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HomeMy WebLinkAbout2023-040 PO 20230315- National Fire Fighter Corp. 1 �,� .� Purchase Order CITY RECO DE raft 9 Fiscal Year 2023 Page: 1 of: 1 :� cz zya galla -- t‘=]t;41'211----iffeAlTiEtla'40 B City of Ashland ATTN: Accounts Payable Purchase 20 E. Main L Ashland, OR 97520 ' Order# 20230315 T Phone: 541/552-2010 0 Email: payable@ashland.or.us • V S H C/O Facilities Maintenance Div E NATIONAL FIRE FIGHTER CORP I 90 North Mountain Ave N 3100 N PACIFIC HWY p Ashland, OR 97520 0 MEDFORD, OR 97501 ti S Phone: 541/488-5358 R T Fax: 541/552-2304 (541) 344-1438 David Arnold S _ 0-.:. 6j�s[a. .s=— [�`(7aff81-—�� ' _§§_ '� ar c'a:[= d� 31 05/01/2023 481 FOB ASHLAND OR City Accounts Payable Ti'ez' _._ _'_Mite Fire Extinguisher Inspection 1 Fire extinguisher inspection and service for FY 2023 1.0 $5,000.00 $5,00,0..000 Goods and Services Agreement($35,000 or less) �" Completion date: June 30, 2023 Project Account: ' ***************GL SUMMARY*************** 088400-602400 $5,000.00 I I 181 By: Date: F — Authorized Signa �Ern $5 000.00 Purchase Order Fr Fiscal Year 2023 Page: 1 of: 1 +.__ 4 �� [� 01_76. ai 5.2 B Cityof Ashland _u--_- I ATTN: Accounts Payable L20 E. Main - Purchase 0230315 Ashland, OR 97520 Order# T Phone: 541/552-2010 O Email: payable@ashland.or.us ✓ SC/O F- ilities Maintenance Div E INDUSTRIAL SOURCE ` H 90 .rth Mountain Ave N PO BOX 2330 p land, OR 97520 O EUGENE, OR 97402 Phone: 541/488-5358 dFax: 541/552-2304 :. .-7 '�' _.�� :sB. �--_ �����^..0 541 344-14.38 - David Arnold 05/0.1/2023 481 11111111111V FOB ASHLAND OR Cit Accounts Pa able Fire Extinguisher Inspection rr 1 Fire extinguisher inspection and se., ce for FY 2023 1.0 $5,000.00 $5,000.00 Goods and Services Agreemer ($35,100 or less) Completion date: June 30, 23 Project Account: ******** ******GL SUMMARY* ************* 088400 .02400 $5 000.00 By:V \! 1Date: c3 Authorized Signat w T 5 000.00 FORM #3 )6/1-A--11. �� CITY OF ASHLAND REQUISITION . Date of request: 4/27/2023 / Required date for delivery: - Vendor Name National Fire Fighter Corp. Address,City,State,Zip 3100 N. Pacific Highway,Medford.OR 97501 Contact Name&Telephone Number Mike Webb 541-210-3895 mikew@nationaifirefighter.com Email address . SOURCING METHOD D Exempt from Competitive Bidding 0 Invitation to Bid ❑ Emergency ❑ Reason for exemption: Date approved by Council: 0 .Form#13,Writtenfindings and Authorization ❑ AMC 2.50 _(Attach copy of council communication) ' 0 Written quote or proposal attached ❑ Written quote or proposal attached If council a.'royal re.uired,attach co. of CC ® Small Procurement ❑ Request for Proposal Cooperative Procurement Not exceeding$5,000 Date approved by Council: 0 State of Oregon ® Direct Award (Attach copyof council communication) Contract# • ❑ VerballWritten quote(s)or proposal(s) 0 Request for Qualifications(Public Works) 0 State of Washington 1 Date approved by Council: Contract# _(Attach copy of council communication) . 0 Other government agency contract 1 Intermediate Procurement 0 Sole Source Agency I. GOODS SERVICES 0 Applicable Form(#5,6,7 & or 8) Contract# I Greater than$5,000 and less than$100,000 0 Written quote or proposal attached Intergovernmental Agreement ❑ (3)Written bids and solicitation attached 0 Form#4,Personal Services$5K to$75K Agency PERSONAL SERVICES Date approved by Council: 0 Annual cost to City does not exceed$25,000. Greater than$5,000 and less than$75,000 Valid until: (Date) Agreement approved by Legal and approvedlsigned.by ❑ Less than$35,000,by direct appointment 0 Special Procurement City-Administrator.AMC 2.50.070(4) ❑ (3)Written proposals&solicitation attached 0 Form#9,Request for Approval 0 Annual cost to City exceeds$25,000,Council ❑ Form#4,Personal Services$5K to$75K 0 Written quote or proposal attached approval required.(Attach copy of council communication) Date approved by Council: Valid until: (Date) Description of SERVICES Total Cost . t1 Fire extinguisher inspection and service for FY23 ;$'5;00 .0:'00; ' Item# Quantity Unit Description of MATERIALS Unit Price Total Cost 1 • $0 $0,00 $0 $0.00 • $0 $0.00 • E] Per attached quotelproposal - TOTAL COST i Project Number: _ _ _ Account Number: 088400-602400 $'$0:00 "Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. IT Director in collaboration with departmentto approve all hardware and software purchases: IT Director Date Support-Yes/No By signing this requisition fo 44 certify that the City's public contr.=mg equirements have been satisfied. Employee: • Department Hea : qual `1.Z7,Z0Z. j to• .reater than .,000) Department ManagerlSupervisor: City Manager: (Greater than$35,01?) 1f Funds appropriated for.current'fiscal year: YES/NO )11A • �' ( 2' 2- ' Fi ance (rector-(Equal to eater than$5,000) Date ` Comments: • Form#3-Requisition L • GOODS AND SERVICES AGREEMENT ($35,000 OR LESS) PROVIDER: National Fire Fighter Corp. • CITY O f PROVIDER'S ASH LAN D CONTACT: Mike Webb 20 East Main Street Ashland,Oregon 97520 ADDRESS: 3100 N.Pacific Highway Telephone: 541/488-5587 Medford,OR 97501 Fax: 541/488-6006 PHONE: 541-779-0167/541-210-3895 This Goods and Services Agreement (hereinafter "Agreement") is entered into by and between the City of Ashland, an Oregon municipal corporation (hereinafter "City") and National Fire Fighter Corp, (a domestic/foreign business corporation)("hereinafter"Provider"),for fire extinguisher inspection and service. L PROVIDER'S OBLIGATIONS 1.1 Provide fire extinguisher inspection and service for FY23 as set forth in the "SUPPORTING DOCUMENTS" attached hereto and, by this reference, incorporated herein. Provider expressly acknowledges that time is of the essence of any completion date set forth in the SUPPORTING DOCUMENTS,and that no waiver or extension of such deadline may be authorized except in the same manner as herein provided for authority to exceed the maximum compensation. Theservices defined and described in the "SUPPORTING DOCUMENTS" shall hereinafter be collectively referred to as "Work." 1.2 Provider shall obtain and maintain during the term of this Agreement and until City's final acceptance of all Work received hereunder,a policy or policies of liability insurance including commercial 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 and Property Damage. 1.2.1 The insurance required in this Article shall include the following coverages: • Comprehensive General or Commercial General Liability, including personal injury, contractual liability,and products/completed operations coverage; and • • Automobile Liability. 1.2,2 Each policy of such insurance shall be on an"occurrence"and not a"claims made"form,and shall: • Name as additional insured "the City of Ashland, Oregon, its officers, agents and employees" with respect to claims arising out of the provision of Work under this Agreement; a Apply to each named and additional named insured as though a separate policy had been issued to each,provided that the policy limits shall not be increased thereby; • Apply as primary coverage for each additional named insured except to the extent that two or more such policies are intended to "layer" coverage and, taken together, they provide total coverage from the first dollar of liability; • Provider shall immediately notify the City of any,change in insurance coverage a Provider shall supply an endorsement naming the City, its officers,employees and agents as additional insureds by the Effective Date of this Agreement; and Page 1 of 6: Goods and Services Agreement between the City of Ashland and National Fire Fighter Corp • • Be evidenced by a certificate or certificates of such insurance approved by the City. 1.3 Provider shall,at its own expense,maintain Worker's Compensation Insurance in compliance with ORS 656.017, which requires subject employers to provide workers' compensation coverage for all of its subject workers. 1.4 Provider 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 this Agreement when employed by Provider. Provider agrees to comply with all applicable requirements of federal and state civil rights and rehabilitation statutes, rules and regulations. Further, Provider 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. 1.5 In all solicitations either by competitive bidding or negotiation made by Provider for work to be performed under a subcontract, including procurements of materials or leases of equipment, each potential subcontractor or supplier shall be notified by the Providers of the Provider's obligations under this Agreement and Title VI of the Civil Rights Act of 1964 and other federal nondiscrimination laws. 1.6 Living Wage Requirements: If the amount of this Agreement is $22,310.46 or more, Provider 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. Provider is also required to post the notice attached hereto as"Exhibit A"predominantly in areas where it will be seen by all employees. 1.7 Assignment: Provider shall not assign this Agreement or subcontract any portion of the Work to be provided hereunder without the prior written consent of the City. Any attempted assignment or subcontract without written consent of the City shall be void. Provider 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 the City of any assignment or subcontract shall not create any contractual relation between the assignee or subcontractor and the City. 2. CITY'S OBLIGATIONS 2.1 City shall pay Provider the hourly rates effective' 4/25/2023 as specified in the SUPPORTING DOCUMENTS. 2.2 In no event shall Provider's total of all compensation and reimbursement under this Agreement exceed the sum of$5,000 (this is maximum, not to exceed amount of ENTIRE Agreement) without express; written approval from the City official whose signature appears below, or such official's successor in office. Provider expressly acknowledges that no other person has authority to order or authorize additional Work which would cause this maximum sum to be exceeded and that any authorization from the responsible official must be in writing. Provider further acknowledges that any Work delivered or expenses incurred without authorization as provided herein is done at Provider's own risk and as a volunteer without expectation of compensation or reimbursement. 