Loading...
HomeMy WebLinkAboutInsurance Certificate: McKinstry Essention, LLC (3) MCKICO.-Ol MJOHNSON f zQ CERTIFICATE OF LIABILITY INSURANCE DATE(M/202Y THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,T! CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLIO BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZ-- 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 1CONTACT - Hub International Northwest LLC ;PHONE -- FAx PO Box 3018 Iwc,No,Ext):(425)489-4500 {Arc,NoI:(425)485-8489 Bothell,WA 98041 aoDE MAILlz�ss;__ ..now.info@ _.hubinternational.com INSURE Rfs)AFFORDINO COVERAGE__- NAIC9._„ INSURER A:The Travelers indemnity Company 25658 INSUREo INSURER B:Travelers Property Casualty Company of America 25674 McKinstry Essention,LLC WSURERC:SAIF Corporation _ 36196_ 16790 NE Mason St.Suite 100 INSURER D:Stead Com _fast Insurance pany ,26387 Portland,OR 97230 - - - __..._—.. — ____ 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. fN5R��T.- ;A aR! POLICY NUMB ER POLICYEFF 4 POLICY EXP .._m- L R TYPE OF INSURANCE MMIDDPrNY MMIDDIYYYYi LIMITS A X COMMERCIAL GENERAL LIABILITY I 2,000 QOQ ----.— _EACH OCCURRENCE cl,v�as-MADs X�OCCUR VTC2K-CO-56438901-IND-25 1/31/2025 3/1/2026 6AI"GeToRcNTEo € 300000 - - X I X PREMISES(ta ouue-rice) f$ X F WA Stop Gap - -j ! I IED EXP(Anyone person $ '10 000 I' PERSONAL$ADV INJURY 2,Q0O 000 GEN'L AGGREGATE LIMIT APP_LWS PER: , I f 4,000,000 �W NERALAGGREGATE $ _ __ POLICY X-jpo L-J LOC PRODUCTS-CUMPlOPAGG $ 4,000,000 } DTHER: _- _-� _-_ T _ A STOP o,aP 1,000,000 B AUTOMOBILELIABIt_ITY ! E f - -�_-_--_ I COMBINEDSINGLELIMIT i 2,000,000 ANYAUTO _ VTCT.J-CAP-5643B913-71L-25 1/3112025 3N12026 BODILY INJURY Per ns r))OWNE $ X -AUTOS - I SCHEDULED I BODILYENJURY{peraccident}�$ - AUTOS ONLY I - AUTOS -- HIRRE�€) NO�'-OY.'NED li PROPERTY bAl.FAGE ,,... ZVOSONLY - AUTOSONLY (Peraccident) 1S - i 1 E _ I UMBRELLA MAB I _ i OCCUR I f EACH OCCURRENCE EXCESS LIAR I CLAILM1S-MAbEtiI AGGREGATE - S DED f RETENTION$ I 3 �- C ,WORKERS COMPENSATION 3 I ---- I -..... 3 S AND EMPLOYERS'LIABILITY L1E.L11ACH,5qqIPENT ST TUj.�,J EftH _ [ ANY PROPRIETOR/PARTNERIEXECUTNE Y!N X 780794 10/112025 10/1/2026 1,000,000 N!A S oFFICERRAEnsBER ExcuaPD� 1,000,000 (Mandatory 1n NH) E.L.DISEASE-EAEA1Pi0YEEl S _ If es,desmbe under - brSGRIPTION OF OPERATIONS below E.L.WSEASE•POLICY LWIT 5 1,000,000 D Professional Liab �EOC 6738794-12 1 3/1/2026 3/112026 1'PER CLAIMlAGG: 2,000,000 I DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:MCK Jobtt209211 City of Ashland is Included as Additional Insured,coverage is primary and non-contributory and waiver of subrogation applies per the attached formslendorsements. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main St Ashland,OR 97520 AUTHOREZED REPRESENTATIVE ACORD 25(2016/03) O 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered(narks of ACORD Policy Number VTC2K-CO-5643B901-IND-25 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - AUTOMATIC STATUS IF REQUIRED BY WRITTEN CONTRACT (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to SECTION 11 —WHO IS AN (a) The Additional Insured -- Owners, Les- INSURED: sees or Contractors -- Scheduled Person Any person or organization that: or Organization endorsement CG 20 10 a. You agree in a written contract or agreement to 07 04 or CG 20 10 04 13, the Additional include as an additional insured on this Coverage Insured — Owners, Lessees or Contrac- Part; and tors -- Completed Operations endorse- ment CG 20 37 07 04 or CG 20 37 04 13, b. Has not been added as an additional insured for or both of such endorsements with either the same project by attachment of an endorse- of those edition dates; or ment under this Coverage Part which includes (b) Either or both of the following: the Addi- such person or organization in the endorsement's tional Insured—Owners, Lessees or Con- schedule; tractors — Scheduled Person Or Organi- is an insured, but: zation endorsement CG 20 10, or the Ad- a. Only with respect to liability for "bodily injury" or ditional Insured — Owners, Lessees or "property damage" that occurs, or for "personal Contractors -- Completed Operations en- injury" caused by an offense that is committed, dorsement CG 20 37, without an edition subsequent to the signing of that contract or date of such endorsement specified; agreement and while that part of the contract or the person or organization is an additional in- agreement is in effect; and sured only if the injury or damage is caused, b. Only as described in Paragraph (1), (2) or(3) be- in whole or in part, by acts or omissions of low, whichever applies: you or your subcontractor in the performance (1) If the written contract or agreement specifical- of"your work"to which the written contract or ly requires you to provide additional insured agreement applies; or coverage to that person or organization by (3) If neither Paragraph(1) nor(2) above applies: the use of: (a) The person or organization is an add!