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HomeMy WebLinkAbout2025-021 Agrmt - J & A Concrete Construction LLCCity Information City of Ashland Contractor Information Firm Name: J&A Concrete Construction LLC Attn: Derek Routh Contact: 20 East Main Street Address: Ashland, Oregon 97520 Phone: (541) 488-5587 Phone: Email: derek. routh@ash land.or. US Email: Contract Summary Procurement Method: Direct award' Completion Date: 06/30/2025 Contract Amount: $ 23,775.00 Abel Castaneda 76010 Truax Rd Central Point, OR 97502 (541) 951-4009 Description of Services: Demolition and construction of new sidewalk at Ashland Airport FBO building Supporting Documents: Estimate Dated: 05/05/2025 Dated: Dated: Dated: This Goods and Services Agreement (hereinafter "Agreement") is entered into by and between the City of Ashland, an Oregon municipal corporation (hereinafter "City") and the Contractor listed under Contractor Information above, (hereinafter "Contractor"), for the services listed under Description of Services and the Supporting Documents as noted in the Contract Summary above. 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 the Supporting Documents, th Supporting Documents shall be given, precedence in the order listed above. The Contractor`s initialsl herein signify acknowledgment and agreement to this provision, if applicable, or if not sign "N/K. The goods and services defined and described in the Supporting Documents shall hereinafter be collectively referred to as "Work." Page 1 of & Goods and Services Agreement between the City of Ashland and J&A Concrete Construction LLC 1. Term and Termination 1.1 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 the Completion Date indicated in the Contract Summary on page one of this Agreement unless sooner terminated as provided in Subsection 1.2. 1.1. Time is of the essence. Time is of the essence for Contractor's performance of each and every obligation and duty under this Agreement. City, by written notice to Contractor of default or breach, may at any time terminate the whole or any part of this Agreement if Contractor fails to provide the Work called for by this Agreement within the time specified herein or within any extension thereof. 1.2. Termination 1.2.1. The City and Contractor may terminate this Agreement by mutual agreement at any time. 1.2.2. 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. 1.2.3. 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. 2. Compensation 2.1. City shall pay Contractor the sum listed as the "Contract Amount" in the Contract Summary on page one of this Agreement as provided herein as full compensation for the Work as specified in the supporting documents. 2.2. In no event shall Contractor's total of all compensation and reimbursement under this Agreement exceed the "Contract Amount" listed in the Contract Summary without express, written approval from the appropriate Department Head or City Manager. Contractor acknowledges that any work delivered, or expenses incurred without authorization as provided herein is done at Contractor's own risk and as a volunteer without expectation of compensation or reimbursement. 3. Contractor's Obligations 3.1. Performance. Provide the goods or services as set forth in the Supporting Documents attached hereto and, by this reference, incorporated herein. 3.2. Nondiscrimination. Contractor 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 Contractor. Contractor agrees to comply with all applicable requirements of federal and state civil rights and rehabilitation statutes, rules and regulations. Further, Contractor 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 Page 2 of 8: Goods and Services Agreement between the City of Ashland and J&A Concrete Construction LLC business enterprise certified under ORS 200.055, in awarding subcontracts as required by ORS 279A.110. 3.3. Subcontractor Notification. In all solicitations either by competitive bidding or negotiation made by Contractor 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 Contractors of the Contractor's obligations under this Agreement and Title VI of the Civil Rights Act of 1964 and other federal nondiscrimination laws. 3.4. Living Wage Requirements. If the amount of this Agreement is $26,429.65 or more, Contractor 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. Contractor is also required to post the notice attached hereto as "Exhibit A" predominantly in areas where it will be seen by all employees. 4. Contractor's Compliance with Tax Laws 4.1. Contractor represents and warrants to the City that: 4.1.1. Contractor shall, throughout the term of this Agreement, including any extensions hereof, comply with: • All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS chapters 316, 317, and 318; • Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Contractor; and Any rules, regulations, charter provisions, or ordinances that implement or enforce any of the foregoing tax laws or provisions. 4.1.2. Contractor further certifies that contractor is not in violation of any Oregon tax laws referenced in ORS 305.380(4). 4.2. Tax Compliance Breach. Contractor'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 Contractor'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. 5. Insurance. Contractor 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 Each policy of such insurance shall be on an "occurrence" and not a "claims made" form, and shall include: 5.1. Commercial general liability -- with a combined single limit, or the equivalent, of not less than $2,000,000 (two million dollars) per occurrence and $3,000,000 (three million dollars) in the aggregate for Bodily Injury and Property Damage. Page 3 of 8: Goods and Services Agreement between the City of Ashland and J&A Concrete Construction LLC 5.2. Commercial Automobile Liability -- with a combined single limit, or the equivalent of not less than $2,000,000 (two million dollars) for each accident for Bodily Injury and Property Damage, including coverage for owned, hired and non -owned vehicles. 5.3. Additional forms: None (See Attached) 5.4. Worker's Compensation. Contractor 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. As evidence of the insurance required by this Agreement, the Contractor shall furnish an acceptable insurance certificate prior to commencing any Work with limits not less than $500,000. 