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HomeMy WebLinkAbout2019-310 PO 20200256- Budget Blinds of SO. OR } Purchase Order Fir4of: VMS ,.� Fiscal Year 2020 Page 1 RECORDER ' I ' B City of Ashland I'E- t� z, ,�� 3����� , �,rt►sE a I ATTN: Accounts Payable L 20 E. Main Purchase 20200256 Ashland, OR 97520 Order# T Phone: 541/552-2010 • O Email: payable@ashland.or.us ✓ H CIO Public Works Department E BUDGET BLINDS OF SOUTHERN OREGON I 51 Winburn Way N 628 N RIVERSIDE AVE STE E+F p -Ashland, OR 97520 0 MEDFORD, OR 97501 'Phone: 541/488-5347 T -Fax: 541/488-6006 R O _ _ �= — Paula Brown 5= z--=_t'! I `NTfir `c�r ;w-.'p4° —t'v 7- -trm_mz-cmi =A mtiz # = Mrrq`_ --j�a 11/08/2019 - 4672 FOB ASHLAND OR/NET30 . Ci Accounts Payable sf=='— ...__w =-==S'r'i=, ' -.t-:ter.=�°i:' _ �� �y - L=11sf.' Br F-7. Solar Shades Ashland Airport 1 Labor and materials for installing solar shades in FBO office at 1 $2,090.0000 $2,090.00 • Ashland Municipal Airport ' Goods and Services Agreement(Less than $25,000) Completion date: 01/31/2020 ' Project Account: • ***************GL SUMMARY*************** 085700-704100 $2,090.00 e - • • r By: 6/%470,14 Date: it-t (ea Authorized Signature j��'1vi 6 =-=s '.2 090.00 e,g z. Z- l(70 40 S FORM #3 CITY OF A request for Purchase '�S H LAN D REQUISITION Date of request: 70/07121)1.9.. Vendor Name Budget Blinds of Southern Oregon Address,City,State,Zip 628 N.Riverside Street Suite E Medford.OR 97501 Contact Name Elizabeth Brett Telephone Number 541-779-7033 Email address ebrett anbudgetblinds.com SOURCING METHOD ❑ Exempt from Competitive Bidding 0 Emergency ❑ Reason for exemption: 0 Invitation to Bid (Copies on file) 0 Form#13,Written findings and Authorization ❑ AMC 2.50 Date approved by Council: 0 Written quote or proposal attached _ O Written quote or proposal attached _(Attach copy of council communication) _(If council approval required,attach copy of CC) ❑ Small Procurement Cooperative Procurement • Less than$5,000 0 Request for Proposal (Copies on file) 0 State of Oregon Date approved by Council:0 Direct Award Contract# _(Attach copy of council communication) Q Verbal/Written quote(s)or proposal(s) 0 State of Washington Intermediate Procurement 0 Sole Source Contract# GOODS&SERVICES ❑ Applicable Form(#5,6,7 or 8) 0 Other government agency contract $5,000 to$100,000 0 Written quote or proposal attached Agency ❑ (3)Written quotes and solicitation attached 0 Form#4, Personal Services$5K to$75K Contract# PERSONAL SERVICES 0 Special Procurement Intergovernmental Agreement $5,000 to$75,000 0 Form#9,Request for Approval 0 Agency -- Date original contract approved by Council: El Less than$35,000,by direct appointment ❑ Written quote or proposal attached (Date) O (3)Written proposals/written solicitation Date approved by Council: _(Attach copy of council communication) O Form#4, Personal Services$5K to$75K Valid until: Date Description of SERVICES Total Cost ' Labor and materials for installing solar shades in FBO office at Ashland Municipal Airport ;^ .2.097.(L0-1 , ; Item# Quantity Unit Description of MATERIALS Unit Price Total Cost :TOTAL:COSTr 0 Per attached quotelproposal I}$5;__ _____. Project Number - - Account Number 0 a 5 7 0 0.7 0 a'1 0 0 $_ z o s o ,o o Project Number -_ _•_ Account Number - $_,_ Project Number _ _ Account Number - $—, , — — *Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. IT Director in collaboration with department to approve all hardware and software purchases: IT Director Date Support-Yes/No By signing this requisition form,Wite l certify tht ttheCity''s public contracting requirements have been satisfied..Employee:0,C -Le47ip'ii Department Head:/141,10-------, 704 4(Equal to or greater than$ o ) Department Manager/Supervisor: City Administrator: (Equal to or greater than$25,000) , Funds appropriated for current fiscal year: YES /NO Deputy Finance Director-(Equal to or greater than$5,000) Date Comments: Form#3-Requisition GOODS AND SERVICES AGREEMENT (LESS THAN$25,000) PROVIDER: Budget Blinds of Southern Oregon CITY O:F PROVIDER'S CONTACT: Elizabeth Brett ASHLAND 20 East Main Street ADDRESS: 628 N Riverside Ave Suite E Ashland, Oregon 97520 Medford, OR 97501 Telephone: 541/488-5587 PHONE: 541-779-7033 Fax: 541/488-6006 This Services Agreement (hereinafter "Agreement") is entered into by and between the City of Ashland, an Oregon municipal corporation(hereinafter"City") and Budget Blinds of Southern Oregon, (an assumed business name) ("hereinafter "Provider"), for labor and materials for installing solar shades in FBO office at Ashland Municipal Airport. 1. PROVIDER'S OBLIGATIONS 1.1 Provide labor and materials for installing solar shades in FBO office at Ashland Municipal Airport 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. The services defined and described in the"SUPPORTING DOCUMENTS"shall hereinafter be collectively referred to as "Work." f 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; • 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 • 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: Agreement between the City of Ashland and Budget Blinds of Southern Oregon • 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 $21,507.75 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. 2. CITY'S OBLIGATIONS 2.1 City shall pay Provider the sum of$2,090.00 as provided herein as full compensation for the Work 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$2,090.00 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. 3.2 Provider is an independent contractor and not an employee or agent of the City for any purpose. 3.3 Provider is not entitled to, and expressly waives all claims to City benefits such as health and disability insurance,paid leave, and retirement. Page 2 of 6: Agreement between the City of Ashland and Budget Blinds of Southern Oregon • 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 latent 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). 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 The following documents are,by this reference,expressly incorporated in this Agreement,and are collectively referred to in this Agreement as the "SUPPORTING DOCUMENTS:" Page 3 of 6: Agreement between the City of Ashland and Budget Blinds of Southern Oregon • The Provider's complete written Consultation Estimate dated 10/03/2019. 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 all 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 January 31, 2020,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 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—Public Works Department Attn: Kaylea Kathol 20 E. Main Street Ashland, Oregon 97520 Phone: (541)488-5587 With a copy to: City of Ashland—Legal Department 20 E. Main Street Ashland, OR 97520 Phone: (541)488-5350 Page 4 of 6: Agreement between the City of Ashland and Budget Blinds of Southern Oregon If to Provider: Budget Blinds of Southern Oregon Attn: Elizabeth Brett 628 N Riverside Ave Suite E Medford, OR 97501 8. WAIVER OF BREACH One or more waivers or failures to object by either party to the other's breach of any provision,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. 