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2021-009 PO 20210321- Industrial Source
L1.i i I holt u A.:i J Fit Purchase Order ,l Fiscal Year 2021 Page: 1 of: 1 I`1<<IC43 fs1� a'il—�I�f.Ce �T T�1�L� ' B City of Ashland" 4= -- _ � ATTN:Accounts Payable Purchase � L 20 E. Main _ Order# 20210321 Ashland, OR 97520 T Phone: 541/552-2010 O Email:payable@ashland.or.us V H CIO Facilities Maintenance Div EINDUSTRIAL SOURCE 1 90 North Mountain Ave POBOX 2330 P Ashland, OR 97520 8 EUGENE, OR 97402 Phone:541/488-5358 • R T Fax: 541/552-2304. {clef vi— i al`' c -. �, _ _ (541)344-1438 David Arnold i — % aii1� _s: F! . �i117�= It flU� s1i� t�- _ 04/08/2021 481 FOB ASHLAND ORCit Accounts Pa able F:, Et:I3 .:.. -_. =953.Yd`?1 fh7. "f __ ch [.1ll_ vlc_._Lal l — (Ia(fi( ( r{:I{ Fire Extinguisher Maintenance - 1 Fire extinguisher inspection and service for FY 2021 1.0 $4,932.72 $4,932.72 Goods&Services Agreement • Completion date: June 30,2021 • Project Account:• • **A************GL SUMMARY************A*A 082400-602400 $4,932.72 • • • . Wiz.- - -- . ,00/60k E ___ _ ,...._„_______„___.______=._ DajV,�. A hor• ed Signature `�i— '•4 932.72 - • FORM#3 CITY�( O FF T j� \ i';lr1►I;, ;�:' i7i' ► i'lii'I:;I;L;:; t)i'!l''� / ' ASHLAND I IFIEQUIISIITIION • Date of request: 4/2/21 Required date for delivery: Vendor Name National Flre Fighter Corp. Address,City,State,Zlp, 3100 North Pacific Highway.Medford,OR 97601 • Contact Name&Telephone Number Mike Webb 641-779-0167 rnikewRnationalfireflghter.com Email address SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Emergency D Reason for exemption: ❑ Invitation to Bid 0 Form 1113,Written findings and Authorization ❑ AMC 2.50 Date approved by Council: ❑ Written quote or proposal attached ❑ Written quote or proposal attached (Attach copy of council communication) (If council approval required,attach copy of CC) El Small Procurement - ❑ Request for Proposal Cooperative Procurement Not exceeding$5.000 Dale approved by Council: ❑ Slate of Oregon la Direct Award _(Attach copy of council communication) Contract 11 ❑ VerbatiWrllten quote(s)or proposal(s) ❑ Rertuest for Qualifications(Public Works) ❑ Stale of Washington Date approved by Council: Contract it (Attach copy of council communication) ❑ Other government agency contract intermediate Procurement ❑ Sole Source Agency GOODS&SERVICES ❑ Applicable Form(115,6,7 or 8) Contract 11 Greater than$5,000 and less titan 5100.000 ❑ Wdtten quote or proposal attached Intergovernmental Agreement O (3)Written quotes and solicilalion attached ❑ Form 114,Personal Services>$5K&475K Agency PERSONAL SERVICES ❑ Special Procurement ❑ Annual cost to City does not exceed$25,000. • Greater than$5,000 and less than$75,000 ❑ Form 119,Request for Approval Agreement approved by Legal and approvedlsigned by ❑ Direct appointment not to exceed$35,000 ❑ Written quote or proposal attached City Administrator.AMC 2.50.070(4) • ❑ (3)Written proposalstvritten solicitation Date approved by Council: [7 Annual cost to City exceeds$25,000,Council ❑ Form 114,Personal Services>$51(&475K Valid until: (Date) approval required.(Attach copy of council communication) Description of SERVICES Total Cost Fire extinguisher inspection and service for 2021 Gl�g r. C $4,932.72 L✓� V Item.# Quantity Unit Description of MATERIALS v Unit Price Total Cost • O Per attached quotelproposal TOTAL COST • $ Project Number _ Account Number 082400-602400 'Expenditure must be charged to the appropriate account numbers for the financials to accurateiy reflect the actual expenditures. IT Director in.collaboration with department to approve all hardware and software purchases: IT Director Date Support-Yes/No By signing this requlslll orm,1 cartify that the City's r ho co Boling requirements have been satisfied. • Employee: Department Head: 1 L 411111Wript -1. toorgeat,rthan Awe) • Department ManagerfSupervisor: City dmi fret r: goal to or greater than$25,000) Funds appropriated for current fiscal year• NO � eputy Finance Director-(Equelto rg aterthan$5,000) Date r ' Comments: , I Form 113-Requisition GOODS& SERVICES AGREEMENT PROVIDER: National Fire Fighter Corp. CITY O F PROVIDER'S ASH LAN D CONTACT: Mike Webb 20 East Main Street Ashland,Oregon 97520 ADDRESS: 3100 N. Pacific Highway Telephone: 541/488-5587 Medford, OR 97501 Fax: 541/488-6006 PHONE: 541-779-0167 This Goods and Services Agreement (hereinafter "Agreement") is entered into by and between the City of Ashland, an Oregon municipal corporation (hereinafter "City") and National Fire Fighter Corp., a domestic business corporation("hereinafter"Provider"),for fire extinguisher service. 1. PROVIDER'S OBLIGATIONS 1.1 Provide annual fire extinguisher service as set forth in the "SUPPORTING DOCUMENTS" attached hereto and,by this reference, incorporated herein. Provider expressly acknowledges that time is of the essence of any completion date set forth in the SUPPORTING DOCUMENTS, and that no waiver or extension of such deadline may be authorized except in the same manner as herein provided for authority to exceed the maximum compensation. The goods and services defined and described in the "SUPPORTING DOCUMENTS"shall hereinafter be collectively referred to as"Work." 1.2 Provider shall obtain and maintain during the term of this Agreement and until City's final acceptance of all Work received hereunder,a policy or policies of liability insurance including commercial general liability insurance with a combined single limit, or the equivalent, of not less than $2,000,000 (two million dollars)per occurrence for Bodily Injury and Property Damage. 1.2.1 The insurance required in this Article shall include the following coverages: • Comprehensive General or Commercial General Liability, including personal injury, contractual liability,and products/completed operations coverage; and • Automobile Liability. 1.2.2 Each policy of such insurance shall be on an"occurrence" and not a"claims made"form,and shall: • Name as additional insured "the City of Ashland, Oregon, its officers, agents and employees" with respect to claims arising out of the provision of Work under this Agreement; • Apply to each named and additional named insured as though a separate policy had been issued to each,provided that the policy limits shall not be increased thereby; • Apply as primary coverage for each additional named insured except to the extent that two or more such policies arc intended to "layer" coverage and, taken together, they provide total coverage from the first dollar of liability; • Provider shall immediately notify the City of any change in insurance coverage • Provider shall supply an endorsement naming the City, its officers,employees and agents as additional insureds by the Effective Date of this Agreement; and r:. • Be evidenced by a certificate or certificates of such insurance approved by the City. Page 1 of 5: Agreement between the City of Ashland and National Fire Fighter Corp. 1.3 All subject employers working under this Agreement are either employers that will comply with ORS 656.017 or employers that are exempt under ORS 656.126. 14 Provider agrees that no person shall, on the grounds of race, color, religion, creed, sex, marital status, familial status or domestic partnership, national origin, age, mental or physical disability, sexual orientation, gender identity or source of income, suffer discrimination in the performance of this Agreement when employed by Provider. Provider agrees to comply with all applicable requirements of federal and state civil rights and rehabilitation statutes, rules and regulations. Further,Provider agrees not to discriminate against a disadvantaged business enterprise,minority-owned business,woman-owned business, a business that a service-disabled veteran owns or an emerging small business enterprise certified under ORS 200.055, in awarding subcontracts as required by ORS 279A.110. 1.5 In all solicitations either by competitive bidding or negotiation made by Provider for work to be performed under a subcontract, including procurements of materials or leases of equipment, each potential subcontractor or supplier shall be notified by the Providers of the Provider's obligations under this Agreement and Title VI of the Civil Rights Act of 1964 and other federal nondiscrimination laws. 2. CITY'S OBLIGATIONS 2.1 City shall pay Provider for its Work at the hourly rates and charges as set forth in Exhibit"X",entitled "Order Confirmation," which is attached hereto and incorporated herein by this reference, as full compensation for Provider's performance of all Work under this Agreement. 2.2 In no event shall Provider's total of all compensation and reimbursement under this Agreement exceed the sum of$4,932.72 without express, written approval from the City official whose signature appears below,or such official's successor in office. Provider expressly acknowledges that no other person has authority to order or authorize additional Work which would cause this maximum sum to be exceeded and that any authorization from the responsible official must be in writing. Provider further acknowledges that any Work delivered or expenses incurred without authorization. 3. GENERAL PROVISIONS 3.1 This is a non-exclusive Agreement. City is not obligated to procure any specific amount of Work from Provider and is free to procure similar types of goods and services from other providers in its sole discretion. 3.2 Provider is an independent contractor and not an employee or agent of the City for any purpose, 3.3 Provider is not entitled to,and expressly waives all claims to City benefits such as health and disability insurance,paid leave,and retirement. 3.4 This Agreement embodies the full and complete understanding of the parties respecting the subject matter hereof. It supersedes all prior agreements,negotiations,and representations between the parties, whether written or oral. 3.5 This Agreement may be amended only by written instrument executed with the same formalities as this Agreement. 