5.4.1. Workers' Compensation Exemption: If applicable, Contractor affirms and certifies that it is exempt from providing Workers' Compensation per ORS 656.027. Exemption criteria: Exempt Contractor initials if exempt: AC Date: 5/12125 6. Additional Insured/Certificates of Insurance. The Contractor shall name the City of Ashland, Oregon, along with its elected officials, officers, and employees, as Additional Insureds on all insurance policies (excluding Professional Liability and Workers' Compensation) necessary for this Agreement. This inclusion applies solely to the services provided by the Contractor under this Agreement. The Contractor's insurance must be primary and non-contributory. Before commencing work, the Contractor must provide acceptable insurance certificates as proof of the required coverage. These certificates must specify all parties included as additional Insureds, treating each named and additional named insured as if they were covered under separate policies, without increasing policy limits. Insuring companies or entities must be accepted by the City. Upon request, the Contractor must provide complete copies of insurance policies and trust agreements to the City. Additionally, the Contractor must provide an endorsement naming the City, its officers, employees, and agents as additional insureds by the Effective Date of this Agreement, accompanied by approved certificate(s) of insurance. 7. Indemnity. Contractor 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 Contractor or its officers, employees, contractors, or agents under this Agreement. 8. 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 addresses set forth above with a copy to: City of Ashland — Legal Department 20 E. Main Street Ashland, Oregon 97520 Phone: (541) 488-5350 Page 4 of 8: Goods and Services Agreement between the City of Ashland and J&A Concrete Construction LLC 6. Remedies 6.1. In the event Contractor 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: 6.1.1. Termination of this Agreement. 6.1.2. Withholding all monies due for the Work that Contractor has failed to deliver within any scheduled completion dates or any Work that have been delivered inadequately or defectively. 6.1.3. Initiation of an action or proceeding for damages, specific performance, or declaratory or injunctive relief. 6.1.4. 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. 6.2. Default: The Contractor shall be in default of this Agreement if Contractor: commits any material breach or default of any covenant, warranty, certification, or obligation under the Agreement; institutes an action for relief in bankruptcy or has instituted against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing business on a regular basis of the type identified in its obligations under the Agreement; or, without written authorization by the City, attempts to assign rights in, or delegate duties under, this Agreement. 6.3. Liability Limitation. In no event shall City be liable to Contractor for any expenses related to termination of this Agreement or for anticipated profits. If previous amounts paid to Contractor exceed the amount due, Contractor shall pay immediately any excess to City upon written demand provided. 7. General Provisions 7.1. Non-exclusive Agreement. City is not obligated to procure any specific amount of Work from Contractor and is free to procure similar types of goods and services from other Contractors in its sole discretion. 7.2. Independent Contractor Status. Contractor is an independent contractor and not an employee or agent of the City for any purpose. 7.3. Statutory Requirements. The following laws of the State of Oregon are hereby incorporated by reference into this Agreement: ORS 2796,220, 2798.230 and 279i3.235 7.4. Assignment. Contractor 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. Contractor 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. Page 5 of 8: Goods and Services Agreement between the City of Ashland and J&A Concrete Construction LLC 7.5. Force Majeure. Neither party to this Agreement shall hold the other responsible for damages or delay in performance caused by acts of God, strikes, lockouts, accidents, or other events beyond the control of the other or the other's officers, employees or agents. 7.6. Deliveries F.O.B destination. Contractor shall pay all transportation and handling charges for the Goods. Contractor is responsible and liable for loss or damage until final inspection and acceptance of the Goods by the City. Contractor remains liable for latent defects, fraud, and warranties. 7.7. Goods Rejection. The City may reject non -conforming Goods and require Contractor to correct them without charge or deliver them at a reduced price, as negotiated. If Contractor 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). 7.8. Goods Warranty Representation. Contractor 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. Contractor shall transfer all warranties to the City. 7.9. Waiver of Breach. One or more waivers or failures to object by either party to the others 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. 7.10. Jurisdiction, 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. 7.11. Severance. 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 Contractor and the City set forth in this Agreement. 8. Merger. This agreement and the attached exhibits constitute the entire understanding and agreement between the parties. No waiver, consent, modification or change of terms of this agreement shall bind either party unless in writing and signed by both parties. Such waiver, consent, modification or change, if made, shall be effective only in the specific instance and for the specific purpose given. There are no understandings, agreements, or representations, oral or written, not specified herein regarding this agreement. Contractor, by signature of its authorized representative, hereby acknowledges that he/she has read this agreement, understands it, and agrees to be bound by its terms and conditions. Page 6 of 8: Goods and Services Agreement between the City of Ashland and J&A Concrete Construction LLC WITNESS WHEREOF, the parties have executed this Agreement in their respective names by their duly authorized representatives as of the dates indicated below. This Agreement may be executed in two counterparts, each of which shall be deemed an original, with equal force and effect as if executed