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HomeMy WebLinkAbout2021-122 PO 20220120- Viking Automatic Sprinkler Co. i FrAV , , Purchase Order 'aa Fiscal Year 2022 Page 1 of: 1 �Y � :a _ B City of Ashland _ l�_�4 r_ FdL -`+ i ri spD or.� :_ ATTN: Accounts Payable L 20 E. Main Purchase r�O n n OL^0 L Ashland, OR 97520 I Order# L L L T Phone: 541/552-2010 O Email: payable@ashland.or.us ✓ H C/O Facilities Maintenance Div E VIKING AUTOMATIC SPRINKLER CO I 90 North Mountain Ave N 3245 NW FRONT AVE p Ashland, OR 97520 D• PORTLAND, OR 97210 Phone: 541/488-5358 R O Fax: 541/552-2304 s!_ e -__7_--v-- tier., — [ - — : Q�� �J-�3e ��. -�t19_�S�on'�isa'='��E� .'[el€�4� �_- _ • I } FORM #3 CITY OF r 7�o (P-'° ASHLAND A request.for a Purchase.;/ I �� REQUISITION Date of request: 8/23/2021 • Required date for delivery: Vendor Name Viking Automatic Sprinkler Company Address,City,State,Zip 4961 Industry Drive.Medford.OR 97502-1200 Contact Name&Telephone Number Mike Baxter 541-773-1052 mike.baxter@vikingsprinkler.net Email address SOURCING METHOD ❑ Exempt from Competitive Bidding 0 Emergency ❑ Reason for exemption: 0 Invitation to Bid I 0 Form#13,Written findings and Authorization ❑ AMC 2.50 Date approved by Council: - i 0 Written quote or proposal attached ❑ Written quote or proposal attached (Attach copy of council communication) If council a.'royal re.uired attach co' of CC ® Small Procurement 0 Request for Proposal Cooperative Procurement Not exceeding$5,000 Date approved by Council: ❑ State of Oregon ® Direct Award _(Attach copy of council communication) Contract# - _- ❑ Verbal/Written quote(s)or proposal(s) 0 Request for Qualifications(Public Works) ❑ State of Washington Date approved by Council: Contract# (Attach copy of council communication) 0 Other government agency contract Intermediate Procurement ❑ Sole Source Agency GOODS&SERVICES 0 Applicable Form(#5,6,7 or 8) Contract# Greater than$5,000 and less than$100,000 ❑ Written quote or proposal attached Intergovernmental Agreement ❑ (3)Written quotes and solicitation attached 0 Form#4,Personal Services>$5K&475KI Agency PERSONAL SERVICES ' ❑ Special Procurement I ❑ 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: I ❑ Annual cost to City exceeds$25,000,Council ❑ Form#4,Personal Services>$5K&<$75K Valid until: (Date) j approval required.(Attach copy of council communication) Description of SERVICES 1 Total Cost 1 Fire sprinkler inspections and maintenance for FY22 '$4,995.00 Item# Quantity Unit Description of MATERIALS Unit Price Total Cost i ❑ Per attached quotelproposal TOTAL COST Project Number _ _ _ Account Number 088400-602400 = *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 requ' •'on form,I certify that the City's public a trading r-quirements have been satisfied. Employee: Department Head: �a� e(2cJ2b2 to or Brea.r than$5,000) Department ManagerlSupervisor: City Administrator: (Equal to or greater than$25,000) Funds appropriated for current fiscal year: YES /NO Deputy Finance Director-(Equal to or greater than$5,000) Date Comments: Form#3-Requisition 1 1 4 GOODS AND SERVICES AGREEMENT ($35,000 OR LESS) PROVIDER: Viking Automatic Sprinkler Company CITY OF PROVIDER'S l'tkS H LAND CONTACT: Mike Baxter 20 East Main Street � Ashland,Oregon 97520 ADDRESS: 4961 Industry Drive Telephone: 541/488-5587 Medford,OR 97502 Fax: 541/488-6006 PHONE: 541-773-1052 This Goods and Services Agreement (hereinafter "Agreement") is 'entered into by and between the City of Ashland, an Oregon municipal corporation (hereinafter "City") and Viking Automatic Sprinkler Company, (a domestic/foreign business corporation) ("hereinafter"Provider"), for fire sprinkler service. 1. PROVIDER'S OBLIGATIONS � 1.1 Provide fire sprinkler inspections and replacements for FY22 as set forth in the "SUPPORTING DOCUMENTS" attached hereto and, by this reference, incorporated herein. Provider expressly acknowledges that time is of the essence of any completion date set forth in the SUPPORTING DOCUMENTS,and that no waiver or extension of such deadline may be authorized except in the same manner as herein provided for authority to exceed the maximum compensation. The services defined and described in the "SUPPORTING DOCUMENTS" shall hereinafter be collectively referred to as "Work." 1.2 Provider shall obtain and maintain during the term of this Agreement and until City's final acceptance of all Work received hereunder,a policy or policies of liabtltty insurance including commercial general liability insurance with a combined single limit, or the equivalent, of not less than $2,000,000 (two million dollars)per occurrence for Bodily Injury and Property Damage. 1.2.1 The insurance required in this Article shall include the following coverages: • Comprehensive General or Commercial General Liability, including personal injury, contractual liability,and products/completed operations coverage; and • Automobile Liability. 