3.6 The following laws of the State of Oregon are hereby incorporated by reference into this Agreement: ORS 279B.220, 279B.230 and 279B.235. Page 2 of 5: Agreement between the City of Ashland and National Fire Fighter Corp. • 3.7 This Agreement shall be governed by the laws of the State of Oregon without regard to conflict of laws principles. Exclusive venue for litigation of any action arising under this Agreement shall be in the Circuit Court of the State of Oregon for Jackson County unless exclusive jurisdiction is in federal court, in which case exclusive venue shall be in the federal district court for the district of Oregon. Each party expressly waives any and all rights to maintain an action under this Agreement in any other venue,and expressly consents that, upon motion of the other party, any case may be dismissed or its venue transferred,as appropriate,so as to effectuate this choice of venue. 3.8 Provider shall defend,save,hold harmless and indemnify the City and its officers,employees and agents from and against any and all claims, suits, actions, losses, damages, liabilities, costs, and expenses of any nature resulting from, arising out of, or relating to the activities of Provider or its officers, employees,contractors,or agents under this Agreement. 3.9 Neither party to this Agreement shall hold the other responsible for damages or delay in performance caused by acts of God,strikes,lockouts,accidents,or other events beyond the control of the other or the other's officers,employees or agents. • 3.10 If any provision of this Agreement is found by a court of competent jurisdiction to be unenforceable, such provision shall not affect the other provisions,but such unenforceable provision shall be deemed modified to the extent necessary to render it enforceable, preserving to the fullest extent permitted the intent of Provider and the City set forth in this Agreement. 4. SUPPORTING DOCUMENTS The following documents are,by this reference,expressly incorporated in this Agreement,and are collectively referred to in this Agreement as the"SUPPORTING DOCUMENTS:" • The Provider's complete written Order Confirmation dated March 9,2021 5. REMEDIES 5.1 In the event Provider is in default of this Agreement, City may, at its option, pursue any or all of the remedies available to it under this Agreement and at law or in equity,including,but not limited to: 5.1.1 Termination of this Agreement; 5.1.2 Withholding all monies due for the Work that Provider has failed to deliver within any scheduled completion dates or any Work that have been delivered inadequately or defectively; 5.1.3 Initiation of an action or proceeding for damages, specific performance, or declaratory or injunctive relief; 5.1.4 These remedies are cumulative to the extent the remedies are not inconsistent,and City may pursue any remedy or remedies singly,collectively,successively or in any order whatsoever. 5.2 In no event shall City be liable to Provider for any expenses related to termination of this Agreement or for anticipated profits.If previous amounts paid to Provider exceed the amount due,Provider shall pay immediately any excess to City upon written demand provided. 6. TERM AND TERMINATION 6.1 Term This Agreement shall be effective from the date of execution on behalf of the City as set forth below (the "Effective Date"), and shall continue in full force and effect until June 30, 2021, unless sooner terminated as provided in Subsection 6.2. Page 3 of S: Agreement between the City of Ashland and National Fire Fighter Corp. • 6.2 Termination 6.2.1 The City and Provider may terminate this Agreement by mutual agreement at any time. 6.2.2 The City may, upon not less than thirty(30) days' prior written notice, terminate this Agreement for any reason deemed appropriate in its sole discretion. 6.2.3 Either party may terminate this Agreement, with cause,by not less than fourteen(14)days' prior written notice if the cause is not cured within that fourteen(14) day period after written notice. Such termination is in addition to and not in lieu of any other remedy at law or equity. 7. NOTICE Whenever notice is required or permitted to be given under this Agreement, such notice shall be given in writing to the other party by personal delivery,by sending via a reputable commercial overnight courier, or by mailing using registered or certified United States mail, return receipt requested, postage prepaid, to the address set forth below: If to the City: City of Ashland—Facilities Maintenance Department Attn: David Arnold 90 North Mountain Avenue Ashland, Oregon 97520 Phone:(541) 552-2292 With a copy to: City of Ashland--Legal Department 20 E.Main Street Ashland, OR 97520 Phone: (541)488-5350 If to Provider: National Fire Fighter Corp. Attn: Mike Webb 3100 North Pacific Highway Medford, OR 97501 541-779-0167 8. WAIVER OF BREACH One or more waivers or failures to object by either party to the other's breach of any provision,term,condition, or covenant contained in this Agreement shall not be construed as a waiver of any subsequent breach,whether or not of the same nature. 9. PROVIDER'S COMPLIANCE WITH TAX LAWS 9.1 Provider represents and warrants to the City that: 9.1.1 Provider shall,throughout the term of this Agreement, including any extensions hereof, comply with: (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS chapters 316,317,and 318; (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Provider; and (iii) Any rules,regulations,charter provisions, or ordinances that implement or enforce any of the foregoing tax laws or provisions. Page 4 of 5: Agreement between the City of Ashland and National Fire Fighter Corp. I • 9.1.2 Provider,for a period of no fewer than six(6)calendar years preceding the Effective Date of this Agreement, has faithfully complied with: (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS chapters 316,317,and 318; (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Provider;and (iii) Any rules,regulations, charter provisions,or ordinances that implement or enforce any of the foregoing tax laws or provisions. 9.2 Provider's failure to comply with the tax laws of the State of Oregon and all applicable tax laws of any political subdivision of the State of Oregon shall constitute a material breach of this Agreement. Further, any violation of Provider's warranty,as set forth in this Article 9,shall constitute a material breach of this Agreement. Any material breach of this Agreement shall entitle the City to terminate this Agreement and to seek damages and any other relief available under this Agreement,at law,or in equity. IN WITNESS WHEREOF the parties have caused this Agreement to be signed in their respective names by their duly authorized representatives as of the dates set forth below. CITY OF ASHLAND: National Fire 'Otter Cor . (PROVIDER): By: �► By: M ; • a Signature Printed Name I Printed Name Pu .I�. Nt l� . Qrc aZ. fe0.5ert..//e_.e._ Title Title bate Date is to be submitted with this signed Agreement) Purchase Order No. Z eS-1 • Page 5 of 5: Agreement between the City of Ashland and National Fire Fighter Corp. INDUSTRIAL SOURCE ORDER CONFIRMATION NATIONALFIRE FIGHTER CORP. EUGENE WELDERS SUPPLY CO.DBA LPM SYSTEMS NATIONAL FIRE FIGHTER WILDLAND CORP. PO BOX 7577 SPRINGFIELD,OR 87475 Thank you for placing your order! Your order is our top priority._ w Order Summary Customer Number: M1072 P/O Number: QUOTE FOR 2021 EXT SER Order Number: 02443620 Payment Method: On account Shipping Information: 03-09-2021 CITY OF ASHLAND- VEHICLE MAINT 20 E MAIN ST ASHLAND OR 97520 Shipping Method: SALESMAN Ordered Items Item Description quantity quantity UOM Price Extended Price Ordered Shipped THIS IS A QUOTE FOR THE ANNUAL EXTINGUISHER SERVICE DUE IN 2021 QUOTE GENERATED FROM 2020 SERVICE ANYTHING NOT LISTED ON THIS QUOTE MAY BE EXTRA EXS SC FIRE PROTECTION SERVICE CALL 5 5 EA $50.47 $252.35 EXS 1YR 1YR INSPECTION EXTINGUISHER 262 262 EA $8.62 $2258.44 6YR AMX10A 6YR AMEREX SERVICE/REFILL ALUM. 3 3 EA $47.52 $142.56 6YR AMX5 6YR AMEREX SERVICE/REFILL 24 24 EACH $29.66 $711.84 6YR ANS5 6YR ANSUL SERVICE/REFILL 1 1 EA $29.66 $29.66 6YR BAD10 6YR BADGER SERVICE/REFILL 1 1 EACH $50.02 $50.02 6YR BADS 6YR BADGER SERVICE/REFILL 2 2 EACH $29.66 $59.32 TF AMX1OB HYDRO AMEREX DC 10# BRASS 10 10 EA $74.66 $746.60 TF AMX2.5 HYDRO AMEREX DC 2.5# 2 2 EA $32.02 $64.04 TF AMX20A HYDRO AMEREX DC 20# ALUM. 1 1 EA $84.60 $84.60 TF AMX5 HYDRO AMEREX DC 5# 7 7 EA $41.02 $287.14 TF CO2 15 HYDRO 15# CO2 EXTINGUISHER 1 1 EA $78.95 $78.95 TF ANS10 HYDRO ANSUL DC 10# 1 1 EA $74.66 $74.66 TF ANS5 HYDRO ANSUL DC 5# 1 1 EA $41.02 $41.02 TF BADS HYDRO BADGER DC 5# 1 1 EA $41.02 $41.02 i • • Ordered Items Item Description Quantity quantity UOM Price Extended Price Ordered Shipped RF2 HAZ10 HAZMAT/HANDLING FEE 1 1 EACH $10.50 $10.50 Subtotal: $4932.72 Tax: $o.00 Del Charge: $0.00 Freight: $0.00 Other: $o.00 Grand Total: $4932.72 1 • .......›,.....1, ® DATE(MMIDD/YYYY) ARD CERTIFICATE OF LIABILITY INSURANCE 3/23/2029 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES • BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED •• REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: KPD Insurance, Inc. PHONE PO Box 784 (AIC.No.Ext):541-741-0550 FAX No):541-741-1674 Springfield OR 97477 ADDRESS: Wo-certs@kpdinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:SAIF Corp 36196 INSURED EUGEWELO2W INSURER B Eugene Welders Supply Co.dba:Industrial Source dba:National Extinguisher Service dba:National Fire Fighter Corp INSURER C: dba:National Fire Fighter Wildland Corp INSURERD: PO Box 7577 INSURER E: Springfield OR 97475 INSURER F: COVERAGES CERTIFICATE NUMBER:1722753867. 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 ADDL SUER POLICY EFF POLICY EXP ' TYPE OF INSURANCE LTR INSD WVD POLICY NUMBER (MM/DDIYYYYI (MMIDD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO-JECT LOC • PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ i AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY _ AUTOS ONLY (Per accident) $ $ UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION 783031 1/1/2021 1/1/2022 XX AND EMPLOYERS'LIABILITY STATUTE ERH ANYPROPRIETORIPARTNER/EXECUTIVE YIN N/A E.L.EACH ACCIDENT $1,000,000 OFFICER/M EMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 E yes,describe under DESCRIPTION OF OPERATIONS below EL,DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) RE:All Operations. *Additional Insured Does Not Apply to Workers'Compensation CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland 20 East Main Street AUTHORIZED REPRESENTATIVE Ashland OR 97520 idfidtic. /164.401pt_ ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD r ACCWD® DATE(MM/DDIYYY) L...