- (a) The Additional Insured — Owners, Les- tional insured only if, and to the extent sees or Contractors — (Form B) endorse- that, the injury or damage is caused by ment CG 20 10 11 85; or acts or omissions of you or your subcon- (b) Either or both of the following: the Addi- tractor in the performance of "your work" tional Insured—Owners, Lessees or Con- to which the written contract or agree- tractors — Scheduled Person Or Organi- ment applies; and zation endorsement CG 20 10 10 01, or (b) Such person or organization does not the Additional Insured —Owners, Lessees qualify as an additional insured with re- or Contractors — Completed Operations spect to the independent acts or omis- endorsement CG 20 37 10 01; sions of such person or organization. the person or organization is an additional in- The insurance provided to such additional insured is sured only if the injury or damage arises out subject to the following provisions: of"your work" to which the written contract or a. If the Limits of insurance of this Coverage Part agreement applies; shown in the Declarations exceed the minimum (2) If the written contract or agreement specifical- limits required by the written contract or agree- ly requires you to provide additional insured ment, the insurance provided to the additional in- coverage to that person or organization by sured will be limited to such minimum required the use of: limits. For the purposes of determining whether CG D6 04 02 19 O 2017 The Travelers Indemnity Company.All rights reserved. Page 1 of 2 COMMERCIAL GENERAL LIABILITY � rr•� this limitation applies, the minimum limits required result in a claim. To the extent possible, such by the written contract or agreement will be con- notice should include: sidered to include the minimum limits of any Um- (a) How, when and where the "occurrence" brella or Excess liability coverage required for the or offense took place; additional insured by that written contract or agreement. This provision will not increase the (b) The names and addresses of any injured limits of insurance described in Section III--Limits persons and witnesses; and Of Insurance. (c) The nature and location of any injury or b. The insurance provided to such additional insured damage arising out of the "occurrence" or does not apply to: offense. (1) Any "bodily injury", "properly damage" or (2) If a claim is made or "suit" is brought against "personal injury" arising out of the providing, the additional insured: or failure to provide, any professional archi- (a) Immediately record the specifics of the tectural, engineering or surveying services, claim or"suit" and the date received; and including: (b) Notify us as soon as practicable and see (a) The preparing, approving, or failing to to it that we receive written notice of the prepare or approve, maps, shop draw- claim or"suit" as soon as practicable. ings, opinions, reports, surveys, field or- (3) Immediately send us copies of all legal pa- ders or change orders, or the preparing, pers received in connection with the claim or approving, or failing to prepare or ap- "suit", cooperate with us in the investigation prove, drawings and specifications; and or settlement of the claim or defense against (b) Supervisory, inspection, architectural or the"suit", and otherwise comply with all policy engineering activities. conditions. (2) Any "bodily injury' or "properly damage" (4) Tender the defense and indemnity of any caused by "your work" and included in the claim or "suit" to any provider of other insur- "products-completed operations hazard" un- ance which would cover such additional fin- less the written contract or agreement specifi- sured for a loss we cover. However, this con- cally requires you to provide such coverage dition does not affect whether the insurance for that additional insured during the policy provided to such additional Insured is primary period. to other insurance available to such additional c. The additional insured must comply with the fol- insured which covers that person or organiza- lowing duties: tion as a named insured as described in Par- (1) Give us