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HomeMy WebLinkAbout2023-139 PO 20240135- Viking Automatic Sprinkler Co. i Purchase Order railC HE• HDEI Fiscal Year 2024 Page: 1 of: 1 _ 'lea(j. • P�S-�arre.Ta e B ,City of Ashland ATTN: Accounts Payable LL 20 E. Main .. � Purchase 202401. 35 Ashland, OR 97520 , Order# T Phone: 541/552-2010 , p Email: payable@ashland.or.us ) V H C/O Facilities Maintenance Div E VIKING AUTOMATIC SPRINKLER CO I 90 North Mountain'Ave N 3245 NW FRONT AVE p Ashland, OR 97520 O PORTLAND, OR 97210 Phone: 541/488-5358 , - R T Fax: 541/552-2304 -1--_-_-v , -E =ia _I—e 1== [a.de Eiii;1,i ,._ °aillaf zf ia_i --.:-.....,:=—_ _�_.._.__ 'L _ ' _i€[ _ r _____— — _ �:5 a�,Q§[=le[�aah 3a el�i � � —� [� �� ci �( r 1 ��¢ � _ —._ 503 227-1171 David Arnold _ —5 9 aa(� =a`- q'_'Q a e�.E.lU( I$I-li. a7�_-I RI.. _ -6 ily iir as „.- ,,- —,.....-7----,-------,---,n a — � -� -�-� ��--� ---��-�`I �-=.� _.__ -i���r___: � lai :Ll =�i�----i[ai- ---- 09/22/2023 928 FOB ASHLAND OR/NET30 — Cit Accounts Pa able _Ira:-I 1- -,._7_,=-,--------_—__;__—=,-, . ti b' .7_ 110-i,-_------__4,..- 7.-m, ....-- -4.14 -.1.1 Wing -' -08 ilyz t On-call Fire Sprinkler Service 1 On-call Fire Sprinkler Inspections and Replacements 1.0 $5,000.00 $5,000.00 Goods and Services Agreement($35,000 or less) Completion date: June 30, 2024 Project Account: Ship To: C/O Purchasing Division . 90 North Mountain Ave Ashland, OR 97520 Phone: 541/488-5354 Fax: 541/488-5320 ; ***************GL SUMMARY*************** _ 088400-602400 $5,000.00 .1' ' By:1 '1 ` ) . Datil”- ---."-= = _--------_-4-8----,---------•:: Authorized Signa,'e I • €° - = FORM #3CITY OF A request for a Purchase Order ASHLAND REQUISITION ro /-001.-- L( Date of request: 7/26/23 . Required date for delivery: Vendor Name Viking Automatic Sprinkler Company Address,City,State,Zip 4961 Industry Drive, Medford, OR 97502 Contact Name&Telephone Number Mike Baxter 541-773-1052 mike.baxterc .vikingsprinkler.net Email address SOURCING METHOD ❑ Exempt from Competitive Bidding, 0 Invitation to Bid ❑ Emergency ❑ Reason for exemption: Date approved by Council: 0 Form#13,Written findings and Authorization, ❑ AMC 2.50 . _(Attach copy of council communication) 0 Written quote or proposal attached ❑ Written quote or proposal attached _(If council approval required,attach copy of CC) ❑ .Small Procurement 0 Request for Proposal Cooperative Procurement Not exceeding$5,000 Date approved by Council: , 0 State of Oregon ® Direct Award _(Attach copy of council communication) Contract# ❑ Verbal/Written quote(s)or proposal(s) 0 Request for Qualifications(Public Works) 0 State of Washington Date approved by Council_ Contract# _(Attach copy of council communication) ❑ Other government agency contract Intermediate Procurement 0 Sole Source Agency GOODS&SERVICES ❑ Applicable Form(#5,6,7 or 8) Contract# 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: ❑ 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 approved/signed 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 ❑. 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) . ates_criptio:02e.o2ERVICES Total Cost Fire sprinkler inspections and replacements for FY24 ;'$5;000.00 Item # Quantity Unit 'Description of MATERIALS Unit Price Total Cost 1 - $0 $0.00 ..- $0 $0.00 • $0 $0.00 1:1 Per attached quotelproposal TOTAL COST ,,:: Project Number: _ _ Account Number: 088400-602400 $5;000x00 `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 ap. = 'e .11 hardware and software purchases: IT Director Date Support-Yes/No By signing this requisition form certify that the City' publi contracting requirements have been satisfied. ? at-2O. . Employee: Department Hea . ual or greater than$5,000) Department Manager/Supervisor: City Manager: (Greater th•n$35,000) Funds appropriated for current fiscal ye r: YE / NO �. ' `i'i AA I. ' ..4; • Finance Direc or-(Equal to.. gg rater than$5,000) '-'~..41, . Comments: Form#3-Requisition VIKING AUTOMATIC SPRINKLER COMPANY 4961 Industry Drive Medford, Oregon 97502-1200 FIRE PROTECTION Tel: (541) 773-1052 Fax: (541) 773-1609 jIRE PROTECTION CONT`RACrOR S SINCE 1930 Apri11,2023 Oregon Inspection/Time&Material rates We are pleased to offer the following information as per our services. Labor Rates are as follows: Inspection/Service rate:$142.00 per hour (includes Van up to 60 miles from office) Fitter-no van:$124.00 per hour Inspection Fee per facility:$55.00 Fire pump inspection fee:$95.00 Viking truck fee over 100 miles:$100.00 per day Engineering/Design:$125.00 per hour. Subsistence/$120.00 per day Viking Automatic Sprinkler Co.offers the different types of services. ■ Quarterly Inspections • Semi-Annual inspections • Annual inspections • 5-year internal inspections ■ Flushing of overhead and underground service mains • Fire pump testing • Sprinkler Head testing • 25 hr.emergency service and repair • Underground install and repair Viking offers parts at a discounted rate from list price due to negotiated pricing from our suppliers. Mike Baxter Viking Automatic Sprinkler Co. 4961 Industry Drive Medford,OR 97502 0:541-773-1052 C:541-415-1789 Mike.baxter©vikingsprinkler.net 1 V OREGON CORPORATION WASHINGTON CORPORATION IDAHO CORPORATION PORTLAND♦MEDFORD SEATTLE♦ LONGVIEW MERIDIAN•POCATELLO CCB#64837 CLN#VIKINAS373NT LIC#FPSC-003 GOODS AND SERVICES AGREEMENT ($35,000 OR LESS) PROVIDER: Viking Automatic Sprinkler Company CITY OF PROVIDER'S ASH LAND CONTACT: Mike Baxter 20 East Main Street Ashland,Oregon 97520 ADDRESS: 4961 Industry Drive Telephone: 541/488-5587 Medford, OR 97502-1200 Fax: 541/488-6006 PHONE: 541-773-1052 This Goods and Services Agreement (hereinafter "Agreement") is entered into by and between the City of Ashland, an Oregon municipal corporation (hereinafter "City") and Viking Automatic Sprinkler Company, (a domestic/foreign business corporation)("hereinafter"Provider"), for fire sprinkler inspections and replacements. 1. PROVIDER'S OBLIGATIONS 1.1 Provide fire sprinkler inspections and replacements for FY24 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." 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 j'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: Goods and Services Agreement between the City of Ashland and Viking Automatic Sprinkler Company • 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 $25,335.05 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 4/1/2023 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 of 6: Goods and Services Agreement between the City of Ashland and Viking Automatic Sprinkler Company 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. 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 2798.235. 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). Page 3 of 6: Goods and Services Agreement between the City of Ashland and Viking Automatic Sprinkler Company 3.I3 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 1,2023. 