in a single document. CITY OF ASHLAND: Fleur Digitally signed by Scott Fleury Scott Fl G Date: 2025.05.i214:59:46 By: 07,00, Signature Scott Fleury Printed Name 5/12/25 Date Purchase Order No. APPROVED AS TO FORM: 1 Digitally signed by Carmel 7ahran CaCarmelZah�^ a [Date:2025.05.13M05:16-OTOU City Attorney J&A Concrete Construction LLC (CONTRACTOR): By: hx&Auji�-� Signature Abel Castaneda Printed Name Owner Title 05/06/2025 Date (W-9 is to be submitted with this signed Agreement) Page 7 of 8: Goods and Services Agreement between the City of Ashland and J&A Concrete Construction LLC City of Ashland INiti3O-- For all hours worked under a service contract between their employer and the City of Ashland if the contract exceeds $26,429.65 or more. For all hours worked in a month, if the employee spends 50% or more of the employee's time in that month working on a project or For additional information: Per hour, effective June 30, 2024. The Living Wage is adjusted annually every June 30 by the Consumer Price Index. portion of the business of their employer, if the, employer has ten or more employees, and has received financial assistance for the project or business from the City of Ashland over $26,429.65; If their employer is the City of Ashland, including the Parks and Recreation Department. In calculating the living wage, employers may add the value of health care, retirement, 401 K and IRS eligible cafeteria plans (including childcare) benefits to the employee's amount of wages, Note: For temporary and part-time employees, the Living Wage does not apply to the first 1040 hours worked in any calendar year. For more details, please see Ashland Municipal Code Section 3.12.020. Call the Ashland City Managers office at 541-488-6002 or write to the City Manager, City Hall, 20 East Main Street, Ashland, OR 97520, or visit the City's website at www.ash land or. LIS, Notice to Employers: This notice must be posted in areas where it can be seen by all employees. Service Address Ashland Airport J&A Concrete Construction LLC. CCB#237481, 7600 Truax Rd. Central Point, OR 97502 Phone: (541) 951-4009 Email: jna.cast2003@gmail.com Prepared For Derek Routh/Ashland Public Works 51 Winburn Way Ashland, OR Estimate # Date 01 . 05/05/2025 Description Total Expenses and Labor $23,775.00 5idewalk(Approx.)- 106` Retaining Wall(Approx.)-49' Includes: -Concrete stair repair -Remove existing concrete -Remove the existing wood wall -Remove gravel walkway and bench -Concrete -Pump -Prep and Form -Pour and Finish -Rock -Removing any bushes needed -Pea gravel/fabric and blocks needed for retaining the wall. -Top Soil and Grass seed Subtotal $23,775.00 Total $23,775.00 Page I of 2 By signing this document, the customer agrees to the services and conditions outlined in this document. Page 2 of 2 AOC" tD �.-- CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) F 05/12/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Progressive Commercial Lines Customer and A ent Servicing World of Insurance LLC 1091 MEDFORD CENTER, MEDFORD, OR 97504 PHONE A/C No Ext : 1-800-444-4487 FAX A/C No): E-MAIL ro ressivecommercial email. ro ressive.com ADDRESS: p 9 @ P 9 INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Artisan and Truckers Casualty Company 10194 INSURED INSURER B : ABEL CASTANEDA DBA: J & A CONCRETE CONSTRUCTION LLC 7600 TRUAX RD INSURER C : INSURER D : CENTRAL POINT, OR 97502-0000 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 125161922390919542DO51225T210034 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE1-1 OCCUR PREMISES (ERENTED rrrence)$ MED EXP (Any one person) PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ PRO- POLICY JECT LOC OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $2 000 000 BODILY INJURY Perperson) $ ANY AUTO A OWNED SCHEDULED AUTOS ONLY %� AUTOS Y N 03584112 05/02/2025 11/02/2025 BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ WORKERS COMPENSATION YIN AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBEREXCLUDED? N / A H- E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) yes, describe under D DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ See ACORD 101 for additional coverage details. $ A Y N 03584112 05/02/2025 11 /02/2025 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland Public Works ACCORDANCE WITH THE POLICY PROVISIONS. 20 E Main St Ashland, OR 97520 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: A�CQf`a� ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED World of Insurance LLC ABEL CASTANEDA DBA: J & A CONCRETE CONSTRUCTION LLC 7600 TRUAX RD CENTRAL POINT, OR 97502-0000 POLICY NUMBER 03584112 CARRIER NAIC CODE EFFECTIVE DATE: 05/02/2025 Artisan and Truckers Casualty Company 10194 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Additional Coverages Insurance coverage(s) Limits ..................................................................................................................... Uninsured/Underinsured Motorist $2,000,000 Combined Single Limit Description of Location/Vehicles/Special Items Scheduled autos only ....................................................................................... 2021 CHEVROLET SILVERADO C2500 1GC4YPEY9MF102093 ....................................................................................... 2003 GMC SIERRA 1GTHC29113E140115 2022 RAM 3500 3C7WRTCL6NG357440 ......................................................... 2019 FORD F750 1 FDNF7DC2KDF02288 Additional Information Certificate holder is listed as an Additional Insured. ACORD 101 (2008/01) ©2008ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Client#: 189672 IACONC2 ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 1 5/07/2025 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 Propel Insurance 1201 Pacific Avenue; Suite 1000 COM Small Business Tacoma, WA 98402-4321 CONTACT Lauren Eling PHONE g00 499-0933 FAX 866 577-1326 MA Lo, Ext : (A/C, No): ADDRESS: Lauren.Eling@propelinsurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Western National Mutual Insurance Co. 15377 INSURED J & A Concrete Construction, LLC 7600 Truax Road INSURER B : INSURER C Central Point, OR 97502 INSURER D 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 CONTRACTOR 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 ADDLSUBR NSR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [* OCCUR CPP127018803 08/01/2024 08/01/2025 