' vided that no one other SECTION IV-COMMERCIAL GENERAL age or destroy a- ployee benefit pro- than an "employee" LIABILfis hereby amended 7.Repra dd. salt, grams', may subscribe to such tefons is hereby amended by the add- ¢. Handling records in benefits and sudi lion of the following: c) Smog; connection with the benefits are made gen- d) Mechanical break- erally available to all Based on our dependence upon your rep- down Including "employee benefit pro- ^employees' who me rosentations as to existing hazards,if un- rapture or bursting grams';or eligible under the plan Intentionally you chodd fail to disclose all caused by ten- d. Effecting,continuing or for such benefits; such hazards at the inception date of your trifugal force; terminating any "art' potty,we will not reject coverage under terminating panidpatbn c. Unemployment insur- this Coverage Part based solely on such e) Setting, sacking, In any benefit included ante, social security /allure. slvinldng or ax- inthe'e to bane- benefits,workers'tarn- pension;or "employee pensetion and disability 1. Damage to Premises Rented to You fit program•• benefits;and 1) Nesting or infeste- However, "edmbidralion' a. The last Subparagraph of Paragraph Lion, or discharge does not include: d. plans, 2. SECTION I - COVERAGES, d Vacation lans Indud- or release of wade ing buy end sell pro- COVERAGE A. -BODILY INJURY products or sese- a. Handling payrol deduc- grams; leave of ab- AND PROPERTY DAMAGE, 2. U- tions, by Maeda, Lions;or sence programs, in- ABILITY Exclusions is hereby de- birds, rodents or cluing military, meter- leted and replaced by the following: other animals. b. The failure to effect or nity, family, and civil maintain any insurance to Exclusions c.through q.do not apply (b) Loss caused dreoti tb ind- nY lame; assistance ( ) y or adequate limits of plans; transportation fling,damage, smo by fire, of tosipr, light- redly by any of the folbw- covera a of insurance, wing, smede or soot m to ra lly c premises ing: g and health club subsi- cupl rented to you or temporarily oo- including but nienmibd dies. copied by you with permission of the 1) Earthquake, volcanic to nrnpbymem in- surance, owner. eruption, landslide or be social s'corn- (2) The following h their dentha ty are de- benefits,workers'tom- laced in their enitrety and re- insurance any other earth move pensation and disability placed by the following: b. The OV provided COVE SEC- meet T. BODILY INJURY ES,COVERAGE benefits. A. BODILY INJURY AND PROP- 2) Water that backs up or 21. 'Suit• means a dvii pro- ) 2. plan authorized h plans" means ceedng in because an money to "property DAMAGE LIABILITY arisen applies f dvemor s cop;a sewer, Alen w a ii ey fogies eror or omcause oo enact, w tdama damage'to premises that out re drain or bla law to allow"errwloyees° this or omission to s are water damage to premises Net ere to elect to pay for certain this insurance apples are both rented b and occupied by you. 3) Water under the ground surface benefits with pre-tax dollars. aleged.°Suit"Includes (1) As respeds Water Damage Le- flaring or seeping 0. 'Employee benefit pro- a. An arbitration proceed- gal Liability,as provided In Pare- through: grams" means a program ing in which such dart- graph 3.b.above: Includes copyrighted material of Insurance Includes copyrighted material of Insurance GA 233 OR 0910 SenAces Office,Inc.,with its permission. Page 7 of 16 GA 211 OR 0910 Services Office,Inc.,with its permission. Page 8 of 16 a) Foundations, one "occurrence" to which b. Cam,Custody or Control Liability deductible amount as has been walls, floors or this insurance applies. Coverage paid by us. paved surfaces; (3) The amount( ) pay is funded SECTION I -COVERAGES, COV- 7. 