written notice as soon as practicable agraph 4., Other Insurance, of Section IV — of an "occurrence" or an offense which may Commercial General Liability Conditions. Page 2 of 2 ©2017 The Travelers Indemnity Company.AD rights reserved. CG I:16 04 02 19 POLICY NUMBER:VTC2KC05643B9011ND25 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OTHER INSURANCE - DESIGNATED ADDITIONAL INSUREDS -- PRIMARY WITH RESPECT TO CERTAIN OTHER INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE OF DESIGNATED ADDITIONAL INSUREDS .Any person or organization that qualifies as an additional insured under such other endorsement to this Coverage Part, if you agree in a written contract to include such person or organization as an additional insured on this Coverage Part 7. and such written contract: a. Specifically requires that this insurance apply on a primary basis or a primary and non-contributory basis, and b. Was signed and executed by you before, and is in effect when, the "bodily injury" or "property damage" occurs or the "personal injury" or "advertising injury" offense is committed PROVISIONS Designated Additional Insureds is primary to any of The following is added to Paragraph 4.a., Primary the other insurance, whether primary, excess, Insurance, of SECTION IV — COMMERCIAL contingent or on any other basis, that is available to GENERAL LIABILITY CONDITIONS: such additional insured which covers such additional insured as a named insured, and we will not share The insurance afforded under this Coverage Part to with that other insurance. any additional insured shown in the Schedule Of CG D4 26 02 19 O 2017 The Travelers Indemnity Company.All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office,Inc.with its permission. POLICY NUMBER: VTC2KC05643B901IND25 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. XTEND ENDORSEMENT FOR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE-- This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general coverage description only. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. Who Is An Insured—Unnamed Subsidiaries C. Incidental Medical Malpractice B. Blanket Additional Insured — Governmental D. Blanket Waiver Of Subrogation Entities — Permits Or Authorizations Relating To E. Contractual Liability--Railroads Operations F. Damage To Premises Rented To You PROVISIONS a. An organization other than a partnership,joint A. WHO IS AN INSURED -- UNNAMED venture or limited liability company; or SUBSIDIARIES b, A trust; The following is added to SECTION II —WHO IS as indicated in its name or the documents that AN INSURED: govern its structure. Any of your subsidiaries, other than a partnership, B. BLANKET ADDITIONAL_ INSURED joint venture or limited liability company, that is GOVERNMENTAL ENTITIES — PERMITS OR not shown as a Named Insured in the AUTHORIZATIONS RELATING TO OPERATIONS Declarations is a Named Insured if: a. You are the sole owner of, or maintain an The following is added to SECTION If -- WHO IS ownership interest of more than 50% in, such AN INSURED: subsidiary on the first day of the policy period; Any governmental entity that has issued a permit and or authorization with respect to operations b. Such subsidiary is not an insured under performed by you or on your behalf and that you similar other insurance, are required by any ordinance, law, building code or written contract or agreement to include as an No such subsidiary is an insured for"bodily injury" additional insured on this Coverage Part is an or "property damage" that occurred, or "personal insured, but only with respect to liability for "bodily and advertising injury" caused by an offense injury", "property damage" or "personal and committed: advertising injury"arising out of such operations. a. Before you maintained an ownership interest The insurance provided to such governmental of more than 50% in such subsidiary; or entity does not apply to: b. After the date, if any, during the policy period a. Any "bodily injury', "property damage" or that you no longer maintain an ownership "personal and advertising injury" arising out of interest of more than 50% in such subsidiary. operations performed for the governmental For purposes of Paragraph 1. of Section II —Who entity; or Is An Insured, each such subsidiary will be b, Any "bodily injury" or "property damage" deemed to be designated in the Declarations as: included in the "products-completed operations hazard". CG D3 16 02 19 O 2017 The Travelers Indemnity Company.All rights reserved. Page 'I of 3 Includes