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2021-095 PO 20220035- National Fire Sprinkler Assoc.
; . Purchase Order Pir CiFiscal Year 2022 Page: 1 of: 1 B City of Ashland - _t I LATTN: Accounts Payable Purchase L Ashlanda�OR 97520 Order# 20220035 T Phone: 541/552-2010 0 Email: payable@ashland.or.us V H .0/O Street Division E NATIONAL FIRE SPRINKLER ASSOC I 90 North Mountain Ave N PO BOX 757032 p Ashland, OR 97520 O BALTIMORE, MD 21275-7032 Phone: 541/488-5313 R T Fax: 541/552-2304 -L 1--1 •'- _—_F_ a=1_— F L€[==j EL-o I _ !1=feo - arrl — — — ! -j _ I t_I_l�t'.-1=§I=1 I_r:= - v �a=�f'—=-= —..� L I_V I I_t_�e Isa_1_ _-_p__� -�•� -;jam---.7..__^I 1= _ 07/12/2021 109 FOB ASHLAND OR/NET30 City Accounts Pa able Fire Extinguisher Services 1 Fire Extinguisher Inspection Services FY 2022 1.0 $4,995.00 $4,995.00 • Goods and Services Agreement Completion date: 06/30/2022 Project Account: ***************GL SUMMARY*************** 088400-602400 $4,995.00 I I E - By: LL/ t '/ Date: 7/// Author zed Signature ! ___ $4 995.00 • FORM #3 ! CITY OF q A.S H LAN D A $'')(:1U ) .r, tor ":I P 1111311 i1z3'? `O"''`Y's'1 REQUISITION P g---d t-,-- ti late of request: 5/27/2021 Required date for delivery: Vendor Name National Fire Fighter Corp. • Address,City,State,Zip 3100 N. Pacific Highway,Medford.OR 1'97501 Contact Name&Telephone Number Mike Webb 541-779-0167 mikewemationalfirefighter.com Email address i SOURCING METHOD ❑ Exempt from Competitive Bidding 0 Emergency ❑ ,Reason for exemption: 0 Invitation to Bid 0 Form#13,Written findings and Authorization ❑ AMC 2.50 Date approved by Council: i ❑ Written quote or proposal attached ❑ Written quote or proposal attached (Attach copy of council communication) _(If council approval required,attach copy of CC) ® Small Procurement 0 Request for Proposal ,Cooperative Procurement Not exceeding$5,000 Date approved by Council: 0 State of Oregon ® Direct Award _(Attach copy of council communication) Contract# • ❑ Verbal/Written quote(s)or proposal(s) 0 Request for Qualifications(Public Works) 0 State of Washington Date approved by Council: Contract# (Attach copy of council communication) ❑- Other government agency contract Intermediate Procurement ❑ Sole Source Agency GOODS&SERVICES 0 Applicable Form(#5,6,7 or 8) s Contract# Greater than$5,000 and less than$100,000 0 Written quote or proposal attached intergovernmental Agreement ❑ (3)Written quotes and solicitation attached ❑ Form#4,Personal Services>$5K&<$75K Agency PERSONAL SERVICES 0 Special Procurement 0 Annual cost to City does not exceed$25,000. Greater than$5,000 and less than$75,000 0 Form#9,Request for Approval Agreement approved by Legal and approved/signed by ❑ Direct appointment not to exceed$35,000 0 Written quote or proposal attached City Administrator.AMC 2.50.070(4) ❑ (3)Written proposals/written solicitation Date approved by Council: ❑ Annual cost to City exceeds$25,000,Council ❑ Form#4,Personal Services>$5K&<$75K Valid until: (Date) • approval required.(Attach copy of council communication) Description of SERVICES Total Cost Fire extinguisher inspection and service for FY22 _ $.4,995.00 Item# Quantity Unit Description of MATERIALS Unit Price Total Cost ❑ Per attached quotelproposal /TOTAL COST O OSS :.. . Project Number _ _ _ , Account Number8241 '60240.0 • 1 *Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. ' IT Director in collaboration with department to approve all hardware and software purchases: IT Director Date Support-Yes/No By signing this requisition form,I certify that the City's pub' '6ntracting requirements have been satisfied. , �1 p Employee: `. Department Head:; -0"l� blZl 2Q2-1 1 -11 W 7 o or greater tt an$5,000) Department Manager/Supervisor: Cit�••r in 1411 ' ' (Equal to or greater than$25,000) Funds appropriated for current fiscal year: NO _ / 7 /9 R/ - put Finance Director-(Equal to rgreat than$5,000) Date S Comments: • • Form#3-Requisition . , . . , . I • , . . , - , GOODS AND.SERVICES AGREEMENT(LESS THAN.$25,0110). : , .., . .. . ,------- : , - PROVIDER; rational FireAfitatcorp. . . : I . . . .0 X T Y PI:r 'PkOtarmirs 1 I ASH LAND CONTACT Mike Webb 20 Esat Main Street . Ashland,01%0;97520 • ADDRESS; 1100 North Pacific Highway Telephone:'541/.488e5 .87' . Medford,'OR.97501. • rex: 5.411/4040500 0 , • -1 rugZiP 4.1.1-779j3157 , . . • i ' . • I Thia andcle and $erv.ines Agreement (hereinafter "Agrecnientryis entered into by and between the City of Ashland, an Oregon rilunicipgi. corporation (hereinafter "Cite) and'-'National Fire Pightet. Corp,. 0. 1 • , I • domestietforeign bosinesi.corpOratien)("hereittafterProvitlet"),for ill-00440811d inspection and service; i 1.. gRowpws.9B14/9ATIQNS . • .4 It Pkovido fire exfiligOlieri**flan Andser*.o for PY22' as set forth in the *SUPPORTING: - I . DOCI)MENTS" attached:hereto and; by this reference,: incorpOrated)iercin.• Provider expressly .i acknowledges that.timeis.of the essence. of any completiOn date-.set forth in.the SUPPORTING • DOCUMENTS,and that no waiver or extension of auch deadline maybe authorized except 173 the same manner as'bertin provided for authority to'exceed.the.4144110nm compensation. Tho services defined 1 i . and.described an the"SUPPORTING DOCUMENTS'''.shall haroinniter be.collectiVely referred tO.as I. "Welt" r , I . , L2 PrOvidershall obtain and maintain during the term of this isgre ement and until Citys final acceptance . I Ofall Nitoricreceivedherennder;a pokey orpolidies.of liability'insurance including c..PlunleCbial general liability insurance with a combined single bruit,or the equivalent, of not less than$2,000,000 (two I. million dollars)per occurrence for 134 iIy injurs,runti Property.beings, 1 .1. The insttrance required in tlds:•Artiele shalt include.the following Coverages: i • Comprehensive •General or Commercial General Liability, including personal injury, I contractual'liability,and prodoetitcompleted operationa coverage; and • I- ... Automobilitiability. , , 1 • Workers'Compensation . • • ! .1;21. Each pokey of such insurance shall be-on nn"occurrence"and not i3..'Waits plada.".form,and . , ahalli. • Name.as additional imiteci istil ,City of Ashland,, Orpgonitsofficers, agents and, i employees" with.raspect,to. claims arialog. out of the provision of Work,under !Ida-. Agrecinen4 , " ! t . a .Apply to each named and additional named inn*as though a separate policy had been issued fa each,provided that the policy shall not be inereasedllierpbY;. • - , . • Apply as primary coverage for each additienatriam. ed.Insured except to the extont.that, . ! two or more such policies art:intended.to PlaYeriii coverage and, taken together, they provide total coverage from the first dollar of liability, . 1 . Provider shall iramediatoiy,notify tha.City of ratchange in insurance coverage : ' 1 . Pa !06;:Cool:15ml Sir/Ices AgrecmCntbotwthallio city of Mhiancrand NationilfiraTiglittr co . , . . . , . , , • • • • • • .Provider thaflsupply anendorsemcntnuningThc CitY,.ita offieers,eniploYces andrigents as.additional insureds by the:gffeetive Date of this•Agreertient;.rurd • •• Betvideneed by a certificate or certificates of.aueli insurance approved by the City,. , Provider Shall,•at its own expense,.Maintain Worker's Cdinriensation insuraneein compliance with , ORS 056,0)7;which requires subject employers to.provlde.workeredompensation coverage fotall Of ita.suhjectWrirlier , • • .1.4 Provider,agrees that no person:ahalli.ontivigrounds of rack color,religion, ctreek-stcoharitar maw, . familialstatus or domestic partnership, national origin, age, mental or physical diaabthty, sexual orientation,.gender:identity or source'of income, stiffer discrimination in the performance of this Agreement when employed by Provider: Provider agrees to comply withill.applicahte requirements of :federal and Statecivil rights and rehabilitation.statutes„.toles and regulations. Further,Provider agrees not to:discriminate against.a disadvantaged.busirresS.enterprise, minority-owned business, woman. owned busincss a business that a_serviee-ditabled veteran owns. or an emerging small business enterpriSe:cortifradjurder ORS 200,055,in awarding subcontracts as required by ORS 279A to,. 