--- CERTIFICATE OF LIABILITY INSURANCE 3/23/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. • If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on • this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTNAME:ACT Angela Sang' Ward Insurance Agency Inc. PHONE FAX PO Box 10167 (Arc.No.Ext):541-687-1117 fA/C,No):541-342-8280 Eugene OR 97440 n oRRess: angela@wardinsurance.net INSURER(S)AFFORDING COVERAGE NAIC II INSURER A:Indemnity Insurance Company of NA 43575 INSURED IAINCOM-01 INSURER B:Ace American Insurance Company 22667 Eugene Welder's Supply Co. INsuRERc:Admiral Insurance Company 23140 • dba Industrial Source/dba National Extinguisher Service dba National Fire Fighter Corp. INSURER D:Hallmark Specialty Insurance Company 26808 PO Box 7577 INSURER E: Springfield OR 97475 INSURER F: COVERAGES CERTIFICATE NUMBER:1229339565 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. IY EFF POLICY EXP TR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM /DD//YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY V V D37720136 6/30/2020 6/30/2021 EACH OCCURRENCE $1,000,000 DAMAGE O RENTED CLAIMS-MADE X OCCUR PREM SES Ea occurrence) $100,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO- X POLICY JECT LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ B AUTOMOBILE LIABILITY Y V H08518713 6/30/2020 6/30/2021 COa accMBINEDident)SINGLE LIMIT $1,000,000 fE X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) $ D UMBRELLA LIAR X OCCUR Y 77HX2095C4 6/30/2020 6/30/2021 .EACH OCCURRENCE $5,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N STATUTE ERH ANYPROPRIETORIPARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ I/yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ • C General Liability for CA00003881201 6/30/2020 6/30/2021 Gen Agg/Occ $2M/$1 M National Fire Fighter Corp Prod.CO/Pers&Adv. $2M/$1 M Med Expense$5,000 Dmg to Rented Prem $300,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) Certificate holder and all entities required by written contract are included as additional insureds on a primary and non-contributory basis with waiver of subrogation as respects to the general liability and auto liability as required by written contract per attached endorsements. Umbrella follows form.All coverages are subject to policy limits,terms,conditions and exclusions. Gen'I Aggregate Limit Applies Per Policy for CA00003881201 Secondary Excess Liability: Policy#:EXC30001807000 See Attached... • CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN I ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland 20 East Main Street AUTHORIZED PRESENTATIVE Ashland OR 97520 Ali ©1988-2015 ACORD CORPORATION. All rights reserved. € ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD • • AGENCY CUSTOMER ID: LAINCOM-01 LOC#: ARD® ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Ward Insurance Agency Inc. Eugene Welder's.Supply Co. dba Industrial Source/dba National Extinguisher Service POLICY NUMBER dba National Fire Fighter Corp. PO Box 7577 Springfield OR 97475 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Policy Term:6/30/2020-6/30/2021 Each Occurrence:$5,000,000 Aggregate:$5,000,000 Underlying Policy Number: 77HX2095C4 Excess Liability for National Fire Fighter Corp. Insurer:Admiral Insurance Company Policy#:GX00000338201 Policy Term:6/30/2020-6/30/2021 Each Occurrence:$10,000,000 Aggregate:$10,000,000 Underlying Policy#:CA00003881201 • ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CHUB B® • COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT Named Insured Eugene Welder's Supply Co.Inc., Endorsement Number See Named Insured Continuation Endorsement Policy Symbol Policy Number Policy Period Effective Date of Endorsement CAL 1108518713 6/30/2020 TO 6/30/2021 6/30/2020 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the policynumber.The remainder of the information is to be completed onlywhen this endorsement is issued subsequent to the preparation of thepolicy. P 4 P P THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM This endorsement modifies the Business Auto Coverage Form. 1. EXTENDED CANCELLATION CONDITION Paragraph A.2.b.—CANCELLATION-of the COMMON POLICY CONDITIONS form is deleted and replaced with the following: b. 6o days before the effective date of cancellation if we cancel for any other reason. 2. BROAD FORM INSURED A. Subsidiaries and Newly Acquired or Formed Organizations As Insureds The Named Insured shown in the Declarations is amended to include: 1. Any legally incorporated subsidiary in which you own more than 50%of the voting stock on the effective date of the Coverage Form. However, the Named Insured does not include any subsidiary that is an "insured" under any other automobile policy or would be an"insured"under such a policy but for its termination or the exhaustion of its Limit of Insurance. 2. Any organization that is acquired or formed by you and over which you maintain majority ownership. However, the Named Insured does not include any newly formed or acquired organization: (a)That is an"insured"under any other automobile policy; (b)That has exhausted its Limit of Insurance under any other policy;or (c) 180 days or more after its acquisition or formation by you, unless you have given us written notice of the acquisition or formation. Coverage does not apply to "bodily injury" or"property damage"that results from an"accident"that occurred before you formed or acquired the organization. B. Employees as Insureds Paragraph A.1. — WHO IS AN INSURED — of SECTION II — COVERED AUTOS LIABILITY COVERAGE is amended to add the following: d. Any"employee" of yours while using a covered"auto"you don't own,hire or borrow in your business or your personal affairs. C. Lessors as Insureds Paragraph A.1. — WHO IS AN INSURED — of SECTION II — COVERED AUTOS LIABILITY COVERAGE is amended to add the following: DA-4817o(06/17) "Includes copyrighted material of Insurance Services Office, Page 1 of 5 Inc.with its permission" )53 CHUBB" e. The lessor of a covered"auto"while the"auto"is leased to you under a written agreement if: (1) The agreement requires you to provide direct primacy insurance for the lessor; and (2) The"auto"is leased without a driver. Such leased"auto"will be considered a covered"auto"you own and not a covered"auto"you hire. However, the lessor is an "insured" only for"bodily injury" or "property damage" resulting from the acts or omissions by: 1. You; 2. Any of your"employees"or agents; or 3. Any person, except the lessor or any "employee" or agent of the lessor, operating an "auto" with the permission of any of 1.and/or 2.above. D. Persons And Organizations As Insureds Under A Written Insured Contract Paragraph A.1 — WHO IS AN INSURED — of SECTION II — COVERED AUTOS LIABILITY COVERAGE is amended to add the following: f. Any person or organization with respect to the operation, maintenance or use of a covered"auto", provided that you and such person or organization have agreed under an express provision in a written "insured contract", written agreement or a written permit issued to you by a governmental or public authority to add such person or organization to thispolicy as an"insured". However,such person or organization is an"insured"only: (1) with respect to the operation,maintenance or use of a covered"auto";and (2) for"bodily injury"or"property damage"caused by an"accident"which takes place after: (a) You executed the"insured contract"or written agreement;or (b) The permit has been issued to you. 3. FELLOW EMPLOYEE COVERAGE EXCLUSION B.5. - FELLOW EMPLOYEE — of SECTION II — COVERED AUTOS LIABILITY COVERAGE does not apply. 4. PHYSICAL DAMAGE—ADDITIONAL TEMPORARY TRANSPORTATION EXPENSE COVERAGE Paragraph A.4.a. — TRANSPORTATION EXPENSES — of SECTION III — PHYSICAL DAMAGE COVERAGE is amended to provide a limit of $50 per day for temporary transportation expense, subject to a maximum limit of $1,000. 5. AUTO LOAN/LEASE GAP COVERAGE Paragraph A. 4. — COVERAGE EXTENSIONS - of SECTION III — PHYSICAL DAMAGE COVERAGE is amended to add the following: c.Unpaid Loan or Lease Amounts In the event of a total"loss"to a covered"auto",we will pay any unpaid amount due on the loan or lease for a covered "auto"minus: 1. The amount paid under the Physical Damage Coverage Section of the policy; and 2. Any: a. Overdue loan/lease payments at the time of the"loss"; b. Financial penalties imposed under a lease for excessive use,abnormal wear and tear or high mileage; c. Security deposits not returned by the lessor: DA-4817o(06/17) "Includes copyrighted material of Insurance Services Office, Page 2 of 5 Inc.with its permission" J54 CHUBB° • d. Costs for extended warranties,Credit Life Insurance,Health,Accident or Disability Insurance purchased with the loan or lease;and e. Carry-over balances from previous loans or leases. We will pay for any unpaid amount due on the loan or lease if caused by: 1. Other than Collision Coverage only if the Declarations indicate that Comprehensive Coverage is provided for any covered"auto"; 2. Specified Causes of Loss Coverage only if the Declarations indicate that Specified Causes of.Loss Coverage is provided for any covered"auto"; or 3. Collision Coverage only if the Declarations indicate that Collision Coverage is provided for any covered"auto. 6. RENTAL AGENCY EXPENSE Paragraph A. 4. —COVERAGE EXTENSIONS — of SECTION III—PHYSICAL DAMAGE COVERAGE is amended to add the following: d. Rental Expense We will pay the following expenses that you or any of your"employees" are legally obligated to pay because of a written contract or agreement entered into for use of a rental vehicle in the conduct of your business: MAXIMUM WE WILL PAY FOR ANY ONE CONTRACT OR AGREEMENT: 1. $2,500 for loss of income incurred by the rental agency during the period of time that vehicle is out of use because of actual damage to, or "loss" of, that vehicle, including income lost due to absence of that vehicle for use as a replacement; 2. $2,500 for decrease in trade-in value of the rental vehicle because of actual damage to that vehicle arising out of a covered"loss";and 3. $2,500 for administrative expenses incurred by the rental agency,as stated in the contract or agreement. 