180 Day Coverage for Newly Formed or b) Basements, as desaibed in Sedim 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 Ranted 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(6)do not amended as follows: other winid 4. Supplementary Payments apply to 'properly damage" to the Subparagraph a. of Paragraph 4, is property of others described therein. hereby deleted and replaced by the foF (c) Loss caused by or resulting Under SECTION I-COVERAGE, SUP- With respell to the insurance provided by to wing: from water that leaks or PLEMENTARY PAYMENTS - COVER- this sedan of the endorsement,the fd- gons from plumbing, heat- AGES AAND B: lowing additional provisions apply: a. Insurance under this provision is at- ing, air conditioning, or fire forded only until the 180th day after protection systems caused a. Paragraph 2,is replaced by the fol- a. The Unfits of Insurance shown in the You acquire or form the organization by or resulting from freezing, lowing: Declarations are replaced by the lira or the end of the policy period, unless: its designated In Section B.Limits of whichever is eager, Up to the limit shown in Section B. 1) You did our best to Limits of Insurance,4.a.Bail Bonds Insurance. 6. Voluntary Property y 8. Waiver of Subrogation maintain heat in the of this endorsement for cost of bail Damage and Care, Custody or building or structure;er bonds required because of accidents Control Liability Coverage of this SECTION IV-COMMERCIAL NS.9. GENERAL or traffic law any vehicle arising out of endorsement with rasped to raver- LIABILITY CONDITIONS,9.Transfer of 2) You drained the equip- the use of any vehicle to which the age provided are i this endorsed not Rights hereby Recovery d Against Othere to , meet and shut off the Bodily Injury Liability Coverage tip- These limits ere Inclusive of and not Us is hereby emended by the addition of water supply if the heat plies. We do not have to furnish in addition to the limits bring ce the following:re- 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 fol- ante, 6.Voluntary Property Dam- have because of payments we make for 1) Plumbing, heating, air lowing: age and Care,Custody or Control Injury or damage arising out of your ongo- eondtionng. fire pro- All reasonable expenses Incurred by Liability Coverage of this endorse- Mg operations or•your work"done under B1�n y meet fix the most regardless will pay in any a written contract requiring such waiver hellion systems, or the the investigation at our request to assist us one ver't,"occurrence" regardess of the with that person or organization and ra- other equipment or tip- in the investigation or defense of the number ob eluded in the.'products-completed However, opera- pliences;or claim or"suit',Including actual loss of lions hazard". However, our rights may 2) The interior of any earnings up to thefmit shown in Sec, (1) Insured ( ) s. only be waived prior injury the'occurrence" dam damage B. Limits of this nd Insurance, en. giving rise make payment iment ur ermo for building or structure,or Loss of Earnings Wendorsement (2) Claims made or brought; � Coy- to personal property in g erage we make paymedt uust this Cov- the Wiling or structure per day because of time off from or erage Part.The impair must.At r - caused by or resulting work. (3) Persons or organizations making after a loss to impair our rights.Al our re- claimsordi in suits". quest,the insured will bring°suitortrans- from rain, mow, sleet 6. Medical Payments g !air those rights to us end help us enforce ' or ice, whether driven The Medical Expense Unfit of My One b. Deductible Clause those rights. p by vied or not. Expo Y Person as stated in the Declarations is (1) Our obligation to pay damages 9. Automatic Additional Insured -Speci- e. Limit of Insurance amended to the limit shown in Section B. on your behalf applies only to the fled Relationships p Thai Damage to Premises Rented to Limits of Insurance, 6. Medical Pay- amount of damages for each 'lx Yoo Umit as shown in the Declare- manta of this endorsement. arrence'v4ulm are in excess a. The foeowing is hereby added to lions Is amended as follows: 6. Voluntary Property Damage and Cara, of the deductible amount stated SECTION II-WHO IS AN INSURED: Custody or Control Liability Coverage in Section B. Limits of Insur- (1)Paragraph 6. of SECTION III- ante, 6. Voluntary Property ( ) Scribed in Paragraph 9.a42)be- LIMITS OF INSURANCE is a. Voluntary Property Damage Cov- Damage and Care,Custody or low (hereinafter referred to as hereby deleted and replaced by erage Control Liability