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 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 June 30, 2024, 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 Viking Automatic Sprinkler Company 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: Viking Automatic Sprinkler Company Attn:Mike Baxter 4961 Industry Dr. Medford, OR 97502 541-773-1052 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 Page 5 of 6: Goods and Services Agreement between the City of Ashland and Viking Automatic Sprinkler Company 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. CITY OF ASHLAND: Viking Automatic Sprinkler Company (PROVIDER): By: 1"n4� By: . L�=- �.d YlL` ( tyv- Signature 4(. r `/ Christina Tilson Printed Name Printed Name P QEc_ Vice President Title Title 't.20 .2) 9/12/2023 Date Date (W-9 is to be submitted with this signed Agreement) Purchase Order No. 02-6i ( Page 6 of 6: Goods and Services Agreement between the City of Ashland and Viking Automatic Sprinkler Company Client#: 131358 VIKIAUTO2 - ACORDTM DATE(MMIDDIYYYY)'CORDTM CERTIFICATE OF LIABILITY INSURANCE 9/18/2023 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Sara Sellin Propel Insurance PHONE 800 499-0933 (FAX 866 577-1326 (A/C,No,Ext): (A/C,No): 805 SW Broadway; Suite 2300 EMAIL sara.sellin r0 elinsurance.com COM Construction ADDRESS: @p p Portland,OR 97205-3363 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Nautilus Insurance Company 17370 INSURED INSURER B:SAIF Corporation 36196 Viking Automatic Sprinkler Co. INSURER c:Zurich American Insurance Company 16535 3245 NW Front Ave Middlesex Insurance Company 23434 Portland,OR 97210 INSURER D: P Y • INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DDIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY ECP200453321 01/31/2023 01/31/2024 EACH OCCURRENCE $2,000,000 CLAIMS-MADE X OCCUR PREMISES(OEa occu ence) $100,000 X BI/PD Ded:5,000 MED EXP(Any one person) $5,000 PERSONAL&ADVINJURY $2,000,000 GENt AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY X ECOT LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: WA Stop Gap $1,000,000 D AUTOMOBILE LIABILITY A0210038 01/31/2023 01/31/2024 COMBINaccidEDent)SI >NGLELIMIT 1 000>aoo (Ea X 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) $ A UMBRELLA LIAB X OCCUR FFX200453421 01/31/2023 01/31/2024 EACH OCCURRENCE $8,000,000• X EXCESS LIAB CLAIMS-MADE AGGREGATE $8,000,000 DED X RETENTION$0 $ B WORKERS COMPENSATION 763948 OR 10/01/2022 10/01/2023 X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER C ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N WC969610811 10/01/2022 10/01/2023 E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? y N/A (Mandatory In NH) CA,ID,AK E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 • A Microbial Subst ECP200453321 01/31/2023 01/31/2024 2,000,000 15,000 Ret A Poll&Prof. Liab ECP200453321 01/31/2023 01/31/2024 2,000,000 15,000 Ret D Install.Floater A0210038 01/31/2023 01/31/2024 250,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Excess policy is following form over General,Auto,Employers,Pollution and Professional Liability. Certificate Holder Includes:The City of Ashland,Oregon,its officers,agents,and employees. CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 90 N Mountain Ave ACCORDANCE WITH THE POLICY PROVISIONS. Ashland,OR 97520 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S6155913/M5688082 LXBOO www.saif.com ■ saiF ;; . Carrier no: 20001 Endorsement no: WC000313 (Ed. 4306) SAIF policy: 763948 Viking Automatic Sprinkler Company Waiver of Our Right to Recover from Others Endorsement We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Description: ALL OPERATIONS Contractor name: Persons and/or organizations with whom the insured-employer is required by written contract to waive subrogation rights. This endorsement does not alter the rights of an injured worker to pursue recovery from another party or SAIF to receive a statutory share of recoveries by an injured worker, even from the party listed in the schedule. The premium charge for this endorsement is based on one (1) percent of your manual premium. Effective date: October 01, 2022 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. Countersigned September 23, 2022 at Salem, Oregon 7 WC000313 Chip Terhune (Ed. 430B) President and Chief Executive Officer 400 High Street SE Salem,OR 97312 P:800.285.8525 F:503.373.8020 Pol_PC1_E430B This page has been left blank intentionally. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule ALL PERSONS AND/OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS,THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS POLICY FOR WORK PERFORMED BY YOU FOR THAT PERSON AND/OR ORGANIZATION • This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 10/01/2022 Policy No. WC 9696108-11 Endorsement No. Insured Viking Automatic Sprinkler Co Premium $ Insurance Company Zurich American Insurance Company Countersigned by WC124(4-84) Copyright 1983 National Council on Compensation Insurance,Inc. Page 1 of 1 WC 00 03 13 This page has been left blank intentionally. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE-OF CANCELLATION TO,DESIGNATED PERSON'OR ORGANIZATION .Policy Number - Polidy-Effective;Date Policy Expiration,'Date, Endorsement Effective Date, EC P2004533-21 1/31/2023 1/31/2024 1/31/2023 This endorsement modifies insurance provided under the following: ENVIRONMENTAL COMBINED POLICY The following is added to SECTION VII—CONDITIONS 2. Cancellation: SCHEDULE Number of Days Advance Notice Of Cancellation: Thirty(30) Days Name and Address of Designated Person(s)or Per written request(s) of the named insured on file with the Organization(s): company. Additional Premium: $150 In consideration of the payment of an additional premium, and notwithstanding anything contained in the policy to the contrary, it is understood and agreed that if we cancel this policy on or before the expiration date set forth in the Declarations, we will mail or deliver to the first Named Insured at the last known address, and the person(s) or organization(s) at the address designated in the SCHEDULE above, written notice of cancellation not less than the number of days shown in the SCHEDULE before the effective date of cancellation. Proof of mailing of notice shall be sufficient proof of notice. The effective date and hour of cancellation stated in the notice shall be the end of the policy period. This endorsement shall not apply if: 1. We cancel due to non-payment of premium, or 2. The policy is non-renewed for any reason. ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED. ECP 1234 10 21 Includes copyrighted material of Insurance Services Office,Inc.,used with its permission. Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED, ;-- LESSOR°OF:LEAS'ED EQUIPMENT AUTOMATIC STATUS.; cOVERAGErA &B ;.