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. Page 5 of 6: Agreement between the City of Ashland and Budget Blinds of Southern Oregon • CITY OF ASHLAND: BUDGET BLINDS OF SOUTHERN OREGON (PROVIDER): By: / By: ()LiJLL9QJ. Q, , Signature Signature /09044 G �✓� A. Noorn, t Printed Name Printed Name bf fj ce, fvd r\mCS c-G6Or Title Title ..10-✓" t - 10 - 2,0t9 Date Date (W-9 is to be submitted with this signed Agreement) Purchase Order No. Page 6 of 6: Agreement between the City of Ashland and Budget Blinds of Southern Oregon CITY OF ASHLAND, OREGON City of Ashland LIVING ALL employers described WAG E below must comply with City of Ashland laws regulating I. 11 • 1 • ' I , . . $15.39 per hour, effective June 30, 2019. /a, The Living Wage is adjusted annually every June 30 by the Consumer Price Index. Employees must be paid a portion of business of their of health care,retirement, living wage: employer, if the employer has 401K and IRS eligible ten or more employees, and cafeteria plans(including has received financial childcare)benefits to the assistance for the project or amount of wages received by > For all hours worked under a business from the City of the employee. service contract between their Ashland in excess of employer and the City of $21,507.75. > Note: For temporary and Ashland if the contract part-time employees,the exceeds$21,507.75 or more. > If their employer is the City of Living Wage does not apply Ashland, including the Parks to the first 1040 hours worked > For all hours worked in a and Recreation Department. in any calendar year. For month if the employee spends more details, please see 50%or more of the > In calculating the living wage, Ashland Municipal Code employee's time in that month employers may add the value Section 3.12.020. working on a project or For additional information: Call the Ashland City Administrator's office at 541-488-6002 or write to the City Administrator, City Hall, 20 East Main Street,Ashland, OR 97520, or visit the City's website at www.ashland.or.us. Notice to Employers: This notice must be posted predominantly in areas where it can be seen by all employees. CITY OF -ASH LAN D 8 RCE OF LEAD "CONS ATE LTA ON D "SPECIAL INSTALL INSTRUCTIONS ■ BUDGET. LA .11_ 1053 G 4 An independently owned INVOICE# ORDER D TE and operated franchise. ■���{{B�� L I I:V J l i E1 "Sou"t ' g n."! " NAME .I r, . I r Pi — Ii. # ;' - L /, /.I, 628 N Riverside Ave Ste E 7501 • ADDRESS ' e ., .� M /, Jing SPECIAL ORDERING INSTRUCTIONS Medford,OR 41-47 o:541-779-7033•o:54i=479-1877. !i� budgetblinds.com CITY 0 / • STATE ZIP !7S.2 05669 r ice,,Js HOME PHON WORK PHONE 61 1�IT-Q 1 '•� ` 4-131 V ,), 31- j (CALLED TO SCHEDUL-�NSTALL `CELL /lf` r EMAIL J ROOM MB/OBIQTY. j WIDTH I LENGTH ICTRL I MANUFACTURER PRODUCT STYLE COLOR NAME COLOR# EXTRAS I PRODUCT'PRODUCT I'D 1 o - " . L 61,1r. ii--eAtif • , ' POI(}1/ '6/It/ 10* r5elilin etiitY(tai 00 3.b 3 Rik (( [OY Ito i l a j' �� g c v-etri ( 4/ 1) 1 0 o DR 1 (CI(.i(CDa ! psi 1) • C s: 0- lac 1( ,1 I D70 E . en. kaktoe t i Icib ' fie ' •.. f2 ,f Cctrccad . (L9O2 G t- `ci .011 1 lb 7. • I k -1- .No �1�� k A.1r . ,ky\1 e \.__Cl ,ih• 1, HO C l! L � Igo 90 01 g A 1.1 Iclo 1biOria I q o it 11 lc/0 12. '1 IL�*f to p ' /Iort`'‘fiA A Ofkit:17 • ti . . iiitioi-D1-a 11 0.1)10°L) SERVICE 1 SUB TOTAL SER E GUARANTEE Il r /`V,�� TAX PAYMENT INFO DATE are OUNT I 11 BCS / itFaFa '1r1 LABOR CUSTOMER'S SIGNATURE. DA O) -'L SHIPPING SERVICE GUARANTEE An independently owned and operated franchise: See the notice of cancellation form on the back of this invoice for an explanation of your(the buyer's)right to cancel TOTAL o tO c this transaction. 53676890-1 l ® DATE(MMIDD/YYYY) A`CPR D CERTIFICATE OF LIABILITY INSURANCE 10/11/20i9 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must 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 Terry Friend Protectors Insurance, LLC • PHONE FAX P.O. Box 4669 (A/C.No.Ext):541-842-2958 (A/c,No):541-772-1906 Medford OR 97504 ADDRESS: tenyfuprotectorsins.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:The Cincinnati Insurance Co 10677 INSURED FDJEN-1 INSURER B:SAIF Corporation 524113 FDJ Enterprises Inc DBA Budget Blinds of Southern Oregon INSURER C: 628 N Riverside INSURER D: Medford OR 97501 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:830681965 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 WD/ LIMITS LTR ,INSD VD POLICY NUMBER (MM/DD/YYYY) (MM/DYYYY) A X COMMERCIAL GENERAL LIABILITY Y ENP 0299241 1/5/2017 1/5/2020 EACH OCCURRENCE $1,000,000 —DAMAGE TO CLAIMS-MADE X OCCUR PREMISES(Ea occu RENTED $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 PRO- LOC JECT PRODUCTS-COMP/OPAGG $2,000,000 X OTHER: $ A AUTOMOBILE LIABILITY EBA 0299241 1/5/2019 1/5/2020 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) A X UMBRELLA LIAB X OCCUR ENP 0299241 1/23/2017 1/5/2020 EACH OCCURRENCE $2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION 796473 1/1/2019 1/1/2020 AND EMPLOYERS'LIABILITY Y/N PER UTE OTH- ER ANYPROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBEREXCLUDED7 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate holder is listed at additional insured per GA233 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. Ashland Airport 403 Dead Indian Memorial Rd AUTHORIZED REPRESENTATIVE Ashland OR 97520 � \ ©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. OREGON CONTRACTORS' COMMERCIAL GENERAL LIABILITY - BROADENED ENDORSEMENT This endorsement modifies insurance Provided under:file following: ,COMMERCIAL GENERAL LIABIUTY COVERAGE PART A. Endorsement.Table of Contents: Coverage: Berlins an Page: 1. Employee Benefit Liability Coverage 2 Unintentional Failure to Disclose Hazards 8 3, Damage to Premises Rented to You8 4. Supplementary Payments 9 5. 'Medical Payrnents ' 10 6. Voluntary Property Damage(Coverage a.)and Care.Custody or-Control 'Liability Coverage(Coverage ... . .. . ....„. .. ......... .... . 10 7. 180 Day Coverage for Newly Formed or Acquired Organizations • 10 8. Waiver of Subrogation 10 9. Automatic Additional Insured-Specified Relationships: 11 X Managers or Lessors of Premisest X Lessor of Leaied Equipment x vendors: X State or Political Subdivisions Permits Relating to Premises; x State or Political Subdivisions.-Perfekt;and x Contractors'Operations 10. Broadened Contractual Liability‘-Work Within 501 of Railroad Property - 16 11. Property Damage to Borrowed Equipment 16 12. Employees as Insureds=Specified Health Care Services 16 X Nurses: x Emergency Medical Technicians and x Paramedics 13. Broadened Notice of occurrence _ : 16 B. Limits Of Insurance: The commercial General Liability Limits of Insurance applyto the insurance provided by this endorsement. except as provided below: 1. Employee Benefit Liability Coverage Each Employee limit $ 1000.000 Aggregate $ 3,000,000 Deductible: $ 1,000 3. Damage to Premises Rented to You The lesser of: a. The Each bcturrence Limit shown in the Declarations: or b. $500,000 unless otherwise stated$ 4. Supplementary Payments a.. Bail bonds: $ 1.000 b. Loss of earnings: S 350 5. Medical Payments Medical Expense Limit: $ 10,000 Includes copyrighted material Of Iniurance GA 233 OR 09 10 Services OffiCe.Inc.with its permission_ Pagel of 16 6. Voluntary Property Damage(Coverage a.)and Care.Custody or Contrel Liability:Coverage (Coverage b.) limits of Insurance(Each Occurrence) Coverage a.