copyrighted material of insurance Services Office, Inc.,with its permission. COMMERCIAL GENERAL LIABILITY C. INCIDENTAL MEDICAL MALPRACTICE pharmaceuticals committed by, or with the 1. The following replaces Paragraph b, of the knowledge or consent of,the insured. definition of "occurrence" in the 5. The following is added to the DEFINITIONS DEFINITIONS Section: Section: b. An act or omission committed in providing "Incidental medical services"means: or failing to provide "incidental medical services", first aid or "Good Samaritan a. Medical, surgical, dental, laboratory, x-ray services" to a person, unless you are in or nursing service or treatment, advice or the business or occupation of providing instruction, or the related furnishing of professional health care services. food or beverages; or 2. The following replaces the last paragraph of b. The furnishing or dispensing of drugs or Paragraph 2.a.(1) of SECTION II — WHO IS medical, dental, or surgical supplies or AN INSURED: appliances. Unless you are in the business or occupation 6. The following is added to Paragraph 4.b., of providing professional health care services, Excess Insurance, of SECTION IV — Paragraphs (1)(a), (b), (c) and (d) above do COMMERCIAL GENERAL LIABILITY not apply to "bodily injury" arising out of CONDITIONS: providing or failing to provide: This insurance is excess over any valid and (a) "incidental medical services" by any of collectible other insurance, whether primary, your "employees" who is a nurse, nurse excess, contingent or on any other basis, that assistant, emergency medical technician is available to any of your "employees" for or paramedic; or "bodily injury" that arises out of providing or (b) First aid or "Good Samaritan services" by failing to provide "incidental medical services" any of your "employees" or "volunteer to any person to the extent not subject to workers", other than an employed or Paragraph 2,a.(1) of Section II — Who Is An volunteer doctor. Any such "employees" Insured. or "volunteer workers" providing or failing D, BLANKET WAIVER OF SUBROGATION to provide first aid or "Good Samaritan services" during their work hours for you -the following is added to Paragraph 8., Transfer will be deemed to be acting within the Of Rights Of Recovery Against Others To Us, scope of their employment by you or of SECTION IV — COMMERCIAL GENERAL performing duties related to the conduct LIABILITY CONDITIONS: of your business. If the insured has agreed in a contract or 3. The following replaces the last sentence of agreement to waive that insured's right of Paragraph S. of SECTION III — LIMITS OF recovery against any person or organization, we INSURANCE: waive our right of recovery against such person or For the purposes of determining the organization, but only for payments we make applicable Each Occurrence Limit, all related because of: acts or omissions committed in providing or a. "Bodily injury" or "property damage" that failing to provide "incidental medical occurs; or services", first aid or "Good Samaritan services"to any one person will be deemed to b. "Personal and advertising injury" caused by be one "occurrence". an offense that is committed; 4. The following exclusion is added to subsequent to the execution of the contract or Paragraph 2., Exclusions, of SECTION I — agreement. COVERAGES — COVERAGE A -- BODILY INJURY AND PROPERTY DAMAGE E. CONTRACTUAL LIABILITY—RAILROADS LIABILITY: 1. The following replaces Paragraph c. of the Sale Of Pharmaceuticals definition of "insured contract" in the "Bodily injury" or "property damage" arising DEFINITIONS Section: out of the violation of a penal statute or c. Any easement or iiicense agreement; ordinance relating to the sale of Page 2 of 3 ©2017 The Travelers indemnity Company.All rights reserved. CG D3 16 02 19 Includes copyrighted material of Insurance Services Office,inc.,with its permission. COMMERCIAL.GENERAL LIABILITY �,.f •k 1 2. Paragraph QI) of the definition of "insured a. Any premises while rented to you or contract" in the DEFINITIONS Section is temporarily occupied by you with permission deleted. of the owner, or F. DAMAGE TO PREMISES RENTED TO YOU b. The contents of any premises while such The following replaces the definition of"premises premises is rented to you, if you rent such damage" in the DEFINITIONS Section: premises for a period of seven or fewer "Premises damage" means "property damage"to: consecutive days. CG D3 16 02 19 O 2017 The Travelers Indemnity Company.All rights reserved. Page 3 of 3 