Coverage of eddtional insured)whom you are the following: this endorsement. The limits of We will pay for'property damage"to Insurance will not be reduced by insured under add this as an rage Part r 6. Subject to 6. above, the property of others arising out of op- byr reason n of: this Cwerege P Damage to Premises orations incidental to the insureds the application of such tletludi- by reason of: ble amount. Rented to You Limit is the business when: (a) A written contract or agree- most we will pay under (2) of Occurrence,2.Duties In the Event O g COVERAGE A. BODILY (1) Damage is caused by the in- of Occurrence,Offense,Claim merit;or INJURY AND PROPERTY sired;or or Suit,applies to each claim or DAMAGE LIABILITY, for (2) Damage occurs while in the in- Irrespective (b) An oral where certificate or a of °suit'Ines Iva oT the amount. trod where a mrtifcete of damages because of"prop- suede possession. We may any insurance Meaning that per- erty damage" to premises (3) ypay my part or all of the son or organization as an while rented to you or tern- With your consent, we will make deductible amount to effect set- addtional insured has been poradly occupied by you these payments regardless of fault. Bement of any claim or "suit" Issued with permission of the and,upon notification of the go- owner, arising out of any tionnttaken,you tall promptly the is an Insured,provided: Includes copyrighted material of Insurance Includes copyrighted material of Insurance GA 233 OR 0910 Services Office,Inc,with its permission. Page 9 of 16 GA 233 OR 0910 Services Office,Inc,with Its permission. Page 10 of 16 • (a) The written or oral contract or use of equipment leased a) My failure to Part with reseed or agreement is to you by such person(s)or make such Inspec- to such products, 1) Currently in effect or organizatlans(s). However, tbns,adjusbnents, d state or bucomey infective tl or this Insuance does not ep- tests or sewidng ( ) My political subdl- py to any 'b:mrence" as the vendor has vision with'Mich you have ing the policy period; which takes place after the agreed to make or agreed per Paragraph and equipment lease expires nonnaly under- 9.a.(1)above to provide in- g) Breaded prior to an (a) My person or organization takes to make in seance,subject to the fol- "oaaaitence'or offense ( ) y p m the usual muss of lowing additional provision: to which this insurance (referred to below as vane business, m can- wauld apply;and dor) with whom you have This Insurance applies only pp y; dedbn no the agreed per Paragraph of the prop or sale with respect to the following (b) They are not specifically 9.a41)above to provide In- of the products; orzatls for which the state named as an additional in- seance, but only with re- or political permit has aired under any other pro- sped to 'bodily Injury' or }) deletion,servicing m, in- Issued a permit in con ie- vision of, or endorsement out of y ramage" arising str ream opra- lion with premises you own, added to, this Coverage out of your products"which or repair opera- rent or control and to which Pert. are dishibuted or sold in the lions,except such this insurance apples: regular course of the van- operations per- (2) Only the following aerates or or- does business, subject to formed at the vac- 1) The existence, melnto- ganizations are additional insur- the following additional ex- does premises In nonce,repair,mnrrue eds under this endorsement,and dudons: connection with lion, erection, or re- Insurance menage provided to the sale of the coeval of advertising menage such additional Insureds is Iirn- 1) The Insurance afforded product; signs, awnings, ne- Red as provided herein: the vendor does not pies, cellar entrances, apply to: g) Products which, coal holes, drivevsys, (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 'properly damage" been labeled or re- sidewalk vaults, street Paragraph 9.a(1)above to for which the van- labeled or used as banners,or decorations provide Insurance, but only dor is obligated to a container,part or and similar exposures; with rasped to liability errs- PaY damages by Ingredient of any or ing out of the ownership, reason