$1,000 Coverage b.$5,000 unless otherwise stated $ Deductibles(Each Occurrence) Coverage a.$250 Coverage b.$250 unless otherwise stated $ COVERAGE PREMIUM BASIS. RATE ADVANCE PREMIUM (a) Area , . (For LiMits in Excess of (For Litnitt in Excess of (b) Payroll $5.000) $5,000) , (c) Gross Sales :(d) Ilnits (e) Other b, Care. Cuttody or Control $ TOTAL ANNUAL PREMIUM S 11. Property Damage to Borrowed Equipment Each Occurrence Limit: $ 10.000 Deductible: $ 250 C. Coverages: 2) Our right and duty to 1. Employee Benet Liability Coverage defend ends when we have used a. The following Op is added to.SECTION I cabte limit of insurance appli- - COVERAGES: EmplOyee Benefit ithe : payment of Liability Coverage. judgrnents or settle- . (1) Insuring Agreement merits. (a) We will pay those sums that No other obligation or habil- the'insured becomes legally ity to pay sums or perferm obligated to pay as dam- acts or services is covered ages caused by any acter- unless explicitly-provided for ror or omission of the in- under Supplementary Pay- mired, Or of any Other; per- , mints. son for'whose acts the in- (b) This insurance applies to sured is legally liable. to damages oniy.if the act, er- which this insurance ap- tor or omission. is negli- plies. We will haVe:the right gently committed in the and duty to defend the in- administration" of your sured against any suit" administration benefit program , teekind those 'deli-Woes. and However, we will have no duty to defend against any 1) Occurs during the pot- "suit" seeking damages to icy period:or which this insurance does not apply We may. at our 2) Occurred prior to the discretion, investigate any effective date of this report of an act, error or endorsement provided: omission and settle any a) You did not have claim or "suit" that may re- knowledge of a suit. But claim or "suit" on 1) The amount we will pay or before the ef.- for damages is limited fectiVe date of this as described in 5E0- endorsement 110N III - LIMITS OFYou will be INSURANCE;And deemed to have Includes copyrighted material othisurance GA 233 OR 09 10 Services Office.inc.,With'itS permission. Page 2 of 16 knowledge of a 1) Failure of any invest- claim or: "suit" ment to perform: when:any.'pautFior- ized - representa 2) ':Errors in providing' 'in- tive"; formation .on past per- formance of investment 1) Reports all, or vehicles;or any part,of the act, error or 3) Advice given to 'any omission to,us. person with respect to or any other that person's decision insurer: to participate or:not to participate in any plan ;ii) Receives a included in the 'em- written or ver- ployee benefit pro- bal demand Or gram". claim for:dam- ages because (I) Workers' Compensation of the act, error and Similar Laws Of omission; Any claim arising out of your and failure to comply with the, b) There is:no other mandatory provisions of any applicable incur workers' compensation, un- , ance. employment compensation (2) ..Exclusions insurance, social security or disability benefits law.or.any This insurance does not a I to: similar law. PPy, (a).' Bodily Injury, Property (g) ERISA Damage or Personal and Damages for which any in- Advertising Injury sured'is liablebecause of li- "Bodily injury'; `'properly ability imposed on „a fiduci- -damage" or "'personal and: ary by the Employee Re- tirement Income Security ,advertising injury'. . _ Act Of 1974; as now or (b) :Dishonest, Fraudulent, hereafter amended. or by Criminal or Malicious Act any similar-federal, state or local laws. Damages arising out of any intentional. dishone"st, (h) Available Benefits fraudulent,criminal or Mali- Any claim for benefits to the cious-act, error or omission, extent thatsuch'b-enefits are committed by any insured. the willful or rec • : k available, With reasonable including less-dinlation of any statute. effort and.cooperation of the insured.from the applicable (C) 'Failure to Perforin'a Con- funds accrued or other col- tract !edible insurance. Damages arising out of fail- (i) Taxes.Fines or Penalties ure of performance of con- xes, fines or penalties, tract by any insurer. including those ;imposed (d)' Insufficiency of Funds under the internal Revenue Code or any similar state.or Damages arising out of an local law insufficiency ;of funds to meet any obligations,_under (j) Employment-Related any plan included in. the Practice's "employee benefit program Any liability arising out of (e) Inadequacy of Perform- any: ance of Investment.1 Ad- (1) Refusel:to employ: vice ,Given With, Respect. to Participation (2) Termination ofem- Any claim based upon: ployment Includes copyrighted material of Insurance GA 233 911,09 10 Services Office,Inc:;ecittfiis permission. . Page'3 of 16. (3) Coercion, 'demotion. tors are insureds. but only evaluation; reassign- with respect to their duties merit. discipline, defa- as your officers or directors. matiOn, harassment, Your stockholders arealso humiliation, discrimina- insureds, but only with .re- .tion or other employ- spect to their liability as ment related practices. stockholders. acts or omissions;or (e) A trust, you are an insured. (4) Consequential liability Your trustees are also in- as::a result_of:(1). (2)or sureds,but only with respect (3)above, to their duties as trustees. This exclusion applies (2) ;Each of the following is also an whether the insured may be insured: held liable it an eMpler or in any other capacitynd (a) Each of your "employees" to any obligation to share who is or was authorized to damages with or repay administer your employee someone else who must benefit program". pay damages because of (b) Any persons. organizations the injury; or "employees" having (3) Supplementary Payments proper temporary authoriia- tioP to administer your "em- SECTION 1 - COVERAGES. ployee benefit program" if ,SUPPLEMENTARY PAY- you die, but only until your MENTS - COVERAGES A AND legal representative is ap- B also apply to this Coverage. pointed. b. Who is an Insured (c) Your legal representative if Employee you die, but only with re- As respects p yee Benefit Liabil- speCt. to duties as such. ity:Coverage,SECTION II -WHO 1S That representative . will AN INSURED.is deleted:in:its entirety have all your rights and du- and replaced by the following: ties under this Coverage (1) If you are designated in the Dec- Part. larations as: (3) Any organization.you newly ac- (a) c(a) An'individual, you and your quire or form, other than a part= spouse are insureds. but nership, joint venture or limited only with respect to the con- liability company.and over which duct of a business of which you maintain ownership or ma- you are the sole owner. lordly interest, will qualify•as a Named Insured if no other simi- (b) A."partnership or joint -ven- lar insurance applies to that:or- ture, you are an insured. ganization. However, coverage Your members, your part- under this provision: nets. and their spouses are also insureds but only with (a) Is afforded only until the respect .to the conduct of 180th day after you acquire your business. or form the organization or the end of the policy period. (c) A limited liability company. whichever is Earlier;and you are an insured. Your members are also insureds. (b) Does not apply to any act, but only with respect to the error or omission that:was conduct of your business. committed before you ac- Your 'managers are `insur- quired or formed the organi- eds. but only with respect to zation. their duties as your manag- c. Limits of Insurance ars. An organization other than a As respects Employee Benefit Liabil- (d) 9 ity Coverage. SECTION:III LIMITS partnership. joint venture Or OF INSURANCE is-deleted in its en- limited liability company,you tirety and replaced by the following` are an insured: Your "ex ecutive officers" and direr- Includes copyrighted material of'Insurance GA 233 OR 0910 Services Qffice,.Inc:,with its permission. 