3. GENERAL PROVISIONS 3.1 This is a non-exclusive Agreement. City is not obligated to procure any specific amount of Work from Provider and is free to procure similar types of goods and services from other providers in its sole discretion. Page 2 of6: Goods and Services Agreement between the City of Ashland and National Fire Fighter Corp 3.2 Provider is an independent contractor and not an employee or agent of the City for any purpose. 33 Provider is not entitled to,and expressly waives all claims to City benefits such as health and disability insurance,paid leave,and retirement. • 3.4 This Agreement embodies the full and complete understanding of the parties respecting the subject matter hereof. It supersedes all prior agreements,negotiations,and representations between the parties, whether written or oral. 3.5 This Agreement may be amended only by written instrument executed with the same formalities as this Agreement. 3.6 The following laws of the State of Oregon are hereby incorporated by reference into this Agreement: ORS 279B.220,279B.230 and 279B.235. 3.7 This Agreement shall be governed by the laws of the State of Oregon without regard to conflict of laws principles. Exclusive venue for litigation of any action arising under this Agreement shall be in the Circuit Court of the State of Oregon for Jackson County unless exclusive jurisdiction is in federal court, in which case exclusive venue shall be in the federal district court for the district of Oregon. Each party expressly waives any and all rights to maintain an action under this Agreement in any other venue,and expressly consents that, upon motion of the other party, any case may be dismissed or its venue transferred,as appropriate,so as to effectuate this choice of venue. 3.8 Provider 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, arising out of, or relating to the activities of Provider or its officers, employees,contractors,or agents under this Agreement. 3.9 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. 3.10 If any provision of this Agreement is found by a court of competent jurisdiction to be unenforceable, such provision shall not affect the other provisions,but such unenforceable provision shall be deemed modified to the extent necessary to render it enforceable,preserving to the fullest extent permitted the intent of Provider and the City set forth in this Agreement. 3.11 Deliveries will be F.O.B destination. Provider shall pay all transportation and handling charges for the Goods.Provider is responsible and liable for loss or damage until final inspection and acceptance of the Goods by the City. Provider remains liable for Iatent defects,fraud,and warranties. •3.12 The City, may inspect and test the Goods. The City may reject non-conforming Goods and require Provider to correct them without charge or deliver them at a reduced price, as negotiated. If Provider does not cure any defects within a reasonable time, the City may reject the Goods and cancel this Agreement in whole or in part. This paragraph does not affect or limit the City's rights,including its rights under the Uniform Commercial Code,ORS Chapter 72(UCC). Page 3 of 6: Goods and Services Agreement between the City of Ashland and National Fire Fighter Corp • • 3.13 Provider represents and warrants that the Goods are new, current, and fully warranted by the manufacturer. Delivered Goods will comply with SUPPORTING DOCUMENTS and be free from defects in labor,material and manufacture,Provider shall transfer all warranties to the City. 4. SUPPORTING DOCUMENTS 4.1 The following documents are, by this reference, expressly incorporated in this Agreement, and are collectively referred to in this Agreement as the"SUPPORTING DOCUMENTS:" • The Provider's complete written Rate Sheet dated April 25,2023. 4.2 This Agreement and the SUPPORTING DOCUMENTS shall be construed to be mutually complimentary and supplementary wherever possible, In the event of a conflict which cannot be so resolved,the provisions of this Agreement itself shall control over any conflicting provisions in any of the.SUPPORTING DOCUMENTS. In the event of conflict between provisions of two of the SUPPORTING DOCUMENTS,the several supporting documents shall be given precedence in the order listed in Article 4.1. 5. REMEDIES 5.1 In the event Provider is in default of this Agreement, City may, at its option, pursue any or all of the remedies available to it under this Agreement and at law or in equity,including,but not limited to; 5.1.1 Termination of this Agreement; 5.1.2 Withholding ail monies due for the Work that Provider has failed to deliver within any scheduled • completion dates or any Work that have been delivered inadequately or defectively; 5.1.3 Initiation of an action or proceeding for damages, specific performance, or declaratory or injunctive relief; 5,1.4 These remedies are cumulative to the extent the remedies are not inconsistent,and City may pursue any remedy or remedies singly,collectively,successively or in any order whatsoever. • 5.2 In no event shall City be liable to Provider for any expenses related to termination of this Agreement or for anticipated profits. If previous amounts paid to Provider exceed the amount due,Provider shall pay immediately any excess to City upon written demand provided. 6. TERM AND TERMINATION 6,1 Term This Agreement shall be effective from the date of execution on behalf of the City as set forth below (the "Effective Date"), and shall continue in full force and effect until June 30, 2023, unless sooner terminated as provided in Subsection 6.2. 6.2 Termination 6.2.1 The City and Provider may terminate this Agreement by mutual agreement at any time. 6.2.2 The City may,upon not less than thirty(30)days' prior written notice,terminate this Agreement for any reason deemed appropriate in its sole discretion. 6.2.3 Either party may terminate this Agreement,with cause,by not less than fourteen(14)days'prior written notice if the cause is not cured within that fourteen (14) day period after written notice. Such termination is in addition to and not in lieu of any other remedy at law or equity. 7. NOTICE Whenever notice is required or permitted to be given under this Agreement, such notice shall be given in writing to the other party by personal delivery,by sending via a reputable commercial overnight courier, or Page 4 of 6: Goods and Services Agreement between the City of Ashland and.National Fire Fighter Corp • • by mailing using registered or certified United States mail, return receipt requested, postage prepaid,to the address set forth below: If to the City: City of Ashland Facilities Maintenance Department Attn: David Arnold 20 E. Main Street • Ashland,Oregon 97520 Phone:(541)552-2292 With a copy to: City of Ashland—Legal Department 20 E. Main Street Ashland,OR 97520 Phone: (541)488-5350 If to Provider: National Fire Fighter Corp. Attn:Mike Webb • 54l7790167/5412103895 8. WAIVER OF BREACH One or more waivers or failures to object by either party to the other's breach of any provis ion,term,condition, or covenant contained in this Agreement shall not be construed as a waiver of any subsequent breach,whether or not of the same nature. 9. PROVIDER'S COMPLIANCE WITH TAX LAWS 9.1 Provider represents and warrants to the City that: 9.1.1 Provider 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 Provider;and (iii) Any rules,regulations,charter provisions,or ordinances that implement or enforce any of the foregoing tax laws or provisions. 9.1.2 Provider,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 Provider;and (iii) Any rules,regulations,charter provisions,or ordinances that implement or enforce any of the foregoing tax laws or provisions. 9.2 Provider's failure to comply with the tax laws of the State of Oregon and all applicable tax laws of any political subdivision of the State of Oregon shall constitute a material breach of this Agreement. Further, any violation of Provider's warranty, as set forth in this Article 9,shall constitute a material breach of this Agreement. Any material breach of this Agreement shall entitle the City to terminate this Agreement and to seek damages and any other relief available under this Agreement,at law,or in equity. Page 5 of 6: Goods and Services Agreement between the City of Ashland and National Fire Fighter Corp 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, CITY OF ASHLAND: National.Fire Fighter Corp.(PROVIDER): By: By: _ /T -�"�• c. elzfrf-- Vo Ackei,W Al2-4•_4 Printed Name Printed Name • topa.c s DIefecuz__ T eLam-,r'c J S/eS e-'V I CC, Title Title .41.? • .2121 _ • `?/-Z-7 --&.& Date Date (LVA is to be submitted with this signed Agreement) Purchase Order No. Page 6 of 6: Goods and Services Agreement between the City of Ashland and National Fire Fighter Corp igitional Fire Fighter • CORP To: City of Ashland From: Mike Webb Attn: Nicole Graham • Phone: 541-210-3895 Phone: 541-552-2292 Email: mikew@nationalfirefighter.com Email: nicole.graham cr ashland.or.us Date: 4-25-23 On behalf of National Fire Fighter Corp.,I am pleased to present the following quotation for service in 2023/2024: Service Call Charge: $62.50 Service Type Extinguisher Type Price* Annual re-certification 2.5#-20#Dry Chemical $9.98 6-year service 2.5#Dry Chemical $27.57 6-year service 5#Dry Chemical $34.11 ' 6-year service 10#Dry Chemical $73.32 6-year service • 20#Dry Chemical $78.81 Hydro-test • 2.5#Dry Chemical $37.45 Hydro-test 5#Dry Chemical $47.98 Hydro-test 1:0#Dry Chemical $87.32 Hydro-test 20#Dry Chemical $98.95 *Extinguisher Service price includes new valve stem, o-ring, collar ring. **The above prices DO NOT include any additional work,parts,repairs,or upgrades to equipment. *Service includes inspection using Building Reports barcode management system. Tracking and reporting of devices supplied at no additional charge. National Fire Fighter Corp. Medford P: 541-779-0167 F: 541-772-4510 • l co DATE(MM/DDNYYY) A 5 o CERTIFICATE OF LIABILITY INSURANCE 12/15/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT k.p.d.Insurance LLC • PHONE FAX • PO Box 784 • INC.No.Ext):541-741-0550 lac.No):541-741-1674 Springfield OR 97477 ADDRESS: wc-certs@kpdinsurance.com INSURER(S)AFFORDING COVERAGE NAIC N INSURER A:*SAIF Corporation 36196 _ INSURED EUGEWEL02W • INSURER B: Eugene Welders Supply Co.dba:Industrial Source dba: National Extinguisher Service dba:National Fire Fighter Corp INSURER C: dba: National Fire Fighter Wildland Corp INSURER D: PO Box 7577 INSURER E: Springfield OR 97475 INSURER F: COVERAGES CERTIFICATE NUMBER:1902591488 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INS!) WVD POLICY NUMBER (MMIDDIYYYY) (MMIDDIYYYY) .- COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $DAMAGE TO CLAIMS-MADE OCCUR PREMISES Ea occurrence)eS • MED EXP(Any one person) S _PERSONAL&ADV INJURY $ GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY n PRO- POLICY LOC PRODUCTS-COMP/OP AGG $ OTHER $ • AUTOMOBILE LIABILITYCOMBINED SINGLE LIMIT $ • • (Ea accident) . ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS - HIRED NON-OWNED PROPERTY DAMAGE $ • AUTOS ONLY AUTOS ONLY (Per accident) $ , UMBRELLA LIAB _OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE ' AGGREGATE $ . DED RETENTIONS $ A WORKERS COMPENSATION 783031 1/1/2023 1/1/2024 XX AND EMPLOYERS'LIABILITY STA UTE gill- AN ANYPROPRIETORIPARTNERIEXECUTIVE YN!A E.L.EACH ACCIDENT $1,000,000 , OFFICERIMEMBEREXCLUDED7 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 E yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) RE:All Operations. *Additional Insured Does Not Apply to Workers'Compensation 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 /�t' 6.4 I • ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD • 1 ® DATE(MM/DD/YYYY) A�o CERTIFICATE OF LIABILITY INSURANCE 6/29/2022 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 CONNAMEACT Linda Shaddon HUB International Northwest,LLC PHONE • FAX PO Box 10167 (A/C.No.ExO:541-687-1117 INC.Nei:541-342-8280 Eugene OR 97440 EMAIL linda.shaddon@hubinternational.com INSURER(S)AFFORDING COVERAGE NAIC 1/ INSURER A:Indemnity Insurance Company of NA 43575 INSURED LAINCOM-01 INSURER B:Ace American Insurance Company 22667 Eugene Welder's Supply Co. INSURER c:Admiral Insurance Company 24856 dba Industrial Source/dba National Extinguisher Service dba National Fire Fighter Corp. INSURER D:Hallmark Specialty Insurance Company 26808 PO Box 7577 INSURER E: Springfield OR 97475 • ' INSURER F: , COVERAGES CERTIFICATE NUMBER:322454487 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. ITR TYPE OF INSURANCE JNSO WVD POLICY NUMBER (MMIDD�YY) (MMIDD�) LIMITS A X COMMERCIAL GENERAL LIABILITY Y V D37720136 6/30/2022 6/30/2023 EACH OCCURRENCE $1,000,000 DAMAGE RENED CLAIMS-MADE X OCCUR . PR M SESO(Ea occurrence) $100,000 MED EXP(Any one person) $10,000 ' PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY PRO-JECT X LOC PRODUCTS-COMP/OP AGO $2,000,000 OTHER: $ B AUTOMOBILE LIABILITY V V H08518713 6/30/2022 6/30/2023 (ECOMBIaaccident)NEDSINGLELIMIT $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) $ . D UMBRELLA LIAB X OCCUR Y 77HX2197DA 6/30/2022 6/30/2023 EACH OCCURRENCE $5,000,000 X EXCESS LIAB CLAIMS-MADE _AGGREGATE $5,000,000 DED RETENTION$ $ WORKERS COMPENSATION OTH- AND EMPLOYERS'LIABILITY Y/N PER ER ANYPROPRIETOR/PARTNER/EXECUTIVEI I N/A E.L,EACH ACCIDENT $ OFFICER/MEMBER EXCLUD ED7 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C General Liability for CA00003881202 6/30/2022 . 6/30/2023 Gen Agg!Occ $2M/$1 M National Fire Fighter Corp Prod.CO/Pers&Adv. $2M/$1 M Med Expense$5,000 Dmg to Rented Prem $300,000 • 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 and auto liability as required by written contract per attached endorsements. Umbrella follows form.All coverages are subject to policy limits,terms,conditions and exclusions. Gen'l Aggregate Limit Applies Per Policy for CA00003881202 • Secondary Excess Liability: Policy#:EXC30001807002 See Attached... 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 5PRESENTATIVE Ashland OR 97520 / I � • ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD , • AGENCY CUSTOMER ID: LAINCOM-01 LOC#: ACORE, ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED HUB International Northwest,LLC Eugene Welder's Supply Co. dba Industrial Source/dba National Extinguisher Service POLICY NUMBER dba National Fire Fighter Corp. PO Box 7577 Springfield OR 97475 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Policy Term:6/30/2022-6/30/2023 Each Occurrence:$5,000,000 Aggregate:$5,000,000 Underlying Policy Number: 77HX2197DA Excess Liability for National Fire Fighter Corp. Insurer:Admiral Insurance Company • Policy#:GX00000338202 Policy Term:6/30/2022-6/30/2023 Each Occurrence:$10,000,000 Aggregate:$10,000,000 Underlying Policy#:CA000038812012 • • • • • • • ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD • CHUBB® COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT Named Insured Eugene Welder's Supply Co.Inc., Endorsement Number See Named Insured Continuation Endorsement Policy Symbol Policy Number Policy Period Effective Date of Endorsement CAL H08518713 6/30/2022 TO 6/30/2023 6/30/2022 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: • BUSINESS AUTO COVERAGE FORM This endorsement modifies the Business Auto Coverage Form. 1. EXTENDED CANCELLATION CONDITION Paragraph A.2.b.—CANCELLATION-of the COMMON POLICY CONDITIONS form is deleted and replaced with the following: b. 6o days before the effective date of cancellation if we cancel for any other reason. 2. BROAD FORM INSURED A. Subsidiaries and Newly Acquired or Formed Organizations As Insureds The Named Insured shown in the Declarations is amended to include: 1. Any legally incorporated subsidiary in which you own more than 5o%of the voting stock on the effective date of the Coverage Form. However, the Named Insured does not include any subsidiary that is an "insured" under any other automobile policy or would be an"insured"under such a policy but for its termination or the exhaustion of its Limit of Insurance. 2. Any organization that is acquired or formed by you and over which you maintain majority ownership. However, the Named Insured does not include any newly formed or acquired organization: (a)That is an"insured"under any other automobile policy; (b)That has exhausted its Limit of Insurance under any other policy;or (c) 18o days or more after its acquisition or formation by you, unless you have given us written notice of the acquisition or formation. Coverage does not apply to"bodily injury"or"property damage"that results from an"accident"that occurred before you formed or acquired the organization. B. Employees as Insureds Paragraph A.1. — WHO IS AN INSURED — of SECTION II — COVERED AUTOS LIABILITY COVERAGE is amended to add the following: d. Any"employee"of yours while using a covered"auto"you don't own,hire or borrow in your business or your personal affairs. C. Lessors as Insureds Paragraph A.1. — WHO IS AN INSURED — of SECTION II — COVERED AUTOS LIABILITY COVERAGE is amended to add the following: DA-4817o(06/17) "Includes copyrighted material of Insurance Services Office, Page 1 of 5 Inc.with its permission 053 • • CHUBB' e. The lessor of a covered"auto"while the"auto"is leased to you under a written agreement if: (1) The agreement requires you to provide direct primary insurance for the lessor;and (2) The"auto"is leased without a driver. Such leased"auto"will be considered a covered"auto"you own and not a covered"auto"you hire. However,the lessor is an "insured" only for"bodily injury" or"property damage" resulting from the acts or omissions by: 1. You; 2. Any of your"employees"or agents;or 3. Any person, except the lessor or any "employee" or agent of the lessor, operating an "auto" with the permission of any of 1.and/or 2.above. D. Persons And Organizations As Insureds Under A Written Insured Contract Paragraph A.1 — WHO IS AN INSURED — of SECTION II — COVERED AUTOS LIABILITY COVERAGE is amended to add the following: f. Any person or organization with respect to the operation, maintenance or use of a covered "auto", provided that you and such person or organization have agreed under an express provision in a written "insured contract",written agreement or a written permit issued to you by a governmental or public authority to add such person or organization to this policy as an"insured". However,such person or organization is an"insured"only: (1) with respect to the operation,maintenance or use of a covered"auto";and (2) for"bodily injury"or"property damage"caused by an"accident"which takes place after: (a) You executed the"insured contract"or written agreement;or (b) The permit has been issued to you. 3. FELLOW EMPLOYEE COVERAGE EXCLUSION B.5. -FELLOW EMPLOYEE— of SECTION II — COVERED AUTOS LIABILITY COVERAGE does not apply. 4. PHYSICAL DAMAGE—ADDITIONAL TEMPORARY TRANSPORTATION EXPENSE COVERAGE Paragraph A.4.a. — TRANSPORTATION EXPENSES — of SECTION III — PHYSICAL DAMAGE COVERAGE is amended to provide a limit.of $50 per day for temporary transportation expense, subject to a maximum limit of $1,000. 