1.2.2 Each policy of such insurance shall be on an "occurrence"and not a"claims made" form, and shall: • Name as additional insured "the City of Ashland, Oregon, its officers, agents and employees" with respect to claims arising out of the provision of Work under this Agreement; • Apply to each named and additional named insured as though a separate policy had been issued to each,provided that the policy limits shall not be increased thereby; • Apply as primary coverage for each additional named insured except to the extent that two or more such policies are intended to "layer" coverage and, taken together, they provide total coverage from the first dollar of liability; o Provider shall immediately notify the City of any change in insurance coverage • Provider shall supply an endorsement naming the City, its officers, employees and agents as additional insureds by the Effective Date of this Agreement; and Page 1 of 6: Goods and Services Agreement between the City of Ashland and Viking Automatic Sprinkler Company o Be evidenced by a certificate or certificates of such insurance approved by the City. 1.3 Provider shall,at its own expense,maintain Worker's Compensation Insurance in compliance with ORS 656.017, which requires subject employers to provide workers' compensation coverage for all of its subject workers. 1.4 Provider agrees that no person shall, on the grounds of race,}color, religion, creed, sex, marital status, familial status or domestic partnership, national origin, age, mental or physical disability, sexual orientation, gender identity or source of income, suffer discrimination in the performance of this Agreement when employed by Provider. Provider agrees to comply with all applicable requirements of federal and state civil rights and rehabilitation statutes, rules and regulations. Further, Provider agrees not to discriminate against a disadvantaged business enterprises,minority-owned business,woman-owned business, a business that a service-disabled veteran owns or an emerging small business enterprise certified under ORS 200.055, in awarding subcontracts as required by ORS 279A.110. 1.5 In all solicitations either by competitive bidding or negotiation made by Provider for work to be performed under a subcontract, including procurements of materials or leases of equipment, each potential subcontractor or supplier shall be notified by the Providers of the Provider's obligations under this Agreement and Title VI of the Civil Rights Act of 1964 and other federal nondiscrimination laws. 1.6 Living Wage Requirements: If the amount of this Agreement is $22,310.46 or more, Provider is required to comply with Chapter 3.12 of the Ashland Municipal Code by paying a living wage,as defined in that chapter,to all employees performing Work under this}Agreement and to any Subcontractor who performs 50%or more of the Work under this Agreement. Provider is also required to post the notice attached hereto as"Exhibit A"predominantly in areas where it will be seen by all employees. 1.7 Assignment: Provider shall not assign this Agreement or subcontract any portion of the Work to be provided hereunder without the prior written consent of the City. Any attempted assignment or subcontract without written consent of the City shall be void. Provider shall be fully responsible for the acts or omissions of any assigns or subcontractors and of all persons employed by them,and the approval by the City of any assignment or subcontract shall not create any contractual relation between the assignee or subcontractor and the City. 2. CITY'S OBLIGATIONS 2.1 City shall pay Provider the hourly rates effective April 26, 2021 as specified in the SUPPORTING DOCUMENTS. 2.2 In no event shall Provider's total of all compensation and reimbursement under this Agreement exceed the sum of$4,995 (this is maximum, not to exceed amount of ENTIRE Agreement) without express, written approval from the City official whose signature appears below, or such official's successor in office. Provider expressly acknowledges that no other person has authority to order or authorize additional Work which would cause this maximum sum to be exceeded and that any authorization from the responsible official must be in writing. Provider further acknowledges that any Work delivered or expenses incurred without authorization as provided herein is done at Provider's own risk and as a volunteer without expectation of compensation or reimbursement. 3. GENERAL PROVISIONS 3.1 This is a non-exclusive Agreement. City is not obligated to procure any specific amount of Work from Provider and is free to procure similar types of goods and services from other providers in its sole discretion. Page 2 o16: Goods and Services Agreement between the City of Ashland and Viking Automatic Sprinkler Company K i 9 j • 3.2 Provider is an independent contractor and not an employee o agent of the City for any purpose. 3.3 Provider is not entitled to,and expressly waives all claims to City benefits such as health and disability insurance,paid leave,and retirement. 3.4 This Agreement embodies the full and complete understanding of the parties respecting the subject matter hereof. It supersedes all prior agreements,negotiations,and representations between the parties, whether written or oral. 3.5 This Agreement may be amended only by written instrument executed with the same formalities as this Agreement. 