'Page 4 Of 16 ' . (1) The Limits of Insurance shown in amount stated in the Decla SeCticin B.Limits of Insurance, rations as applicable to 1. Employee Benefit Liability Each Employee. The limits Coverage and the rules :below of insurance shall not be're- fix the most we will pay regard- duced by the amount of this less of the nuinber"of: deductible_ (a) Insureds: (b) The deductible amount Stated in the Declarations (b) Claims rflacle or "suits" applies to all damages sus- brought: Wined by any one 'ern- (c) Persons or organizations ployee", including such Making claims or bringing "employee's" dependents "suits"; and benefitiaries, because of all acts, errors or writ= (o) Acts.,errors or omissions;or Mont to 'Which this instiv- ante applies. (e) Benefits included in .your "employee benefirProgram". (c) The terms of this iiistitanCe, including those with respect (2) The Aggregate Limit Shown in to: Section B. Limits of InsUrande. 1. Employee Benefit Liability 1) Our right .and duty to Coverage of this endorsement is defend the insured the most we will pay for all dam- against any ,Isuits" ages because of acts, errors or seeking those dam- omissions negligently committed ages; arid in the "administration of your Your duties: and the "employee benefit,program". 2) dutiei of-any other in- (3) Subject to the limit,described in volved insUted, in the (2) ;above. the Each Employee event of an act, error or Limit shown in Section B. Limits omission.or claim. of Insurance. 1. Employee apply irrespective of the ap, Benefit Liability Coverage of plication of the deductible this endorsement is the-mott Yoe will pay for all damages amount. tamed by any one 7emplbyee". (d) We may pay any part or all including damages sustained by of the deductible amount to such "employees" dependents effect settlement of any and betieficianesas a result of. Claim or"suit"and, upon no- (a) .An act error or omission:or fification of the action taken you shall promptly reim- (b) A series of related acts. er- burse us for such part of the rors or otrisstpas, regard- deductible amount as we less of the amount of time have paid. that lapses between such ads, errors or omissions, d. Additional Conditions negligently committed in the As respect Employee Benefit Li. "administration" of your "em- ability Coverage. SEGTION IV - COMMERCIAL GENERAL. LIAM- ployee benefit program". ITY CONDMONS is amended as fOl- However,the amount paid under 16ws: this endorsement shall not ex- ceed, and will be subject to the (1) Item 2. Duties'in the Event of lintit$'and restrictions that aPP1Y Occurrence..Offerise. ;taint or SuR is deleted in its entirety and to die •payment of benefits in any replaced by the fcilkiwitig: plan included in the "employee benefit program". 2. Duties in the Event of an (4) Deductible Amount Act, EOM. Or Omission. or Claim ot Suit (a) Our obligation to Pay dam- a. You must see to it that ages 00'behalf a the in we are notified as soon - mired 'apOliei only to the• as'predicable Of an act. amount'of, damages M ex- cess of the dedUttible error or omission which Includes copyrighted materiatOf InsUrpriCe GA 233 911 09 10 Sennces Office,Inc..With its petmissiOn. Page 5 of 16 may result in a claim. surance may also To the extent possible. apply notice should include: d. No insured will, except (1) What the act._error at that insured's own or omission was cost, voluntarily make a and When it oc- payment, assume any curred:and obligation, or incur any expense without our (2) The names and consent.. addresses of;any - one who may suf- (2) Item 5. Other Insurance is de- fer damages as a leted in its entirety and replaced result of the 'act, by the following: error or omission. 5. Other Insurance b. If a claim is made or „suit„ If other valid and collectible is brought'against insurance is available to the any insured,you must: insured for a loss we cover (1) Immediately re- under.this Coverage Part. cord the specifics our obligations are limited of the claim or as follows: • "suit” and the date received;and a. Primary Insurance (2) Notify us as soon This insurance is pri- as practicable. mary except when c. below applies. If this in- You must see to it that surance is primary, our we receive written no- obligations are not af- tice of the claim or fected unless any of the "suit"as soon as practi- . Other insurance is also. cable. primary. "Then. we will share with all that other c. You and any other in- insurance by the volved insured must: method described in b. (1) Immediately send below. us copies of any b. Method of Sharing demands, notices. summonses or le- If all of the other insur- gal papers re- ance permits contribu- ceived in connec 'tion by equal shares, tion with'the claim we will follow this or"suit"; 'method also.Under this (2) Authorize us to Ob- approach each' insurer contributes tam records and . equal amounts until it has other information; paid its applicable limit (3) Cooperate with us of insurance or none of in the investigation the loss remains, or settlement of whichever comes first: the claim or de- If any of the other in- fense against the surance does not per- °suit":and mit contribution : 'by (4) Assist us: upon equal shares. we Will our request. in the contribute b y limits. enforcement of Under this method, any right' against each insurer's 'share.,is 'any person Or or based on the ratio of its ganiiatian which applicable limit .of 'In- may be liable to surance to the total ap- the insured be- plicable limits of 'insur- cause of an act, , ance of all insurers. error or -omission C. No Coverage to which this 'in- ' Includes copyrighted material of Insurance GA 233 OR 0910 Services;Office, Inc.,With its permission. Page 6 of 16 This insurance shall not providing some or all of the cover any loss for following benefits to "em- which the insured,is en- ptoyees", whether provided titled to recovery under through a "cafeteria plan"or any other insurance in otherwise: force previous to the ef- fective .date of this a. Group life insurance; Coverage Part. group accident or health.