of the as- other thing or sub- maintenance or use of that sunption of liability stance by or for 2) The mostmdion,ereo- part of a premises leased to In a contract or the vendor,or lion,or removal of ale- you,subject to the falbwing agreement. This velars;or addtional exdusbns exclusion does not h) 'Bodily Injury" or apply to labliy for "property damage" 3) The ownership,of any 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'ocarrtenm'wfiidm in the absence of omissions of the this insurance. the centred or vendor, its em takes place after you (a) My state or political tyou shave W Y agreement; elseeac on anyone vision with which you raph cease to be a tenant in that premises b) My express war- behalf. on Its agreed per Paragraph ranty unauthorized 9.a.(1)above to provide the in- g Structural alterations, seance,subject to the lot- new construction or by You; 2) apply to any does cured lowing provisions demolition operations a) My Plaided or apply to any za insured performed by or on be- chemical change person or organization: 1) This insurance applies half of such additional In the product a) From whom you only with respect to op- insured. made Intentionally have acquired yu or performed by f (b) My person or organization by the vendor; such products, or you on your aeh or any ingredient, for which s the state or from which you lease d) Repackaging, ex- political subdivision has equipment with whom you rapt when um- part or container- Issued a permit. have agreed per Paragraph packed solely for entering into, so- 9.a.(1)above to provide in- the purpose of in- companykg or 2) This Insurance does not cmminsg such apply to t °bodily injury', or seance.Such person(s)or spedion, demon-r products;or but only to(the are tent that the station,testing,or p a; "property damage' or but oby to me extent that the substitution of b) When liability In "personal and advert's- the ropertliyamage"y injury: parts under in- eluded within the operations out performed "properly damage"or"per- saudlona from me "products- for thel state r political send and advertising Injury' manufacturer, and completed opera- for the stns or politicel is caused by your negl- then repackaged lions hazard" has subdvidon. gene,acts or omissions In in the original cal- been excluded un- (I) For 'your work" performed the maintenance, operation vainer, der this Coverage in Oregon, any person or Includes copyrighted material of Insurance Includes copyrighted material of Insurance GA233 OR 0910 Services Office,Inc.,with its permission. Page 11 of 16 GA233 OR 0910 SeMoes Office,Ina,with its permission. Page 120116 organization with which you (a) Subparagraphs (e), (f) and ct tectural or engi- primary to other insurance have agreed per Paragraph (g)do not apply to hbocily In- nearing activities available to the additional 9.241)above to provide in- lull or "properly damage- Insured erect: events,but only to the ex- included within the 'prod- 3) Professional services tent that the liability is udscanpleted operations do not include services 1) As otherwise provided cased by your work'per- hazard. within construction in SECTION IV - formed for that additional N- means,methods,tech- COMMERCIAL GEN- sired and only to the extent (b) Subparagraphs(a), (d). (e) piques, sequences and ERAL LIABILITY that suth liability is mused and(g)do not apply to"bed- procedures employed CONDITIONS, S. by your negligence or the ily Injury', 'property dam- by you in connedbn Other Insurance, b. construction of those acting age" or 'personal and ad- with construction work Excess Insurance;or on your behalf.A person or vertising injuy arising out you perform. organization's status as an of the see negligence or 2) For any other valid end Insured under this provision willful misconduct of the ad- (d) Subparagraphs (f) and (g) rdlectible insurance of this endorsement conti- ditional Insured or its"em- do not apply to 'badly N- available to the addi- ues for only the period of ployeee';or jury or'properly damage" tional insured as an ad- time required by the written arising out o/yourworlC for ad- ditional Insured by at- time required or agreement, but (c) Subparagraph(f)and(9)do which a consolidated(wrap- tachment of an en- innoeveorbeyondtee, but not apply to 'badly injury", up)insurance program has dorsement to another "property damage"or"per- been provided by the prime Insurance policy that is ration date of this Coverage send and advertising in o/ Part. If there is no written g t'N' or owner project bass. on an excess contract or agreement,or If arising out of.. or owner of the construction a In- basis.In such case,the project in which you are in- coverage provided n- no period of time is required 1) The rendering of, or volved, der this endorsement by the written contract or failure to render, any shall also be excess. agreement,a person or or- professional services b. Only with regard to Insurance pro- e bon's status as an in- by you or on your be- idled to an additional Insured desig- (2) Condition 11.Conformance to sired sired under this endorse- half, but only with re- noted under Paragraph )Sub- Specific Written Contract or ment ends when your op- sped to either or both paragraphs(f)and (g)above,bove,SEC- orations added: for that insured are of the foliovAng opera- TION III-LIb1 TS OF INSURANCE Is 11. Conformance to S cdnpieled, bons amended to include: Specific (g) For "your work" performed a) Providing engi- The limits a Written Contract or In the "coverage territory" plthosee to the additional Agreement but not in Oregon,any rI- turd or surveying written are those specified agreement In the g n per- lured a to others; thelen centred or of this Cot ra in a. Wit respect to ade- non or ohave are with services to others; Part,Declarations of this Coverage sated Insureds Par tle- Paiah you have ) above per and Pert,whichever are less If it limits sorbed above Paragraph Paragraph 9ra insurance,abt oth areemen, or If them em Is contracts If a.(2J(ftt above only: provide inmran®, but only b) Providing,or hiring agreement, or ethers is no written with respect to Ilabli ads- independent pro- If a agreement contract or P N contract or agreement,the limits ap- ' in out o(° r work" fessionals to pro- agreement beMeen g tau Per vide, engineering. those s to the additional Declarations are and the additional sireddtoytuaoeoniyourl in- 9 or thoseove aged atheheeamsof n- you sired you or on your tea- arexHecural or Insured specifies that by Y this Coverage Part.The limits of In- uce.A person an insured in surveying ion with avanos are inclusive of and not In e coverage for the edd- tion's dohs as an insured in connection with addtim to the limits of insurance Banal insured: under his provision of this construction work shown in the Declarations. endorsement continues for you perform. (1) Be provided by the m only the period of time re- c. SECTION IV-COMMERCIAL GEN- Insurance Se- quined by the written oat- 2) Subject to Paragraph 3) ERAL LIABILITY CONDITIONS Is vices Office form below, professional number CG 3dorm tract or agreement,but in no services include: hereby amended as follows: number CG 32 61, event beyond the expiration date of this Coverage Part, a) Preparing,approve (1) Condition emended to o.include:Insurance is 3G 32 de: 3263;or or CG If them is no written contract ing, or failing to or agreement,or if no period prepare or ap- (a) Where required by a written (2) Include coverage of time is required by the prove,maps,shop centred or agreement,this for completed op- written contract or agree- drawings, opt- insurance is primary and/or eations;or ment,a person or organize- Ions, reports, sur- noncontributory as respects lions status as an insured veya field orders, any other Insurance pricy (3) r"y Include rare, under this endorsement change orders, or Issued to the additional In- ends "your when your operations drawings and sued, and such other in- and where the limits or for that insured are con- specficatons;and swan policy shall be ex- coverage provided to plated. toss and/ e nmmsriwit- more a restrictive Insured in b) spedicrn Supervisory or es this whichever applies,with wore re5ddiw Nan (3) Any Insurance ed designated n an perform alas part addtional insured designated performed as port this insurance. was sin that en under Paragraph 9.a.