1.5 In all solicitations either by competitive bidding or negotiation made by Provider'for:work to be performed under A.subcontract, including preearernerni-of:Materials or Leases of equipment, each .potential stihcontractor or supplier shall be notified by theProvideri Odle Provider's obligations under this Agreement and titicArt:orthe CivillRights.Act of i94 and other federal nondiserimiriation laws. L.0 lioiving.Wage Requirements If amount of this Agreement is.$22.00243 or more..Provider is required to comply with°Chapter j412.of the.Ashland.Mhoielpal.Code b?.)paying a.living wage, a defined. in that chapter; to all.'employees performing* *ork.under this Agreement and to any Stibeontrantorwho performs 50%or ntOre oftlieWorknriderthiS Agreement. Provider is also required to post the notiee attached hereto*as"Exhibit A".predominantly in areas where•-it will be seen by all •ernployees, 1.7 Assignittentt Provider shall not assign this Agteetrient Or subcontract any pardon of the.Work to be provided hereunder without the.prier Written•consent of the City Any attempted-assignment or subcontract without.writtemeonsent cfthoCityshall be Void.. Provider aliallbeftillyrespousible.forthe .nets or ornissi.ons.of any assigns or subcontractors.and of pert*employed by them,and the approval by the•City of any asaignMentor.subcontract shall netcreate.-60.Contreetual rieletion betivecri the assiinee or inbcoritnieter and the'City. • . ;. CITY'S'ORLIC+A.31011Slit;T.. • 2,i city shall pay rroVider the's* • •• • ••: • - ; forte . . . • . . 4roposali4rovidkl-itereitt,an4ul1.coMpensation-for4e—Wo4as specified•in.the SUPPORTING • IJOCUiv1ilstf8. • .2,2 In no event Oat provider's toted Of ail cOMpensationaod reinthin*Cment under this Atreement-eXceed the'Seat of$5,000.003 five thousand dollars ifithout express,Written approval:front the City official whose signature appears below,or such ofliciaPasuccesSor in offrOe. Provider expressly acknowledges that no Other person has.authority to order or authorize additional Work which.would-eausethis - maximum aiim tO•be exceeded and that anyanthorizatirer,from the responsible oflicial must be in. wilting. Provider further acknowledges that any Work:delivered or-674P6t*sincurred without authorization as provided herainis.done at Provider's own risk and as a voInnlecr without expectation of compensation or mintburserrient. • 1e2 04: awls and Services Agteereent between the City otAshlarei end Nstional Firs Fighter Corp. • • , , . . . . , 3. GENERAL PROVISIONS • • 3,1 This is a non-exclusive Agreement City is not obligated toprocureany spceifiComOuntefWOriefrein 1 Provider and is free to procure similar types of goods and services from other\providers in its:sole discretion, , t 3.2. .Provider Is an indeDendent Contractor and not an•employee Or agent ado City for any porcine: . . . . . . 33 Provider isnot cutitha tol andexpresslywaives all claims to:Citybenefits such as health and disability insnralteergaid leave,'and retirement. , . ., . • , 34. This Agreement embodies the full arid complete understanding of the parties:lespcollng:tbe subject matte 4000004010.0r-agreements,negotiations,and representations between tilt parties; , .1 •I ,.'.., whether.vaitten 4::T.oral.. I: 34 This Agreement may be amended only by Written instrument executed Iwith the same formAities,0 this Agreement. .. . - • 0 Thcfrelloring laii.ts'of the*ate of Oregon ere hereby.ineMporated by refcrenceintothis.Agreemenn. ORS.31,91340;2791309 and 2790.231. .. . .: 3:I This Agreement.:ShOt be governedby the laws of th0.$tate..of Oregon wirkmt regardto conflict of laws printiplcs. Exclusive venue for litigation of any action arising under tbia.AgreeMont:'shall be in the: Circuit Court of the State of Oregon for Jackson County unless exelesivejetlociictiOn is federal Court, in which case exclusive while shalibe in the federal district court for the district of Oregon. Each party i expressly waives any a:401001a to Maintain an.actionundoithis Agreement in any other vogue,and 40Sqly.consents that, upon motion•uf the whet party, any case may be dismissed or its yoMie. tr-sofegott.os apProPriste;SO as-M effectuate thiS choke,Of venue. I , . 3',8 :Provider shall defend; SOO,held harmless and indemnify the City and itsofficers,'employees and agents.from and against any and all,claims, suits, actions, losses, damages, liabilities, oosts, and 'ovenses of any nature resulting.from, arising out of;or relating to the activities.of Provider or its officers,.employees,contractors,or agents under this M001,4 . . 3.R Neither party to this,Agroernent shall hold the Other:.rosponsitge:for damages or deln.y in performance caused by bails:.Of n ad,.strikes,lockouts,accidents,.or.other events beyond the control of the tither or the'Other's officers,employees or agents. [ , . • !, , 3.10 If provision of this Agreement is found by a cat.*ofcc4p0104kiri0419#0.t01:10.4netiforCeable; 1 - ,. SP°hProishIn'shali lultssaircct ti‘0410 provisions,but such 110, er#70Neatii#. 0111ipti shall be deemed 1: ' modified to the extent necessary to render it onfaccallici preserving to,the fullest extent permitted the. t. , - „ • intent of Providerand the City sit forth in this Agre:Oient.. 1 . 3.11 Deliveries will. F.O.i/destination:Provtiter slt bapay all tranl spoltationand handling clorgcslorflic ., . „ . ; .„ ..;, , . , Goods rrovidor is responsibleand liable for loss or dotage untilfingunspeotmg.atut acceptance of 'Ow<304A by dio qty.,::!'r.Oitidi.r remains liable for latent'defects,tratich andlvatranties, 1 • .• i .. 3;12 The City may inspect and test the(beds TheCity may:ilea non-tenfonlaing Goods an4 require . ., — • [.. . Proyider to.correct:them without charge or deliver sthem i:at ereduced price,as negetlated..1f-Frovulcc. does not cure.. any 44fcct4 within a teasogal*114tei the•qty:nay'reject tho.6:odds and cancel this 1 i 1 , t •Oge 3 of 6: 0:Jo4 tutA Scrvicps.Agrarrivit'ilotwcen the City 9r AsbUtlii and Motional Pire Fishtet Corp: [ . , 1 . , , . i • , • • . • Agreement:in Whale in.part Thispataguipli des Mit:effect orlimit the City's rightS,..ineluding its •:.rights.under the:Uniform.Ctrunerchil•COdefORS'Chapter 72(0CC): 3.13. Pr wider represents and warrants That the en)* are•new, current•and fully Warranted by the manefacturehs Delivered.Goods will comply with SUPPORTING DOCUMENTS and be.free from .defects in labor;niaterialtindmanufactore.•PrOvider shalLtransferall waundlies to the City. 4. .SWPORTI11/4t0 DOCUMENTS: • • The fallowing documents are, by this:reference, expressly incorporated:in this Agreement, and•are . collectively referred to in thiSAgreenientas the"SUPPORTING:DOCUMENTS:" .