5. AUTO LOAN/LEASE GAP COVERAGE Paragraph A. 4. = COVERAGE EXTENSIONS -of SECTION III —PHYSICAL DAMAGE COVERAGE is amended to add the following: c.Unpaid Loan or Lease Amounts In the event of a total"loss"to a covered"auto",we will pay any unpaid amount due on the loan or lease for a covered "auto"minus: 1. The amount paid under the Physical Damage Coverage Section of the policy;and 2. Any: a. Overdue loan/lease payments at the time of the"loss"; b. Financial penalties imposed under a lease for excessive use,abnormal wear and tear or high mileage; c. Security deposits not returned by the lessor: DA-4817o(06/17) "Includes copyrighted material of Insurance Services Office, Page 2 of 5 Inc.with its permission' 054 CHUBB0 d. Costs for extended warranties,Credit Life Insurance,Health,Accident or Disability Insurance purchased with the loan or lease;and e. Carry-over balances from previous loans or leases. • We will pay for any unpaid amount due on the loan or lease if caused by: 1. Other than Collision Coverage only if the Declarations indicate that Comprehensive Coverage is provided for any covered"auto'; 2. Specified Causes of Loss Coverage only if the Declarations indicate that Specified Causes of Loss Coverage is provided for any covered"auto"; or 3. Collision Coverage only if the Declarations indicate that Collision Coverage is provided for any covered"auto. 6. RENTAL AGENCY EXPENSE Paragraph A. 4. —COVERAGE EXTENSIONS—of SECTION III—PHYSICAL DAMAGE COVERAGE is amended to add the following: • d. Rental Expense We will pay the following expenses that you or any of your"employees" are legally obligated to pay because of a written contract or agreement entered into for use of a rental vehicle in the conduct of your business: • • MAXIMUM WE WILL PAY FOR ANY ONE CONTRACT OR AGREEMENT: 1. $2,500 for loss of income incurred by the rental agency during the period of time that vehicle is out of use because of actual damage to, or "loss" of,that vehicle, including income lost due to absence of that vehicle for use as a replacement; 2. $2,500 for decrease in trade-in value of the rental vehicle because of actual damage to that vehicle arising out of a covered"loss";and • 3. $2,5oo for administrative expenses incurred by the rental agency,as stated in the contract or agreement. • 4. $7,500 maximum total amount for paragraphs 1.,2.and 3.combined. 7. EXTRA EXPENSE—BROADENED COVERAGE • Paragraph A.4. — COVERAGE EXTENSIONS — of SECTION III — PHYSICAL DAMAGE COVERAGE is amended to add the following: e. Recovery Expense • We will pay for the expense of returning a stolen covered"auto"to you. 8. AIRBAG COVERAGE Paragraph B.3.a. - EXCLUSIONS — of SECTION III — PHYSICAL DAMAGE COVERAGE does not apply to the accidental or unintended discharge of an airbag. Coverage is excess over any other collectible insurance or warranty specifically designed to provide this coverage. 9. AUDIO,VISUAL AND DATA ELECTRONIC EQUIPMENT-BROADENED COVERAGE Paragraph C.1.b. —LIMIT OF INSURANCE-of SECTION III-PHYSICAL DAMAGE is deleted and replaced with the following: b. $2,000 is the most we will pay for"loss"in any one"accident"to all electronic equipment that reproduces,receives or transmits audio,visual or data signals which,at the time of"loss",is: (1) Permanently installed in or upon the covered "auto" in a housing, opening or other location that is not normally used by the"auto"manufacturer for the installation of such equipment; DA-4817o(06/17) "Includes copyrighted material of Insurance Services Office, Page 3 of 5 Inc.with its permission" 055 • CHUBB' (2) Removable from a permanently installed housing unit as described in Paragraph 2.a. above or is an integral part of that equipment;or (3) An integral part of such equipment. lo. GLASS REPAIR—WAIVER OF DEDUCTIBLE Under Paragraph D.-DEDUCTIBLE—'of SECTION III—PHYSICAL DAMAGE COVERAGE the following is added: No deductible applies to glass damage if the glass is repaired rather than replaced. ii.TWO OR MORE DEDUCTIBLES Paragraph D.-DEDUCTIBLE—of SECTION III—PHYSICAL DAMAGE COVERAGE is amended to add the following: ' If this Coverage Form and any other Coverage Form or policy issued to you by us that is not an automobile policy or Coverage Form applies to the same"accident",the following applies: 1. If the deductible under this Business Auto Coverage Form is the smaller(or smallest)deductible,it will be waived; or 2. If the deductible under this Business Auto Coverage Form is not the smaller (or smallest) deductible, it will be reduced by the amount of the smaller(or smallest)deductible. 12.AMENDED DUTIES IN THE EVENT OF ACCIDENT,CLAIM,SUIT OR LOSS Paragraph A.2.a. -DUTIES IN THE EVENT OF AN ACCIDENT,CLAIM,SUIT OR LOSS of SECTION W-BUSINESS AUTO CONDITIONS is deleted and replaced with the following: a. In the event of"accident",claim,"suit"or"loss",you must promptly notify us when the"accident"is known to: (i) You or your authorized representative,if you are an individual; (2) A partner,or any authorized representative,if you are a partnership; (3) A member,if you are a limited liability company;or (4) An executive officer,insurance manager, or authorized representative,if you are an organization other than a partnership or limited liability company. Knowledge of an"accident", claim, "suit" or"loss"by other persons does not imply that the persons listed above have such knowledge.. Notice to us should include: (i) How,when and where the"accident"or"loss"occurred; (2) The"insured's"name and address;and (3) To the extent possible,the names and addresses of any injured persons or witnesses. 13.WAIVER OF SUBROGATION Paragraph A.5. -TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US of SECTION IV— BUSINESS AUTO CONDITIONS is deleted and replaced with the following: 5. We will waive the right of recovery we would otherwise have against another person or organization for"loss"to which this insurance applies, provided the "insured"has waived their rights of recovery against such person or organization under a contract or agreement that is entered into before such"loss". To the extent that the "insured's" rights to recover damages for all or part of any payment made under this insurance has not been waived,those rights are transferred to us.That person or organization must-do everything necessary to secure our rights and must do nothing after"accident"or"loss"to impair them. DA-4817o(06/17) "Includes copyrighted material of Insurance Services Office, Page 4 of 5 Inc.with its permission" 056 • • CHUBB". • At our request, the insured will bring suit or transfer those rights to us and help us enforce them. 14. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS Paragraph B.2. - CONCEALMENT, MISREPRESENTATION or FRAUD of SECTION IV — BUSINESS AUTO • CONDITIONS-is deleted and replaced with the following: If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not void coverage under this Coverage Form because of such failure. 15. AUTOS RENTED BY EMPLOYEES Paragraph B.5. - OTHER INSURANCE of SECTION IV—BUSINESS AUTO.CONDITIONS.- is amended to add the following: e. Any"auto"hired or rented by your"employee"on your behalf and at your direction will be considered an"auto" you hire.If an"employee's"personal insurance also applies on an excess basis to a covered"auto"hired or rented by your "employee" on your behalf and at your direction, this insurance will be primary to the "employee's" personal insurance. i6. HIRED AUTO—COVERAGE TERRITORY Paragraph B.7.b.(5).-POLICY PERIOD,COVERAGE TERRITORY of SECTION IV-BUSINESS AUTO CONDITIONS is deleted and replaced with the following: (5)Anywhere in the world if a covered "auto" of the private passenger type is leased,hired, rented or borrowed without a driver for a period of 45 days or less;and 17. RESULTANT MENTAL ANGUISH COVERAGE Paragraph C. of - SECTION V — DEFINITIONS is deleted and replaced by the following: "Bodily injury"means bodily injury,sickness or disease sustained by any person,including mental anguish or death as a result of the"bodily injury"sustained by that person. • • DA-4817o(06/17) "Includes copyrighted material of Insurance Services Office, Page 5 of 5 Inc.with its permission" 057 • • • Insured;Eugene Welder's Supply Co. COMMERCIAL AUTO Policy 10 H08518713 CA 00 01 1013 BUSINESS AUTO COVERAGE FORM 19 Mobile Only Mose"autos"that are land vehicles and that would godly under the definition Equipment of"mobile equipmenT under this policy If they were not subject to a compulsory or Subject To financial responsibility law or other motor vehicle Insurance lay/Where they are Various provisions In this policy restrict coverage, SECTION I—COVERED AUTOS Compulsory Or licensed or princlpatygaraged. al Read Ore entre policy carefully to determine rights, R sports duties and what Is and Is not covered. Item Two of the Declarationsfoeacho hour the"autos"that OrOt erfMoty are covered"autos"for each of your coverages,autos,The VOrehicle Other Motor • Throughout this policy the words'you"and"your" following numerical symbols describe the"autos"that Vehicle refer to the Named Insured shown ill the Declarations, may be covered"autos".The symbols entered next to Insurance Lav/ The words'ba","us"and"our"refer to the company a coverage an the Declarations designate the only Only providing this Insurance. "autos"that are covered"autos". Other wards end phrases that appear In.quotation A.Description Of Covered Auto Designation B.Owned Autos You Acquire Alter The Policy SECTION II—COVERED AUTOS LIABILITY marks have special meaning.Rarer to Section V— Symbols Begins COVERAGE Definitions. 1.If Symbols 1,2,3,4,5,8 or 19 are entered A.Coverage next to a coverage In Item Two of the We W11I pay all sums an'Insured'legally must pay Symbol Description OI Covered Auto Designation Symbols Declarations, then you have coverage for as damages because Of"bodily injury'or"property • 'autos'that you acquire of the type described 1 Any"Aut •o" (fir the remainder of the otic period. damage"to Welch this Insurance applies,caused r y ofby an"accident"and resulting from the ownership 2 Owned"Autos' Only those"autos"you own(and for Covered Autos Liability Coverage any 2.But,If Symbol 7 laenlered next to a coverage maintenance or use of a covered"auto". Only 'trailers"you don't own while attached to power units you own).This Includes In Item Two of the Declarations,an'auto"you those"autos"you acquire ovmershlp of after the policy begins. WeWilalsooveedsumsion cost or expense" enmust acquire will be a covered"auto" for that pay as a"covered pollution cost a sed by"to 3 Owned Private Only the private passenger"autos"you cam.This Includes those private coverage only It which this Insurance applies, caused an Passenger passenger"Woe you acquire ownership of after the policy begins, • a.We already cover aft"autos"that you own "accident' and resulting from the ownership. Autos Only - for Ural coverage or It replaces en"auto" maintenance or use of covered"autos'.However, 4 Owned Only those"autos"you own That are not of the private passenger type(and for you previously owned that had that we will only pay for the"covered pollution cost or "Autos"Other Covered Autos Llabilty Coverage any'trailers"you don't own while attached to coverage;and• expense" if there Is either"bodily Injury' or Than Private pourer units you own).This Includes those"autos"not of the private