3.6 The following laws of the State of Oregon are hereby incorporated by reference into this Agreement: ORS 279B.220,279B.230 and 279B.235. 3.7 This Agreement shall be governed by the laws of the State of Oregon without regard to conflict of laws principles. Exclusive venue for litigation of any action arising under this Agreement shall be in the Circuit Court of the State of Oregon for Jackson County unless exclusive jurisdiction is in federal court, in which case exclusive venue shall be in the federal district court for the district of Oregon. Each party expressly waives any and all rights to maintain an action under this Agreement in any other venue,and expressly consents that, upon motion of the other party, any case may be dismissed or its venue transferred,as appropriate, so as to effectuate this choice of venue. 3.8 Provider shall defend,save,hold harmless and indemnify the City and its officers,employees and agents from and against any and all claims, suits, actions, losses, damages, liabilities, costs, and expenses of any nature resulting from, arising out of, or relating to the activities of Provider or its officers, employees,contractors, or agents under this Agreement. 3.9 Neither party to this Agreement shall hold the other responsible for damages or delay in performance caused by acts of God,strikes, lockouts,accidents,or other events beyond the control of the other or the other's officers,employees or agents. 3.10 If any provision of this Agreement is found by a court of competent jurisdiction to be unenforceable, such provision shall not affect the other provisions, but such unenforceable provision shall be deemed modified to the extent necessary to render it enforceable, preserving to the fullest extent permitted the intent of Provider and the City set forth in this Agreement. 3.11 Deliveries will be F.O.B destination. Provider shall pay all transportation and handling charges for the Goods. Provider is responsible and liable for loss or damage until final inspection and acceptance of the Goods by the City. Provider remains liable for latent defects,fraud,and warranties. 3.12 The City may inspect and test the Goods. The City may reject non-conforming Goods and require Provider to correct them without charge or deliver them at"la reduced price, as negotiated. If Provider does not cure any defects within a reasonable time, the City may reject the Goods and cancel this 1/4 Agreement in whole or in part. This paragraph does not affect or limit the City's rights, including its rights under the Uniform Commercial Code,ORS Chapter 72(UCC). Page 3 of 6: Goods and Services Agreement between the City of Ashland and Viking Automatic Sprinkler Company I. 3.13 Provider represents and warrants that the Goods are new, current, and fully warranted by the manufacturer. Delivered Goods will comply with SUPPORTING DOCUMENTS and be free from defects in labor,material and manufacture.Provider shall transfer all warranties to the City. 4. SUPPORTING DOCUMENTS 4.1 The following documents are, by this reference, expressly incorporated in this Agreement, and are collectively referred to in this Agreement as the"SUPPORTING DOCUMENTS:" o The Provider's complete written Rate Sheet dated April 26,2021. 4.2 This Agreement and the SUPPORTING DOCUMENTS shall be construed to be mutually complimentary and supplementary wherever possible. In the event of'a conflict which cannot be so resolved,the provisions of this Agreement itself shall control over any conflicting provisions in any of the SUPPORTING DOCUMENTS. In the event of conflict between provisions of two of the SUPPORTING DOCUMENTS,the several supporting documents shall be given precedence in the order listed in Article 4.1. 5. REMEDIES 5.1 In the event Provider is in default of this Agreement, City may, at its option, pursue any or all of the remedies available to it under this Agreement and at law or in equity, including,but not limited to: 5.1.1 Termination of this Agreement; 5.1.2 Withholding all monies due for the Work that Providers has failed to deliver within any scheduled completion dates or any Work that have been delivered inadequately or defectively; 5.1.3 Initiation of an action or proceeding for damages, specific performance, or declaratory or injunctive relief; 5.1.4 These remedies are cumulative to the extent the remedies are not inconsistent,and City may pursue any remedy or remedies singly,collectively,successively or in any order whatsoever. i 5.2 In no event shall City be liable to Provider for any expenses related to termination of this Agreement or for anticipated profits. If previous amounts paid to Provider exceed the amount due,Provider shall pay immediately any excess to City upon written demand provided . 6. TERM AND TERMINATION 6.1 Term This Agreement shall be effective from the date of execution on behalf of the City as set forth below (the "Effective Date"), and shall continue in full force and effect until June 30, 2022, unless sooner terminated as provided in Subsection 6.2, 6.2 Termination 6.2.1 The City and Provider may terminate this Agreement by mutual agreement at any time. 6.2.2 The City may, upon not less than thirty (30) days' prior written notice,terminate this Agreement for anyreason deemed appropriate in its sole discretion. 