• * The Provid ees hourly rate sheet. • TheProVideris firm•price bid(s)for each individual project. REMEDIES 5.1 In the oVent.ProvideriS.in default'of this.Agreement,City.may,atilt 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; 5J1aWithhelding all Monies due for the Work that Provider has failed to deliver within any scheduled completion dates or any Work that havebeen deliVered inadequately or defectively, 5.1.3 Initiation of an action or proceeding for damages, specific perfOrminice, or.:declaratory or injunctive relief; (- 5.1A These remedies are oututilatttre to the extent the remedies are not inconsistent, and City may pursue any remedy or remedies singly,collectively,successively or In any order whets:60er, 5.2' In no event shall thy be liabletoProvider for any expenses related totermination of this Agreement . Or fbr•anticipated:profits:If previous amounts paid•toIrovider exceed the amount due,Provider shall payinunediatelyanY excess to city upon written dentand provided. b. TEM AND TERMINATION .6.1 Tani This AgreeMent shall be effective fthin.thellata of execution on behalf of the City as Set forth-helinv (the "Effective..Diter)and.shall.eohlinbe in MI force and ffeet mull ante 30,2022,unless:sooner terniinittCd.es provided hi.Rabsectinn 6.2 Teithinatitai . 6,24•TIiti City Provider maysterrninate this.Agreercent.by mutual agreement at any time. ( 22 The City may,upon not less than thirty(30)days'prior written Wide,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 hettido iftlie.cause is'not Aired within that.fourteen(A)day period.Mier written Mize, Such termination is in additiori to and not in iienUtany other remedy.at law or equity; 7. NOTICE Whenever notice 4.0quirod.or permitted to be given under this Agreement,such notice shall be given in writing Ic the other party hy personal clelivety, by sending via a reputable commercial oVernight courier,or byinailing'usingxegistered or certified United states mall,return receipt requested;postage prepaid,to the address set forth below: If to the City: Fgeo of 6t"Coeds end SeMees Agreement between the City of.Ashlandled National Fite Fighter Corp. • • . . . .. City plASidand. • :Facilities Maintenaace Department I1 Attn: DM/id-Arnold. 20 E..lvlain Street • • i Ashland,Oregon 97520 one:(541)552-2292(541).552-2292 . With ieopy.to: • 'City of Ashland•--X.,egal:Periartraerrt ZO E.Main Sept Ii Ashland,QR 91520 1 rtione.;(54)488-050 .. , #0.•Providert. I National Fire Fightor,orp, Attn:Mike Webb . . •1 5414794167 . . I.. 8. WAIVR OF itAEACTI One or more Waif/els or failures to;object I:I either:imtyto::theother!O'breach tf•any provision,...tOrm,. • . .., . .. condition,or covenant contained this Agreement.shall.riot be construed g a waivOk of any subseciont: I • breq4i whet**not of the sitmenatOre, .1 9. •POVIDER'S COMPLIAlgc Wri'll-TAX,TAWS • . i , 9.1 ;Provider representsawl warrant*to die City that: r .93,1,Provider shall,throughout the:tentiof this Agreement,'including any extensioRS hereof,comply I .. . . .with: (i) .All tax laws of the State of Orton,inducting bnt.not limited to 1:10.:105..67Q,and MS. 1 • • 1 chapters 3.10)31%4143133 ;. ;.; ... 01.) Any,..tax provisions impoSealjy.a pplidoal subdivision•orthe,Slateot Oregon 41)011c0e. • .. -to Provider;and 1 Oil) Any rules;regulations;chattel:P*4113ns;or ordinances thatiinp.lement•or.enforce any of the foregoing tax laws cr.provisiont, I. • 9,12ProviderPfern period of no fewer than six(6)calendar years preceding the Effective Date of this ' Agreement,:haaaithfully complied • (i) All troclavis Of theState abrupt!,including but not limited to Qg4:395'49:axtd1A.5 .- . • chapters 316,3171andl15; I 1 (Ii) itriy fox prnyinions imposed by.:ipolitical.Subdiv.' Oicn of the State of Oregon applicable • . •. to:Provider;and : • (iii):- Any rotes;regulations,chatter provisions,or ordinances that implement or enforce any of . . • the foregoing'tat laws or provisions. , ! , . . .,. 9:2 Proviciee*fttilute to comply With-the tat laws of the state of Omen and all oppileable:tat lawsi of tiny , .political subdivision of the State Of•Oregon shall constitute a material breach of tins Agreement • ‘ Further,any violation of Provider's viarianty,,•as set fOrth in this AttiOle 9;,shall constitute a material . , . :. breach of this Agreemerit. Any material'breach of this Agteeittentshall entitle the City to terminate 11! • this Agreement and to seek damage*and any other relief available under this Agreement,at law,O.in- i . e•t1441Y- r •0 0 . I . . .P.aga.5.of 6:.Goods and Se:oleos Agreement betwee.n it. 0 PitY-Pf Milandind NEdidnaniiii Fkliter Corp; . 0 . . • t . . 1 ' 1 IN WITNESS WfIEREOrthe partios.have caused this Agreementio be signed In their respective names by their duly authorked.reiniesentatives as Of the dates Set forth behnv: arropAsxmoipi. National pine Fighter Ow !I OP, By:. 11111PAgagliThlb.; ief • 4111111 Signature. , isnir Vi-gtscy 14(4khet.e. (41-elo • Printed Name ' printed:Nettle • • (tigeS; UlteEic.xr I 6cArkA Se?k_ss Sgr-occa , Title Title 4,1-Lti 104 • Date Date (WA is to be submitted With this signed Agreement) .4# PUrehase Order No, • • • • iifige.6 of* Goads and&Tykes Agreement behveen the City Of Athland'and National Vire Fighter Cain. II trtionai- Firt, FightEr CORP To: City of Ashland - From: Mike Webb Attn: Nicole Graham Phone: 541-210-3895 Phone: 541-552-2359 Email: mikew@nationalfirefighter.com Email: nicole.graham@ashland.or.us Date: 4-26-21 On behalf of National Fire Fighter Corp.,I am pleased to present the following quotation for service in 2019: Service Call Charge: $47.95 Out of Area travel: $99/I1our Service Type Extinguisher Type Price* Annual re-certification 2.5#-20#Dry Chemical $8.62 6-year service 2.5#Dry Chemical $24.55 6-year service 5#Dry Chemical $29.66 6-year service 10#Dry Chemical $47.52 6-year service 20#Dry Chemical $66.55 Hydro test 2.5#Dry Chemical $32.02 Hydro-test 5#Dry Chemical - $41.02 Hydro-test 10#Dry Chemical ! $74.66 Hydro-test 20#Dry Chemical $88.55 *Does not include Hazmat fee *Extinguisher Service price includes new valve stem, o-ring, collar ring &flag seal. **The above prices DO NOT include any additional work,parts,repairs, or upgrades to equipment. *Service includes inspection using Building Reports barcode,management system. Tracking and reporting of devices supplied at no additional charge. II � Thank you for allowing us the opportunity to quote this businessL We look forward to hearing from you. National Fire Fighter Corp. Medford P: 5412779-0167 F: 541-772-4510 I { Please Sign and Return Date li I,I . � J II 1 I h AcoREP CERTIFICATE OF LIABILITY INSURANCE DAT12D/YYYY) �� 31 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 CONTRACTI BETWEEN.THE ISSUING INSURER(S), AUTHORIZED • REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. ,• If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain 1 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 CONAME: I KPD Insurance,Inc. PHONE I (Arc.No.Ext):541-741-0550 FAX No):541-741-1674 i PO Box 784 E-MAIL Springfield OR 97477 ADDRESS: Vic-certs@kpdinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# I INSURERA:SAIF borp 36196 I t INSURED EUGEWELO2W INSURER B: Eugene Welders Supply Co.dba:Industrial Source 1 dba:National Extinguisher Service dba:National Fire Fighter Corp INSURER C: • dba:National Fire Fighter Wildland Corp INSURER D: I PO Box 7577 INSURER E: , Springfield OR 97475 INSURER F: I COVERAGES CERTIFICATE NUMBER:1722753867 REVISION NUMBER: i THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED ATO 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 I 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. 