=-insurance; Ben- e. Additional Definitions tal, vision and hearing As respects Employee Benefit Li- plans; and flexible ability Coverage, 'SECTION V - spending accounts; DEFINITIONS is amended -as 'fol- other than an "em- that no one lows: ployee" may subscribe (1) The following definitions are to such ,benefits and added: such benefits are made generally :available to 1. "Administration"means: those "employees" who a. Providing information to satisfy the plan's eligi- bility "'employees", including' requirements: their dependents and b. Profit sharing plans. beneficiaries, with re- employee savings sped to eligibility for or plans, employee stock. scope of "employee ownership plans, pen- benefit programs"; sion plans and stock subscription plans, pro- b. Interpreting the "em- vided that no one other ployee� -benefit pro- than an "employee'` grams may subscribe to such c. Handling records in benefits and such connection with' the benefits are made gen- "employee benefit pro- erally available to all grams";or "employees" who are eligible, under the plan d: Effecting,.continuing or for such benefits; terminating any "em- ployee's" participation c. Unemployment insur- included ance, Social security in any benefit in the"employee bene- benefits, workers''com- fitprogram", pensation and disability benefits: and However, "administration" does not include` d. Vacation plans, includ- ayroll'deduc- ing buy, and 'sell 'ab- a. Handling p a grams; leave of ab- , or sence programs. in- dud ing military, mater- b. The failure to effect or nity. family, and 'civil maintain any insurance leave:billion assistance or adequate limits of plans; transportation coverage of insurance, and 'health 'dub subsi- including but not limited dies. to .unemployment in- surance, social security - (2) The following definitions are de- benefits, workers' COM- leted in their entirety =and re- pentagon and disability placed by the following: benefits. 21. "Suit" means a civil pro- 2. "Cafeteria plans" means ceeding in which money plan authorized by applica- damages because of an act. ble law to allow"employees" error or omission to which to elect to pay for certain this insurance applies .are benefits With pre-tax'dollart. alleged. "Suit"includes: 3. ''Employee benefit pro- a. An arbitration proceed- grams" means a program_ ing in which such-dam= Indudes,copyrighted Material of Insurance GA 233 OR 0910 Services Office,Inc.,uvit 'its"permission. Page.7 cif 16 • .ages are claimed and The exclusions under SECTION to which the insured I - COVERAGES: COVERAGE BODILY INJURY AND A.must submit Or does Submit with our con- PROPERTY DAMAGE LIABIL- sent ITY. 2. Exclusions.other than I. War and the. NUclear Energy b. Any other alternative Liability Occlusion, are deleted dispute resolution pro- and the following are added: ceeding in Which. Stich damages are Claimed This insurance does not apply to: and to which the in- sured submits with our (a) "Property damage": Consent;or 1) Assumed in Any con- c. An.appeal of.a civil pro-. tract;or ceeding. 2) Loss Caused by or re- B., "Employee'means a person suiting from any of the actively employed, formerly folloWirig: employed, on leave of ab- ' a) Wear and tear sence or disabled, or re- -tired. !Employee includes a b) Rust, corrosion, leased worker"."Employee" fungus, decay,de- does not include a "tempo- terioratiOn. hidden rary wOrker". or latent defect or any quality in 2. Unintentional Failure to Disclose.Haz-, property that ards causes it to dam- SEC ION IV-COMMERCIAL GENERAL age or destroy it- LIABILITY 'CONDITIONS. 7. Represen= self; tattoos is hereby amended by the addi- c) 'Smog; ton of the following: d) Mechanical break- Based on our dependence upon your rep- down including resentations as to existing hazardt, 'run- intentionally you should fail to disclose all rupture or bursting Caused by cen- such hazards at the inceptiOn date of your trifugal force; policy,we will not reject coverage udder. this Coverage'Part based solely on such e) Setthrig, cracking, failure. shrinking or eX- panSion; or 3. Damage to Premises Rented to You f) Nesting r infesta a. The last Subparagraph of Paragraph tiOn, or'discharge 2. SECTION. I - COVERAGES. _ _ COVERAGE A. - BODILY INJURY' • or release Of waste products 'or:secre- mp PROPERTY DAMAGE. 2. LI- tions, by insects, ABILITY Exclusions is hereby de- birds, rodents or feted and replaced by the following: other animals: Exclusions c.through q.do not apply (b) Loss caused directly or indi- to damage by fire, exploSion, light, redly by any of the follow- riing, smoke or :soot to. 'premises ing: while rented to you;or temporarily Oc- cupied. by.yon with permission of the 1) Earthquake, volcanic owner. eruption, landslide or , any other earth MOVe- _b. The insurance provided under, SEC= TION I-COVERAGES.COVERAGE trqrlt: A. BODILY INJURY AND PROP- 2) Water that'backs up or _ ERTY DAMAGE LIABILITY applies overflows from a seater, to "property damage" arising out of drain or sump water'damage to premises that are . both rented to and occupied by you. 3) Water under the ground surface pressing on. or (1) As respects Water Damage Le- flowing or seeping gal Liability,as provided in Para- through: 'graph 3.b.above: Includes Copyrighted material of Insurance GA 233 OR 09 10 :Seniices.021fice',inc.,with:iti permission. page 8 of 16 . , a) Foundations, one "occurrence" to which Walls. floors or this insurance applies. paved surfaces; (3) The amount we Will pay is limited b) Basements, as described in Secticin B. Urn- whether paved or its of Inturance. 3. Damage Co not;or Premises Rented to You of this c) Doors. windows or endorsement. other openings. 4. SOppleMentary Payments (c) Loss caused by or resulting Under SECTION I - COVERAGE, SUP- frOm water that leaks or PLEMENTARY PAYMENTS - COVER- flows 'from plUmbing, heat- AGES A AND B: ing, air conditioning, or fire protection systems caused a. Paragraph 2. is replaced by the fol- 'by or resulting from freezing, lowing: unless: , Up to the limit shown in Section B. 1) You did your best to Limits of InsuranCe,4.a.Bail Bonds maintain heat, in the of-this,endorsement for cost Of bail building or structure: or bonds reqUired because of accidents or traffic law violations arising out of 2) You drained the equip- the use of any vehicle to which the ment and shut off the Bodily Injury Liability Coverage ap- water supply if the heat plies. We do not have to furnish was not maintained. these bonds. (d) Loss to or damage to: b. Paragraph 4. is replaced by the fol- lowing: 1) Plumbing, heating, air conditioning, fire pro- All reasonable expenses incurred by tection systems. or the insured at our request to assist us other equipment or ap- in the investigation Or defense of the pliances or claim or"suit".including actual loss of earnings up to the limit shown in Sec- 2) The interior of any tion B. Limits of Insurance. 