43 6.2.3 Either party may terminate.this Agreement, with cause, by not less than fourteen(14)days' prior written notice if the cause is not cured within that fourteen (14) day period after written notice. Such termination is in addition to and not in lieu of any other remedy at law or equity. 7. NOTICE Whenever notice is required or permitted to be given under this, Agreement, such notice shall be given in writing to the other party by personal delivery, by sending via a reputable commercial overnight courier, or 1111 Page 4 of 6: Goods and Services Agreement between the City of Ashland and Viking Automatic Sprinkler Company It by mailing using registered or certified United States mail, return receipt requested, postage prepaid, to the address set forth below: If to the City: City of Ashland—Facilities Maintenance Department Attn: David Arnold 20 E.Main Street Ashland,Oregon 97520 Phone: (541)552-2292 With a copy to: City of Ashland—Legal Department 20 E.Main Street Ashland,OR 97520 Phone: (541)488-5350 If to Provider: Viking Automatic Sprinkler Company Attn:Mike Baxter 541-773-1052 8. WAIVER OF BREACH One or more waivers or failures to object by either party to the other's breach of any provision,term,condition, or covenant contained in this Agreement shall not be construed as a waiver of any subsequent breach,whether or not of the same nature. 9. PROVIDER'S COMPLIANCE WITH TAX LAWS 9.1 Provider represents and warrants to the City that: 9.1.1 Provider shall, throughout the term of this Agreement, including any extensions hereof, comply with: (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS chapters 316,317,and 318; (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Provider;and (iii) Anyrules,regulations, chatter provisions,or ordinances that implement or enforce anyof g p the foregoing tax laws or provisions. 9.1.2 Provider, for a period of no fewer than six(6)calendar years preceding the Effective Date of this Agreement, has faithfully complied with: (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS chapters 316,317,and 318; (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Provider; and (iii) Any rules, regulations,charter provisions,or of dinances that implement or enforce any of the foregoing tax laws or provisions. 9.2 Provider's failure to comply with the tax laws of the State of Oregon and all applicable tax laws of any political subdivision of the State of Oregon shall constitute a material breach of this Agreement. Further, any violation of Provider's warranty, as set forth in this Article 9, shall constitute a material breach of this Agreement. Any material breach of this Agreement shall entitle the City to terminate this Agreement and to seek damages and any other relief available under this Agreement,at law,or in equity. Page 5 of 6: Goods and Services Agreement between the City of Ashland and Viking Automatic Sprinkler Company IN WITNESS WHEREOF the parties have caused this Agreement to be signed in their respective names by their duly authorized representatives as of the dates set forth below. CITY OF ASHLAND: Viking Automatic S inkier Company(PROVIDER): By: By: %2./ I nature Signatuk(j(// ) Star i.U� DEee%Li-M 1/4/7er Printed Name Printed Name Pelt\pu�. c_ wawears cat��c.�¢ Si : t Title Title it!26(7024 F- /6 -02 f Date Date • (W-9 is to be submitted with this signed Agreement) Purchase Order No. • I it Page 6 of 6: Goods and Services Agreement between the City of Ashland and Viking Automatic Sprinkler Company gk� t VIKING AUTOMATIC SPRINKLER COMPANY 4961 Industry Drive t �b` Medford, Oregon 97502-1200 f' Tel: (541)773-1052 Fax: (541)773-1609 - FIRE PROTECTION FIRE PROTECTION CONTRACTOR S SINCE 1930 I April 26,2021 i INSPECTION&T&M RATES We are pleased to offer the following information as per our services. The inspection fees are as follows: -Inspection/service rate:$130.00 per hour(includes van up to 60 miles from office) -Inspection fee per facility:$55.00 -Compliance fee(Fire Department)$17.55 per inspection -Viking Automatic Sprinkler Co.offers the different type of services. a. Quarterly inspections b. Semiannual inspections c. Annual inspections d. 5-year internal inspections e. Flushing of overhead&underground systems f. Fire pump testing g. Sprinkler head testing h. 24 hr.emergency service&repair i. Underground installs and repairs Viking offers parts at a discounted rate from list price due to negotiated pricing from our suppliers. Please give me a call if you have any questions or need any furthe clarification. Thank you for calling Viking. 