1 INSR ADDLSUER POLICY EFF POLICY EXP LIMITS I TYPEOFINSURANCE LTRINSO MD POLICY NUMBER (MMIDD/YYYYI (MMIDD/YYYY) COMMERCIAL GENERAL LIABILITY , EACH OCCURRENCE $ VIRGE TO RENTED j CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ - MED EXP(Any one person) $ ' PERSONAL&ADV INJURY $ GENt AGGREGATE LIMIT APPLIES PER: 1 GENERAL AGGREGATE $ • POLICY JET LOC PRODUCTS-COMP/OP AGG $ , $ 1 OTHER: COMBINEDSINGLE LIMIT $ AUTOMOBILE LIABILITY (Ea accident) ANY AUTO BODILY INJURY(Per person) $ . 1 OWNED • SCHEDULEDBODILY INJURY(Per accident) $. I AUTOS ONLY AUTOS PROPERTY DAMAGE • HIRED NON-OWNED (Per accident) $ AUTOS ONLY AUTOS ONLY $ I UMBRELLA LIABOCCUR EACH OCCURRENCE $ — I EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ ' $ A WORKERS COMPENSATION 783031 1/1/2021 111/2022 X STATUTE X ETH_ AND EMPLOYERS'LIABILITY YINi ANYPROPRIETOR/PARTNER/EXECUTIVE N/A EL.EACH ACCIDENT $1,000,000 OFFICERIMEMBEREXCLUDED?' (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 B yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 I 1 I i i 11 1 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) i RE:All Operations. 1. *Additional Insured Does Not Apply to Workers'Compensation , I i 1 k CERTIFICATE HOLDER CANCELLATION 111 1 = SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE I! THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN N ACCORDANCE WITH THE POLICY PROVISIONS. II City of Ashland Ii 20 East Main Street , AUTHORIZED REPRESENTATIVE li Ashland OR 97520 I j &ititat_ I? '©1988-2015 ACORI3 CORPORATION. All rights reserved. r ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD • I 1 ® DATE(MM/DD/YYYY) A�o CERTIFICATE OF LIABILITY INSURANCE 3,23/2oz1 • 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. I 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 NAMEACT Angela Sangl Ward Insurance Agency Inc. P 1ONNo.Ext):5412687-1117 (FAAic PO BOX 10167 .Nn(:541-342-8280 Eugene OR 97440 E-MAIL E-MAILADDREs: angels anwardinsurance.net .INSURER(S)AFFORDING COVERAGE NAICS INSURER A:Indemnity Insurance Company of NA 43575 INSURED LAINCOM-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 0:Hallmark Specialty Insurance Company 26808 PO Box 7577 INSURER E: Springfield OR 97475 INSURER F: . COVERAGES CERTIFICATE NUMBER:1229339565 1 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEDI 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 1 POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDD/YYYY) (MMIDDIYYYY) A X COMMERCIAL GENERAL LIABILITY Y Y 037720136 6/30/2020 6/30/2021 EACH OCCURRENCE $1,000,000 DAMAGE O_CLAIMS-MADE X OCCUR 1 PREM SES Ea occu eEEDnce) $100,000 MED EXP(Any one person) $10,000 1 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY 'E: X LOC _PRODUCTS-COMP/OP AGG $2,000,000 OTHER: i $ '. B AUTOMOBILE LIABILITY V Y H08518713 6/30/2020 6/30/2021Ea COMacciBINdenqE 1 INGLELIMIT $1,000,000 ( X ANY AUTOBODILY INJURY(Per person) $ OWNED ^SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY _ AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ X X (Per accident) AUTOS ONLY _ AUTOS ONLY i $ D UMBRELLA MB X OCCUR Y 77HX2095C4 6/30/2020 6/30/2021 EACH OCCURRENCE $5,000,000 X EXCESSLIAB CLAIMS-MADE AGGREGATE $5,000,000 DED RETENTION$ $ WORKERS COMPENSATION I I STATUTE I ERH AND EMPLOYERS'LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICERJMEMBEREXCLUDED? (Mandatory in NH) N/A E.L.DISEASE-EA EMPLOYEE $ Eyes,describe under EL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below C General Liability for CA000038812016/30/2020 6/30/2021 Gan Agg/Occ $2M/$1M National Fire Fighter CarpI Prod.CO/Pers&Adv. $2M/$1 M Med Expense$5,000 Dmg to Rented Prem $300,000 DESCRIPTION OF OPERATIONS/LOCATIONS 1 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 policylimits,terms,conditions and exclusions. I Gen'I Aggregate Limit Applies Per Policy for CA00003881201 • Secondary Excess Liability: Policy#:EXC30001807000 1 See Attached... 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 PRESENTATIVE Ashland OR 97520 j) 1 /I j ;©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#: ACRD ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Ward Insurance Agency Inc. Eugene Weldei's Supply Co. dba Industrial Source/dba National Extinguisher Service POLICY NUMBER dba National Fire Fighter Corp. PO Box 7577 Springfield ORC97475 CARRIER NAIC CODE j. 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 Polley 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 I! . CHUBB' COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT � Named Insured Eugene Welder's Supply Co.Inc., j Endorsement Number See Named Insured Continuation Endorsement Policy Symbol Policy Number Policy Period Effective Date of Endorsement CAL H08518713 6/30/2020 TO 6/30/2021 6/30/2020 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. 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 of 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) 18o 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.i. — 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 S Paragraph A.i. — 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 i of 5 Inc,with its permission 053 CHUBB° e. The lessor of a covered"auto"while the"auto"is leased to your under a written agreement if: (1) The agreement requires you to provide direct primary 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 this policy 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" •054 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"; OT 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.1.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; fi DA-4817o(o6/17) "Includes copyrighted material of Insurance Services Office, Page 3 of 5 • Inc.with its permission" t, 055 • CHUBS° (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. io. 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: x. 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: (r) 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: (i) 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.S. -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" • 056 I . CHUBB° At our request, the insured will bring suit or transfer those fights 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 1 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. J ' 1 I i - 1 S i DA-4817o(06/17) "Includes copyrighted material of Insurance Services Office, Page 5 of 5 Inc,with its permission"• 057 • Insured:Eugene Welder's Supply Co. COMMERCIAL AUTO Policy#:H08518713 CA 00 01 1013 19 Mobile Only those"autos"that are land vehicles and that would qualify under the definition BUSINESS AUTO COVERAGE FORM 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 Compulsory Or licensed or principally garaged. Various provisions In this policy restrict coverage. SECTIONI—COVERED AUTOS Financial Read the entire policy carefully to determine rights, Item Two of the Declarations shows the"autos"that Responsibility duties and what is and iss not covered. are covered"autos"for each 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"we","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 all sums an"insured°legally must pay Declarations, then you have coverege for as damages because of"bodily in u or"property Symbol • Description Of Covered Auto Designation Symbols 'autos"that you acquire of the type described damage"to which this insurance applies, ase 1 Any"Auto" for the remainder of the policy period. by an"accident"and resulting