passenger b.You tell us Within 30 days after you acquire "property damage'to which this Insurance applies Passenger type you acquire ownership of after the policy begins. ft that you want us to cover it for that that Is caused by the same"accident'. "Autos"Ont./ coverage. We have the right and duty to defend any 6 Owned"Autos" Only those"autos"you own that are required to have no-fault benefits In the state C.Certain Trailers,Mobile Equipment And 'insured'against a"suit"asldng for such damages Subject To where they are licensed or principally garaged,This Includes those"autos"you Temporary Substitute Autos ora"covered pollution cost or expense".However, No-fault acquire ownership of after the policy begins provided they are required to have no- vie have no duty to defend any"insured'against a fault benefits in the state where they are licensed or principally garaged, If Covered Autos Liability Coverage Is provided by "suit" eeeldrg damages lot"bodily Injury' or this Coverage Form, the IollovAng types of d 8 Owned"Autos" Only those"autos"you own that because of the laIn the state where they are Vehicles ere also covered"autos"for Covered 'property damage"CIT a"covered pollution cost°r Subject To A licensed or principally garaged are required to have and cannot reject Uninsured Autos Liabli Coverage: expense"to which this Insurance does not apply. Compulsory Motorists Coverage.This includes those"autos"you acquire ownership of after the riY g We may Investigate and settle any claim or"suit" Uninsured policy begins provided they are subject to the same slate uninsured motorists 1.'Trailers"with a load capadty o12,000 pounds as we consider appropriate.Our duty to defend or Motorists Law requirement or less designed primarily for travel on public seltie ends when the Covered Autos Liability 7 Specifically Only those"autos"described in Item Three of the Declarations farndricha roads, Coverage Limit of Insurance has been exhausted Described premium charge is shwm(and for Covered Autos Liability Coverage any"trailers" 2."While equipment'while being carried or by payment of judgments or settlements. "Autos" you dont own vette attached to any power unit described in Item Three). toured by a covered"auto". 1.Who Is An Insured 8 Hired"Autos" Only those"autos"you lease,hire,rent or borrow.This dues not Include any"auto" 3.My"auto"you do not ovm calcite used with the Tho following are"Insureds". Only you lease,hire,rent or borrow from any of your"employees",partners(Il you area permission of Its owner as a temporary a.You for any covered"auto". partnership),members(If you area limited liability company)or members of their substitute fora covered"auto"you can that Is• b.Anyone else while usingwith your households. out of service because of Its: permission a covered auto you own, ire • 9 Non-owned Only those"autos"you do not own,lease.hire,renter borrow that are used In• a.Breakdovm; or borrow except: "Autos"Only connection with your business.This Includes"autos"owned by your"employees", b.Repair; partners(Ir you are a partnership),members(II you are a limited liability company) (1)The owner or anyone else from.Nom or members of their households but only virile used In your business or your a Servicing; you Nre arborrow ecovered°auto', personal affairs. d.'Less;or This exception does not apply If the e.Destruction. covered"auto"Is a'Haller"connected to a covered"autd"you own. CA 00 01 1013 @ Insurance Services Office,Inc,2011 Page 1 of 12 Page 2 of 12 Cr Insurance Services Office,Ina,2011 CA 00 01 1013 • • • • (2)Your"employee"lithe covered"auto"Is These payments will not reduce the Limit of 4.Employee indemnification And Employer's b.Ager It Is moved from the covered"auto"to owned by that"employed'or a member Insurance. Liability the place where Itis finally delivered by the at his or her household. 'insured'. b.OutafsGla Coverage Extensions "Roddy Injury'to: (3)Someone using a covered"auto"while Mlle a covered"auto"Is away from the a.An"employee"of the'insured'arising out e,Movement Of Property By Mechenlcai • he or she Is wnridng in a business of state where Itis licensed,we writ: of and In the course of Device selling,servicing,repairing,parldng cr "Bodo injury'or""property damage-results • • stating"autos"unless that business Is (1)Increase the Limit of Insurance for (1)Employment by the insured;or from"Bodily movemenle of property by resulting yours. Covered Autos Liability Coverage to (2)Performing the duties related to the meet the r fi sppeeclred by amechanicals device(other than a hand vexed • compulso m finandel respanstxlity conduct of the"insured's"twslness;or (4)Ahyone other than your"employees", unless the device Is attached to the covered partners (II you are a partnership), law of the where the covered b.The spouse,child,parent,brother or sister "auto", members(if you ere a limited liability "auto"Is being Used.This extension of that"employed"as a consequence of g,Operations - company)ora lessee or borrower or does not apply to the limit or limits Paragraph a,above. a any of their"employees",'Ale moving specified by any late governing motor This exclusion applies: "Baily of the operation hrIn)Urjury' r"property damage"arising out o eh. property to or from a covered"auto'. carders of passengers or property, (1)Whether the"insured"may be Gable as a.Any equipment listed In Paragraphs 6.b. (5)A partner(if you area partnership)ora (2)'Provide the minimum amounts and an employer or In any other capacity, and e,o. of the definition of "mobile member(II you area limited!lability types of other coverages,such as no. and equipment:or company)fora covered"auto"owned by fault,required al outhhstate vehicles by ' him or her or a member of Ms or her the Jurisdiction where the covered"auto" (2)To any obligation to share damages with b.Machinery or equipmj,ehl Is an,attached househeW. or repay someone else who must pay to or part of a landdvehicle that would Is being used. damages because of the Injury, quality Under the definition of "mobile c.Anyone liable for the conduct of an We wall not pay anyone more than once for 'insured'described above but only to the the same elements of lass because of But this exclusion does not apply to"coolly equipment"If II were not subject to a cadent of that liability. these extensions. InJuy to domestic"employees"not entitled to compulsory or financial responsibility law or workers'compensation benefits or to liability other motor vehicle Insurance law where It • B.Exclusions assumed by the"Insured"under an Insured is licensed or principally garaged. a.Supplementary Payments Thls Insurance does not apply to any of the contract".For the purposes of the Common 10,Completed Operations We will pay far the"insured': fallowing: Foran, a domestic"employee"Is a person "Radii injury'or (1)At a engaged N household or domestic work Y J N' 'property damage'arising out expenses we Incur. • 1.Expected Or Intended Injury performed principally In connection vrith a of your work after that work has been • (2)Up to$2,000 for cost of ball bonds "Bodily Injury'ar"property damage'expected residence premises. completed or abandoned. • (Including bonds for related traffic law or intended from the slaridpoint of the 5.Fellow Employee in this exclusion,your work means: • violations) required because of an "Insured', a,Work or operations pedonmed by you or on 'SccIdere we cover-We do not have to "Bodily injury'to: 2,Contractualyour behalf,and furnish these bonds. a.My fellow"employee" of the'Insured' J The cost of bonds to release Liability assumed under any contract or • arising out al and In the course of the(clow Is.Meledats,pans or equfpmenl Nmished In 1) agreement. "employee's" employment or Wage connedlonVriNsuchwerkaroperaUone. attachments we defend,In any"butt"onagly ors!bondd But this exclusion does notto liable for Insured' but ons ranr apply Y "employee's" dupes tel to the conduct of Your work Includes v2rrverb or amounts within our Limit of Insurance. damages: your business;or representations made at any rime with respect (4)An reasonable expenses Incurred by the a.Assumed Ina contract or agreement that Is b.The spouse,child.parent,brother or sister to the fitness,quality,durability or performance of "Insured'at our request,Including actual an"insured contrail',provided the"bodily of that fellow"employee"as a consequence b'ebove.Ne ttems Included In Paragraph e.or loss of earnings up to$250 a day injury' or property damage" occurs of Paragraph a.above. because of lime Wham wade subsequent to the execution of the contract 6.Care,Custody Or Control Your work vnll be deemed completed at the or agreement or earliest of the following times: (5)All court costs taxed against the b.That the "insured' would have In the "Property damage"to or"covered pollution cost (1)When all of the Work called for In your Insured" In any Suit" against the absence of the contract are agreement. •• or expense" involving property wIed or contract has been completed; "Insured"we defend.a alta However,these9 transported by the "insured' or In the p payments do not Include attorneys'fees 3.Workers'Compensation "insureds"care,custody or control.But this (2)When at of the Work to be done at the or attorneys'expenses taxed against theexclusion does not apply to liability assumed site has been completed it your contract 'Insured". My obligation for which the"insured'or the under a sidetrack agreement. calls for work at more than one site:or Insureds"Insurer maybe hell liable under (6)Al interest on the full amount of any any workers'compensation,disability benefits 7.Handling Of Property (3)When that pad of the work done at a job judgment that accrues after entry of the or unemployment compensation taw or any "Bodily Injury'or"property damage"resulting site has been put la Its Intended use by judgment In any 'Suit" against the similar law. from Ne of le any person or organization other than handling property: Insuretwe defend,but our duty to pay another contractor or subcontractor Interest ends when we have paid, a.Before It is moved from the place where It is working on the same project offered to pay or deposited In court the accepted