1474.4& Bawler& Mike Baxter Viking Automatic Sprinkler Co I 4961 Industry Drive Medford,OR 97502 T:541-773-1052 C:541-415-1789 On the web:http://vikingsprinkler.net 44.1or/ft LNG FIRE PROTECTION OREGON CORPORATION WASHINGTON CORPORATION IDAHO CORPORATION PORTLAND♦MEDFORD SEATTLE♦ LONGVIEW MERIDIAN♦POCATELLO CCB#64837 CLN#VIK]NAS373NT LIC#FPSC-003 I • Client#: 131358 • VIKIAUTO2 ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 2/01/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. ' If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Sara Sellin Propel Insurance PHONE500 499-0933 (ac, No): 866 577-1326 (A/C,No,Ext): Portland Commercial Insurance Mass; Sara.Sellin@propelinsurance.com 805 SW Broadway,Suite 2300 1 INSURER(S)AFFORDING COVERAGE NAIC# Portland,OR 97205-3363 INSURERA:Nautilus Insurance Company 17370 INSURED INSURER B:SAIF',Corporation 36196 Viking Automatic Sprinkler Co Zurich American Insurance Company 16535 3245 NW Front Ave INSURER C: P Y INSURER D:Union Insurance Company 25844 Portland,OR 97210 • INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: i REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSR MD POLICY NUMBER (MMIDDIYYYY) (MMIDDIYYYY) • A X COMMERCIAL GENERAL LIABILITY ECP200453319 01/31/2021 01/31/202 EACH OCCURRENCE $1,000,000 DppMAGETO RENTED I ,CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $100,000 I X BI/PD Ded:5,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY X JECOT LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: i WA Stop Gap $1,000,000 COMBINED SI D AUTOMOBILE LIABILITY CPA6037965 01/31/2021 01/31/202 (EOMBIa accident) NGLE LIMIT $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY _ AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) • •$ A UMBRELLA LIAB X OCCUR FFX200453419 01/31/2021 01/31/20221_EACH OCCURRENCE $6,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $6,000,000 DED X RETENTION SO $ WORKERS COMPENSATION ( ) STATUTE ER B 763948 OR 10/01/2020 10/0112021 X PER ERH- AND EMPLOYERS'LIABILITY Y/N C ANY PROPRIETOR/PARTNER/EXECUTIVE WC9696108 10/01/2020 10/01/2021 E.L EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? Y N/A I (Mandatory in NH) CA,ID,MT,AK,CO I E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $1,000,000 D Install.Floater CPA6037965 01/31/2021 01/31/2022 250,000 h A Microbial Subst ECP200453319 01/31/2021 01/31/2022 1,000,000 15,000 SIR A Poll&Prof.Liab ECP200453319 01/31/2021 01/31/2022 1,000,000 I 5,000 Ded ) DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) is Excess policy is following form over General,Auto,Employers,Pollution and Professional Liability. lj Certificate Holder includes:The City of Ashland,Oregon,its officers,agents,and employees. 11 I Ii1 CERTIFICATE HOLDER CANCELLATION Cityof Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 East Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Ashland,OR 97520 A AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #54468849/M4468588 I SSS00 t This page has been left blank intentionally. I� 4 f ' I ' T' � I e I � I - I c 4 Y THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ....:...... . ADDITIONAL INS•UREP.==-LESSOR OF LEASED EQUIPMENT • ? : .: .. : AUTOMATIC':STATUS- COVERAGE A& B .....:.. .... ..... Endorsement Effective Policy Number Policy Effective Date Policy Expiration Date Date ECP2004533-19 1/31/2021 1/3'l/2022 1/31/2021 I I This endorsement modifies insurance provided under the following: ENVIRONMENTAL COMBINED POLICY I. SECTION III—WHO IS AN INSURED is amended to include as an additional insured any person(s)or organization(s) from whom you lease equipment with whom you have agreed under a written contract or written agreement, in effect during this policy period,that such person(s)or organization(s)be added as an additional insured on this policy, but only with respect to liability for bodily injury or property damage under SECTION I — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY, or personal and advertising injury under SECTION 1— COVERAGE B — PERSONAL AND ADVERTISING INJURY LIABILITY directly caused by your maintenance, operation or use of equipment leased to you by such person(s)or organization(s). Such contract or agreement must be executed and in effect prior to your maintenance,operation or use of such leased equipment. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. We will not extend any insurance coverage to such additional insured that is not provided to you in this policy; and 3. The insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. II. With respect to the insurance afforded to these additional insureds: 1. Their status as an additional insured ends when their contract or agreement with you for such leased equipment ends;and 2. This insurance does not apply to any occurrence which takes place after the equipment lease expires;and 3. The coverage provided by this endorsement shall not apply to any claim or suit based upon or arising from an actual or alleged act, error or omission in the performance of professional services of such additional insured person(s)or organization(s). III. With respect to the insurance afforded to these additional insureds,the following is added to SECTION V—LIMITS OF INSURANCE: The most we will pay on behalf of the additional insured Is the amount of insurance: 1. Required by the contract or agreement;or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. IV. SECTION VII—CONDITION 10.