from the 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 We will also pay all sums an"insured"legally must those"autos"you acquire ownership of after the policy begins. acquire will be a covered "auto" for that a 3 Owned Private Onlytheprivate passenger"autos°you own.This includes those private coverage onlyif: pay as a"coveredinsurance pollutionacost a expense"to p g 9 � which this 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 state 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 or a"covered pollution cost or expense".However, Temporary Substitute Autos we have no dutyto defend any"insured"against a No-fault acquire ownership of after the policy begins provided they are required to have no- 9 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 6 Owned"Autos" Onlythose"autos"you own that because of the law in the state where the are this Coverage Form, the following types of "property damage"or a"covered pollution cost or y vehicles are also covered 'autos" for Covered Subject To A licensed or principally garaged are required to have arid cannot reject Uninsured--- Autos LiabilityCoverage: _ -- - Wp mayay"Investigate and ean claim not apply. Compulsory Motorists Coverage.This includes those'autos"you acquire ownership of after the We Investigate and settle any 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 P y 2. "Mobile equipment!' while being carried or by payment of judgments or settlements. Described premium charge is shown(and for Covered Autos Liability Coverage any°trailers" "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 b.Anyone else while using with your households, out of service because of its: permission a covered"auto"you own,hire 9 Non-owned Only those°autos"you do not own,lease,hire,rent or borrow that are used in a. Breakdown; 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 area partnership),members Of you are a limited lability company) c. Servicing; you or borrow a covered"auto". or members of their households but only while used in your business or your This hire o tion does not I If the personal affairs. d. "Loss';or P apply e. Destruction. covered"auto"is a"trailer"connected to a covered"auto°you own. CA 00 01 1013 0 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 "insured", of his or her household. b. Out-of-state Coverage Extensions "Bodily injury"to: (3) Someone using a covered"auto"whileWhile 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 1 Employment b the"insured";or °Bodily injury"or"property damage"resulting storing"autos"unless that business is (1) Increase the Limit of Insurance for () Y yours. Covered Autos Liability Coverage to (2) Performing the dutiesfrom the movement of property by a related to the mechanical device(other than a hand truck) Anyone other thanyour "employees", meet the limits specified by a conduct of the"insured's"business;or unless the device is attached to the covered (4) y compulsory or financial responsibility b.The spouse,child,parent,brother or sister "auto". of that"employee" as partners (if you are a partnership), law of the jurisdiction where the covereda consequence of members (if you are a limited liability "auto" is being used. This extension 9. Operations company) or a lessee or borrower or does not apply to the limit or limits Paragraph a.above. "Bodily injury"or"property damage"arising out any of their"employees",while moving specified by any law governing motor This exclusion applies: of the operation of: properly to or from a covered"auto". carriers of passengers or property. (1)Whether the'insured"may be liable as a. Any equipment listed in Paragraphs 6.b. (5) A partner(if you are a partnership)or a (2)Provide the minimum, amounts and an employer or in any other capacity and 6,c. of the definition of "mobile member Of you are a limited liability types of other coverages.such as no- and equipment";or company)for a covered"auto'owned by - fault,required of out-of-state vehicles by (2) To any obligation to share damages with b. Machinery or equipment that is on,attached him or her or a member of his or her the jurisdiction where the covered"auto" or repay someone else who must pay to or part of a land vehicle that would household. is being used. damages because of the injury. qualify under the definition of "mobile c.Anyone liable for the conduct of an We will not pay anyone more than once for But this exclusion does not apply to"bodily equipment" if it were not subject to a "insured"described above but only to the 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• 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 pay for the insured": following: Form, a domestic "employee" is a person "Bodily injury'or°property damage'arising out engaged In household or domestic work your work °proafter thattywork has been out (1) All expenses we incur. 1. Expected Or Intended Injury performed principally in connection with a ofabandoned. ed etor (2) Up to $2,000 for cost of bail bonds "Bodily injury"or"property damage"expected residence premises. Inoothismpmpll edluab,nrworkmeans: (Including bonds for related traffic law or intended from the standpoint of the 5. Fellow Employee violations) required because of an insured". "Bodily Injury"to: a.Work or operations performed by you or on "accident"we cover.We do not have to 2. Contractual your behalf;and furnish these bonds, a.Any fellow "employee' of the "insured" b. Materials,parts or equipment furnished in Liability assumed under any contract or arising out of and in the course of the fellow connection with such work or operations. (3)The cost of bonds to release agreement. °employee's" employment or while attachments in any "suit" against the But this exclusion does not apply to liability for performing duties related to the conduct of Your work Includes warranties or insured"wen ourdefend, it o only for bond our business;or representationsat any time with respect --- ---- damages:—--_ Yr penin ante work made snable our Limit incurred nI urred to the fitness,quality,durability o_ rm _ ______ _ (4) "in reasonable expenses ncludi g by the a. Assumed In a contract or agreement that is b. The spouse,child,"epamployee" as a consequencenn sister 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 b.above, loss of earnings up to $250 a day injury" or "property damage" occurs of Paragraph a.above. subsequent to the execution of the contract 6. Care,Custody Or Control Your work will be deemed completed at the because of time off from work. or agreement or earliest of the following times: (5) All court costs taxed against the "Property damage"to or"covered pollution cost (i) When of the called for in your "insured" in any "suit" against the b. That the 'insured" would have in the or expense° involving property owned or When all hasobeen work completed;all "insured"we defend. However, these absence of the contract or agreement. transported by the "insured" or in the payments do not include attorneys'fees 3. Workers'Compensation 'insured's"care, custody or control. But this (2) When at of the work to be done at the or attorneys'expenses taxed against the Anyobligation for which the"insured"or the exclusion does not apply to liability assumed site has been completed if your contract "Insured". under a sidetrack agreement. calls for work at more than one site;or °iny "insurer may be held liable under When that part of the work done at a job (6) All interest on the full amount of any any workers'compensation,disability