4. $7,500 maximum total amount for paragraphs 1.,2.and 3.combined. 7. EXTRA EXPENSE—BROADENED COVERAGE Paragraph A.4. — COVERAGE EXTENSIONS —of SECTION III —PHYSICAL DAMAGE COVERAGE is amended to add the following: e. Recovery Expense We will pay for the expense of returning a stolen covered"auto"to you. 8. AIRBAG COVERAGE Paragraph B.3.a. - EXCLUSIONS — of SECTION III — PHYSICAL DAMAGE COVERAGE does not apply to the accidental or unintended discharge of an airbag. Coverage is excess over any other collectible insurance or warranty specifically designed to provide this coverage. 9. AUDIO,VISUAL AND DATA ELECTRONIC EQUIPMENT-BROADENED COVERAGE Paragraph C.i.b.—LIMIT OF INSURANCE-of SECTION III-PHYSICAL DAMAGE is deleted and replaced with the following: b. $2,000 is the most we will pay for"loss"in any one"accident"to all electronic equipment that reproduces,receives • or transmits audio,visual or data signals which,at the time of"loss",is: (1) Permanently installed in or upon the covered "auto" in a housing, opening or other location that is not• normally used by the"auto"manufacturer for the installation of such equipment; • I ' DA-4817o(06/17) "Includes copyrighted material of Insurance Services Office, Page 3 of 5 Inc.with its permission" D55 • CHUBB' (2) Removable from a permanently installed housing unit as described in Paragraph 2.a. above or is an integral part of that equipment;or (3) An integral part of such equipment. 10. GLASS REPAIR—WAIVER OF DEDUCTIBLE Under Paragraph D.-DEDUCTIBLE—of SECTION III—PHYSICAL DAMAGE COVERAGE the following is added: No deductible applies to glass damage if the glass is repaired rather than replaced. 11.TWO OR MORE DEDUCTIBLES Paragraph D.-DEDUCTIBLE—of SECTION III—PHYSICAL DAMAGE COVERAGE is amended to add the following: If this Coverage Form and any other Coverage Form or policy issued to you by us that is not an automobile policy or Coverage Form applies to the same"accident",the following applies: 1. If the deductible under this Business Auto Coverage Form is the smaller(or smallest)deductible,it will be waived; or 2. If the deductible under this Business Auto Coverage Form is not the smaller (or smallest) deductible, it will be reduced by the amount of the smaller(or smallest)deductible. 12.AMENDED DUTIES IN THE EVENT OF ACCIDENT,CLAIM,SUIT OR LOSS Paragraph A.2.a.-DUTIES IN THE EVENT OF AN ACCIDENT, CLAIM,SUIT OR LOSS of SECTION IV-BUSINESS AUTO CONDITIONS is deleted and replaced with the following: a. In the event of"accident",claim,"suit"or"loss",you must promptly notify us when the"accident"is known to: (1) You or your authorized representative,if you are an individual; (2) A partner,or any authorized representative,if you are a partnership; (3) A member,if you are a limited liability company;or (4) An executive officer,insurance manager,or authorized representative,if you are an organization other than a partnership or limited liability company. Knowledge of an"accident", claim, "suit" or "loss"by other persons does not imply that the persons listed above have such knowledge. Notice to us should include: (1) How,when and where the"accident"or"loss"occurred; (2) The"insured's"name and address;and (3) To the extent possible,the names and addresses of any injured persons or witnesses. 13. WAIVER OF SUBROGATION Paragraph A.5. -TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US of SECTION IV— BUSINESS AUTO CONDITIONS is deleted and replaced with the following: 5. We will waive the right of recovery we would otherwise have against another person or organization for"loss"to which this insurance applies, provided the "insured"has waived their rights of recovery against such person or organization under a contract or agreement that is entered into before such"loss". To the extent that the "insured's" rights to recover damages for all or part of any payment made under this insurance has not been waived,those rights are transferred to us.That person or organization must do everything necessary to secure our rights and must do nothing after"accident"or"loss"to impair them. DA-4817o(06/17) "Includes copyrighted material of Insurance Services Office, Page 4 of 5 Inc.with its permission" )56 • CHUBB° At our request, the insured will bring suit or transfer those rights to us and help us enforce them. •, 14. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS Paragraph B.2. - CONCEALMENT, MISREPRESENTATION or FRAUD of SECTION IV — BUSINESS AUTO CONDITIONS-is deleted and replaced with the following: If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not void coverage under this Coverage Form because of such failure. 15. AUTOS RENTED BY EMPLOYEES Paragraph B.5. - OTHER INSURANCE of SECTION IV— BUSINESS AUTO CONDITIONS - is amended to add the following: e. Any"auto"hired or rented by your"employee" on your behalf and at your direction will be considered an"auto" you hire. If an"employee's"personal insurance also applies on an excess basis to a covered"auto"hired or rented by your "employee" on your behalf and at your direction, this insurance will be primary to the "employee's" personal insurance. 16. HIRED AUTO—COVERAGE TERRITORY Paragraph B.7.b.(5).-POLICY PERIOD, COVERAGE TERRITORY of SECTION IV—BUSINESS AUTO CONDITIONS is deleted and replaced with the following: (5)Anywhere in the world if a covered"auto" of the private passenger type is leased,hired, rented or borrowed without a driver for a period of 45 days or less;and 17. RESULTANT MENTAL ANGUISH COVERAGE Paragraph C. of - SECTION V — DEFINITIONS is deleted and replaced by the following: "Bodily injury"means bodily injury,sickness or disease sustained by any person,including mental anguish or death as a result of the"bodily injury"sustained by that person. DA-4817o(06/17) "Includes copyrighted material of Insurance Services Office, Page 5 of 5 Inc.with its permission" )57 Insured:Eugene Welder's Supply Co. COMMERCIAL AUTO Policy#:H08518713 CA 00 01 1013 BUSINESS AUTO COVERAGE FORM 19 Mobile Only those"autos"that are land vehicles and that would qualify under the definition Equipment of"mobile equipment"under this policy if they were not subject to a compulsory or Subject To financial responsibility law or other motor vehicle Insurance law where they are Various rovisions in this policyrestrict coverage. SECTION I—COVERED AUTOS Compulsory Or licensed or principally garaged. Read.the entire policy carefullytodetermine rights, DeclarationsFinancial Responsibility duties and what is and is not covered. are Two of the Deciore each shows the es.that r OtherMo are covered'autos"for of your coverages.The Or Other Motor Throughout this policy the words you' and "your" following numerical symbols describe the"autos'that Vehicle refer to the Named Insured shown in the Declarations. may be covered"autos".The symbols entered next to Insurance Law The words lore","us"and'our refer to the company a coverage on the Declarations designate the only Only providing this insurance. "autos"that are covered"autos". Other words and phrases that appear in quotation A.Description Of Covered Auto Designation B.Owned Autos You Acquire After The Policy SECTION II—COVERED AUTOS LIABILITY marks have special meaning.Refer to Section V— Symbols Begins COVERAGE Definitions. 1. If Symbols 1,2,3,4,5,6 or 19 are entered A.Coverage next to a coverage in Item Two of the We will pay allsums an insured'legally must pay Symbol Description Of Covered Auto Designation Symbols Declarations, then you have coverage for as damages because of"bodily injury"or"property "autos"that you acquire of the type described from damage" pp 1 Any"Auto" for the remainder of the oll g °toiwhich this insurance a lies,caused p cY period. by an'accident"and resulting frothe ownership, 2 Owned"Autos" Only those"autos"you own(and for Covered Autos Liability Coverage any 2.But,if Symbol 7 is entered next to a coverage maintenance or use of a covered"auto'. Only trailers'you don't own while attached to power units you own).This includes in Item Two of the Declarations,an"auto'you those'autos'you acquire ownership of after the policy.begins. Weawills also paye alld sumslu an"insured legally must acquire will be a covered "auto" for that pay as a"covered pollution cost or expense"to 3 Owned Private Only the private passenger"autos"you own.This includes those private coverage only if: which this insurance applies, caused by an Passenger passenger'autos"you acquire ownership of after the policy begins. a. We already cover all"autos'that you own 'accident" and resulting from the ownership, Autos"Only for that coverage or it replaces an'auto' maintenance or use of covered"autos".However, 4 Owned Only those"autos"you own that are not of the private passenger type(and for you previously owned that had that we will only pay for the"covered pollution cost or 'Autos"Other Covered Autos Liability Coverage any'trailers"you don't own while attached to coverage;and expense' if there is either 'bodily injury" or Than Private power units you own).This includes those"autos"not of the private passenger b. You tell us within 30 days after you acquire 'property damage'to which this insurance applies Passenger type you acquire ownership of after the policy begins. it that you want us to cover it for that that is caused by the same'accident'. "Autos'Only coverage. We have the right and duty to defend any 5 Owned"Autos" Only those"autos"you own that are required to have no-fault benefits in the slate C.Certain Trailers,Mobile Equipment And insured'against a'suit"asking for such damages Subject To where they are licensed or principally garaged.This Includes those"autos'you Temporary