—Other Insurance is amended by the addition of the following which supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from ariy other insurance available to a person(s) or organization(s)included as an additional insured under this endorsement provided that: 1. The additional insured person(s)or organization(s)is a Named Insured under such other insurance;and 2. You have agreed in writing in a contract or agreement,in effect during this policy period,that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured person(s) • or organization(s). Such contract or agreement must be executed and in effect prior to your maintenance,operation or use of the equipment leased to you by such person(s)or organization(s),which is the subject of such contract or agreement. ECP 1239 01 21 Includes copyrighted material of Insurance Services Office,Inc.,used with its permission. Page 1 of 2 • However,this provision does not apply if the other insurance available to the person(s)or organization(s) included as an additional insured is Owners and Contractors Protective Liability, Railroad Protective Liability, or similar project- specific, primary insurance. V. This endorsement does not apply to an additional insured which has been added to this policy by an endorsement showing the additional insured in a SCHEDULE of additional insureds, and which endorsement applies to that designated additional insured. • ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED. 1 1 t � 1a I ECP 1239 01 21 Includes copyrighted material of Insurance Services Office,Inc.,used with its permission. Page 2 of 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AD,D.ITIONAL INSUf ED: OWNERS;:•LESSEES :OR CONTRACTORS --ONGOING'OP`ERATIONS 4 COVERAGE.'4 :B, D Endorsement Effective Policy Number Policy Effective Date Policy Expiration Date Date ECP2004533-19 1/31/2021 1/31/2022 1/31/2021 This endorsement modifies insurance provided under the following: ENVIRONMENTAL COMBINED POLICY I. SECTION III—WHO IS AN INSURED is amended to include as an additional insured: 1. Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement, in effect during this policy period, that such person or organization be added as an additional insured on this policy; and 2. Any other person or organization you are explicitly required to add as an additional insured under the contract or agreement described in Paragraph 1.above. (I Such contract or agreement must be executed and in effect priordto the performance of your work which is the subject of such contract or agreement. Such person(s)or organization(s)is an additional insured only with'respect to liability for bodily injury or property damage under SECTION I — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Coverage D.1 —Contractors Pollution Legal Liability and Coverage D.4—Microbial Substance Contractors Pollution Liability, or personal injury or advertising injury under SECTION I -COVERAGE B—PERSONAL AND ADVERTISING INJURY LIABILITY directly caused by: a. Your acts or omissions;or b. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional Insl tired described in Paragraph 1.or 2.above. However,the insurance afforded to such additional insured described above: a. Only applies to the extent permitted by law; and b. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured, and c. Will not extend beyond that which is provided to you in this policy. A person's or organization's status as an additional insured under this endorsement ends when your operations for the person or organization described in Paragraph 1.above are completed. insurance afforded to these additional insureds,the following With respect to the additional exclusions apply: This insurance does not apply to: a. Bodily injury, property damage or personal and advertising injury arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveyinglservices, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection,architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment,training or monitoring of others by that insured, if the occurrence which caused the bodily injury or property damage,or the offense which causeid the personal and advertising injury,involved the rendering of, or the failure to render any professional architectural, engineering or surveying services. b. Bodily injury or property damage occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project(other than service,maintenance or repairs)to be performed by or onlbehalf of the additional insured(s)at the location of the covered operations has been completed;or ECP 1246 01 21 Includes copyrighted material of Insurance Services Office,Inc.,used with its permission. Page 1 of 2 (2) That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. III. With respect to the insurance afforded to these additional insureds, tie following is added to SECTION V—LIMITS OF INSURANCE: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement described in Paragraph 1.1.;or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. IV. With respect to the insurance afforded to these additional insureds, the following is added to SECTION VI— REPORTING, DEFENSE, SETTLEMENT&COOPERATION: 1. Duties --Additional Insured An additional insured must see to it that: a. We are notified in writing as soon as practicable of an occurrence or offense which may result in a claim or suit; b. We receive written notice of a claim or suit as soon as practicable; and c. A request for defense and indemnity of the claim or suit will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured, if the contract or agreement requires that this coverage be primary and noncontributory. Ii V. SECTION VII—CONDITION 10.