EACHOCCURRENCE $1,000,000 PREMI6ESOEa oNcurrDence $100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $1 ,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO - POLICY JECT LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS-COMP/OPAGG $2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ A X UMBRELLA LAB EXCESS LAB X OCCUR CLAIMS -MADE CPP127018803 08/01/2024 08/01/202 EACH OCCURRENCE $1 000000 AGGREGATE $1 OOO 000 DED X RETENTION $1 O 000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT 1 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION City of Ashland 20 East Main Street Ashland, OR 97520 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) 1 of 1 #S7330121 /M6850448 © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD LKE00 This page has been left blank intentionally. Western National Mutual Insurance Company 4700 West 77th Street Edina, MN 55435 www.wnins.com Policy Number: CPP 1270188 03 RENEWAL DECLARATION Named Insured: J & A CONCRETE CONSTRUCTION FORMS AND ENDORSEMENTS SCHEDULE Coverage Line Form Number Ed. Date Description General Liability IL0017 (11/98) Common Policy Conditions General Liability IL0021 (09/08) Nuclear Energy Liab Excl Endr General Liability IL0142 (09/08) OR Changes -Domestic Partner General Liability IL0279 (09/08) OR Changes General Liability WNIL09 (06/16) Automatic Termination Provisio General Liability CG0001 (04/13) Comml Gen Liab Coverage Form General Liability CG0300 (01/96) Deductible Liability Insurance General Liability CG2106 (05/14) Excl-Access or Disclosure General Liability CG2109 (06/15) Exclusion -Unmanned Aircraft General Liability CG2116 (04/13) Excl-Designated Prof Service General Liability CG2118 (10/17) Oregon - Marijuana Exclusion General Liability CG2147 (12/07) Excl-Employ.-Related Practices General Liability CG2154 (01/96) Ex-Desig Op Covrd/Cons Ins Pro General Liability CG2160 (09/98) Excl-Yr 2000 Computer Rel & Ot General Liability CG2167 (12/04) Fungi or Bacteria Excl. (CGL) General Liability CG2171 (01/15) Excl Oth Acts Terr Outside US General Liability CG2176 (01/15) Excl Punitive Damages General Liability CG2186 (12/04) Excl-Exterior Insul & Fin Sys General Liability CG2187 (01/15) Conditional Excl of Terrorism General Liability CG2426 (04/13) Amendment of Ins. Contract Def General Liability CGMU0009 (06/22) Comm Gen Liab Enhancement Endt General Liability WNGL02 (07/10) Punitive Damages Exclusion General Liability WNGL10 (01/04) Excl-Lead Liability Endt General Liability WNGL104 (03/16) Cyber Liability General Liability WNGL117 (12/18) Cyber Crime Coverage Endt General Liability WNGL15 (12/16) Exclusion -Asbestos General Liability WNGL21 (07/14) Abuse or Molestation Excl General Liability WNGL49 (07/15) Addl Insd-Own, Less, Cont-Auto General Liability WNGL50 (07/15) Addl Insd-Own, Less, Cont-Comp Issued Date: 07/22/2024 WN IL 26 07 07 INSURED COPY Page 7 of 7 COMMERCIAL GENERAL LIABILITY WN GL 49 07 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to in- clude as an additional insured any person or or- ganization for whom you are performing opera- tions when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with re- spect to liability for "bodily injury", "property dam- age" or "personal and advertising injury" caused, in whole or in part, 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 for the additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are com- pleted. However: 1. The insurance afforded to such additional in- sured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the in- surance afforded to such additional insured will not be broader than that which you are re- quired by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these ad- ditional insureds, the following additional exclusion applies: This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the ren- dering of, or the failure to render, any profes- sional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to pre- pare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifica- tions; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against an additional 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 dam- age", or the offense which caused the "person- al and advertising injury", involved the render- ing of or failure to render any professional services by you with respect to your providing engineering, architectural or surveying serv- ices in your capacity as an engineer, architect or surveyor. WN GL 49 07 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 2 2. "Bodily injury" or "property damage" occurring after: a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than serv- ice, maintenance or repairs) to be per- formed by or on behalf of the additional in- sured(s) at the location of the covered op- erations has been completed; or b. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or or- ganization other than another contractor or subcontractor engaged in performing oper- ations for a principal as a part of the same project. C. With respect to the insurance afforded to these ad- ditional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is re- quired by a contract or agreement, the most we will pay on behalf of the additional insured is: 1. The minimum amount required by the contract or agreement; or 2. The Limits of Insurance shown in the Declara- tions; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. D. The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek any contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. WN GL 49 07 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 2 COMMERICAL GENERAL LIABILITY CG MU 0009 06 22 COMMERCIAL GENERAL LIABILITY ENHANCEMENT ENDORSEMENT The Commercial General Liability Enhancement Endorsement is an optional endorsement that provides coverage enhancements. The following is a summary of broadened coverages provided by this endorsement. No coverage is provided by this summary, refer to following endorsement for changes in your policy. SUMMARY OF COVERAGES PAGE Bodily Injury And Property Damage Liability • Non Owned Watercraft Up To 50 Feet................................................................................... 2 Property Damage Liability • Elevators............................................................................................................................... 3 • Fire, Lightning, Explosion Or Sprinkler Leakage Exception .................................................... 