benefits 7. Handling Of Property (3) 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 judgment in any 'suit" against the similar law. from the handling of property: any person or organization other than "insured"we defend,but our duty to payanother contractor or subcontractor paid,ends when we have a. Before it is moved from the place where it is working on the same project. accepted by the "insured" for movement offered to pay or detosited in court the into or onto the covered"auto";or paof the judgment that is within our 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 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 upon a covered"auto"if: resulting from one"accident". followingunder Comprehensive Coverage: 11. Pollution P '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; which the"pollutants"are contained payments for the same elements of"loss"under of the actual,allegedpa , or threatenedleasergo, b. "Loss"caused by hitting a bird or animal; dispersal, seepage, migration,. release or are upset,overturned or damaged as this Coverage Form and any Medical Payments a result of the maintenance or use of Coverage endorsement, Uninsured Motorists and escape of"pollutants": a covered"auto";and Coverage endorsement or Underinsured Motorists c. "Loss"caused by falling objects or missiles. a. That are, or that are contained In any Coverage endorsement attached to this Coverage property that is: (b) The discharge, dispersal, seepage, Part However,you have the option of having glass Being transported or towed by,handled migration,release or escape of the breakage caused by a covered 'auto's" (1) 9 P "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. . A.Coverage Collision Coverage. , from the covered"auto"; 12. Warg 4. Covera a Extensions (2) Otherwise in the course of transit by or 1.We will pay for"loss"to a covered"auto"or its on behalf of the insured';or 'Bodily injury" or "property damage" arising equipment under: a. Transportation Expenses directly or indirectly out of: a. Comprehensive Coverage We will pay up to $20 per day, to a (3) Being stored, disposed of, treated or a. War,Includingundeclared or civil war, maximum of $600, for temporary processed in or upon the covered From any cause except "auto"; b. Warlike action by a military force,including transportation expense incurred by you b. Before the"pollutants" or anyroe action in hindering or defending against an (1) another object;o auto's" collision with because of the total theft of a covered p property rty in "auto"of the private passenger type.We which the "pollutants" are contained are actual or expected attack, by any P (2) The covered"auto's"overturn, wilt pay only for those covered"autos"for moved from the place where they are government, sovereign or other authority accepted by the "insured" for movement using military personnel or other agents;or b. Specified Causes Of Loss Coverage which you carry either Comprehensive orSpecified Causes.Of Loss Coverage.We into or onto the covered"auto";or c. Insurrection, rebellion, revolution, usurped Caused by: - will pay for temporary transportation power or action taken by governmental expenses incurred duringthe period c.After the "pollutants" or/any property in (1) Fire,lightning or explosion; P which the "pollutants" are contained are authority in hindering or defending against Theft; beginning 46 hours after the theft and moved from the covered"auto"to the place any of these. (2) ending,regardless of the policy's expiration, where they am 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 4 Flood; or we pay for its"loss". any professional () 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 (6) The sinking; burning, collision or For Hired Auto Physical Damage,we will • similar"pollutants"that are needed for or result contest or activity.This Insurance also does derailment of any conveyance pay expenses for which.an "insured" from the normal electrical, hydraulic or not apply while that covered "auto" Is being transporting the covered"auto". becomes legally responsible to pay for loss mechanical functioning of the covered"auto"or prepared for such a contest or activity. of use of a vehicle rented or hired without a "its parts if: —' — C.Limit Of insurance -- -c. Collision-Coverage---—- driver-under-a-written rentalcontractor (1) The"pollutants"escape,seep, migrate Regardless of the number of covered 'autos", , Caused by: agreement. We will pay for loss of use or are discharged,dispersed or released g1 The covered "auto's collision with expenses if caused by: g P "insureds", premiums paid, claims made or ( ) directly from an"auto°part designed by vehicles involved in the"accident",the most we another object;or (1) Other than collision only if the its manufacturer to hold,store, receive will payfor the total of all damages and"covered Declarations indicates that or dispose of such"pollutants";and (2) The covered"auto's"overturn. Comprehensive Coverage is provided P P polltiocost or expense"combined resulting from P 9 . (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 Specified any equipment listed In Paragraphs 6.b. Inured each time a covered "auto" of the Causes Of Loss Coverage is provided and 6.c. of the definition of "mobile private passenger type is disabled.However, for any covered"auto";or equipment". the labor must be performed at the place of disablement. • i I CA 00 01 1013 0 Insurance Services Office,Inc.,2011 Page 5 of 12 Page 6 of 12 ©Insurance Services Office,Inc.,2011 CA 00 01 1013 (2) Removable from a permanentlyinstalled (2) The"insured's"name and address;and (3) indicate onlyaif the overagtio is b. speed-measuringAny device designed or t,usuched to detect g p (3)To the extent ossible,the names and indicates that Collision Coverage is equipment, as radar housing unit as described In Paragraph p provided for any covered"auto". or laser detectors, and any jamming b.(1)above;or addresses of any injured persons and However, the most we will pay for any apparatus intended to elude or disrupt (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 (1) Assume no obligation, make no installed, that reproduces, receives or condition will be made in determining actual 1. We will not pay for'loss'caused by or resulting transmits audio,visual or data signals. cash value in the event of a total"loss"_ payment or incur no expense without our consent, except at the"insured's" excludeddregard ardll ess of any other cause or xcl ay rdfollowing. othe "loss" isd.Any accessories used with the electronic 3. If a repair or replacement results in better than own cost. eequipment described in Paragraph c, like kind or quality,we will not payfor the event that contributes concurrently or in any (2) Immediately send us copies of any sequence to the"loss". above. amount of the betterment. request, demand, order, notice, 5. Exclusions 4.c. and 4.d. do not apply to D.Deductible summons or legal paper received •a. Nuclear Hazard concerning the claim or"suit". equipment designed to theh "auto's solely by For each covered"auto",our obligation to pay for, (1) The icfssion or any weapon employing use of the power from f'l "arts' electrical repair, retum or replace damaged or stolen (3) Cooperate with us in the investigation or atomic fissionreactionnsfoor or system at the me eIn is: property will be reduced by the applicable settlement of the claim or defense (2) Nuclear or radiation, er a. Permanently Installed or upon the _ deductible