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. POLICY NUMBER: VTC2KC05643B901IND25 COMMERCIAL GENERAL LIABILITY F,.h THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TOTAL AGGREGATE LIMIT OTHER THAN PROJECTS AND DESIGNATED PROJECT AND LOCATION AGGREGATE LIMITS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE —LIMITS OF INSURANCE AND DESIGNATED PROJECTS AND LOCATIONS LIMITS OF INSURANCE Total Aggregate Limit $ 25,000,000 (Other Than Projects and Products-Completed Operations) Designated Location Aggregate Limit $ 4,000,000 (Other Than Products-Completed Operations) Designated Project Aggregate Limit $ 4,000,000 (Other Than Products-Completed Operations) General Aggregate Limit $ 4,000,000 (Other Than Products-Completed Operations) Designated Projects: Each "Project" away trom premises owned by or rented to you Designated Locations: Each premises owned by or rented to you Designated Locations: Each premises owned by or rented to you PROVISIONS 1. The General Aggregate Limit (Other Than 1. The Limits of Insurance shown in the Products-Completed Operations) shown in the Declarations or the Schedule — Limits Of Declarations is replaced by the Limits of Insurance And Designated Projects And Insurance shown in the Schedule — Limits Of Locations, whichever apply, and the rules Insurance And Designated Projects And below fix the most we will pay regardless of Locations. the number of: 2. The following replaces Paragraph 1. of SECTION a. Insureds; III—LIMITS OF INSURANCE: b. Claims made or"suits" brought; CG D4 69 02 19 ©2017 The Travelers Indemnity Company.All rights reserved. Page 1 of 3 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL GENERAL LIABILITY c. Persons or organizations making claims under Coverage B. Instead, the or bringing "suits`;or General Aggregate Limit described in d. "Projects" or"locations". Paragraph 2.d, below applies to such 3. The following replaces Paragraph 2, of SECTION damages. III—LIMITS OF INSURANCE: (5) Any payments made for damages or 2. a. The Total Aggregate Limit shown in the medical expenses to which the Schedule - Limits Of Insurance And Designated Project Aggregate Limit Designated Projects And Locations is the applies will reduce the Designated most we will pay for the sum of all Project Aggregate Limit for the amounts under the Designated Location applicable "project". Such payments Aggregate Limit and all amounts under will not reduce the Total Aggregate Limit, the General Aggregate imit the General Aggregate Limit. This described in Paragraph 2.d. below, includes: the Designated Project Aggregate (1) Damages under Coverage A, except Limit for any other "project" or the damages because of"bodily injury" or Designated Location Aggregate Limit. "property damage" included in C. Subject to the Total Aggregate Limit the "products-completed operations described in Paragraph 2.a. above, the hazard"; Designated Location Aggregate Limit (2) Damages under Coverage B;and shown in the Schedule — Limits Of (3) Medical expenses under Coverage C. Insurance And Designated Projects And b. The Designated Project Aggregate Limit Locations applies and is further subject to shown in the Schedule -- Limits Of all of the following provisions: Insurance And Designated Projects And (1) The Designated Location Aggregate Locations applies and is further subject to Limit is the most we will pay for the all of the following provisions: sum of: (1) The Designated Project Aggregate (a) Damages under Coverage A Limit is the most we will pay for the because of "bodily injury" and sum of: "property damage" caused by (a) Damages under Coverage A "occurrences"; and because of "bodily injury" and {b) Medical expenses under "property damage" caused by Coverage C for "bodily injury' 41 occurrences"; and caused by accidents; (b) Medical expenses under that can be attributed only to Coverage C for "bodily injury' operations at a single "location" caused by accidents; that can be attributed only to (2) The Designated Location Aggregate operations at a single "project". Limit applies separately to each "location". (2) The Designated Project Aggregate (3) The Designated Location Limit applies separately to each g Aggregate "project". Limit does not apply to damages because of"bodily injury" or"property (3) The Designated Project Aggregate damage" included in the "products- Limit does not apply to damages completed operations hazard". because of bodily injury or property Instead, the Products-Completed damage" included in the "products- i I teations completed operations hazard", p Aggregate Limit Instead, the Products-Completed described in Paragraph 3. below Operations Aggregate Limit applies to such damages. described in Paragraph 3. below (4) The Designated Location Aggregate applies to such damages. Limit does not apply to damages (4) The Designated Project Aggregate ssunder Coverage B. Instead, the Limit does not apply to damages General Aggregate Limit described in Page 2 of 3 O 2017 The Travelers indemnity Company.All rights reserved. CG D4 69 02 19 Includes copyrighted material of Insurance Services Office.Inc.with its permission. COMMERCIAL GENERAL LIABILITY r.