—Other Insurance is amended by the addition of the following which supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to a person(s) or organization(s)included as an additional insured under this endorsement provided that: 1. The additional insured person(s)or organization(s)is a Named Inlsured under such other insurance; and 2. You have agreed in writing in a contract or agreement,in effect dulling this policy period,that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured person(s) or organization(s). Such contract or agreement must be executed and in effect prior to the performance of your work which is the subject of such contract or agreement. However,this provision does not apply if the other insurance available to the person(s)or organization(s) included as an additional insured is Owners and Contractors Protective Liabilityi Railroad Protective Liability, or similar project- specific, primary insurance. VI. This endorsement does not appy I to an additional insured which has been added to this policy by an endorsement showing the additional insured in a SCHEDULE of additional ins reds, and which endorsement applies to that designated additional insured. ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED. = I ECP 1246 01 21 Includes copyrighted material of Insurance Services Office,Inc.,used with its permission. Page 2 of 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. s„ DITI(MALI NS,VRED;°;:r OWNERS, LESSEES;..QR:,CONTRi4CTORS AUTOMATIC STATUS COMPLETED OPERATIONS COVERAGE A, D 1 & D 4 j Endorsement Effective Policy Number Policy Effective Date Policy Expiration Date Date ECP2004533-19 1/31/2021 1/31/2022 1/31/2021 This endorsement modifies insurance provided under the following: ENVIRONMENTAL COMBINED POLICY I. SECTION Ill—WHO IS AN INSURED is amended to include as an additional insured: 1. Any person or organization for whom you have performed operations when you and such person or organization have agreed in writing in a contract or agreement, in effect during this policy period, that such person or organization be added as an additional insured on this policy; and' 2. Any other person or organization you are explicitly required to add as an additional insured under the contract or agreement described in Paragraph 1.above. Such contract or agreement must be executed and in effect prior to the performance of your work included in the products-completed operations hazard which is the subject of such contract or agreement. Such person(s)or organization(s)is an additional insured only with respect to liability for bodily injury or property damage under SECTION I — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Coverage D.1 —Contractors Pollution Legal Liability and Coverage D.4—Microbial Substance Contractors Pollution Liability, directly caused by your work performed for the additional insured described in Paragraph 1. or 2.above, and included in the products-completed operations hazard. However,the insurance afforded to such additional insured described above: a. Only applies to the extent permitted by law;and b. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured;and c. Will not extend beyond that which is provided to you in this policy. H. With respect to the insurance afforded to these additional insureds,the following additional exclusions apply: This insurance does not apply to: Ei a. Bodily injury or property damage arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: 1, (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications;or (2) Supervisory, inspection, architectural or engineering activities: This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the occurrence which caused the bodily injury or property damage involved the rendering of, or the failure to render any professional architectural, engineering or surveying services. III. With respect to the insurance afforded to these additional insureds,Ithe following is added to SECTION V—LIMITS OF INSURANCE: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement described in Paragraph 1.1.; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. IV. With respect to the insurance afforded to these additional insureds, the following is added to SECTION VI— ECP 1248 01 21 Includes copyrighted material of Insurance Services Office,Inc.,used with its permission. Page 1 of 2 1 REPORTING, DEFENSE, SETTLEMENT& COOPERATION: 1. Duties--Additional Insured An additional insured must see to it that: a. We are notified in writing as soon as practicable of an occurrence which may result in a claim or suit; b. We receive written notice of a claim or suit as soon as practicable; and c. A request for defense and indemnity of the claim or suit will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured, if the contract or agreement requires that this coverage be primary and noncontributory. V. SECTION VII—CONDITION 10.