° - 'Policy Number Policy Effective Date Policy Expiration'Date Endorsement Effective, Date, ,- . ECP2004533-21 1/31/2023 1/31/2024 1/31/2023 This endorsement modifies insurance provided under the following: ENVIRONMENTAL COMBINED POLICY I. SECTION III—WHO IS AN INSURED is amended to include as an additional insured any person(s)or organization(s) from whom you lease equipment with whom you have agreed under a written contract or written agreement, in effect during this policy period, that such person(s) or organization(s) be added as an additional insured on this policy, but only with respect to liability for bodily injury or property damage under SECTION I — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY, or personal and advertising injury under SECTION I— COVERAGE B — PERSONAL AND ADVERTISING INJURY LIABILITY directly caused by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s). Such contract or agreement must be executed and in effect prior to your maintenance, operation or use of such leased equipment. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. We will not extend any insurance coverage to such additional insured that is not provided to you in this policy; and 3. The insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. II. With respect to the insurance afforded to these additional insureds: 1. Their status as an additional insured ends when their contract or agreement with you for such leased equipment ends; and 2. This insurance does not apply to any occurrence which takes place after the equipment lease expires; and 3. The coverage provided by this endorsement shall not apply to any claim or suit based upon or arising from an actual or alleged act, error or omission in the performance of professional services of such additional insured person(s) or organization(s). III. With respect to the insurance afforded to these additional insureds,the following is added to SECTION V—LIMITS OF INSURANCE: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. IV. SECTION VII—CONDITION 10.—Other Insurance is amended by the addition of the following which supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to a person(s) or organization(s) included as an additional insured under this endorsement provided that: 1. The additional insured person(s) or organization(s) is a Named Insured under such other insurance; and 2. You have agreed in writing in a contract or agreement, in effect during this policy period,that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured person(s) or organization(s). Such contract or agreement must be executed and in effect prior to your maintenance, operation or use of the equipment leased to you by such person(s) or organization(s),which is the subject of such contract or agreement. ECP 1239 01 21 Includes copyrighted material of Insurance Services Office,Inc.,used with its permission. Page 1 of 2 • However, this provision does not apply if the other insurance available to the person(s) or organization(s) included as an additional insured is Owners and Contractors Protective Liability, Railroad Protective Liability, or similar project- specific, primary insurance. V. This endorsement does not apply to an additional insured which has been added to this policy by an endorsement showing the additional insured in a SCHEDULE of additional insureds, and which endorsement applies to that designated additional insured. ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED. ECP 1239 01 21 Includes copyrighted material of Insurance Services Office,Inc.,used with its permission. Page 2 of 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL'INSURED, OWN'ERS,'LESSEES OR,CONTRACTORS AUTOMATIC STATUS. ONGOING OPERATIONS COVERAGE A, B, D1-& D:4 " r PolicyNumber Policy'Effective'Date ' ,folic 'Expiration Date Endorsement Effective ` y Y p - :Date ECP2004533-21 1/31/2023 1/31/2024 1/31/2023 This endorsement modifies insurance provided under the following: ENVIRONMENTAL COMBINED POLICY I. SECTION III—WHO IS AN INSURED is amended to include as an additional insured: 1. Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement, in effect during this policy period, that such person or organization be added as an additional insured on this policy; and 2. Any other person or organization you are explicitly required to add as an additional insured under the contract or agreement described in Paragraph 1. above. Such contract or agreement must be executed and in effect prior to the performance of your work which is the subject of such contract or agreement. Such person(s)or organization(s)is an additional insured only with respect to liability for bodily injury or property damage under SECTION I — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Coverage D.1 —Contractors Pollution Legal Liability and Coverage D.4—Microbial Substance Contractors Pollution Liability, or personal injury or advertising injury under SECTION I -COVERAGE B—PERSONAL AND ADVERTISING INJURY LIABILITY directly caused by: a. Your acts or omissions; or b. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured described in Paragraph 1.or 2. above. However, the insurance afforded to such additional insured described above: a. Only applies to the extent permitted by law; and b. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured, and c. Will not extend beyond that which is provided to you in this policy. A person's or organization's status as an additional insured under this endorsement ends when your operations for the person or organization described in Paragraph 1. above are completed. II. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: a. Bodily injury, property damage or personal and advertising injury arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the occurrence which caused the bodily injury or property damage,or the offense which caused the personal and advertising injury, involved the rendering of, or the failure to render any professional architectural, engineering or surveying services. b. Bodily injury or property damage occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs)to be performed by or on behalf of the additional insured(s)at the location of the covered operations has been completed; or ECP 1246 01 21 Includes copyrighted material of Insurance Services Office,Inc.,used with its permission. Page 1 of 2 (2) That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. III. With respect to the insurance afforded to these additional insureds, the following is added to SECTION V— LIMITS OF INSURANCE: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement described in Paragraph 1.1.; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. IV. With respect to the insurance afforded to these additional insureds, the following is added to SECTION VI— REPORTING, DEFENSE,SETTLEMENT&COOPERATION: 1. Duties --Additional Insured An additional insured must see to it that: a. We are notified in writing as soon as practicable of an occurrence or offense which may result in a claim or suit; b. We receive written notice of a claim or suit as soon as practicable; and c. A request for defense and indemnity of the claim or suit will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured, if the contract or agreement requires that this coverage be primary and noncontributory. V. SECTION VII—CONDITION 10.