4.b. building or structure. or Loss of Earnings of this endOrsement to personal property in per day because of time off from the building or,structure Work. caused by or resulting from rain, snow, sleet 5. Medical Payments or ice, whether driven by wind or not. The Medical Expense Limit, of Any One Person as stated in the Declarations is C. Limit Of Insurance amended to thelimit shown in Section B. Limits of Insurance, 5. Medical Pay- The Damage to Premises Rented to merits of this endorsement. You Limit as shown in the Declara- tions is amended as follows: 6. Voluntary Property Damage and Care, (2) Paragraph 6of SECTION - Custody or Control Liability Coverage . III LIMITS OF INSURANCE is a. Voluntary Property Damage Coy- hereby deleted and replaced by erage " 'the following: We will pay for ''property damage"to 6. Subject to 5. aboVe, the property of others arising out of op- Damage to Premises erations incidental to the insured's Rented to You Limit is the business when: most we will pay under . COVERAGE A. BODILY (1) in Damage is caused by the in- INJURY AND PROPERTY surer!:or DAMAGE LIABILITY.: for (2) Damage occurs while in the in- damages because of"prop- - d's surepossession. erty 'damage" to premises while rented to you or tem- With your consent, we will make porarily occupied by you these payments regardless of fault. with permission of the oWner, arising out Of any Includes'copyrighted material of Insurance GA 233 OR 09 10 Services Office,Inc;,with its permission. Page 9 of 16 • L Care, Custody Or Control Liability deductible amount as has been Coverage paid by us. SECTION I - COVERAGES. COV- 7. 180 Day Coverage for Newly Formed or ERAGE A. BODILY INJURY AND Acquired Organizations PROPERTY DAMAGE LIABILITY.2. SECTION 11:- WHO IS AN INSURED is Exclusions.j. Damage to Property. amended as follows: Subparagraphs(3), (4)and'(5);do not apply to "property damage" to the ,Subparagraph a. of Paragraph 4. is property of others described therein, hereby deleted and replaced by the fol- With respect to the insurance provided by lowing: this section of the;endorsement, the fol- a. Insurance under this provision is af- lowing additional provisions apply; forded only until the 180th day after a. The Limits of Insurance shown in the you acquire or form the organization Declarations are replaced by the rim- or the end of the policy period, its designated in Section B. Limits of whichever is earlier, Insurance, 6. Voluntary Property g. Waiver of Subrogation Damage. and Care. Custody or . Control Liability Coverage of this SECTION IV :COMMERCIAL GENERAL endorsement with respect to cover- LIABILITYCONDITIONS. 9.Transfer of age provided by this endorsement Rights of Recovery Against Others to These limits are inclusive of and not Us is hereby amended by the addition of in addition to the limits being re- the following: placed. The Limits of Insurance shown in Section B.Limits of Insur- We waive any right of recovery we may ance. 6. Voluntary Property Dam- have because of payments we make for age and Care, Custody or Control injury or damage arising out of your ongo- Liability Coverage of this endorse- ing operations or"your work" done under meat fix the most we will pay in any a written contract requiring such waiver one "occurrence" regardless of the with that person or organization and in- number of: cluded in the"products-completed,;opera- tions hazard".' However. our rights may (1) Insureds; only be waived prior to the "occurrence" (2) Claims made or"suits".brought; giving rise to the injury or damage: for which we make payment under this Coy- or , Part. The insured must do nothing (3) Persons or organizations making after a loss to impair our rights.At our re- claims or bringing"suits". quest,the insured will bring"suit"or trans- fer those rights to us and help us enforce b. Deductible Clause those rights. (1) Our obligation to pay damages 9. Automatic Additional Insured - Speci- onyour behalf applies onlyto the fled Relationships amount of damages for each "occurrence"which are in excess a. The following 'is hereby added to of the deductible amount stated SECTION II-WHO IS AN INSURED: in Section B. Limits of Insur- io a (1) Any person or organization de- ance, 6. Voluntary Pp rty scribed in Paragraph 9.a:(2) be- Damage and Care. Custody or low (hereinafter referred tO as Control Liability Coverage of additional insured)whom you are this endorsement. The limits of required to add as an additional insurance will not be reduced by insured under this Coverage Part the application of such deducti= by reason of ble amount. (2) Condition 2.Duties in the Event (a) A written.contractor agree- ment:or of Occurrence, Offense, Claim or Suit, applies tO each claim or (b) An oral agreement or con- "suit"irrespective of the amount. tract where a. certificate of (3) We may pay any part orall of the insurance :showing'thatper- deductible 'amount to effect;set son or .organization as an additional insured has been dement of any claim or "suit"- issued, and, upon notification of the ac- tion taken,you shall promptly re- is an insured,provided: imburse us for such part of the Includes copyrighted material of Insurance GA 293'OR 09'10 Services Office,,Inc.,with its permission. Page 10 of 16 • . (a) The Written or oral contract or Use of equipment leased or agreement is: to you by such person(s) or 1) Currently in effed or •organizations(S). However, becomes insurance does not ap- becomes effective dur- ply to any ss , ing the policy period; occurrence"and which takes ,place .after the equipment lease expires. 2) Executed ,prior to an (c) .Any person or organization "occurrence"or offense (referred to below as yen- to Which this insurance dor) With 'whom you livewould apply:and agreed per Paragraph (b) They are not ' PeCifically 9.a.(1) above to provide in- named as an:additional in- surancebut only with re- sured under any other pro- sped to ."bodily injury" or vision at or endorsement 'property damage" arising added to, this coverage out of lour.produCts"which Part, are distributed Or sold in the regular course of the Ven- (2) Only the following persons or or- dor's business, subject to ganizations are additional insur- the following additional :ex- edi under this endorsement,and clusions: insurancecoverage provided•tO such additional :insureds is urn- 1) The insurance afforded ited as provided herein: the vendor does not apply to: (a) The manager or lessor of a premises leased to you with a) "Bodily injury" or whom you have agreed per "property damage" Paragraph 9for which the yen- provide insurance, but only dor is obligated tO With respect to liability aris- pay damages by ing out of the Ownership, reason of the as. maintenance or use 'of that .sumption of liability part of a premises leased to in a contract or you, subject to the following agreement This exclusion does not additional exclusions: exclusion apply to liability fcir This insurance does.not ap- damages that the ply to: Vendor Would have in the absence of 1) Any"oCcutrence" Which the contract or takes place after you agreement; cease to,be-a tenant in that premises. 11) Any express waN, rarity unauthorized 2) Structural alterations. 14Y Wu: new :construction or demolition operations c) Any ,physical or performed by or on be- chemical change half Of such additional in the product insured. made intentionally by the vend0r; (b) Any person or organization from which .you lease d) Repackaging, :ex- eqUipmeht with whom you cept when un- have agreed per "Paragraph packed solely for _ , . 9.a.