by the Insured'for movement part Of the judgment that Is within our Into or onto the covered"auto;or Limit of Insurance. CA 00 01 10 13 O Insurance Services OBce,Ina,2011 Page3 of12 Page 40112 Sa Insurance Services Office,lite,,2011 CA 00 01 10 13 • • Work that may need service,maintenance, Paragraphs b.and e.above of this exclusion All"bodily Injury","property damage"and"covered 3.Glass Breakage—Hitting A Bird Or Animal— correction,repair or replacement,but which Is do not apply to"accidents"that occur away pollution cost or expanse" resulting tram Falling Objects Or Missiles • otherwise complete, will be treated as from premises owned by or rented to an continuous or repeated exposure to substantially If you carry Comprehensive Coverage for the ' completed. "Insured"vnth respect to"pollutants"not in or the Frame conditions will be considered as damaged covered"auto",we will pay for the 11.Pollution upon a covered"auto"If resulting from one"accident". following under Comprehensive Coverage: "Bodily Injury'or"property damage"adsing out (a)The"pollutants"or any property In • No one will be entitled to receive duplicate a.Glass breakage; of the actual,alleged or threatened discharge, which the"pollutants'are contained payments far the same elements of"loss"under dispersal, seepage, migration, release or are upset,overturned or damaged as this Coverage Form and any Medical Payments h.'Loss"caused by hitting a bird or animal; a result of the maintenance or use of Coveragendorsement, Uninsured Motorists and' escape of"pollutants": a covered"auto';and Coverage endorsement orach Underinsured this Molodsts e,'Loss"caused by failing objects or missiles. a.That are, or that are contained In any b The dischar Coverage endorsement attached to this Coverage property that Is: O le,dispersal,seepage, Pad bHowever,reakage you have the option'vof end having glass 1 Beingtransported or towed h handled migration,release or escape of the breakage caused by a covered "auto's" () o Ppy, "pollutants" Is caused directly by SECTION III—PHYSICAL DAMAGE COVERAGE collision or overturn considered a"loss"under or handled for movement into,onto or such upset,overturn or damage, Collision Coverage. from the covered"auto; • A.Coverage g 12.War 1.We win payler"Ioss'toecovered"auto'or hs 4.Coverage Extensions (2)Otherwise In the course of transit by ar on behalf of the'Insured";or "Bodily Injury'or"properly damage"arisingequipment under. a.Transportation Expenses (3)Being stored,disposed of,treated or - directly or indirectly out of: a.Comprehensive Coverage We will pay up to$20 per day, to a processed In or upon the covered a.War,including undeclared or civil war, From any cause except maximum of 5600, for temporary "auto"; b,Warlike action by a military force,Including 1 The covered "autos" collision with transportation expense incurred by you b.Before the"ollulants'or anyo action In hindering or defending against an () because of the total theft of a covered p property In another object:or "auto"of the passenger type.We which the"pollutants"are contained are actual en expected attack, by any private cover er moved from the place Where they are government,sovereign or other authority (2)The covered"auto's"overturn. vng pay only for those covered"autos"for accepted by the'insured'for movement using military personnel or other agents:or b.Specified Causes Of Loss Coverage which you carry either Comprehensive or SpInto or onto the covered"auto";or e•Insurrection,rebellion,revolution.usurped Caused viii pay Causes t mf Loss transport We c.After the"pollutants"or any property In power or action taken by govammental ex rpes for temporarydduring transportation Which the"pollutants"are contained are authority in hindering or defending against (1 Fire,(Shining or explosion; expenses Incurred the period an of these. (2 Theft; beginning 4a hours after the theft and moved from the covered"auto"to the place Y ending,regardless of the polity's expiration, Where they are finally delivered,disposed of 13.Racing (3 Windstorm,hall or earthquake; when the covered"auto"Is returned to use or abandoned by the"insured'. Covered"autos"While used In any professional - (4 Flood; orae pay for Its"loss". Paragraph a.above does not apply to fuels, or organhed racing or demolition contest or (5 Mischief or vandalism;or h.Loss Of Use Expenses lubricants, fluids, exhaust gases or other stunting activity,or while practidng for such (5 The sinking, burning, collision or For Hired Auto Physical Damage,we will from that are needed for or result contest or activity.This Insurance also doesderailment of anconveyance pay expenses for which en "Insured" from the normal electrical, hydraulic or not apply while that covered"auto"Is 13019g transporting the covered"auto"c , becomes legally responsible to pay for loss mechanical functioning of me covered"auto"or prepared for such a contest or activity. transporting use of a vehicle rented or hired without a Rs pads It C.Limit Oflnsurancec.Collision Coverage driver under a mitten rental contract or (1)The"pollutants"escape,seep,migrate Regardless of the number of covered"autos", Caused by. agreement We will pay for.loss of use or are discharged,dispersed or released ^Insureds',, premiums paid, claims made or (1)The covered "auto's" collision with expenses lfcaused by: directly from an"auto•pad designed by vehicles Involved In the"accident',the most we another object or (1)Other than collision only If the its manufacturer la hold.store,receive Will pay for the total of all damages and"covered 2 The covered"auto's"overturn., Declarations indicates that or dispose of such"pollutants':and pollution cost or expense"combined resulting from () (2)The'bodily injury'."property damage"or anyone"accident"Is the Lint Of Insurance for 2.Towing Comnrehensive Coverage Is provided for any covered"amp'; "covered pollution cost or expense" Covered Autos Liability Coverage shown In the We will pay up to the limit shover In the (2)Specified Causes Of Loss only if the does not arise out of the operation of Declarations. Declarations for towing and labor costs Declarations indicates that Specified any equipment listed In Paragraphs 6.h. Incurred each time a covered"auto"of the Causes Of Loss Coverage Is provided end 6.0.of the definition of"mobre private passenger type Is disabled.However, equipment"'. the labor must be performed at the place of for any covered"auto or disablement. • CA 00 01 1013 G Insurance Services Office,Inc,2011 Page 5 of 12 Pogo B of 12 m Insurance Services Office,Inc.,2011 CA 00 61 1013, • • • • (3)Collision only If the Declarations b.Any device designed or used to detect (2)Removable from permanently Installed (2)The"insured's"name andeddress;and Indicates that Collision Coverage Is speed-measuring equipment such as radar housing unit as described In Paragraph (3)•To the extent possible,the names and provided for any covered"auto". or laser detectors, and any jammIng b.(1)above;or addresses of any Injured persons and apparatus Intended to elude or disrupt An Integral capeHowever,the most we vs$pay for any (3) e part of such equipment as witnesses. expenses for loss of use Is 520 per day,to speed-measuring equipment described In Paragraphs b.(1)and b.(2) b.Additionally,you and any other InvoNed a maximum of$600. a Any electronic equipment,without regard to above. "insured'must: B.Exclusions whether this equipment Is permanently 2.An adjustment for depredation and physical Installed, that reproduces, receives or condition will be made In determiningactual (1)Assume no obllgallmake no 1.We WI/not pay for"loss'caused by or resultingtransmits audio,visual or data signals. payment or Incur no en,expense without from any of the (olloing. Such"losss"' Is Is cash value In the event al a totalloss' our consent,except at the"Insureds" excluded regardless al any other cause or d.Any accessories used with the electronic 3.If s repair or replacement results In better than avm cost ,,,, event that contributes concurrently or In any equipment described In Paragraph c, Iike Idnd or quality,ora vet not pay for the (2)(gypedialety send us copies of any sequence to the loss". above. amount of the betterment request demand, order, notice, . a.Nuclear Hazard 5.Exclusions 4.e.and 4.d.do not apply to D.Deductible summons or legal paper received equipment designed to be operated solely by concerning the claim cur"evil". (1)The explosion of any weapon employing use of the power from the"auto's'electrical Far each covered"auto",our obligation to pay for, atomic fission or fusion;or system that,al the lime of"loss",Is: repair, return or replace damaged or stolen (3)Cooperate vrith us In the Investigation at (2)Nuclear reaction or radiation, ordeductible will ba.reduced by the applicable settlement of the claim or defense a.Permanently Installed In or upon the deductible sham In the Declarations. Any against the"salt'. •• radioactive contamination, however covered"auto'', Comprehensive Coverage deductible sham In the caused. R g (4)Authorize us to obtain medical records b.Removable from a homing unit Witch Is Declarations does not apply to'lose caused byor other pertinent Information. • b.War Or Military Action permanently Installed In or upon the fire or lightning. (5)Submit to examination,at our expense, (1)War,Including undeclared or civil war; covered"auto'; SECTION IV—BUSINESS AUTO CONDITIONS• by physicians of our choice,as often as (2)Warlike action by a military force, c.An Integral part of the same unit housing The follovAng conditions apply In addition to the we reasonably require. Including action In hindering or any electronic equipment described In Common Policy Conditions: e,11 thele Is"loss'to a Covered"auto"or Its • defending against an equal or expected Paragraphs a.and b.above;or 'A.Loss Conditions equipment,you must also do the following: attack,by any government sovereign or d.Necessary for the normal operation of the other authority using military personnel covered"auto'or the monitoring of the 1.Appraisal For Physical Damage Lass (1)Promptly notify the police If the covered . or other agents;or covered"auto's'operating system. It you and we disagree