Substitute Autos ora"covered pollution cost or expense".However, No-fault acquire ownership of after the policy begins provided they are required to have no- we have no duly to defend any"insured"against a fault benefits in the state where they are licensed or principally garaged. If Covered Autos Liability Coverage is provided by 'suit" seeking damages for 'bodily injury or this Coverage Form, the following types of "property 6 Owned'Autos' Only those"autos"you own that because of the law in the state where they are p p rty damage'or a"coveredcovenpollution cost or vehicles are also covered "autos' for Covered ex cosy°to which this. insurance does not Subject To A licensed' or principally garaged are required to have and cannot reject Uninsured Autos Liability Coverage: Papply. Compulsory Motorists Coverage.This includes those'autos'you,acquire ownership of after the We may investigate and settle any claim'or"suit" Uninsured policy begins provided they are subject to the same state uninsured motorists 1.'Trailers'with a load capacity of 2,000 pounds as we consider appropriate.Our duty to defend or Motorists Law requirement or less designed primarily for travel on public settle ends when the Covered Autos Liability 7 Specifically Only those'autos"described in Item Three of the Declarations for which a roads. Coverage Limit of Insurance has been exhausted Described premium charge is shown(and for Covered Autos Liability Coverage any"trailers" 2.'Mobile equipment° while being carried or by payment of judgments or settlements. 'Autos" you don't own while attached to any power unit described in item Three). towed by a covered"auto'. 1. Who Is An Insured 8 Hired"Autos' Only those'autos"you lease,hire,rent or borrow.This does not include any"auto" 3.Any"auto"you do not own while used with the The following are insureds': Only you lease,hire,rent or borrow from any of your'employees",partners(if you are a permission of its owner as a temporary a. You for any covered'auto'. partnership),members(if you are a limited liability company)or members of their substitute for a covered"auto"you own that is Anyone b. else while usingwith households. out of service because of its: your 9 Nonowned Onlythose.'autos"you do not own,lease,hire,rent or borrow that are used in a. Breakdown; permission a covered'auto"you own,hire or borrow except: "Autos"Only connection with your business.This Includes"autos"owned by your'employees", b. Repair, (1)'The owner or anyone else. from whom partners(if you are a partnership),members(if you area limited liability company) c. Servicing; you hire or borrow a covered"auto". or members of their households but only while used in your business or your personal affairs. d. 'Loss';or This exception does not apply if the e. Destruction. covered"auto"is.a'bailer"connected to a covered"auto"you own. CA 00 01 10 13 6 Insurance Services Office,Inc.,2011 Page 1 of 12 Page 2 of 12 @ Insurance Services Office,Inc.,2011 CA 00 01 1013 (2) Your"employee"if the covered"auto'is These payments will not reduce the Limit of 4. Employee Indemnification And Employer's b. After it is moved from the covered"auto'to owned by that'employee"or a member Insurance. Liability the place where it is finally delivered by the of his or her household. b. Out-of-state Coverage Extensions "Bodily Injury"to: "insured". (3) Someone using a covered"auto"while While a covered "auto"is away from the a.An"employee"of the"insured"arising out 8. Movement Of Property By Mechanical he or she is working in a business of state where it is licensed,we will: of and in the course of: Device selling, servicing, repairing, parking or "Bodily injury"or"property damage"resulting storing"autos" unless that business is (1) Increase the Limit of Insurance for (1) Employment by the"insured";or Covered Autos LiabilityCoverage to from the movement of property by a yours. g (2) Performing the duties related to the mechanical device (other than a hand truck) meet the limits specified by a conduct of the Insureds"business;or (4) Anyone other than your 'employees", compulsory or financial responsibility unless the device is attached to the covered partners (if you are a partnership), law of the jurisdiction where the covered b.The spouse,child,parent,brother or sister 'auto". members (if you are a limited liability "auto" is being used. This extension of that "employee" as a consequence of 9. Operations company) or a lessee or borrower or does nota ! to the limit or limits Paragraph a.above. anyof their"employees",while moving apply "Bodily injury"or"property damage"arising out specified by any law governing motor This exclusion applies: of the operation of: property to or from a covered"auto". carriers of passengers or property. P Apartner(ifyou area partnership)ora (1) Whether the"insured'in a"mayt ber liable as a. Any equipment listed in Paragraphs 6.b. (5) li (2) Provide the minimum amounts and an employer or in any other capacity and 6.c. of the definition of 'mobile member (if you area limited liability types of other coverages,such as no- and company)for a covered'auto"owned by fault,required of out-of-state vehicles byequipment";or him or her or a member of his or her the jurisdiction where the covered"auto" (2) To any obligation to share damages with b. Machinery or equipment that is on,attached household. or repay someone else who must pay to or part of a land vehicle that would is being used. c. Anyone liable for the conduct of an We will not pay anyone more than once for damages because of the injury. equipment' qualify under the defin(ot of "mobile insured"described above but only to the But this exclusion does not apply to "bodily if it were not subject to a the same elements of loss because of Injury"to domestic"employees"not entitled to compulsory or financial responsibility law or extent of that liability. these extensions. j ry" P ry P ty workers'compensation benefits or to liability other motor vehicle insurance law where it 2. Coverage Extensions B.Exclusions assumed by the"insured"under an "insured is licensed or principally garaged. a. Supplementary Payments This insurance does not apply to any of the contract.For the purposes of the Coverage 10. Completed Operations We will payfor the"insured": following: Form, a domestic "employee' is a person 9 engaged in household or domestic work "Bodily injury"or"property damage'arising out (1) All expenses we incur. 1. Expected Or intended Injury performed principally in connection with a of your work after that work has been (2) Up to $2,000 for cost of bail bonds 'Bodily injury'or"property damage"expected residence premises. completed or abandoned. (including bonds for related traffic law or intended from the standpoint of the 5. Fellow Employee In this exclusion,your work means: violations) required because of an insured". a. Work or operations performed by you or on "accident"we cover.We do not have to "Bodily injury"to: 2. Contractual your behalf;and furnish these bonds. a. Any fellow °employee" of the "insured° Liability assumed under any contract orarising out of and in the course of the fellow b. Materials, parts or equipment furnished in (3) The cost of bonds to release agreement. connection with such work or operations. attachments in any"suit" against the "employee's' employment or while "insured"we defend,but only for bond But this exclusion does not apply to liability for performing duties related to the conduct of Your work includes warranties or amounts within our Limit of Insurance. damages: your business;or representations made at any time with respect a.Assumed in a contract or agreement that is b.The spouse,child,parent,brother or sister to the fitness,quality,durability or performance (4)Alln reasonable expenses incurred by the g P of any of the items included In Paragraph a.or "insured'at our request,including actual an"insured contract',provided the"bodily of that fellow"employee"as a consequence loss of earnings up to $250 a day injury" or "property damage" occurs of Paragraph a.above. b.above. because of time off from work. subsequent to the execution of the contract 6. Care,Custody Or Control Your work will be deemed completed at the or agreement;or earliest of the following times: (5) All court costs taxed against the "Property damage"to or"covered pollution cost 'insured" in any "suit against the b.That the "insured" would have in the or expense" involving property owned or (1) When all of the work called for in your =insured' we defend. However, these absence of the contract or agreement transported by the Insured" or in the contract has been completed; payments do not include attorneys'fees 3. Workers'Compensation "insured's" care, custody or control. But this (2) When all of the work to be done at the or attorneys'expenses taxed against theAny obligation for which the"Insured"or the exclusion does not apply to liability assumed . site has been completed if your contract "insured'. "insured's" insurer may be held liable under under a sidetrack agreement calls for work at more than one site;or (6)All interest on the full amount of any any workers'compensation,disability benefits 7. Handling Of Property (3) When that part of the work done at a job judgment that accrues after entry of the or unemployment compensation law or any "Bodily injury"or"property damage"resulting site has been put to its intended use by in any "suit" against the similarlaw. any person or organization other than judgment from the handling of property insured'we defend,but our duty to pay another contractor or subcontractor interest ends when we have paid, a. Before it is moved from the place where it is working on the same project. offered to pay or deposited in court the accepted by the "insured" for movement part of the judgment that is within our into or onto the covered"auto";or Limit of Insurance. CA 00 01 1013 ©Insurance Services Office,Inc.,2011 Page 3 of 12 Page 4 of 12 @ Insurance Services Office,Inc.,2011 CA 00 01 1013 ..._...______..._-_____......._.._._.._._____..___..--_______........._.__-... .._ _ --...__.-._.._.. ..._.._.. --... —. .... I_....