(1) above to provide in- the purpose of in- surance. Such' person(s) or Spediorn, demon- organization(s)are insureds stration; teSting, or but only to the extent that the substitution ,of the liability for"bodily injury's. parts under in- "property'damage" Or "per- structions from the serial and advertising injury" manufacturer, and is caused by your negli- then repackaged . . gence,,acts or omissions in in the original con- the maintenanCe, operation tainei-, Includes copyrighted Material of Insurance GA 231 OR 09 10 ServiCeS Office.Inc.,With its permission. Page 11 of 16 „_. e) Any llu#are, -to Part with respect make such inspec- to such products. tions, adjustrrients. Anystate orpolitical subdi- vision tests or servicing (d) p- as the vendor has vision rith which you have agreed to,make.or agreed per Paragraph normally under- 9.a.(1)'above to 'provide in- takes to make in surance, subject'to the'fol- the usual course of lowing additional provision: business, in con- This insurance applies only nection =with, the with respect to the following distribution or sale hazards.for which'the state of the products: or political subdivision has I). Demonstration, in- issued a permit in ;connec- stallation, servicing tion with premises you own, or repair opera- rent Or control and to which :tions. except such this insurance applies: operations per- 1) The existence, mainte- formed at the ven- nance, repair, construe- does premises in tion, erection, or re- connection with moval of advertising the sale of the signs, awnings. Carlo- product; pies, cellar entrances, g) Products which, coal holes, driveways, after distribution or manholes, marquees, sale byyou, have hoist away openings, been labeled eled,or re- sidewalk vaults, street labeled d as banners, or decorations a container;part or and similar exposures; ingredient of :any ar Other thing or sub- 2) The construction. 'erec- stance by or for tion, or removal of'ele- the vendor or 'vators;or h) "Bodily injury" or 3) The ownership, main- "property;damage" tenance,or use of any arising Out 'of the elevators covered by negligence, acts or this insurance. omissions of the vendor, its em- (e) Any state or political subdi- ployees Or anyone vision with which 'you have else acting on 'its agreed per Paragraph behalf. 9.a.(1) above to'provide fol- 2) in- This insurance does not surance, subject'to the:apply to any insured lowing provisions: person or organization: 1) This insurance applies a) Prom whom you only'with respect to,op- have acquired erations performed by such products, or you or 'on your behalf for which the state or any ingredient, political subdivision has part Or container, issued a permit entering into, ac- companying or 2) This insurance does not containing such apply to"bodilyinjury". products;or "property damage" or "personal and advertis- b) When, liability in- ing injury"arising out of chided within the' operations performed "products- for the state nr political completed. opera- . subdivision. tions hazard"'. has been excluded un- (f) For 'your work" performed der this Coverage in Oregon. any person or Includes:copyrighted material of Insurance GA 233 OR 0910 Services Office, Inc.,with its permission. page 12 of 16 'organization with which you (a) Subparagraphs. le), '(I) and have agreed per Paragraph (g)do not apply to"bodily in- 9.a.(1) above to provide in- •jury' or "property .damage" surance; but only"to the ex- included within ;the "prod tent that the liability is acts-completed operations caused by "your work" per- hazard"; formed for that additional in- sured and only to the extent (b) Subparagraphs (a); (d), (e). that such liability,is caused and(g)do not apply.to"bod- by your negligence or the ily injury", "property dam- negligence of those acting age" or '"personal and ad- on your behalf. A'person or vertising injury' arising out organization's status as;an of the sole negligence .or insured under this provision willful misconduct of the ad- of this endorsement cortin- ditional insured or its "em- ues for .only the .period of ployees".or time required by the written contract'or agreement, but (c) Subparagraph 0) and(9)do � not apply to bodily injury',, in no event beyond the expi- "property damage" or "per; ration date of this Coverage , Part If there is no 'written sonal and-advertising injury' arising'oat of contract or agreement, or if no period of time is required 1) The rendering of, or by the written contract or failure to render, any agreement, a person or or- professional services ganization's status as anin- by you or on your be- sured under this endorse- half, but only with ce- ment ends when your.op- spect to either or both erations for that insured are of the following opera- completed. tions: (g) For "your work* performed a) Providing -engi- in the "coverage territory" neering; architec- but not in Oregon,.any per- ' 'tural or surveying son or organization with services to others; which you have agreed per and Paragraph 9.a.(1) above to provide insurance, but 'only b) Providing; or hiring with respect to liability anis- independent pro- ing out of "your yvork" 'per- fessionals to pre- formed for that additional in- vide. engineering. sured by you or on your be- architectural or 'half. A person or organize- surveying services in connection with tions status':es an "insured . under this provision of this construction work endorsement continues -for you perforin. only the period of time re- 2) Subject to Paragraph 3) quired by the written con- below, professional tract or agreement,but in,no services include:- event.beyond the expiration ' date of this Coverage Part. a) Preparing. approv- If there is no written contract ing, or failing to or agreement.or if no period prepare or ap- of time is required by the prove, maps. shop written contract or :agree- drawings,' opin- ment,a person or organize, ions, reports, sur- 'tion's status as an insured veys. -field orders. under this endorsement change orders, or ends when your operations - drawings and for that insured are Com- specifications:and pleted. b) Supervisory or in- (3) Any insurance provided to an spection activities additional, insured designated performed as part under Paragraph 9,a:(2); of any related er- Includes copyrighted material of insurance. GA 233 OR 0910 Services Office,Inc..with its perission. Page 13 of 16 chitecturat or engi- primary to other insurance neering activities. available to the additiorial insured except 3) Professional services do not include services 1) As otherwise provided within construction in SECTION IV ,, - means, methods, tech- COMMERCIAL . GEN- Moues, sequences and ERAI_ LIABILITY procedures employed CONDITION. 5. by you in connection Other Insurance, b: with construction work Excess Insurance:or you perform. 2) For any other valid and (d) Subparagraphs (f) and (g) collectible insurance do not apply to "bodily in- available, to the addi- jury' or "property damage" tional insured as an ad- . arising out of"your work"for ditional insured. by at- which a consolidated (wrap= tachment of an en- up) insurance program has dorsement to another been provided by the,prime insurance policy that is contractor/project manager written on an excess or owner of the construction basis. In such case,the project in which you are in- coverage provided un- volved. der this endorsement shall also be excess. b. Only with regard to insurance pro- vided to an additional insured desig- (2) Condition 11. Conformance to nated under Paragraph 9.a.