—Other Insurance is amended by the addition of the following which supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to a person(s) or organization(s) included as an additional insured under this endorsement provided that: 1. The additional insured person(s) or organization(s) is a Named Insured under such other insurance; and 2. You have agreed in writing in a contract or agreement, in effect during this policy period, that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured person(s) or organization(s). Such contract or agreement must be executed and in effect prior to the performance of your work which is the subject of such contract or agreement. However, this provision does not apply if the other insurance available to the person(s) or organization(s) included as an additional insured is Owners and Contractors Protective Liability, Railroad Protective Liability, or similar project- specific, primary insurance. VI. This endorsement does not apply to an additional insured which has been added to this policy by an endorsement showing the additional insured in a SCHEDULE of additional insureds, and which endorsement applies to that designated additional insured. ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED. ECP 1246 01 21 Includes copyrighted material of Insurance Services Office,Inc.,used with its permission. Page 2 of 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL.INSURED 1OWNERS, LESSEES'OR CONTRACTORS , AUTOMATIC STATUS COMPLETED;OPERATIONS COVERAGE A, D:1 & D':4 Policy Number', Policy+Effective,Date Policy Expiration}Date Endorsement Effective. Date ECP2004533-21 1/31/2023 1/31/2024 1/31/2023 This endorsement modifies insurance provided under the following: ENVIRONMENTAL COMBINED POLICY I. SECTION III—WHO IS AN INSURED is amended to include as an additional insured: 1. Any person or organization for whom you have performed operations when you and such person or organization have agreed in writing in a contract or agreement, in effect during this policy period, that such person or organization be added as an additional insured on this policy; and 2. Any other person or organization you are explicitly required to add as an additional insured under the contract or agreement described in Paragraph 1.above. Such contract or agreement must be executed and in effect prior to the performance of your work included in the products-completed operations hazard which is the subject of such contract or agreement. Such person(s)or organization(s) is an additional insured only with respect to liability for bodily injury or property damage under SECTION I — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Coverage D.1 —Contractors Pollution Legal Liability and Coverage D.4—Microbial Substance Contractors Pollution Liability, directly caused by your work performed for the additional insured described in Paragraph 1. or 2.above, and included in the products-completed operations hazard. However, the insurance afforded to such additional insured described above: a. Only applies to the extent permitted by law; and b. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured; and c. Will not extend beyond that which is provided to you in this policy. II. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: a. Bodily injury or property damage arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the occurrence which caused the bodily injury or property damage involved the rendering of, or the failure to render any professional architectural, engineering or surveying services. III. With respect to the insurance afforded to these additional insureds, the following is added to SECTION V— LIMITS OF INSURANCE: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement described in Paragraph 1.1.; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. IV. With respect to the insurance afforded to these additional insureds, the following is added to SECTION VI— ECP 1248 01 21 Includes copyrighted material of Insurance Services Office,Inc.,used with its permission. Page 1 of 2 REPORTING, DEFENSE,SETTLEMENT&COOPERATION: 1. Duties --Additional Insured An additional insured must see to it that: a. We are notified in writing as soon as practicable of an occurrence which may result in a claim or suit; b. We receive written notice of a claim or suit as soon as practicable; and c. A request for defense and indemnity of the claim or suit will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured, if the contract or agreement requires that this coverage be primary and noncontributory. V. SECTION VII—CONDITION 10.—Other Insurance is amended by the addition of the following which supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to a person(s) or organization(s) included as an additional insuredunder this endorsement provided that: 1. The additional insured person(s) or organization(s) is a Named Insured under such other insurance; and 2. You have agreed in writing in a contract or agreement, in effect during this policy period,that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured person(s) or organization(s). Such contract or agreement must be executed and in effect prior to the performance of your work included in the products-completed operations hazard which is the subject of such contract or agreement. However, this provision does not apply if the other insurance available to the person(s) or organization(s) included as an additional insured is Owners and Contractors Protective Liability, Railroad Protective Liability, or similar project- specific, primary insurance. VI. This endorsement does not apply to an additional insured which has been added to this policy by an endorsement showing the additional insured in a SCHEDULE of additional insureds, and which endorsement applies to that designated additional insured. ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED. ECP 1248 01 21 Includes copyrighted material of Insurance Services Office,Inc.,used with its permission. Page 2 of 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AD`DITIONALiNSURED ARCHITECTS,,'ENGINEERS OR�`S.URVEYORS-. - NOT:ENGAGED BY THEl,'NAI4ED INSURED COVERAGE A & B Policy'Number Policy Effective'Date' " Policy Expiration Date Endorsernent:Effective. Date. ECP2004533-21 1/31/2023 1/31/2024 1/31/2023 This endorsement modifies insurance provided under the following: ENVIRONMENTAL COMBINED POLICY SCHEDULE Name(s) Of Additional Insured Engineer(s),Architect(s) Any person or organization that you are required by written Or Surveyor(s) Not Engaged By The Named Insured: contract or agreement to include as an additional insured. • I. SECTION III — WHO IS AN INSURED is amended to include as an additional insured the architects, engineers or surveyors shown in the SCHEDULE,while not engaged by you, are explicitly required under a written contract or written agreement, in effect during this policy period, to be added as additional insureds to this policy, but only with respect to liability for bodily injury or property damage under SECTION I — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY, or personal and advertising injury under SECTION I — COVERAGE B— PERSONAL AND ADVERTISING INJURY LIABILITY directly caused by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations performed by you or on your behalf. Such contract or agreement must be executed and in effect prior to your performance of such ongoing operations. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. We will not extend any insurance coverage to such additional insured that is not provided to you in this policy; and 3. The insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. II. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to bodily injury, property damage or personal and advertising injury arising out of the rendering of or failure to render any professional services, including: 1. The preparing, approving, or failing to prepare or approve, maps, drawings, opinions, reports, surveys, change orders, designs or specifications; or 2. Supervisory, inspection or engineering services. • This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the occurrence which caused the bodily injury or property damage, or the offense which caused the personal and advertising injury, involved the rendering of or the failure to render any professional services. III. With respect to the insurance afforded to these additional insureds, the following is added to SECTION V—LIMITS OF INSURANCE: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. ECP 1250 01 21 Includes copyrighted material of Insurance Services Office,Inc.,used with its permission. Page 1 of 2 IV. SECTION VII—CONDITION 10.—Other Insurance is amended by the addition of the following which supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to the additional insured architects, engineers or surveyors shown in the SCHEDULE to this endorsement provided that: 1. The additional insured architect, engineer or surveyor is a Named Insured under such other insurance; and 2. It is explicitly required under a written contract or written agreement, in effect during this policy period, that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured architect, engineer or surveyor. Such contract or agreement must be executed and in effect prior to the performance of your ongoing operations,which are the subject of such contract or agreement. However,this provision does not apply if the other insurance available to the person(s) or organization(s) included as an additional insured is Owners and Contractors Protective Liability, Railroad Protective Liability, or similar project- specific, primary insurance. ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED. • ECP 1250 01 21 Includes copyrighted material of Insurance Services Office,Inc.,used with its permission. Page 2 of 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER'OF SUBROGATION'.' .. (TRANSFER OF RIGHTS O'F RECOVERYjAGAINSTOTHIERS TO US) ' AUTOMATIC STATUS COVERAGE A;SR,0 Policy Number Policy Effective Date Policy Expiration Date Endorsement'Effective = Date ECP2004533-21 1/31/2023 1/31/2024 1/31/2023 This endorsement modifies insurance provided under the following: ENVIRONMENTAL COMBINED POLICY I. The following is added to Paragraph 17. Subrogation of SECTION VII—CONDITIONS: We waive any right of recovery against any person(s) or organization(s) because of payments we make under COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY, COVERAGE B — PERSONAL AND ADVERTISING INJURY LIABILITY, and COVERAGE D—CONTRACTORS POLLUTION LIABILITY under this policy. Such waiver by us applies only if: 1. The insured has agreed in writing in a contract or agreement with such person(s) or organization(s) to waive its right of recovery; and 2. The insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This waiver does not apply in any jurisdiction where such waiver is held to be illegal or against public policy or in any situation where the person(s) or organization(s) against whom subrogation is to be waived is found to be solely negligent. This endorsement does not apply to any person(s) or organization(s) designated in a SCHEDULE of person(s) or organization(s) against whom rights of recovery have been waived. ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED. ECP 1260 01 21 Includes copyrighted material of Insurance Services Office,Inc.,used with its permission. Page 1 of 1 • THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ,PER-PROJECT,AGGREGATE LIMITS,OF INSURANCE —AUTOMATIC STATUS.- Policy Number Policy.Effective Date Policy Expiration,-Date Endorsement Effective. Date ECP2004533-21 1/31/2023 1/31/2024 • 1/31/2023 This endorsement modifies insurance provided under the following: ENVIRONMENTAL COMBINED POLICY I. For all sums which the insured becomes legally obligated to pay as damages caused by occurrences under SECTION I—COVERAGE A—BODILY INJURY AND PROPERTY DAMAGE LIABILITY, and for all medical expenses caused by accidents under SECTION I — COVERAGE C — MEDICAL PAYMENTS, which can be attributed only to covered operations at a single project: 1. A separate Per-Project Aggregate Limit applies to each project, and that limit is equal to the lesser of: a. The General Aggregate Limit shown in the Declarations; or b. $2,000,000. 2. The Per-Project Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A—BODILY INJURY AND PROPERTY DAMAGE LIABILITY except damages because of bodily injury or property damage included in the products-completed operations hazard, and for medical expenses under COVERAGE C— MEDICAL PAYMENTS regardless of the number of: a. Insureds; b. Claims made or suits brought; or c. Persons or organizations making claims or bringing suits. 3. Any payments made under COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY for damages or under COVERAGE C — MEDICAL PAYMENTS for medical expenses shall reduce the Per-Project Aggregate Limit for that particular project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Per-Project Aggregate Limit for any other project. 