-_. ........._....._._.._....._...._... Work that may need service, maintenance, Paragraphs b.and c.above of this exclusion All"bodily injury","property damage"and"covered 3. Glass Breakage—Hitting A Bird Or Animal— correction,repair or replacement,but which is do not apply to `accidents"that occur away pollution cost or expense" resulting from Falling Objects Or Missiles otherwise complete, will be treated as from premises owned by or rented to an continuous or repeated exposure to substantially If you carry Comprehensive Coverage for the completed. "insured"with respect to"pollutants"not in or the same conditions will be considered as damaged covered"auto",we will pay for the 11. Pollution upon a covered"auto"if: resulting from one"accident". following under Comprehensive Coverage: "Bodily injury"or"property damage"arising out (a) The"pollutants" or any property in No one will be entitled to receive duplicate a. Glass breakage; of the actual,alleged or threatened discharge, which the"pollutants"are contained payments for the same elements of"loss"under dispersal, seepage, migration, release or are upset,overturned or damaged as this Coverage Form and any Medical Payments b. "Loss"caused by hitting a bird or animal; escape of"pollutants": a result of the maintenance or use of Coverage endorsement, Uninsured Motorists and a.That are, or that are contained in any a covered"auto";and Coverage endorsement or Underinsured Motorists c. `Loss"caused by falling objects or missiles. property that is: (b) The discharge, dispersal, seepage, Coverage endorsement attached to this Coverage However,you have the option of having glass migration, release or escape of the Part• breakage caused by a covered "auto's" (1) Being transported or towed by,handled `pollutants" is caused directly by SECTION III—PHYSICAL DAMAGE COVERAGE collision or overturn considered a"loss"under or handled for movement into,onto or such upset,overturn or damage. from the covered"auto"; A.Coverage Collision Coverage. (2) Otherwise in the course of transit by or 12. War 1. We will pay for"loss"to a covered"auto"or its 4. Coverage Extensions on behalf of the insured";or `Bodily injury" or "property damage" arising equipment under. a. Transportation Expenses directly or indirectly out of: (3) Being stored, disposed of, treated or a. Comprehensive Coverage We will pay up to $20 per day, to a processed in or upon the covered a.War,including undeclared or civil war; From any cause except maximum of $600, for temporary "auto"; b. Warlike action by a military force,including (1) The covered 'auto's' collision with transportation expense incurred by you b. Before the"pollutants"or any propertyin action in hindering or defending against an because of the total theft of a covered another object;or which the "pollutants° are contained are actual or expected attack, by any 'auto" of the private passenger type.We moved from the place where they are government, sovereign or other authority (2) The covered"auto's"overturn. will pay only for those covered`autos"for accepted by the "insured" for movement using military personnel or other agents;or b. Specified Causes Of Loss Coverage which you carry either Comprehensive or into or onto the covered`auto";or a Insurrection, rebellion, revolution, usurped Caused by: Specified Causes Of Loss Coverage.We or action taken bygovernmental y will pay for red uri transportationth e. Afterhicthe `" ufor any propertyaindin power g (1) Fre,Oghtningorexplosion; expenses incurred during the period which the "pollutants" are contained are authority in hindering or defending against beginning 48 hours after the theft and moved from the covered"auto"to the place any of these. (2) Theft; g g ending,regardless of the policy's expiration, where they are finally delivered,disposed of 13. Racing (3) Windstorm,hail or earthquake; when the covered"auto'is returned to use or abandoned by the"insured". Covered"autos"while used in any professional (4) Flood; or we pay for its"loss". Paragraph a.above does not apply to fuels, or organized racing or demolition contest or (5) Mischief or vandalism;or b. Loss Of Use Expenses lubricants, fluids, exhaust gases or other stunting activity, or while practicing for such similar"pollutants"that are needed for or result contest or activity.This insurance also does (6) The sinking, burning, collision or For Hired Auto Physical Damage,we will from the normal electrical, hydraulic or not apply while that covered"auto" is being derailment of any conveyance pay expenses for which an 'insured" mechanical functioning of the covered`auto"or prepared for such a contest or activity. transporting the covered"auto". becomes legally responsible to pay for loss its parts if: C.Limit Of Insurance c. Collision Coverage of use of a vehicle rented or hired without a (1) The"pollutants"escape,seep, migrateCaused b driver under a written rental contract or or are discharged,dispersed or released Regardless of the number of covered "autos", Y agreement. We will pay for loss of use directly from "auto"part designed by "Insureds", premiums paid, claims made or (1) The covered °auto's" collision with expenses if caused by: vehicles involved in the or"accident",the most we another object (1) Other than collision only if the its manufacturer to hold,store,receive ec will pay for the total of all damages and"covered (2) indicates that or dispose of such`pollutants";and pollution cost or expense"combined resulting from (2) The covered"auto's"overturn. Comprehensive Coverage is provided (2) The"bodily injury','property damage"or any one"accident°is the Limit Of Insurance for 2. Towing for any covered"auto"; "covered pollution cost or expense" Covered Autos Liability Coverage shown in the We will pay up to the limit shown in the (2) Specified Causes Of Loss only if the does not arise out of the operation of Declarations. Declarations for towing and labor costs Declarations indicates that S ecified any equipment listed in Paragraphs 6.b. incurred each time a covered "auto" of the p and 6.c. of the definition of "mobile private passenger type is disabled. However, Causes Of Loss Coverage is provided equipment'. for any covered"auto";or the labor must be performed at the place of disablement. CA 00 01 1013 O Insurance Services Office,Inc.,2011 Page 5 of 12 Page 6 of 12 ©Insurance Services Office,Inc.,2011 CA 00 01 1013 (3) Collision only if the Declarations b.Any device designed or used to detect (2) Removable from a permanently installed (2) The insureds"name and address;and indicates that Collision Coverage is speed-measuring equipment,such as radar housing unit as described in Paragraph (3) To the extent possible,the names and provided for any covered"auto°. or laser detectors, and any jamming b.(1)above;or addresses of any injured persons and apparatus intended to elude or disrupt However, the most we will pay for any (3) An integral part of such equipment as witnesses. expenses for loss of use is$20 per day,to speed-measuring equipment described in Paragraphs b.(1)and b.(2) b. Additionally, you and any other involved a maximum of$600. c. Any electronic equipment,without regard to above. 'insured"must: B.Exclusions whether this equipment is permanently 2.An adjustment for depreciation and physical for loss"caused by or resultinginstalled, that reproduces, receives or condition will be made in determining actual 1.We will not pay (1) Assume no obligation, make no transmits audio,visual or data signals. cash value in the event of a total loss". payment or incur no expense without from any of the following. Such 'loss" is our consent, except at the insureds" excluded regardless of any other cause or d.Any accessories used with the electronic 3. If a repair or replacement results 1n better than own cost. event that contributes concurrently or in any equipment described in Paragraph c. like kind or quality, we will not pay for the sequence to the"loss'. above. amount of the betterment (2) Immediately send us copies of any 5. Exclusions 4.c. and 4.d. do nota I to request, demand, order, notice, a. Nuclear Hazard apply D.Deductible summons or legal paper received equipment designed to h "auto's solely by concerning the claim or"suit". (1)The explosion of any weapon employing use of the power from the"auto's"electrical For each covered"auto",our obligation to pay for, atomic fission or fusion;or system that,at the time of"loss",Is: repair, return or replace damaged or stolen (3) Cooperate with us in the investigation or (2) Nuclear reaction or radiation, or a. Permanently installed in or upon the property will be reduced by the applicable settlement of the claim or defense radioactive contamination, however covered"auto"; deductible shown in the Declarations. Any against the"suit". Comprehensive Coverage deductible shown in the caused. (4) Authorize us to obtain medical records b.War Or MilitaryAction b. Removable from a housing unit which is Declarations does not apply to loss"caused by or other pertinent information. permanently installed in or upon the fire or lightning. (1) War,including undeclared or civil war, covered"auto"; SECTION iV—BUSINESS AUTO CONDITIONS (5) Submit to examination,at our expense, by physicians of our choice,as often as (2) Warlike action by a military force, c.An integral part of the same unit housing The following conditions apply in addition to the we reasonably require. including action in hindering or any electronic equipment described in Common Policy Conditions: defending against an actual or expected Paragraphs a.and b.above;or c. If there is"loss"to a covered'auto"or its attack,by any government,sovereign or d. Necessary for the normal operation of the A Loss Conditions equipment,you must also do the following: other authority using military personnel covered "auto" or the monitoring of the 1.Appraisal For Physical Damage Loss (1) Promptly notify the police if the covered or other agents;or covered"auto's"operating system. If you and we disagree on the amount of loss", "auto"or any of its equipment is stolen. (3) insurrection, rebellion, revolution, 6.We will not pay for"loss"to a covered"auto" either may demand an appraisal of the"loss". (2)-Take all reasonable steps to protect the usurped power or action taken by due to"diminution in value". In this event,each party will select a competent covered "auto" from further damage. governmental authority in hindering or appraiser. The two appraisers will select a Also keep a record of your expenses for defending against any of these. C.Limits Of Insurance competent and impartial umpire. The consideration in the settlement of the 2.We will not pay for"loss"to any covered"auto" 1.The most we will pay for: appraisers will state separately the actual cash claim. value and amount of"loss".If they fail to agree, while used in any professional or organized a. 