(2) Sub- Specific Written Contract or paragraphs (f) and,(g) above. SEC- Agreement is hereby added: TION ill-LIMITS OF INSURANCE is amended to include: 11. Conformance to Specific Written Contract or The limits applicable to the additional Agreement insured are those specified :in the. written contract or agreement or in a. With respect to addi- the Declarations of this Coverage tional insureds de- Part, whichever are less. If no,limits scribed in Paragraph are specked in the written contract or 9.a.(2)(f)above only: agreement. or if there is no written If a written contract or contract or agreement, the limits ap-. agreement between plicable to The additional insured are you and the additional those specified in the Declarations of insured specifies that this Coverage Part. The limits of in- coverage for the addi- surance are inclusive 'of and not in' tional insured: additionto the limits Of insurance shown in the Declarations. (1) Be provided by the Insurance Ser- c. SECTION IV - COMMERCIAL GEN- vices Office addi- ERAL LIABILITY CONDITIONS is tional insured foam hereby amended as follows: number CG 32 61. (1) ;Condition 5: Other Insurance is CG 32 62 or CG amended'to include: 32 63:or (a) Where required by a:written (2) include coverage contract or agreement, this for completed op- insurance is primary and For erations:or. noncontributory'as respects (3) ,Include coverage any other insurance policy for"your work": issued to the additional in- sured, and such other in- and where the limits or surance policy shall be ex- coverage provided to cess and 1 or noncontribut- the add itional insured is ing, whichever applies,with more restrictive than this insurance. was . specifically re- Any insurance provided by re- quired in that written (b) Any or agreement, this endorsement •shall be the terms of :Para- includes copyrighted material of Insurance GA 233 OR.0910 Services Office,Inc..with its permission. Page 14 of 16 graphs 9,a.(3)(a)or 9.b. agreement specifies above, or any combina- the .Insurance Services tion thereof shall"be in- Office additional in- terpreted as providing sured form number CG ;the limits or coverage 20 10 but does not :required by the terms of specify which edition,or the written contract or specfies an"edition that agreement. but only to does not exist. Para- the extent that such lim- graphs 9.a:3.b. and its :or coverage is in- 9.b. of this endorse- cluded within the terms ment shall not apply of the Coverage Part'to and Paragraph which this endorsement 9.a.(3)(a). of this en- is attached. dorsenent shall apply. b. With respect to addi- 10. Broadened Contractual Liability-Work tional insureds de- Within 50'of Railroad Property scribed in Paragraph It'is hereby agreed that Paragraph.f.(1)of 9.a.(Z)(g)above only: Definition 12, "insured contract" (SEC- If SECIf a written contract or TION V-DEFINITIONS) is deleted. agreement between you and the additional 11• Property r ter'ty Damage to Borrowed Equip- insured specifies that coverage for the addi- a. The following is hereby added to'Ex- tional insured: elusion j. Damage to Property of a. ' Be provided by the Paragraph 2.. Exclusions. of SEC- Insurance Ser- TION I-COVERAGES. COVERAGE vices Office addi- A. BODILY INJURY AND PROP- tional insured form ERTY.;DAMAGE LIABILITY: number CG 20 10 Paragraphs (3) and (4)of this exclu- or CG 20 37 sign do not apply to tools or'equip- (where edition merit loaned to you,provided they are specified);or not'being used to perform operations b. Include coverage at the time of loss: for completed op- b. With respect to the insurance pro- erations: or vided by this section of the endorse- c. Include coverage inept. the following additional:provi- for" our work" cions apply and where the,limits or (1) The Limits of insurance shown in coverage provided to the Declarations are replaced by the additional insured:is the limits designated in Section more restrictive :than B. Limits of Insurance. "11. of was specifically re- this endorsement with respect to quired in that written coverage provided by this en- contract or agreement, dorsement. These limits are in- the terms a of Para- elusive of and not in :addition to graphs 9.a:(3)(a). the limits being replaced. The 9-a.(3)(b)or 9.4.above. Limits of Insurance shown in or any combination. Section B. Limits of Insurance. thereof. shall be inter- 11. Of:this endorsement fixe the preted as providing the most we will pay in,any one"oc- limits or coverage re- currence regardless of the quired by the terms of Minter of the written contract or (a) Insureds: agreement but onlyto the extent that such lim- (b) Claims made or "suits" its Cr coverage is in- brought.or eluded within the:terms :of the"Coverage Part to (c) Persons or organizations which this endorsement' making claims or bring is attached. If,however, suits". the written. contract or lndudes-copyrighted material of Insurance GA233 OR 0910 Services Office;Inc.:with its"permission; Page 15 of 16 i . (2) Deductibie Clause a. Nurses; (a) Our obligation to pay dam- b. Eniergency Medical Technicians;or 'ages on your behalf applies only to the amount Of dam- c. Paramedics, ages for each "Occurrence" in the jurisdiction where an "Occurrence" which are in excess of th „ or'offense to which this insurance applies DeduCtible amount Stated e in ectiiin B. Limits.Of irisur takas place. ance. 11. of this endorse- 13. Broadened Notice of Occurrence ment. The limits .of 'insur- ance will not be reduced by Paragraph a. of Condition 2. Duties in the application of such De- the Event of Occurrence, Offense, ductible amount Claim or Suit(SECTION IV-COMMER- CIAL. GENERAL LIABILITY CONDI- (b) Condition 2. Duties in the TIONS)is hereby deleted and replaced by Event of'Occurrence. Of- the following: fense. Claim or Silk ap- plies to each claim Or"suit" a. You must see to it that we are notified irrespective of the amount. as soon As practicable„of an "occur- rence"or an Offense which may result (c) We may pay any part or all in a claim.To the extent possible,pg, Of the deductible amount to tice should include: effect settlement of any claim Or"suit"and, upon no- (1) Hew. when and where the "oc- tffication of the action taken. currence"or offense took place; you shall promptly rein? (2) The names and addresses of .burse us for such part of the ' deductible amount as has any injured persons •and wit- nesses:and been paid by us. (3) The nature and location 'of any 12. Employees as' Insureds - Specified injury or damage arising out of Health Care Services the"occurrence"or offense. It is hereby agreed that Paragraph This requirement applies only when 2.a.(1)(d) of SECTION II - WHO IS AN the occurrence'or offense is known INSURED. does net apply to your "em- to an"authorized representative". ployees" who provide professional health care services on your behalf as duly Ii-: Censed: Includes copyrighted material of Insurance GA 233 OR 09 10 Services Office.Inc..'with its Perrnidiion. Page 16 of 16