4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Per-Project Aggregate Limit. II. For all sums which the insured becomes legally obligated to pay as damages caused by occurrences under SECTION I — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY which cannot be attributed only to covered operations: 1. Any payments made under SECTION I —COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY for damages shall reduce the amount available under the General Aggregate Limit or the Products Completed Operations Aggregate Limit,whichever is applicable; and 2. Such payments shall not reduce any Per-Project Aggregate Limit. III. When coverage for liability arising out of the products-completed operations hazard is provided, any payments for damages because of bodily injury or property damage included in the products-completed operations hazard will reduce the Products-Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Per- Project Aggregate Limit. IV. If the applicable project has been abandoned,delayed,or abandoned and then restarted,or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables,the particular project will still be deemed to be the same project. V. The provisions of SECTION V—LIMITS OF INSURANCE not otherwise modified by this endorsement shall continue to apply as stipulated. ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED. ECP 1289 01 21 Includes copyrighted material of Insurance Services Office,Inc.,used with its permission. Page 1 of 1 ENDORSEMENT This endorsement forms a part of the policy to which it is attached. Please read it carefully. WAIVEROF'SUBROGATION `SCHEDULED,.ENT RITIES, It is agreed that the Company, in the event of any payment under this policy, waives its right of recovery against the person(s) or organization(s) shown in the schedule below, but only at the specific written request of the Named Insured either before or after loss, wherein such waiver of subrogation has been included before loss as part of a written contractual undertaking by the Named Insured. This waiver of subrogation shall apply only with respect to losses occurring due to operations undertaken as per the specific contract existing between the Named Insured and such person(s) or organization(s) shown in the schedule below and shall not be construed to be a waiver of subrogation with respect to other operations of such person(s) or organization(s) shown in the schedule below in which the Named Insured has no contractual interest. No waiver of subrogation shall directly or indirectly apply to any employee, employees or agents of either the Named Insured or of the person(s) or organization(s) shown in the schedule below, and the Company reserves its right or lien to be reimbursed from any recovery funds obtained by any injured employee. This waiver of subrogation does not apply in any jurisdiction or situation where such waiver is held to be illegal or against public policy or in any situation wherein the person(s) or organization(s) shown in the schedule below against whom subrogation is to be waived is found to be solely negligent. SCHEDULE Name of Person(s)or Organization(s): Any person or organization that you are required by written contract or agreement to provide a waiver of subrogation. ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED. ENV 2013 06 18 Page 1 of 1 ENDORSEMENT This endorsement forms a part of the policy to which it is attached. Please read it carefully. ORDER OF COVERAGE AND CONTRIBUTION - OTHER.INSURANCECONDITION'- This endorsement modifies insurance provided under the following: FOLLOW FORM EXCESS LIABILITY COVERAGE FORM SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Any person or organization that you are required by written contract or agreement to include as an additional insured. Additional Premium: $1,263 Paragraph 8. Of Section III—Conditions is deleted and replaced by the following: 8. Other Insurance a. This insurance is excess over, and shall not contribute with any of the other insurance, whether primary, excess, contingent or on any other basis. However: (1) This condition will not apply to other insurance specifically written as excess over this Coverage Form. (2) If you specifically agree in a written contract or written agreement, in effect during this policy period, that the insurance provided to any person or organization that qualifies as an insured under this insurance must apply on a primary basis, or a primary and noncontributory basis, then insurance under this policy is subject to the following provisions: (a) This insurance will apply before any other insurance that is available to such additional insured which covers that person or organization as a Named Insured; and (b) We will not seek contribution from that other insurance, provided that the injury or damage for which coverage is sought is caused by an event that takes place or is committed subsequent to the signing of that contract or agreement by you. This insurance, in all cases, will always apply after the Commercial Liability Coverages shown in the Schedule of Underlying Insurance. When this insurance is excess, if no other insurer defends, we may undertake to do so, but we will be entitled to the insured's rights against all those other insurers. b. When this insurance is excess over other insurance, we will pay only our share of the ultimate net loss that exceeds: (1) The total amount that all such other insurance would pay for the loss in the absence of the insurance provided under this Coverage Form; plus (2) The total of all deductible and self-insured amounts under all that other insurance. ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED. FFX 8055 05 19 Page 1 of 1 This page has been left blank intentionally. COMMERCIAL AUTO CA 70 57 06 22 SPECIAL BROAD FORM AUTO ENDORSEMENT This endorsement modifies Insurance provided under the following: BUSINESS AUTO COVERAGE FORM 1. Broadened Who Is An Insured the extent that person or organization qualifies Under Section II - Covered Autos Liability as an "insured" under the Who is An Insured Coverage, the following is added to Coverage provision contained in Paragraph A.1. of A.1.Who Is An Insured: Section II - Covered Autos Liability Coverage in the Business Auto Coverage Form. d. Employees As Insureds The insurance afforded under this provision Any "employee" of yours is an "insured"while only applies if the "bodily injury" or "property using a covered "auto"you don't own, hire or damage" occurs: borrow in your business or personal affairs. 