'Loss" to any one covered "auto" is the (3) Permit us to inspect the covered"auto" they will submit their differences to the umpire. racing or demolition contest or stunting activity, lesser of: and records proving the"loss°before its (1)The actual cash of the damaged A decision agreed to byanytwo will be or while practicing for such contest or activity. g repair or disposition. We will also not pay for loss"to any covered g binding.Each party will: "auto" while that covered "auto" is being or stolen property as of the time of the a. Pay is chosen appraiser,and (4) Agree to examinations under oath at our reared for such a contest or activity. "loss";or request and give us a signed statement prepared (2)The cost of repairing or replacing the b. Bear the other expenses of the appraisal of your answers. 3.We will not pay for"loss"due and confined to: damaged or stolen property with other and umpire equally. 3. Legal Action Against Us a. Wear and tear, freezing, mechanical or • property of like kind and quality. If we submit to an appraisal,we will still retain No one may bring a legal action against us electrical breakdown. b.All electronic equipment that reproduces, our right to deny the claim. under this Coverage Form until: b. Blowouts,punctures or other road damage receives or transmits audio,visual or data 2. Duties In The Event Of Accident,Claim,Suit a. There has been full compliance with all the to tires. signals in any one loss"is$1,000,if,at the Or Loss terms of this Coverage Form;and time of"loss",such electronic equipment is: We have no duty exclusion does not apply to such"loss' to provide coverage under b. Under Covered Autos Liability Coverage, resulting from the total theft of a covered (1) Permanently installed in or upon the this policy unless there has been full we agree in writing that the insured"has an "auto°. covered"auto"in a housing,opening or compliance with the following duties: obligation to pay or until the amount of that 4.We will not pay for "loss" to any of the other location that.is not normally used a. In the event of'accident",claim, 'suit"or obligation has finally been determined by following: by the "auto" manufacturer for the "loss",you must give us or our authorized judgment after trial. No one has the right installation of such equipment; representative prompt notice of the under this policy to bring us into an action a. Tapes,records,discs or other similar audio, "accident"or"loss".Include: to determine the°insured's"liability. visual or data electronic devices designed for use with audio,visual or data electronic (1) How,when and where the"accident"or equipment "loss"occurred; CA 00 01 1013 ©Insurance Services Office,Inc.,2011 Page 7 of 12 Page 8 of 12 ©Insurance Services Office,Inc.,2011 CA 00 01 1013 4. Loss Payment—Physical Damage 5. Other Insurance 7. Policy Period,Coverage Territory 2. Any other land vehicle that is subject to a Coverages a. For anycovered "auto" compulsory law or At our option,we may: Coverage Form you own, this Under this Coverage Form, we cover other motr veh cleninsu insurance where it is P Y gprovides primary "accidents"and"losses'occurring: a. Payfor, repair or re lace damaged or insurance.For any covered"auto'you don't licensed or principally garaged. P 9 a During the policy period shown in the stolen property; own, the insurance provided by this Declarations;and However, 'auto" does not include 'mobile b. Return the stolen roe Coverage Form is excess over any other equipment". property,rty,at our expense. collectible insurance. However, while a b. Within the coverage territory. We will pay for any damage that results to covered "auto" which is a "trailer' isC."Bodily injury" means bodily injury, sickness or the"auto"from the theft;or connected to another vehicle,the Covered The coverage territory is: disease sustained by a person, including death c. Take all or any part of the damaged or Autos Liability Coverage this Coverage (1) The United States of America; resulting from any of these. stolen property at an agreed or appraised Form provides for the"trailer"is: (2) The territories and possessions of the D.'Covered pollution cost or expense"means any value. (1) Excess while it is connected to a motor United States of America; cost or expense arising out of: If we pay for the "loss", our payment will vehicle you do not own;or (3) Puerto Rico; 1. Any request, demand, order or statutory or include the applicable sales tax for the (2) Primary while it is connected to a (4) Canada;and regulatory requirement that any "insured" or damaged or stolen property. covered"auto"you own. others test for, monitor, clean up, remove, (5) Anywhere in the world if a covered contain,treat,detoxifyor neutralize,or in 5.Transfer Of Rights Of Recovery Against any b. For Hired Auto Physical Damage Coverage, "auto'of the private passenger type is wayrespond to, or assess the effects of, Others To Us anycovered"auto"you lease,hire,rent or leased, hired, rented or borrowed P •pollutants";or If any person or organization to or for whom we borrow is deemed to be a covered"auto' without a driver for a period of 30 days 2. Anyclaim or "suit" make payment under this Coverage Form has you own. However, any "auto' that is or less, by or on behalf of a e rights to recover damages from another,those leased„hired, rented or borrowed with a provided that the "insured's' responsibility to governmentaloftesting authority for damages cleaning because rights are transferred to us. That person or driver is nota covered"auto". P h ntafor, monitoring,, e up, pay damages Is determined in a'suit on the removing, containing, treating, detoxifying or organization must do everything necessary to c. Regardless of the provisions of Paragraph merits, in the United States of America, the neutrefzing, or in any way responding to, or secure our rights and must do nothing after a.above, this Coverage Form's Covered territories and possessions of the United States assessing the effects of,"pollutants". accident'or"loss"to impair them. Autos Liability Coverage is primary for any of America, Puerto Rico or Canada, or in a B.General Conditions liability assumed under an "insured settlement we agree to. 'Covered pollution cost or expense" does not 1. Bankruptcy contract". We also cover 'foss" to, or "accidents" include any cost or expense arising out of the Bankruptcy or Insolvencyof the'insured"or the 9anyother Involving, a covered "auto" while beingactual,alleged raor threatened discharge,dispersal, P cYd. When this Coverage Form and seepage, migration, release or escape of "insured's" estate will not relieve us of any Coverage Form or policy covers on the transported between any of these places. 'pollutants": obligations under this Coverage Form. same basis, either excess or primary,we 8. Two Or More Coverage Forms Or Foibles will pay only our share.Our share is the Issued B Us a. That are, or that are contained in any 2. Concealment,Misrepresentation Or Fraud proportion that the Limit of Insurance of our y property that is: This Coverage Form is void in any case of Coverage Form bears to the total of the If this Coverage Form and any other Coverage (1) Being transported or towed by,handled fraud by you at any time as it relates to this limits of all the Coverage Forms and Form or policy Issued to you by us or any or handled for movement Into, onto or Coverage Form. It is also void if you or any policies covering on the same basis. company affiliated with us applies to the same from the covered'auto"; other "insured", at anytime, intentionallyaccident", the aggregate maximum Limit of 6. Premium Audit Insurance under all the Coverage Forms or (2) Otherwise in the course of transit by or conceals or misrepresents a material fact on behalf of the"insured";or concerning: a.The estimated premium for this Coverage policies shag not exceed the highest applicable Form is based on the exposures you told us Limit of insurance under any one Coverage (3) Being stored, disposed of, treated or a.This Coverage Form; you would have when this policy began.We Form or policy.This condition does not apply to processed in or upon the covered b.The covered"auto"; will compute the final premium due when any Coverage Form or policy issued by us or "auto'; we determine your actual exposures.The an affiliated company specifically to apply as b. Before the " any property in c.Your interest in the covered'auto";or estimated total premium will be credited excess Insurance over this Coverage Form. 'pollutants"or which the "pollutants" are contained are d.A claim under this Coverage Form. against the final premium due and the first SECTION V—DEFiNR10NS moved from the place where they are 3. Liberalization Named Insured will be billed for the A."Accident' includes continuous or repeated accepted by the "Insured" for movement balance,if any.The due date for the finalinto or onto the covered"auto";or If we revise this Coverage Form to provide premium or retrospective premium is the exposure to the same conditions resulting in more coverage without additional premium date shown as the due date on the bill.If "bodily injury"or"property damage". c.After the 'pollutants" or any property in charge, your policy will automatically provide the estimated total premium exceeds the B."Auto'means: which the "pollutants' are contained are the additional coverage as of the day the final premium due,the first Named Insuredmoved from the covered"auto"to the place revision is effective in your state. will get a refund. 