shown in the Declarations. Any against the"suit". radioactive contamination, however covered"auto"; Comprehensive Coverage deductible shown In the (4) Authorize us to obtain medical records caused. b. Removable from a housing unit which is Declarations does not apply to"loss"caused by or other pertinent information. b.War Or Military Action permanently Installed in or upon the fire or lightning. (5) Submit to examination,at our expense, (1) War,including undeclared or civil war, covered'auto"; SECTION N—BUSINESS AUTO CONDITIONS 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: c. If there is"toss"to a covered"auto"or its defending against an actual or expected Paragraphs a.and b.above;or A.Loss Conditions equipment,you must also do the following: attack,by any government,sovereign or d. Necessary for the normal operation of the (1) Promptly notifythe police if the covered other authority using military personnel covered auto" or the monitoring of the 1.Appraisal For Physical Damage Loss 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. govemmental 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. while used In any professional or organized a."Loss" to any one covered "auto" is the value and amount of"loss".If they fail to agree, (3) Permit us to inspect the covered"auto" they will submit their differences to the umpire. and records proving the"loss"before its racing or demolition contest or stunting activity, lesser of: - A decision agreed to by any two will be repair or disposition. — or while-practicing for such contest or activi ----_ ty+ 1 The'olen oroaiue of the damaged binding:Each party will: - We will also not pay for"loss"to any covered O or stolen property as of the time of the (4)Agree to examinations under oath at our "auto" while that covered "auto" is being "loss";or a. Pay its chosen appraiser,and request and give us a signed statement prepared for such a contest or activity. (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 This exclusion does not apply to such"loss" time of'loss",such electronic equipment Is: We have no duty 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"1n 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 any covered "auto" you own, this Under this Coverage Form, we cover compulsory or financial responsibility law or At our option,we may: Coverage Form provides primary "accidents"and"losses"occurring: 1 other motor vehicle insurance law where it is insurance.Forcovered"auto" don't licensed or principally garaged. a. Pay for, repair or replace damaged orany you a. During the policy period shown in the stolen property; own, the Insurance provided by this Declarations;and However, "auto' does not include "mobile Coverage Form is excess over any other equipment°. b. Return the stolen property,at our expense. collectible insurance. However, while a b.Within the coverage territory. C."Bodily Injury" means bodily Injury, sickness or We will pay for any damage that results to covered 'auto" which Is a "trailer' Is The coverage territory is: disease sustained by a person, including death the"auto°from the theft;or connected to another vehicle,the Covered 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°hailer"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) Primarywhile it is connected to a (4) Canada;and regulatory requirement that any 'insured" or damaged or stolen property. covere "auto"you own. others test for, monitor, clean up, remove, (5)Anywhere in the world if a covered contain,treat,detoxify or neutralize,or in any 5. Transfer Of Rights Of Recovery Against b. For Hired Auto Physical Damage Coverage, "auto"of the private passenger type is way respond to, or assess the effects of, Others To Us any covered"auto"you lease,hire,rent or leased, hired, rented or borrowed "pollutants';or If any person or organization to or for whom we borrow Is deemed to be a covered"auto" without a driver fore period of 30 days 2. Any claim or "suit" by or on behalf of a make payment under this Coverage Form has you own. However, any "auto" that is or less, governmental authority for damages because rights to recover damages from another,those leased, hired, rented or borrowed with a provided that the "insured's" responsibility to of testing for, monitoring, cleaning up, rights are transferred to us.That person or driver is not a covered"auto". 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 neutralizing,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 isprimaryfor anyof America, Puerto Rico or Canada, or In a B.General Conditions liabilityassumed under an insuresettlement we agree to. Include pollutionccostcost noexpense" doestof not Include any cost or expense arising out of the contract". We also cover "loss" to, or 'accidents° actual,alleged or threatened discharge,dispersal, 1. Bankruptcy - 9 9 P Bankruptcyd. When this Coverage Form and any other involving, a covered 'auto" while being seepage, migration, release or escape of or insolvency of the"insured"or the Coverage Form or policy covers on the transported between any of these places. "pollutants': _ °insured's' estate will not relieve us of any same basis, either excess or primary,we 8. Two Or More Coverage Forms Or Policies obligations under this Coverage Form. g a.That are, or that are contained in any will pay only our share. Our share is the Issued By Us property that is: 2. Concealment,Misrepresentation Or Fraud proportion that the Limit of insurance of our If this Coverage Form and any other Coverage (1) Beingtransported by, ed This Coverage Form is void in any case of Coverage Form bears to the total of the Form or policy issued to you by us or any or hndled for movementdinto,ontoorfraud by you at any time as it relates to this limits of all the Coverage Forms and company affiliated with us applies to the same Coverage Form.It is also void if you or any policies covering on the same basis. P Y PP from the a in thered"auto'; accident', the aggregate maximum Limit of (2) Otherwise in the course of transit by or other "insured", at any time, intentionally s. Premium Audit Insurance under all the Coverage Forms or on behalf of the"Insured';or conceals or misrepresents a material fact ___- i t - - e - shall not exceed the fil-hest a—livable concerning: a. The estimated premium forsreths told Coverage policies9 PP 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"; wit compute the final premium due when any Coverege Form or policy issued by us or auto"; we determine your actual exposures.The an affiliated company specifically to apply as b. Before the"pollutants"or any property in c.Your interest In the covered"auto';or estimated total premium will tie credited excess insurance over this Coverage Form, which the "pollutants" are contained are d.A claim under this Coverage Form. against the final premium due and the first SECTION V—DEFINITIONS 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 exposure to the same conditions resulting in premium or retrospective premium is the •j -property g P P P property more coverage without additional premium date shown as the due date on the bill.If "bodilym u ordamage". c.After the ollllutan" or anyroe 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 themoved from the covered"auto'to the place state. final premium due,the first Named Insured 1.A land motor vehicle, "trailer" or semitrailer where they are finally delivered,disposed of revision is effective in yourwill get a refund. designed for travel on public roads;or or abandoned by the"insured". 