(2): of any related ar- contra in that written (b) Any insurance shall by contract or agreement, Para- this endorsement shall be the terms of Pare- Includes copyrighted material of Insurance Includes copyrighted 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 graphs 9.a.(3)(a)or 9.b. agreement specifies (2) Deductible Clause a. Nurses; above,or any combine- the Insurance Services tion thereof,shall be in- Office additional b- (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 specifywhich edton,or ages for each'Occurrence" In the Jurisdiction where an"occurrence" the written contract or spedles an edtim that which are in excess of the or offense to which this insurance applies agreement, but only to does not Sat, Pare- Deductible amount stated In takes place the extent that such Ion- graphs 9.a.3.b. and Section B.Limits of Maur. 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.Dulles In which this endorsement 9.a.(3)(a) of this en- the application of sudh De- the Event of Occurrence, Offense, is attached. dorsement shall apply. dudile amount. Claim or Suit(SECTION IV-COMMER- CIAL GENERAL LIABILITY CONDI- b. Wth respect to add- 10. Broadened Contractual Liability-Work (b) Condtion 2.Duties In the TONS)is hereby deleted and replaced by tional insureds de- Within 60 of Railroad Property Event of Occurrence, Of- the fdlowing: sated in Paragraph tense, Claim or Suit ep- 9.a.(2)(g)above only: It is hereby agreed that Paragraph f.(1)of plies to each claim or"suit a. You must me to it that we am notified Definition 12. Insured centred' (SEC irrespective of the amount. as soon as practicable of an"maar- I(a written contract or TON V-DEFINITIONS)Is deleted. (c) We may reneger an offense which may result agreement between 11. Property Damage Equip- ( ) y pay any part or all in a claim.To the extent possible,no- you and the additional p rty amt a to Borrowed E ul of the deductible amount to tics should include: insured specifies that ment effect settlement of any coverage for the add- claim or'suit'and,upon no- (1) How,when and where the"co- tional insured: a. The following is hereby added to Ex- tificatim of the action taken, emend?or offense took place; elusion J. Damage to Property of you shall promptly reira a. Be provided by the TIONIph 2., Exc SiOns of SEC- bursa us for such part of the (2) The names end addresses of Insurance Ser- deductible amount as has any injured persons and wit- vices Office adds- A. BODILY INJURY AND PROP- been paid by tor. nesses;and tional insured form ERTY DAMAGE LIABILITY: number CG 20 10 12. Employees as Insureds - Spedfled (3) The nature and location of arty or CG 20 37 Paragraphs(3)end(4)of this azdu- Health Care SeMces Injury or damage arising out of or CG edition don do not apply to tools or equip- the"omwrenm'or offense. (where or meat loaned to you,provided they are It is hereby agreed that Paragraph This requirement applies only when at the time used to of operations SECTION II- apply too your the"occurrence"or offense is known Iam- b. Include coverage to an"adhorized representative". for completed op- playacts"who provide professional health or b. With respect to the Insurance pro- cam services on your behalf as duty It- erations; by this section of the endorse- �„md. c. Include coverage anent the following additional provi- for"your work, siens apply and where the limits or (1) The Limits of insurance shown in coverage provided to Na 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 reseed 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.