1. A land motor vehicle, "trailer or semitrailer where they are finally delivered,disposed of 4. No Benefit To Bailee—Physical Damage designed for travel on public roads;or or abandoned by the"insured". Coverages b. If this policy is issued for more than one year,the premium for this Coverage Form We will not recognize any assignment or grant will be computed annually based on our any coverage for the benefit of any person or rates or premiums in effect at the beginning organization holding, storing or transporting of each year of the policy. property for a fee regardless of any other provision of this Coverage Form. CA 00 01 1013 0 Insurance Services Office,inc.,2011 Page 9 of 12 Page 10 of 12 ©Insurance Services Office,Inc.,2011 CA 00 01 1013 Paragraph a.above does not apply to fuels, 5. That part of any other contract or agreement 4. Vehicles, whether self-propelled or not, However, "mobile equipment" does not include lubricants, fluids, exhaust gases or other pertaining to your business (including an maintained primarily to provide mobility to land vehicles that are subject to a compulsory or similar"pollutants"that are needed for or result indemnification of a municipality in connection permanently mounted: financial responsibility law or other motor vehicle from the normal electrical, hydraulic or with work performed for a municipality)under a. Power cranes,shovels,loaders,diggers or insurance law where it is licensed or principally mechanical functioning of the covered"auto"or which you assume the tort liability of another to drills;or garaged.Land vehicles subject to a compulsory or its parts,if: pay for'bodily injury"or"property damage"to a financial responsibility law or other motor vehicle third party or organization.Tort liability means b. Road construction or resurfacing equipment insurance law are considered"autos°. (1) The"pollutants'discharged, ,dispersed escape,seep,dorreleasedd a liabilitythat would be imposed bylaw in the such as graders,scrapers or rollers; or are discharged,dispersed or L "Pollutants" means any solid,liquid, gaseous or directly from an'auto'part designed by absence of any contract or agreement or 5. Vehicles not described in Paragraph 1.,2.,3. thermal Irritant or contaminant, including smoke, its manufacturer to hold,store,receive 6. That part of any contract or agreement entered or 4.above that are not self-propelled and are vapor,soot,fumes,acids,alkalis,chemicals and or dispose of such"pollutants";and into,as part of your business,pertaining to the maintained primarily to provide mobility to waste.Waste includes materials to be recycled, (2) The"bodily injury", rental or lease, by you or any of your permanently attached equipment of the reconditioned or reclaimed. y'J do "property damage"or "employees", of an auto". However, such following types: "covered pollution cost or expense" y M."Property damage"means damage to or loss of does not arise out of the operation of contract or agreement shall not be considered a. Air compressors, pumps and generators, use of tangible property. any equipment fisted in Paragraph 6.b. an "insured contract' to the extent that it including spraying, welding, building N. •"Suit"means a civil proceeding in which: or 6.c. of the definition of "mobile obligates you or any of your'employees"to cleaning, geophysical exploration, lighting equipment". pay for"property damage"to any'auto"rented and well-servicing equipment or 1. Damages because of "bodily injury" or or leased by you or any of your"employees". b. Cherry pickers and similar devices used to 'property damage";or Paragraphs b.and c.above do not to An insured contract"does not include that part of raise or lower workers;or 2. A"covered pollution cost or expense'; accidents" that occur away from premiremi ses any contract or agreement owned by or rented to an'Insured"with respect 6. Vehicles not described in Paragraph 1.,2.,3. to which this insurance applies,are alleged. to"pollutants'not In or upon a covered"auto" a.That indemnifies a railroad for"bodily injury" or 4.above maintained primarily for purposes "Suit"Includes: if: or "property damage" arising out of other than the transportation of persons or (a) The 'pollutants"or any property construction or demolition operations,within cargo. However, self-propelled vehicles with a. An arbitration proceeding in which such m 50 feet of any railroad property and the following types of permanently attached damages or "covered pollution costs or which the"pollutants"are contained affecting any railroad bridge or trestle, equipment are not'mobile equipment'but will expenses'are claimed and to which the are upset,overturned or damaged as tracks, roadbeds, tunnel, underpass or be considered'autos': "Insured"must submit or doessubmit with a result of the maintenance or use of crossing; our consent;or a covered"auto";and g a. Equipment designed primarily for. b.That pertains to the loan,lease or rental of b.Any other alternative dispute resolution (b) The discharge, dispersal, seepage, (1) Snow removal; proceeding in which such damages or migration,release or escape of the an auto" to you or any of your ? 9 g "pollutants" is caused directlybyemployees",if the'auto"is loaned,leased (2) Road maintenance,but not construction covered pollution costs or expenses'are P or rented with a driver,or or resurfacing;or claimed and to which the insured submits such upset,overturn or damage. c.That holds a person or organization (3) Street cleaning; with our consent E.'Diminution in value' means the actual or engaged in the business of transporting b. CherryO. Temporary worker" means a person who is perceived loss In market value or resale value P g pickers and similar devices mounted furnished to you to substitute for a permanent which results from a direct and accidental'loss". property by'auto"for hire harmless for your on automobile or truck chassis and used to use of a covered "auto" over a route or raise or lower workers;and "employee"on leave or to meet seasonal or short- tens workload conditions. F. "Employee' includes a °leased worker". territory that person or organization is w Air compressors, pumps and generators, 'Employee' does not include a 'temporary authorized to serve by public authority. including spraying, welding, building P. 'Trailer"includes semitrailer. worker". I. "Leased worker"means a person leased to you by cleaning, geophysical exploration, lighting G."Insured" means any person or organization a labor leasing firm under an agreement between or well-servicing equipment qualifying as an insured in the Who Is An Insured you and the labor leasing firm to perform duties provision of the applicable coverage.Except with related to the conduct of your business."Leased respect to the Limit of Insurance, the coverage worker"does not include a"temporary worker". afforded applies separately to each insured who is J. "Loss" means direct and accidental loss or seeking coverage or against whom a claim or 'suit"is brought damage. H."Insured contract"means: K."Mobile equipment" means any of the following t A lease of premises; types of land vehicles, including any attached machinery or equipment: 2.A sidetrack agreement 1. Bulldozers,farm machinery,forklifts and other 3.Any easement or license agreement,except In vehicles designed for use principally off public connection with construction or demolition roads; operations on or within 50 feet of a railroad; 2. Vehicles maintained for use solely on or next to 4.An obligation, as required by ordinance, to premises you own or rent Indemnify a municipality,except in connection 3.Vehicles that travel on crawler treads; with work fora municipality; CA 00 01 1013 ©Insurance Services Office,Inc.,2011 Page 11 of 12 Page 12 of 12 ©Insurance Services Office,Inc.,2011 CA 00 01 10 13 ...._....----------....._—____. - - — , POLICY NUMBER: D37720136 Eugene Welder's Supply Co, DBA Industrial Source ADDITIONAL INSURED-WHERE REQURED UNDER CONTRACT OR AGREEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ R CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM Section II-Who is an Insured, 1.,is amended to add as an additional insured: (f) Any person or organization to whom you become obligated to include as an additional insured under this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" arising out of your operations or premises owned by or rented by you. However,the insurance provided will not exceed the lessor: 1. The coverage and/or limits of this policy,or 2. The coverage and/or limits required by said contract or agreement Authorized Agent LD-16422 (04/04) Reprinted with permission of Insurance Services Office Page 1 of 1 POLICY NUMBER: D37720136 Eugene Welder's Supply Co,DBA Industrial Source NON-CONTRIBUTORY ENDORSEMENT FOR ADDITIONAL INSUREDS THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY COVERAGE Schedule Organization Additional Insured Endorsement (If no information is filled in, the schedule shall read: 'Alf persons or entities added as additional insureds through an endorsement with the term'Additional Insured in the title') For organizations that are listed In the Schedule above that are also an Additional Insured under an endorsement attached to this policy,the following is added to Section IV.4.a: If other insurance is available to an insured we cover under any of the endorsements listed or described above (the 'Additional Insured") for a loss we cover under this Ow, this insurance will apply to such bss on a primary basis and we will not seek contribution from the other insurance available to the Additional Insured. • Authorized Agent LD-20287 (06/06) Page lof I a POLICY NUMBER: D37720136 COMMERCIAL GENERAL LIABILITY Eugene Welder's Supply Co, DBA Industrial Source CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: as required by written contract or agreement Information required to complete this Schedule, if not shown above,will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 ©Insurance Services Office, Inc., 2008 Page 1 of 1 0