1. During the policy period, and e. Newly Acquired Organizations 2. After the execution of such written Any organization you newly acquire or form, contract, and other than a partnership, joint venture or limited liability company, and over which you 3. Prior to the expiration of the period that the maintain ownership or majority interest, will written contract requires such insurance to qualify as a Named Insured if there is no other be provided to the additional insured. similar insurance available to that organization. B. This insurance is primary to and will not seek However: contribution from any other auto insurance 1. Coverage under this provision is afforded issued to the person or organization in the only until the 90th day after you acquire or schedule under your policy provided that: form the organization or the end of the 1. The person or organization is a Named policy period;whichever is earlier; and Insured under such other insurance; and 2. Coverage does not apply to "bodily injury", 2. Prior to the "accident" you have agreed in "property damage" or "covered pollution writing in a contract or agreement that this cost or expense" that occurred before you insurance would be primary and would not acquired or formed the organization. seek contribution from any other insurance f. For Any Covered"Auto": available to the person or organization. Who Is An Insured is amended to include as 3. Waiver of Transfer of Rights of Recovery an insured any organization or subsidiary The Transfer of Rights of Recovery Against thereof which is a legally incorporated entity of Others to Us Condition does not apply to any which you own a financial interest of more person(s) or organization(s) for whom you are than 50 percent of the voting stock on the required to waive subrogation with the respect to effective date of this endorsement. coverage provided under this Coverage Form, but This provision applies only if there is no similar only to the extent that subrogation is waived: insurance available to the entity described A. Under a written contract or agreement with above. such person(s)or organization(s), and 2. Additional Insured by Contract, Agreement or B. Prior to the"accident"or the,"loss." Permit 4. Broadened Supplementary Payments SECTION II - LIABILITY COVERAGE, Paragraph Coverage Extension 2.a. Supplementary A.1. Who is An Insured is amended to include Payments under Section II - Covered Autos the following as an"insured": Liability Coverages is amended as follows: A. Any person or organization, where you have A. Paragraph 2.a.(2) is amended to pay up to agreed by written contract to add as an $3,000 for cost of bail bonds; and additional insured, is an insured but only to CA 70 57 06 22 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 4 with its permission. B. Paragraph 2.a.(4) is amended to pay for loss (2) Specified Causes Of Loss only if the of earnings up to $500 a day because of time Declarations indicate that Specified off from work. Causes of Loss Coverage is provided 5. Fellow Employee Bodily Injury Extension for any covered "auto"; or The Fellow Employee exclusion contained in (3) Collision only if the Declarations Section II - Covered Autos Liability Coverage indicate that Collision Coverage is does not apply. provided for any covered "auto". 6. Accidental Airbag Discharge However, the most we will pay for any expenses for loss of use is$50 per day, to The following is added to Exclusion B.3.a. under a maximum of$1,500. Section III -PHYSICAL DAMAGE: 9. Rental Reimbursement This exclusion does not apply to the accidental discharge of an airbag in a covered auto for a loss A. For any covered "auto" for which that Physical Damage Coverage is shown in the Comprehensive and Collision coverages are Declarations. provided, we will pay for rental reimbursement 7. Towingexpenses incurred by you for the rental of an "auto" because of"loss"to a covered "auto". We will pay up to the limit shown in the B. We will pay up to the limit shown in the Declarations for towing and labor costs incurred Declarations for rental reimbursement each time a covered "auto" that is a private expenses incurred by you for the rental of an passenger type, light truck or medium truck is "auto" because of "loss"to a covered "auto". disabled. However, the labor must be performed Payment applies in addition to the otherwise at the place of disablement. applicable amount of each coverage you have 8. Physical Damage Coverage Extensions on a covered "auto". No deductibles apply to The following replaces the Coverage Extensions this coverage. under Section III-PHYSICAL DAMAGE: C. We will pay only for those expenses incurred a. Transportation Expenses during the policy period beginning 24 hours We will payupto $75 after the "loss" and ending, regardless of the per day to a policy's expiration, with the lesser of the maximum of $1,500 for temporary following number of days: transportation expense incurred by you 1. The number of days reasonably required to because of the total theft of a covered "auto" of the private passenger, truck or repair or replace the covered "auto". If van type with a Gross Vehicle Weight of loss is caused by theft, this number of less than 10,000 pounds. days is added to the number of days it takes to locate the covered "auto" and We will pay only for those covered "autos" return it to you. for which you carry either Comprehensive 2. The number of days shown in the or Specified Causes of Loss Coverage. We Schedule. will pay for temporary transportation expenses incurred during the period D. Our payment is limited to the lesser of the beginning 48 hours after the theft and following amounts: ending, regardless of the policy's 1. Necessary and actual expenses incurred. expiration, when the covered "auto" is 2. The maximum payment ment stated in the returned to use or we pay for its"loss". Schedule applicable to "any one day" or b. Loss Of Use Expenses "any one period". For Hired Auto Physical Damage, we will E. This coverage does not apply while there are pay expenses for which an "insured" spare or reserve "autos" available to you for becomes legally responsible to pay for loss your operations. of use of a vehicle rented or hired without a F. If "loss" results from the total theft of a driver under a written rental contract or covered "auto" of the private passenger type, agreement. We will pay for loss of use we will payunder ths coverage that expense if caused by: 9 only amount of your rental reimbursement (1) Other than collision only if the expenses which is not already provided for Declarations indicate that under the Physical Damage Coverage Comprehensive Coverage is provided Extension. for any covered "auto"; Page 2 of 4 Includes copyrighted material of Insurance Services Office, Inc., CA 70 57 06 22 with its permission. G. Our payment under this coverage extension is (e) Carry-over balances from previous excess over any other rental reimbursement loans or leases. coverage available to you. B. This coverage extension applies to covered 10.Hired Auto Physical Damage autos that are loaned or leased for a period of A. If you have Comprehensive or Specified six months or longer and which have been Causes of Loss and Collision Coverages provided Physical Damage Coverage. The provided on your owned "autos" you may "loss" must be caused by damage for which extend Physical Damage Coverage to any coverage is shown in the Declarations. "autos" you lease, hire, rent or borrow; C. For the purposes of this clause, the following