4. No Benefit To Bailee—Physical Damage b. if this policy is issued for more than one Coverages 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 Cr Insurance Services Office,Inc.,2011 Page 9 of 12 Page 10 of 12 C.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)undera. 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 itsparts,if. pay for"bodily Injury'or"property damage"to a financial responsibility law or other motor vehicle b. Road construction or resurfacing equipment Insurance law are considered"autos". third party or organization.Tort liability means (1) The"p isc a rge ,dispersed escape,ed or migrate such as graders,scrapers or rollers; or are discharged,dispersed or released a liability that would be imposed by law in the 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, rental or lease, by you or any of your permanently attached equipment of the reconditioned or reclaimed. (2) The"bodily injury","property damage"eor' following types: "covered pollution cost or expense" "employees", of any "auto". However, such 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 listed 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 6.0. 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 apply 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 premises agreement:orag owned by or rented to an'insured"with respect any contract6.Vehicles not described in Paragraph 1.,2.,3. fa 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: •, it or "property damage" arising out of other than the transportation of persons or a.An arbitration proceeding in which such (a)The "pollutants"or any property in construction or demolition operations,within cargo. However, self-propelled vehicles with damages or "covered pollution costs or which the"pollutants"are contained 50 feet of any railroad property and the following types of permanently attached damages" are ovi ed to which the are upset,overturned or damaged as affecting any railroad bridge or trestle, equipment are not'mobile equipment'but will expense must claimed or anddet submit the a result of the maintenance or use of tracks, roadbeds, tunnel, underpass or be considered"autos": "insured" ;or a covered"auto";and crossing; a. Equipment designed primarily for. b.Any other alternative dispute resolution (b) The discharge, dispersal, seepage, b.That pertains to the loan,lease or rental of (1) Snow removal; proceeding in which such damages or an auto" to you or any of your "pollutants" release s escape directlyof the "employees",if the"auto"is loaned,leased (2) Road maintenance,but not construction "covered pollution costs or expenses"are such upset, isv caused mgebyor resurfacing;or _ claimed and to which the insured submits such upset,overturn or damage. or rented with a driver,or with our consent c. That holds a person or organization (3) Street cleaning; E."Diminution in value" means the actual aengaged in the business of transporting b. Cherry pickers and similar devices mounted O."Temporary worker" means a person who is whichchired loss in market value iord resalel"lvalue property by"auto'for hire harmless for your on automobile or truck chassis and used to furnished to you to substitute for a permanent results from a direct and accidental"loss". use of a covered"auto" over a mute or raise or lower workers;and employee°on leave or to meet seasonal or short _ - F._"Employ_ee" Includes a "leased worker". territory that person or organization Is_ _ c. Air compressors, pumps and generators, term workload conditions. "Employee' does nor include a 'temporary -- -- authorized to serve bypublic authority: P. Trailer"includes semitrailer. inbluding--spraying,- welding, building--- - 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 • damage. "suit"Is brought H."Insured contract'means: K."Mobile equipment" means any of the following types of land vehicles, including any attached 1. A lease of premises; 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 for a 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 1013 POLICY NUMBER: D37720136 Eugene Welder's Supply Co, DBA Industrial Source ADDITIONAL INSURED-WHERE REQURED UNDER1CONTRACT OR AGREEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM I , 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 I , 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: "All 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 M.4.a: r other Insurance is available to an insured we cover under any of the endorsements listed or described above (the 'Additional Insured") for a bss we cover under Ills poky, this insurance will appy to such bss on a primary basis and we will not seek contribution from the other insurance available to the Additional Insured. • • Authorized Agent • 5 LO-20287 (06106) Page lof 1 • • 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 13 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. • e , CG 24 04 05 09 ©Insurance Services Office, Inc.,2008 Page 1 of 1 0 POLICY NUMBER: 037720136 Eugene Welder's Supply Co, DBA Industrial Source ADDITIONAL INSURED-WHERE REQURED UNDER CONTRACT OR AGREEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT 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 "bodiy 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 l Organization Additional Insured Endorsement (If no information is filled in, the schedule shall read: "All persons orentities 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 N.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 bss we cover under this porky; this insurance will appy to such bss on a primary basis and we will not seek.contribution from the other insurance available to the Additional Insured. • Authorized Agent 1 1 LD-20287 (06/06) Page 1 of 1 COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT DA-48170 (06/17) Highlights-Please refer to form for exact wording and coverage Number Enhancement 1. Extended Cancellation 60 Days 2A Broad Form Named insured You control 50%of voting stock; Newly Acquried up to 180 Days 2B Employees As Inureds 2C Lessors As Insureds 2D Persons or Organizations As Insureds Under a Written Contract Any person or Organization with respect to operation, maitenance or use of covered "auto"under written "insured contract",written agreement,or written permit issued to you by a governmental or public authority. 3 Fellow Employee Coverage 4 Physical Damage-Additional Temporary Transporationa Expense $50 per day for temporary transporation expense/$1,000 Maximum 5 Auto Loan/Lease Gap Expenses that your or any of your"employees"are legally obligated to pay because of written contract or agreement entered into for 6 Rental Agency Expense use of rental vehicle in the conduct of your business: 7 Extra Expense-Broadend Coy. Recovery expense of returning a stolen covered"auto" 8 Airbag Coverage 9 Audio,Visual And Data Electronic Equipment-Broadened Coverage $2,000 for"loss" in any one"accident" 10 Glass Repair-Waiver of Deductible No deductible applies to glass damage if the glass is repaired rather than replaced. 11 Two or More Deductibles 12 Amended Duties in the Event of Accident,Claim,Suit or Loss Knowledge of Accident 13 Waiver of Subrogation Transfer of Rights of Recovery Against Others to US 14 Unintentional Failure to Disclose Hazards • 15 Autos Rented by Employees 16 Hired Auto-Coverage Territory 17 Resultant Mental Anguish Coverage "Bodily injury"includes mental anguish