on the amount o("toss" "auto"or any of its equipment Is stolen. • (3)Insurrection. rebellion, revolution, 6.We will not pay for"loss"to a covered"auto' either may demand an appraisal of the"loss'. (2)Take ail reasonable steps to protect the usurped power or action taken by due to"diminution In value". In this event each party will select a competent coveted "auto"from further damage. , governmental authority In hindering or • appraiser.The Mn appraisers will select a Also keep a record of your expenses for e a C.Limits Of Insurance competent and impartial umpire. The consideration In the settlement of the defending against any of these. Pe Pa P ' 2.We vAll not pay for lose to any covered"pule 1.The most we vrill pay for. appraisers vAil state separately the actual cash claim whilevalue and amount ol"loss".If they fail to agree, (3)Permit us to Inspect the covered"auto" rade used In any contest professional or organized a.'toss"to any one covered"auto"is the Pe they v.111 submit their differences to the umpire• and records proving the"loss"before Its raring or practicingacticontest c olest activity, lesser of; A decision agreed to byanytwo vol be P or while for such contest or adNdy, (1)The actual cash value of the damaged prepair or disposition. binding.Each party will: We will also not pay for red"to any covered "t stolen property as of the lime of the (4) ue to give us a under oath at our "auto" while that covered "oma" Is being 'loss';or a.Pay its chosen appraiser,and request and give us a signed•slalemenl prepared for such a contest or activity. ' The cost of repairing or repladng the b.Bear the other expenses of the appraisal of your ensurers. •• 3,We will not pay forlorn"due and confined to: damaged or stolen property with other and umpire equally, 3.Legal Action Against Us a.Wear and tear, freezing, mechanical or property of t:he kind and quality. 11 caw submit to an appraisal,we will s1i0 retain Na one may bring a legal action against us • • electrical breakdown. b.All electronic equipment that reproduces, our right to deny the claim. under this Coverage Form until: • b.Blawnuls,punctures or other road damage receives or transmits audio,visual or data 2.Duties In The Event of Accident,Claim,Suit a,There has been NA compliance svih all the • to tires. signals In any one'loss"Is 51.000.11.at the Or Loss terms of this Coverage Farm;and • • This exclusion does not apply to such'loss" time of"loss",such electronic equipment Is: We have no duty to provide coverage under b.Under Covered Autos Liability Coverage, • resulting from the total theft of a covered (1)Permanently Installed In or upon the this policy unless there hat been full we agree In writing that the'Insured'has an ' "auto". covered"auto"Inc housing,opening or compliance with the(alloying duties: obligation to pay or until the amount of that • other location that is riot normally used a.In the event of"accident',claim,"suit'or obligation has finally been determined by 4.We wnl not pay for"ices" to any of the bythe "auto" manufacturer for the y following: 'ions",you must prom us or our authorized Judgment after trial.No one has the right • Installation at such equipment; representative prompt notice of the under this policy to bring us Into an adios • a.Tapes' discsorother similar audio, visual at data electronic le r ic devices designed "accident'or"oss".Include: to determine the"Insureds"liability. fr use Mb audio,visual or data electronic (1)How,vben and twrere the"acdden['or equipment. lass'occurred; 1 CA 00011013 ©Insurance Services Office,Inc.,2011 Page 7 of 12 Page 6 of 12 ®Insurance Services Office,Inc.,2011 CA 00 01 10 13 • • • 4.Loss Payment—Physical Damage 5.Other Insurance 7.Policy Period,Coverage Territory 2.Any other land vehicle that is subject to a Coverages e.For any covered "auto°you own, this Under this Coverage Form, we cover compulsory insurance responsibility law or At our option,we may. Coverage Farm provides primary "acddenls"and losses''occurring. other molar vehicle Insurance law vfiere it Is a.,Payfor, repair or replace damaged or Insurance.For any covered"auto"you don't licensed or principally garaged. rt p g own, the Insurance ovkled h this a.During the policy period shown In the However, "auto" does not Include "mobile stolen property, s Y Declarations;aim Coverage Farm Is excess aver any other equipment', h.Return the stolen property,at our expense. collectiblevreInsurance. However, vitro a b.Within the coverage territory. We will pay for any damage that results to covered "auto" which is a 'trailer Is C.'Bodily Injury' eusta means bodily Injury,insickness dor eath the"auto"ham the theft;et connected to another vehicle,the Covered The TheUntedSaes resulting 'sustained n any by a person,Including death e.Take at or any part of the damaged or Autos Liability Coverage this Coverage (1)The United States of America; resulting from of these. stolen property al an agreed or appraised Form provides for the"trailer"Is: (2)The territories and possessions of the D."Covered pollution cost or expense'means any value. (1)Excess Mime It is connected to a motor United States of America;. cost or expense earring out oh If we pay for the lass".our payment Will vehicle you do not oven;or • (3)Puerto Rico; 1.My request,demand,order or statutory or Include the applicable sales tax for the (2)Primary while It Is connected to a (4)Canada;and regulatory requirement that any"insured"or ,— damaged or stolen propedy. covered"auto"you own. Anywhere In the world If a covered others test far,monitor,clean up,remove, 5.Transfer Of Rights Or Recover Against (� contain,heal,detoxify or assess t tae,or In any Others r Us y g b.For Hired Auto Physical Damage Coverage, "auto"of the private passenger type Is way respond to,or the effects of, any covered"auto"you lease,hire,rent of leased, hired rented or borrowed "pollutants",or It any person or organization to or for ve tom we borrow Is deemed to be a covered"auto" without a driver far a period of 30 days 2.An claim or'hots'bywon behalf of a make payment under this Coverage Form has you oven. However, any"auto' that Is or less, Y rights to recover damages from another,these leased,hired,tented at borrowed With a provided that the'Insureds"responsibility to governmental for, monitoring, ffor damages because rights are transferred to us.That person or driver is note covered"auto", "o nY re lylrg, ntng,treating, detoxifig up, pay damages Is United Stateste Ina"said an the removing,neutralizing,o r Inian treallne ondi iging or securiz ighstts an musthdo nocengary toer c,Regardless i the erage Fs Covered merits,s the osses nsof oe UniedcS,les ta le any way responding to,or secure our rights and must a nothing after a.above,this Coverage Form's Covered territories and Puerto or the United Elates assessing the effects of"pollutants". "accldenl"ar'loss"to Impair them. Autos Liability Coverage Is primary far any of America,puerto Rico Canada,or In a B.General Conditions liability assumed under an "Insured settlement we agree to. "Covered o cost or expense"does not Include anyy ccostost or expense arising out of the centred". We also cover "loss" to, or "acckenls'1.Bankruptcy actual,alleged or threatened discharge,dispersal, Bankruptcy or Insolvency a(the"Insofar orthe d•When this Coverage Form and any other Ins/oh/Mg, a covered "auto" while being seepage, migration, release or escape of "Insured's"estate vA0 not relieve us of any Coverage Farm or policy covers on the transported between any of these places. "potutani obligations under this Coverage same basis,ether excess or primary:we 0.Twu Or More Coverage Forms Or Policies g g a.That are,or that are contained In any Will pay only our share.Our shares the Issued By Us that Is: ' 2.Concealment,fllsropreseetallon Or Fraud proportion that the Limit of Insurance of our pra Petty If this Coverageany other Coverage Form and This Coverage Form Is void In any case of Coverage Form bears to the total of the (1)Being transported or towed 6y,handled fraud by you at any time as it relates to this limits of all the Coverage Forms and Form or policy issued to you by us or any or handled for movement Into,onto or Coverage Farm.It Is also void If you or any policies covering on the same basis company affiliated with us applies to the same from the covered"auto'; other 'Insured", at anytime, Intentionally accident',the aggregate maximum Limit of 2 Otherwise In the course of transit b or y 0.Premium Audit Insurance under all the Coverage Forms or () Y conceals or misrepresents a material fad a,The estimated premium for this Coverage policies shat not exceed the highest applicable an hehallaflhe'Insured'or concerning: Foran Is based on the exposures you told us Limit at Insurance under any one Coverage (3)Being stored,disposed of,treated or a.This Coverage Form; you Would have when this policy began.We i Farm or policy.This condgion does not apply to processed N or upon the covered b.The covered"auto`, will compute the final premium due viten any Coverage Form or policy Issued by us or "add; e.Your Interest In the covered"auto";or we determine your actual exposures.The an affiliated company specifically to apply as . b.Before the"pollutants"or any property in estimated total premium Will be credited excess Insurance over this Coverage Form, Witch the"pollutants"are contained are d.A claim under this Coverage Form. against the final premium due and the first SECTION V—DEFINITIONS moved from the place where they are 3.Liberalization Named Insured viii be billed for the • A."Accident' Includes continuous or repeated accepted by the'Insured'for movement we revbalance,if any.The due date for the final Into or onto the covered"auto",or If revise thN Coverage Form to provide exposure to the same conditions resulting In more coverage without additional premium dateshcAvn asm or t hedue da premium `o of the lhtinif 'bodily injury'or"property damage". c.Alter the"pollutants"ar any property in charge,your policy will automatically provide the estimated total premium exceeds the B."Auto"means: which the"pollutants"are contained are the additional coverage as of the day the final premium due,the first Named Insuredmoved from the covered"auto"to the place revision is effective In your slats. Will Beta refund. 