% Paragraph 2.d. below applies to such General Aggregate Limit applies will damages. reduce: (5) Any payments made for damages or (a) The Total Aggregate Limit; and medical expenses to which the Designated Location Aggregate Limit (b) The General Aggregate Limit. applies will reduce: Such payments will not reduce the (a) The Total Aggregate Limit; and Designated Project Aggregate Limit (b) The Designated Location for any "project" or the Designated Aggregate Limit for the applicable Location Aggregate Limit for any "location". "location". Such payments will not reduce the 4. The following replaces Paragraph 3. of SECTION General Aggregate Limit described in III—LIMITS OF INSURANCE: Paragraph 2.d. below, the 3, The Products-Completed Operations Aggre- Designated Project Aggregate Limit gate Limit shown in the Declarations is the or the Designated Location most we will pay under Coverage A for Aggregate Limit for any other damages because of "bodily injury" or "location". "property damage" included in the "products- d. Subject to the Total Aggregate Limit completed operations hazard". Any payments described in Paragraph 2.a. above, the made for such damages will not reduce the General Aggregate Limit shown in the Total Aggregate Limit, the General Aggregate Schedule — Limits Of Insurance And Limit, the Designated Project Aggregate Limit Designated Projects And Locations for any "project" or the Designated Location applies and is further subject to all of the Aggregate Limit for any"location". following provisions: S. The following is added to the DEFINITIONS (1) The General Aggregate Limit is the Section: most we will pay for the sum of: "Location" means any designated location shown (a) Damages under Coverage A in the Schedule — Limits Of Insurance And because of "bodily injury" and Designated Projects and Locations that is owned "property damage" caused by by or rented to you. For the purposes of "occurrences and medical determining the applicable aggregate limit of expenses under Coverage C for Insurance, each "location" that includes a "bodily injury" caused by premises involving the same or connecting lots, accidents, that cannot be or premises whose connection is interrupted only attributed only to operations at a by a street, roadway or waterway, or by a right-of- single "project" or a single way of a railroad, will be considered a single "location"; and "location". (b) Damages under Coverage B. "Project" means any designated project shown in the Schedule — Limits Of Insurance And (2) The General Aggregate Limit does Designated Projects And Locations that is away not apply to damages for "bodily from premises owned by or rented to you and at injury" or "property damage" included which you are performing operations pursuant to in the "products-completed oper- a contract or agreement. For the purposes of ations hazard". Instead, the determining the applicable aggregate limit of Products-Completed Operations insurance, each "project"that includes a premises Aggregate Limit described in involving the same or connecting lots, or Paragraph 3. below applies to such premises whose connection is interrupted only by damages. a street, roadway or waterway, or by a right-of- (3) Any payments made for damages or way of a railroad, will be considered a single medical expenses to which the project . CG D4 69 02 19 0 2017 The Travelers Indemnity Company.All rights reserved. Page 3 of 3 Includes copyrighted material of Insurance Services Office,Inc.with its permission. wVNV.saif.com S dw- f■ Work. Life. „h Oregon. Carrier no: 20001 Endorsement no: WC000313 (Ed. 43013) SAIF policy: 780794 McKinstry Essention LLC 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 1, 2025 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. WC000313 Chip Terhune (Ed. 4306) President and Chief Executive Officer 400 High Street SE Salem,OR 97312 P:800,285.8525 F:503.373,8020 Poi PC1 E430B