provided you have Liability Coverage for hired is added to the Other Insurance Condition in "autos". the Business Auto Coverage Form: B. The hired"auto" must be of like kind and used The insurance provided by the Auto Loan and as the "autos" owned and covered under this Lease Gap Coverage is excess over any other Coverage Form. collectible insurance including but not limited C. The most we will pay for "loss" to any hired to any coverage provided by or purchased "auto"in any one"accident"is the least of the from the lessor or any financial institution. following amounts: 12.Personal Effects (1) $75,000 The following is added to A.4. Coverage (2) The actual cash value of the hired"auto"at Extensions under Section III-Physical Damage the time of the"loss" Coverage: (3) The cost of repairing or replacing the hired A. We will extend Physical Damage Coverage on a covered"auto"to include personal property auto" with other property of like kind and owned by you,a relative or an"employee"that quality is in the covered "auto" at the time of "loss". D. The following deductible provisions apply: The "loss" must be caused by damage for (1) The deductible will be equal to the largest which coverage is shown in the Declarations. deductible applicable to any owned "auto" There must be evidence of forced entry for for that coverage shown in the loss caused by theft. Declarations. B. The exclusion referring to tapes, records, E. Any "auto" that is leased, hired, rented or discs or other similar audio, visual or data borrowed with a driver is not a covered "auto" electronic devices designated for use with under this coverage extension. audio, visual or data electronic equipment 11.Auto Loan And Lease Gap Coverage does not apply. Section III-PHYSICAL DAMAGE is amended by C. The most we will pay for any one"loss" under the addition of the following: this coverage extension is$2,000. No Physical A. In the event of a total "loss" to a covered Damage Coverage deductible applies to this "auto" shown in the Declarations, we will pay coverage extension. any unpaid amount due on the lease or loan D. Coverage provided by this Personal Effects for a covered"auto", less: extension is excess over any other collectible (1) The amount paid under the policy's insurance. Physical Damage Coverage; and E. The coverage extension does not apply to the (2) Any: following property: (a) Overdue or any deferred lease/loan (1) Any device designed or used to detect payments at the time of the"loss"; speed-measuring equipment such as radar or laser detectors and any jamming (b) Financial penalties imposed under a apparatus intended to elude or disrupt lease for excessive use, abnormal wear speed-measurement equipment; and tear or high mileage; (2) Tools; (c) Security deposits not returned by the 3 lessor; ( ) Jewel ry, precious metals and loose gems; (d) Costs for extended warranties, Credit (4) Money and securities; or Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and CA 70 57 06 22 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 4 with its permission. (5) Property specifically insured or covered under the Business Personal Property Coverage of this policy. 13.Glass Deductible Under Section III - PHYSICAL DAMAGE, the following is added to A.3. Glass Breakage - Hitting A Bird Or Animal - Falling Objects Or Missiles Coverage: The Comprehensive Coverage deductible shown in the Declarations does not apply to glass breakage if such glass is repaired rather than replaced. 14.Broad Knowledge Of Accident, Claim, Suit Or Loss Under Section IV - Business Auto Conditions, the following is added to Loss Conditions A.2. Duties In The Event Of Accident,Claim,Suit Or Loss: Knowledge of an"accident", claim,"suit"or"loss" by an agent or "employee" of an insured or receipt of any demand, notice, summons or other legal paper in connection with a claim or"suit" by any agent or "employee" of any insured shall not in itself constitute knowledge of the named insured or receipt of the named insured, unless a partner, member, manager, executive officer or director shall have such knowledge or shall have received such demand, notice, summons or legal paper. 15.Unintentional Failure To Disclose Hazards Under Section IV - Business Auto Conditions, the following is added to General Conditions B.2.Concealment,Misrepresentation Or Fraud: If in your representations to us you unintentionally failed to disclose all hazards and exposures subject to this insurance, we shall not deny all coverage under this policy because of such oversight. 16.Mental Anguish A. The definition of"bodily injury" under Section V-Definitions is replaced by the following: "Bodily injury" means bodily injury, sickness or disease sustained by a person, including "mental anguish" or death resulting from any of these at any time. B. The following definition is added to Section V -Definitions: "Mental anguish" means extreme pain or distress inflicted upon an individual's emotional and intellectual condition with regard to the individual's response to the environment. Page 4 of 4 Includes copyrighted material of Insurance Services Office, Inc., CA 70 57 06 22 with its permission. POLICY NUMBER: COMMERCIAL AUTO CA 76 01 06 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED - PRIMARY AND NONCONTRIBUTORY - COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM AUTO DEALERS COVERAGE FORM • With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s)or organization(s)who are"insureds"for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated. Named Insured: Endorsement Effective Date: SCHEDULE Name Of Person(s)Or Organization(s): Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Each person or organization shown in the B. Primary And Noncontributory Insurance Schedule is an "insured" for Covered Autos This insurance is primary to and will not seek Liability Coverage, but only to the extent that contribution from any other auto insurance issued person or organization qualifies as an "insured" to the person or organization in the schedule under the Who Is An Insured provision contained under your policy provided that: in: (1) The person or organization is a Named Insured (1) Paragraph A.1. of Section II -Covered Autos under such other insurance; and Liability Coverage in the Business Auto and Motor Carrier Coverage Forms; or (2) Prior to the "accident" you have agreed in writing in a contract or agreement that this (2) Paragraph D.2. of Section I - Covered Autos insurance would be primary and would not Coverages of the Auto Dealers Coverage seek contribution from any other insurance Form. available to the person or organization. CA 76 01 0615 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 A0201060 with its permission. 08/05/2022 Middlesex Insurance Company 1 00001 0000000000 22217 0 N c378eb5c-93b7-462b-8957-fd5468121828 This page has been left blank intentionally.