1.A land motor vehicle,'trailer"or semitrailer they are finally delivered,disposed of 4.No Benefit To Bailee—Physical Damage b.If lists policy Is Issued for mare than one designed for travel on pulsar'roads;or or abandoned by the'Insured'. Coverages year,the premium for this Coverage Form We Will not recognize any assignment or grant will be computed annually based on our any coverage far the benefit of any person ar rates or premiums In effect at the beginning • organization holding, steam or transporting of each year of the policy, property for a foe regardless of any other provision of this Coverage Form. CA 00 01 1013 CO Insurance Services Office,Inc,2011 Page 9 of 12 Page 104412 Or Insurance Services Office,Inc.,2011 CA 00 01 1013 a ' • ' Paragraph a.above does nal apply to fuels, 5.That part of any other contract or agreement 4.Vehicles, whether sell-propelled or not, However,"mobile equipment"does not Made lubricants, 0ulds, exhaust gases or other pertaining to your business (Including an maintained primarily to provide mobility to land vehicles that are subject to a compulsory or similar"pollutants"that ere needed for or result Indemnification of a munidpality In connection permanently mounted: financial responsibility law or other motor vehicle from the normal electrical, hydraulic or with work performed for a muntclpally)under a.Power cranes,shovels,loaders,diggers or Insurance law where it Is.licensed or principally mechanical functioning of the covered"auto"or which you assume the tort liability of another to drills;or garaged.Land vehicles subject to a compulsory or Its parts,it pay for'bodily Injury'or"property damage"la a financial responsibility law or other molar vehicle (1)The"pollutants"escape,seep,migrate Ihird.party or organization.Tort liability means b.Road construction or resurfacing equipment Insurance law are considered"autos". cr am discharged,dispersed or released a liability that would be.imposed by law In the such as graders,scrapers or rollers; L."Pollutants"means any solid,liquid,gaseous or directly from an"auto"pan designed by absence of any contract or agreement or 5.Vehicles not described in Paragraph 1.,2.,3. thermal Irritant or contaminant Including smoke, its manufacturer to hold,store,receive 6.That part of any contract or agreement entered or 4.above that are not selfpropelied and are vapor,soot fumes,acids,alkalis,chemicals and or dispose or such"pollutants;and Into,as part of your business,pertaining to the maintained primarily to provide mobility to waste.Waste Includes materials to be recycled, (2)The'bodily Injury', rental or lease, by you or any of your permanently attached equipment of the reconditioned or reclaimed, y J y,"p opertyda expense" "employees".a( au a However, such following types: "covered pollution cost or any" H."Property damage"means damage to or loss of , does not arise out of the operation of contractor agreement shall not be considered a.Air compressors,pumps and generators, use of tangible property. an ul hent listed In Paragraph s.b. an'Insured contract"to the extent that f Including spraying, welding, building y p obligates you or any of your"employees'to cleaning,geophysical exploration,lighting N."Suit•means a obit proceeding Nvhlch: or ipm of the definition of 'mobile a for"property damage"to any'auto" and weltservidn equipment Damages because of 'bodily Injury' or • • equipment". pay P PedY 8" 'a g q pment or 1. Paragraphs b,and a.above do not appl to or leased by you or any of your"employees'. b.Chef "property or y ry pickers aM sinter deNcos used to "accidents"that occur away from premises An'Insured contract'does not Include that part of raise or lower workers;or 2.A"covered pollution cost or expense'; owned by or rented to an"insured'vdth respect any contract of agreement 6.Vehicles not described In Paragraph 1.,2„3. to which this Insurance applies,are alleged. , to"pollutants”not In or upon a covered"auto" a.That indemnifies a railroad for'bediy Injury' or 4,above maintained primarily for purposes "Suit"Includes: • It or "property damage" arising out of other than the transportation of persons or (a)The"pollutants'or any property In construction or demolition operations,W,thin cargo.However,sell-propelled vehicles with a.An arbitration proceeding In which such which the"pollutants"are contained 50 feet of any railroad property and the followitlg types of permanently attached damages or"covered pollution costs or p° affectinganyrailroad bridge or trestle, equipment are not"mobile equipment"but wit expenses are claimed and to which the are upset,resultoftheoverNmee ante or use of tracks. roadeds, tunnel,underpass or - bcnsidered"autos". 'Insured"must submit or does submit with a c d maintenance or use of crossing; our consent;or a covered"auto;and a.Equipment designed primarily for i b.Thalpertains to the loan,lease or rental of b.Any other alternative dispute resolution c {b)The discharge,dispersal,seepage, (1)Snow removal; proceeding In which such damages or migration,release or escape of the 'auto" to you ar any of your P n9 9 "pollutants' N caused dkectl b "employees",If the"auto'Is loaned,leased (2)Road maintenance,but not construction "coveted pollution costs or expenses are . pro y y or rented with a driver,or or resurfacing;or claimed and to which the insured submits such upset,overturn ar damage, vrilb our consent E."Diminution In value" means the actual or e•That holds a parson or organization (3)Street cleaning; perceived loss In market value or resale value engaged In the business of transporting b.Cherry pickers end similar devices mounted O.Temporary you te'means a person who Is which results from a direct and accidental'lose'. property by"auto'for hire harmless for your on automobile or truck chassis and used to furnished to yyou to substitute fora permanent use of a covered"auto'over a route or false or lowerworkers;and "employee"on leave or to meet seasonal or short- F."Employee" Includes a "leased worker'. territory that person or organba0on Is e.Air compressors, um and a term workload conditions. "Employee" does not Include a 'temporary authorized to servo bp pumps generators vmrker', pubilc authority. Including spraying, welding; building P.'Traltet'Includes semltraller. I.'Leased worker"Means a person leased to you by cleaning,geophysical exploration,lighting G."Insured" means any person or organization a labor leasing firm under an agreement between erwet-servicing equipment • qualifying as en Insured In the Who is An Insured you and the labor leasing firm to perform duties • provision of the applicable coverage.Except with related to the conduct of your business.'Leased • respect to the Limit of Insurance,the coverage worker'does not include a Temporary worker". afforded applies separately to each Insured who Is • "Loss" means direct and ecddental loss or seeking coverage or against whom•a claim or •.damage. "suit"Is brought H."Insured contract"means: K."Mobile equipment'means any of the fallowing 1.A lease of anises; types of land.vehicles,Including any attached pr machinery or equipment • . 2,A sidetrack agreement; 1.Bulldozers,farm machinery,'Wills and other 3.Any easement or license agreement,except in vehicles designed for use prindpa0y oll public connection with construction or demolition roads; ' operations on or within 50 feet of a railroad; 2.Vehicles maintained for use solely on or next to ' 4.An obligation,as required by ordinance,to premises you cam errant Indemnify a municipality,except in connection 3.Vehicles that traveler crawler treads; • with work far a municipally, 1 CA 00 01 1013 ©Insurance Services Office,Inc.,2011 Page 11 of 12 Page 12 0112 Cr Insurance Services Office,Inc.,2011 CA 00 01 1013 • • POLICY NUMBER: D37720136 • Eugene Welder's Supply Co, DBA Industrial Source ADDITIONAL INSURED-WHERE REQURED UNDER CONTRACT OR AGREEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM Section II-Who is an Insured, 1.,is amended to add as an additional insured: (f) Any person or organization to whom you become obligated to indude as an additional insured under this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization, but only with respect to liability for "bodiy injury", "property damage" or "personal and advertising injury" arising out of your operations or premises owned by or rented by you. However,the insurance provided will not exceed the lessor: 1. The coverage and/or limits of this policy,or 2. The coverage and/or limits required by said contract or agreement • • Authorized Agent LD-16422 (04/04) Reprinted with permission of Insurance Services Office Page 1 of 1 POLICY NUMBER: D37720136 COMMERCIAL GENERAL LIABILITY Eugene Welder's Supply Co, DBA Industrial Source CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: as required by written contract or agreement Information required to complete this Schedule, if not shown above,will be shown in the Declarations. • The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. • • • • CG 24 04 05 09 ©Insurance Services Office, Inc.,2008 Page 1 of 1 ❑ • POLICY NUMBER: D37720136 • Eugene Welder's Supply Co,DBA Industrial Source • NON-CONTRIBUTORY ENDORSEMENT FOR ADDITIONAL INSUREDS THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY COVERAGE Schedule Organization Additional Insured Endorsement (If no information is filled in, the schedule shall read: 'Alf persons or entities added as additional insureds through an endorsement with the term "Additional Insured in the title') For organizations that are listed In the Schedule above that are also an Additional Insured under an endorsement attached to this policy,the•followi ng is added to Section I1/.4.a: If other insurance is available to an insured we cover under any of the endorsements listed or described above (the "Additional Insured") for a bss we cover under this poky, this insurance will apply to such bss on a primary basis and we will not seek contribution from the other insurance available to the Additional Insured. • • • Authorized Agent LD-20287(06/06) Page lof 1