(3)(a). the limits being replaced. The 9.a(3)(b)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 fix the prated as providing the most we wilt pay in any one'no- liras a coverage re- arrant& regardless of the quired by the terms of number oh the written contract or (a) Insureds; agreement, but only to the extent that such tint- (b) Claims made or 'suits' its or mverege 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, huts". the written contract or Includes copyrighted material of Insurance Includes copyrighted material of Insurance GA 213 OR 09 10 Services Office,Inc.,with its permission. Page 16 of 16 GA233 OR 09 10 Services Office,Inc,with its permission. Page 16 of 16 www.saif.com Oregon Workers' Compensation Work. Certificate of Insurance Salo Life. Certificate holder: CITY OF ASHLAND PUBLIC WORKS DEPARTMENT 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 Orpac Systems Mike Godfrey 920 S Grape St 541.687.1117 mike @wardinsurance.net Medford, Or 97501-3631 Issued 03/06/2019 Limits of liability Policy 811124 Bodily Injury by Accident $1,000,000 each accident Period 10/01/2018 to 10/01/2019 Bodily Injury by Disease $1,000,000 each employee Body Injury by Disease $1,000,000 policy limit Description of operations/locations/special items Thinmanager contract 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_CertificateOfInsurance • Purchase Order Fir All - , ,� Fiscal Year 2019 Page: 1 of: 1 B City of Ashland l igm_m_:_ .aii in daliNdi;�_ :_ I ATTN: Accounts Payable Purchase L L 20 E. Main 20190438 Ashland, OR 97520 Order# -r 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 R T Fax: 541/488-6006 `4=t§[:Lela-Jm.il1=OI§I§s o1=i me3_J§(a o -'1§1_§1.1=1-4 =`-_:•_,-i 1s1=_=i=.IE31.1_Ic -- — —_-_1=111 .WA'i=JE=1d=1§E;= (541) 773-7751 Paula Brown —ep=.4=a lr s+le--'3-1E1a 91111=1x1,—.— 1: ='v=ia v §-r.— =P-1I==1'=1:1'1srasle' §t__ _ - - = ot:._NE e[_§ha.1.1=1 e)- 04/10/2019 489 FOB ASHLAND OR Cit Accounts_Payable Thinmanager and Development 1 Thinmanager Software and Development 1 $11,208.0000 $11,208.00 Personal Services Agreement ($25,000.00 or less) Completion date; 06/30/2019 Project Account: .k....**.******* GL SUMMARY*************** 081500-604100 , $11,208.00 • By: Date: 1 thorized Signature P $11,208.00 FORM **(b 1. ' CITY OF •A rquest for a Pur c haso Or d er f 0 ASHLAND e REQUISITION Date of rec nest: 03/05/2019• Vendor Name Pacific Electrical Contractors LL, � o 1 Address,City,State,Zip 920 South Grape Street Medford, Oregon 97501 r �4 �L A L `� 1, co r Contact Name Eric Summers C � r tee >\��J _ 3 S� Telephone Number Ht 541-773-7751 ax 2- d_. y� Email address t� .w - --poi SOURCING METHOD no 11 �.2, ,t " - . r� ❑ Exempt from Competitive BiddIn d 7V, Ij rV't fi r+ ❑ Reason for exemption: �0 1 iv`5❑( rivitation to Bid (Copies on file) ❑ AMC 2.50 B v 4Date approved by Council: �7 / ❑ Written quote or proposal attach d 8 (Attach copy of council communication)` � /'� r 1_,, - ❑ Small$5,000 �" _.4 A, _ Less than$5,000 ❑ Request for Proposal (Copies on fih G • Date approved by Council_ ❑ Direct Award G`( .2� _(Attach copy of council communication)d p•'� ❑ VerbalNVritlen quote(s)or pro osal(s) 1 9. %` Intermediate Procurement ❑ Sole Source " GOODS&SERVHc ❑ Applicable Form(#56,7 or 0)$5 000 to,$1D013 ❑ Written quote or proposal attached❑ (3YWritten q ❑ Form#4, Personal Services$5K to$7/PERSONAL SER ❑ Special Procurement I/r p $5,000 to$75,000 "❑ Form#9,Request for Approval / �y�, � 1 .a.,s ❑ Less than$35,000,by direct appointment `i' Written quote or proposal attached f w 0 7 S S ❑ (3)Written proposals/written solicitation D to approved by Council: / ❑ Form#4, Personal Services$5K to$75K Valid until: (Da Description of SERVICES Total Cost Thinmanager and development $ 11,208 0 Item# Quantity Unit Description of MATERIALS Unit Price Total Cost � El Per attached quotelproposal TOTAL_COST Expenditure must be charged to the appropriate account numbers for the financials to reflect the actual expenditures accurately. - -- - Project Number _ _ _ Account Number 081500 - 604100 $ 11208.00 _ _ — Project Number _ _ Account Number Project Number _ _ _ Account Number - $_, I • IT Director in collaboration with department to approve all hardware and software purchases: By signing this requisition form,l certify that the ' 's public contracting requirements have been satisfied. IT Director Date Support-Yes/No Employee:demo N n� 1%�� - @l O+IDepartment Head: i�R'�% Z�— 044.47t Zen, / (Equal to or greater than$5,000) Department Manager/Supervisor: City Administrator:' / (E. .1-te-m'gre ter th n$25,000) Funds appropriated for current fiscal year:/YES/ e- ` ,L�►0 L� 1 i I' Fs ate Director- 'q itoorgreaterthanS5,000) Dale Comments: Form#3-Requisition