3 • Borrowed Equipment ($25,000 Per Occurrence, $50,000 Aggregate, $2,500 Deductible Per Occurrence..................................................................................... 3 Supplementary Payments — Amended • Bail Bonds Up To$5,000....................................................................................................... 3 • Loss of Earnings Up To $500/Day........................................................................................ 3 Who Is An Insured Amendments • Employee Bodily Injury To A Co-Employee............................................................................ 4 • Newly Formed Or Acquired Organizations For Up To 180 Days ............................................. 4 • Blanket Additional Insured — Vendors — As Required By Contract .......................................... 4 • Blanket Additional Insured — Lessor Of Leased Equipment .................................................... 6 • Blanket Additional Insured — Managers Or Lessors Of Premises ............................................ 6 • Blanket Additional Insured — State Or Governmental Agency Or Subdivision Or Political Subdivision — Permits Or Authorizations............................................................ 7 • Blanket Additional Insured — State Or Governmental Agency Or Subdivision Or Political Subdivision — Permits Or Authorizations Relating To Premises ......................... 8 Damage To Premises Rented To You —$300,000............................................................................ 9 Medical Payments Increased Limit — $10,000 Or Amount Shown on Declarations ............................ 9 Conditions • Knowledge of Occurrence, Offense, Claim Or Suit Amended ................................................. 9 • Unintentional Failure To Disclose Hazards............................................................................. 9 • Waiver of Subrogation......................................................................................................... 10 Insured Contract Amended.............................................................................................................. 10 Personal And Advertising Injury Redefined • Televised, Videotaped Or Electronic Publication.................................................................. 10 CG MU 0009 06 22 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 10 COMMERCIAL GENERAL LIABILITY CG MU 0009 06 22 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY COMMERCIAL GENERAL LIABILITY ENHANCEMENT ENDORSEMENT This endorsement modifies the insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. The SECTIONS of the Commercial General Liability Coverage Form identified in this endorsement will be amended as shown below. SECTION I — COVERAGES AMENDMENTS COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY A. Non Owned Aircraft Or Watercraft Item 2. Exclusions, Paragraph g. is replaced by the following: g. Aircraft, Auto Or Watercraft "Bodily injury" or "property damage" arising out of the ownership, maintenance, use or entrustment to others of any aircraft, "auto" or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and "loading or unloading". This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the super- vision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage" involved in the ownership, maintenance, use or entrustment to others of any aircraft, "auto" or watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to: (1) A watercraft while ashore on premises you own or rent; (2) A watercraft you do not own that is: (a) Less than 50 feet long; and (b) Not being used to carry persons or property for a charge; This Subparagraph (2) applies to any person, who with your expressed or implied consent, either uses or is responsible for the use of the watercraft; (3) Parking an "auto" on, or on the ways next to, premises you own or rent, provided the "auto" is not owned by or rented or loaned to you or the insured; (4) Liability assumed under any "insured contract" for the ownership, maintenance or use of aircraft or watercraft; or (5) "Bodily injury" or "property damage" arising out of: (a) The operation of machinery or equipment that is attached to, or part of, a land vehicle that would qualify under the definition of "mobile equipment" if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged; or (b) The operation of any of the machinery or equipment listed in Paragraph f. (2) or f. (3) of the definition of "mobile equipment". CG MU 0009 06 22 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 10 B. Damage To Property Coverage Extensions Item 2. Exclusions, Paragraph j. is replaced by the following: j. Damage To Property "Property damage" to: (1) Property you own, rent, or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another's property; (2) Premises you sell, give away or abandon, if the "property damage" arises out of any part of those premises; (3) Property loaned to you; (4) Personal property in the care, custody or control of the insured; (5) That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations, if the "property damage" arises out of those operations; or (6) That particular part of any property that must be restored, repaired or replaced because "your work" was incorrectly performed on it. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire, lightning, explosion or sprinkler leakage) to premises, including the contents of such premises, rented to you for a period of seven or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in SECTION III — LIMITS OF INSURANCE. However, the provisions of this paragraph do not apply if coverage for Damage To Premises Rented To You is excluded by endorsement. Paragraph (2) of this exclusion does not apply if the premises are "your work" and were never occupied, rented or held for rental by you. Paragraphs (3) and (4) of this exclusion do not apply to the use of elevators. Paragraphs (3), (4), (5) and (6) of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph (4) of this exclusion does not apply to "property damage" to borrowed equipment while not being used to perform operations at the jobsite. Subject to Paragraph 2. of SECTION III — LIMITS OF INSURANCE, the rules below fix the most we will pay for "property damage" under this provision: (1) $25,000 any one "occurrence", regardless of the number of persons or organizations who sustain damages because of that "occurrence"; (2) $50,000 annual aggregate; and (3) We will pay only for damages in excess of $2,500 as a result of any one "occurrence", regardless of the number of persons or organizations who sustain damages because of that "occurrence". We may, or if required by law, pay all or any part of any deductible amount, if applicable, to effect settlement of any claim or "suit". Upon notice of our payment of a deductible amount, you shall promptly reimburse us for the part of the deductible amount we paid. Paragraph (6) of this exclusion does not apply to "property damage" included in the "products -completed operations hazard". The insurance provided for "property damage" from the use of elevators and for "property damage" to borrowed equipment is excess over any other valid and collectible property insurance (including any deductible portion thereof) available to the insured whether primary, excess, contingent or on any other basis. C. Damage To Premises Rented To You Item 2. Exclusions, the last paragraph is replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion or sprinkler leakage to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Paragraph 6. of SECTION III — LIMITS OF INSURANCE. CG MU 0009 06 22 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 10 COVERAGE B — PERSONAL AND ADVERTISING INJURY LIABILITY D. Personal And Advertising Injury Item 2. Exclusions is amended by replacing Sub -paragraphs b. and c. with the following: b. Material Published With Knowledge Of Falsity "Personal and advertising injury" arising out of oral, written, televised, videotaped or electronic publication, in any manner, of material, if done by or at the direction of the insured with knowledge of its falsity. c. Material Published Prior To Policy Period "Personal and advertising injury" arising out of oral, written, televised, videotaped or electronic publication, in any manner, of material whose first publication took place before the beginning of the policy period. SUPPLEMENTARY PAYMENTS — COVERAGES A AND B E. Supplementary Payments — Coverages A and B Item 1. is amended by replacing Subparagraphs b. and d. with the following: b. Up to $5,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. SECTION II —WHO IS AN INSURED AMENDMENTS A. Employee Bodily Injury To A Co -Employee Paragraph 2. a. (1) is replaced by the following: However, none of these "employees" or "volunteer workers" are insureds for "bodily injury" or "personal and advertising injury": (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co -"employee" while in the course of his or her employment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of the co -"employee" or "volunteer worker' as a consequence of Paragraph (1)(a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraph (1)(a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. However, if a suit seeking damages for "bodily injury" or "personal and advertising injury" to any co -"employee" or other "volunteer worker' arising out of and in the course of the co -"employee's" or "volunteer worker's" employment or while performing duties related to the conduct of your business, or a suit seeking damages brought by the spouse, child, parent, brother or sister of the co -"employee" or other "volunteer worker', is brought against you or a co -"employee" or a "volunteer worker', we will reimburse the reasonable costs that you incur in providing a defense to the co -"employee" or "volunteer worker' against such matters. Any reimbursement made pursuant to this sub -section will be in addition to the limits of liability set forth in the Declarations. B. Newly Acquired Organizations Paragraph 3. a. is replaced by the following: a. Coverage under this provision is afforded only until the 1801h day after you acquire or form the organization or the end of the policy period, whichever is earlier; CG MU 0009 06 22 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 10 The following are added: C. Blanket Additional Insured —Vendors —As Required By Contract 1. Section II — Who Is An Insured is amended to include as an additional insured any person(s) or organization(s) (referred to throughout this endorsement as vendor) with whom you have agreed in a written contract, executed prior to loss, to name as an additional insured, but only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business. However, a. The insurance afforded to such vendor only applies to the extent permitted by law; and b. If coverage provided to the vendor is required by a contract or agreement, the insurance afforded to such vendor will not be broader than that which you are required by the contract or agreement to provide for such vendor. 2. With respect to the insurance afforded to these vendors, the following additional exclusions apply: a. The insurance afforded the vendor does not apply to: (1) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (2) Any express warranty unauthorized by you; (3) Any physical or chemical change in the product made intentionally by the vendor; (4) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; (5) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; (6) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; (7) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or (8) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (i) The exceptions contained in Subparagraphs (4) or (6); or (ii) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. 3. This Provision C. does not apply: a. To any insured person or organization from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products; b. To any vendor for which coverage as an additional insured specifically is scheduled by endorsement; or c. When liability included within the "products -completed operations hazard" has been excluded for such product either by the provisions of the coverage part or by endorsement. 4. With respect to the insurance afforded to these vendors, the following is added to Section III — Limits Of Insurance: If coverage provided to the vendor is required by a contract or agreement, the most we will pay on behalf of the vendor is: a. The minimum amount required by the contract or agreement; or b. The Limits of Insurance shown in the Declarations; CG MU 0009 06 22 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 10 whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. 5. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: 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 an additional 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 failure to render any professional services by you with respect to your providing engineering, architectural or surveying services in your capacity as an engineer, architect or surveyor. D. Blanket Additional Insured —Lessor Of Leased Equipment 1. Section II — Who Is An Insured is amended to include as an additional insured any person(s) or organization(s) from whom you lease equipment when you and such person(s) or organization(s) have agreed in writing in a contract or agreement, executed prior to loss, that such person(s) or organization(s) be added as an additional insured on your policy. Such person(s) or organization(s) is an insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused by your negligent acts or omissions in the maintenance, operation or use of equipment leased to you by such person(s) or organization(s). However, the insurance afforded to such additional insured: 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. c. Does not apply to any "occurrence" which takes place after the equipment lease expires; A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. 2. With respect to the insurance afforded to the Lessor, the following additional exclusions apply: "Bodily injury" or "property damage" arising out of: (1) The assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the Lessor would have in the absence of the contract or agreement; (2) Any express warranty made by the Lessor; (3) The demonstration, installation, servicing, inspections, adjustments, tests, repair, or maintenance operations by or for the Lessor; (4) The negligence or strict liability of the Lessor for its own acts or omissions or those of its employees or anyone else acting on its behalf; or (5) Any failure on the part of the Lessor to provide information, instructions and/or warnings with respect to the maintenance, use or operation of the equipment. 3. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is: a. The minimum amount required by the contract or agreement; or b. The Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG MU 0009 06 22 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 10 4. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: 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 an additional 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 failure to render any professional services by you with respect to your providing engineering, architectural or surveying services in your capacity as an engineer, architect or surveyor. E. Blanket Additional Insured —Managers Or Lessors Of Premises 1. Section II — Who Is An Insured is amended to include as an additional insured any person(s) or organization(s) with whom you have agreed in a written contract, executed prior to loss, to name as an additional insured, but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you, subject to the following additional exclusions: This insurance does not apply to: a. Any "occurrence" which takes place after you cease to be a tenant in that premises. b. Structural alterations, new construction or demolition operations performed by or on behalf of such additional insured. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. If coverage provided to the additional insured is required by a contract or agreement, 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. 2. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is: a. The minimum amount required by the contract or agreement; or b. The Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. 3. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: 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 an additional 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 failure to render any professional services by you with respect to your providing engineering, architectural or surveying services in your capacity as an engineer, architect or surveyor. CG MU 0009 06 22 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 10 F. Blanket Additional Insured —State Or Governmental Agency Or Subdivision Or Political Subdivision —Permits Or Authorizations Section II — Who Is An Insured is amended to include as an additional insured any state or governmental agency or subdivision or political subdivision with whom you have agreed in a written contract, executed prior to loss, to name as an additional insured, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. If coverage provided to the additional insured is required by a contract or agreement, 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. 2. This insurance does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or b. "Bodily injury" or "property damage" included within the "products -completed operations hazard". 3. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is: a. The minimum amount required by the contract or agreement; or b. The Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. 4. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: 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 an additional 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 failure to render any professional services by you with respect to your providing engineering, architectural or surveying services in your capacity as an engineer, architect or surveyor. G. Blanket Additional Insured — State Or Governmental Agency Or Subdivision Or Political Subdivision — Permits Or Authorizations Relating To Premises Section II — Who Is An Insured is amended to include as an additional insured any state or governmental agency or subdivision or political subdivision with whom you have agreed in a written contract, executed prior to loss, to name as an additional insured, subject to the following provision: 1. This insurance applies only with respect to the following hazards for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization in connection with premises you own, rent or control and to which this insurance applies: a. The existence, maintenance, repair, construction, erection or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures; or b. The construction, erection or removal of elevators; or CG MU 0009 06 22 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 8 of 10 c. The ownership, maintenance or use of any elevators covered by this insurance. However, a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. If coverage provided to the additional insured is required by a contract or agreement, 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. 2. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is: a. The minimum amount required by the contract or agreement; or b. The Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. 3. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: 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 an additional 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 failure to render any professional services by you with respect to your providing engineering, architectural or surveying services in your capacity as an engineer, architect or surveyor. SECTION III — LIMITS OF INSURANCE AMENDMENTS A. Damage To Premises Rented To You Paragraph 6. is replaced by the following: 6. Subject to Paragraph 5. above, the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, lightning, explosion or sprinkler leakage, while rented to you or temporarily occupied by you with permission of the owner is the greater of: a. $300,000; or b. The amount shown next to the Damage To Premises Rented To You Limit in the Declarations. However, the provisions of this paragraph do not apply if Damage To Premises Rented To You Coverage is excluded by endorsement. B. Medical Expense Limit Paragraph 7. is replaced with the following: 7. Subject to Paragraph 5. above, the most we will pay under Coverage C for all medical expenses because of "bodily injury" sustained by any one person is the greater of: a. $10,000; or b. The amount shown next to the Medical Expense Limit in the Declarations. This insurance does not apply if coverage for Medical Expenses is excluded either by the provisions of the coverage part or by endorsement. CG MU 0009 06 22 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 9 of 10 SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS AMENDMENTS A. Knowledge Of Occurrence Item 2. Duties In The Event Of Occurrence, Offense, Claim or Suit is amended by adding the following: e. You must give us or our authorized representative prompt notice of an "occurrence", claim or loss only when the "occurrence", claim or loss is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) An executive officer or insurance manager, if you are a corporation; or (4) A member or manager, if you are a limited liability company. B. Other Insurance Item 4. Other Insurance, b. Excess Insurance (1) (a) (ii) is replaced by the following: (ii) That is fire, lightning, explosion or sprinkler leakage insurance for premises rented to you or temporarily occupied by you with permission of the owner; C. Unintentional Failure To Disclose Hazards Item 6. Representations is replaced by the following: 6. Representations And Unintentional Failure To Disclose Hazards a. By accepting this policy, you agree: (1) The statements in the Declarations are accurate and complete; (2) Those statements are based upon representations you made to us; and (3) We have issued this policy in reliance upon your representations. b. If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Part because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non -renewal. D. Waiver of Subrogation Item 8. Transfer of Rights of Recovery Against Others to Us is hereby amended by the addition of the following: We waive any right of recovery we may have because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a written contract, executed prior to loss, requiring such waiver with that person or organization and included in the "products -completed operations hazard". However, our rights may only be waived prior to the "occurrence" giving rise to the injury or damage for which we make payment under this Coverage Part. The insured must do nothing after a loss to impair our rights. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce those rights. SECTION V — DEFINITIONS AMENDMENTS A. Insured Contract Amended Paragraph 9. a. is replaced by the following: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion or sprinkler leakage to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract"; B. Personal And Advertising Injury Redefined Paragraph 14. d. and e. are replaced by the following: d. Oral, written, televised, videotaped or electronic publication of material that slanders or libels a person or organization or disparages a person's or organization's goods, products or service; e. Oral, written, televised, videotaped or electronic publication of material that violates a person's right of privacy; CG MU 0009 06 22 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 10 of 10 POLICY NUMBER: UMB 1054070 01 COMMERCIAL LIABILITY UMBRELLA WN CU 119 02 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY SCHEDULED ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL LIABILITY UMBRELLA COVERAGE PART SCHEDULE Name Of Additional Insured Persons) Or Organ izatiorl CITY OF ASHLAND, OREGON ITS OFFICERS, AGENTS AND EMPLOYEES Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to: Section IV — Conditions — 5. Other Insurance and 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 an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) The additional insured is shown in the Schedule; and (3) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. (4) The order of payment specified by this endorsement only applies to the extent permitted by law. The following is added to: SECTION II — LIMITS OF INSURANCE For the purposes of this endorsement only, we will not pay more on behalf of the additional insured and the lesser of: 1. The minimum limits of insurance required in a written contract on a primary and non-contributory basis for such additional insured, but only to the extent the required Limits of Insurance are in excess of the "underlying insurance," or 2. The Limits of Insurance available after the payment of "ultimate net loss" on any insured's behalf from any claim or "suit". This provision is included within and does not act to increase the limit of insurance stated in the Declarations. Coverage will not be broader than the coverage provided by the underlying insurance listed in the "Schedule of Underlying Coverages." WN CU 119 02 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1