—Other Insurance is amended by the addition of the following which supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to a person(s) or organization(s)included as an additional insured under this endorsement provided that: 1. The additional insured person(s)or organization(s)is a Named Insured under such other Insurance;and 2. You have agreed in writing in a contract or agreement,in effect during this policy period,that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured person(s) or organization(s). Such contract or agreement must be executed and in effect prior to the performance of your work included in the products-completed operations hazard which is the subject of such contract or agreement. However,this provision does not apply if the other insurance available to the person(s)or organization(s) included as an additional insured is Owners and Contractors Protective Liability, Railroad Protective Liability, or similar project- specific, primary insurance. VI. This endorsement does not apply to an additional insured which has been added to this policy by an endorsement showing the additional insured in a SCHEDULE of additional insureds, and which endorsement applies to that designated additional insured. ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED. • 11 rrY tr� I 13 ECP 1248 01 21 Includes copyrighted material of Insurance Services Office,Inc.,used with Its permission. Page 2 of 2 � I ` I THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED;-ARCHITECTS, ENGINEERS DRS OR SURVEYORS NOT:E.NGAGE.D.,BYTHE NAMED INSURED • S COVERAGEA&'B Policy Number Policy Effective Date Policy Expiration Date Endorsemene Effective Date ECP2004533-19 1/31/2021 1/31/2022 1/31/2021 This endorsement modifies insurance provided under the following: ENVIRONMENTAL COMBINED POLICY SCHEDULE Name(s) Of Additional Insured Engineer(s),Architect(s) Any person or organization that you are required by written Or Surveyor(s) Not Engaged By The Named Insured: contract or agreement to include as an additional insured. � I I j I. SECTION III —WHO IS AN INSURED is amended to include as an additional insured the architects, engineers or surveyors shown in the SCHEDULE,while not engaged by you,are explicitly required under a written contract or written agreement, in effect during this policy period,to be added as additional insureds to this policy, but only with respect to liability for bodily injury or property damage under SECTION I — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY, or personal and advertising injury under SECTION I — COVERAGE B— PERSONAL AND ADVERTISING INJURY LIABILITY directly caused by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations performed by you or onlyour behalf. Such contract or agreement must be executed and in effect prior to yo6r performance of such ongoing operations. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. We will not extend any insurance coverage to such additional insured that is not provided to you in this policy; and 3. The insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. II. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to bodily injury, property damage or,personal and advertising injury arising out of the rendering of or failure to render any professional services, including: 1. The preparing, approving, or failing to prepare or approve, maps, drawings, opinions, reports, surveys, change orders, designs or specifications; or 2. Supervisory, inspection or engineering services. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring,employment,training or monitoring of others by that insured,if the occurrence which caused the bodily injury or property damage, or the offense which caused the personal and advertising injury, involved the rendering of or the failure to render any professional services. III. With respect to the insurance afforded to these additional insureds,the following is added to SECTION V—LIMITS OF fi INSURANCE: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance` ECP 1250 01 21 Includes copyrighted material of Insurance Services Office,Inc.,used with its permission. Page 1 of 2 • IV. SECTION VII—CONDITION 10.—Other Insurance is amended by the addition of the following which supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to the additional insured architects, engineers or surveyors shown in the SCHEDULE to this endorsement provided that: 1. The additional insured architect, engineer or surveyor is a Namedllnsured under such other insurance; and 2. It is explicitly required under a written contract or written agreement, in effect during this policy period, that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured architect, engineer or surveyor. Such contract or agreement must be executed and in effect prior to the performance of your ongoing operations, which are the subject of such contract or agreement. However,this provision does not apply if the other insurance available to the person(s)or organization(s)included as an additional insured is Owners and Contractors Protective Liability, Railroad Protective Liability, or similar project- specific,primary insurance. ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED. la Ii ii i ECP 1250 01 21 Includes copyrighted material of Insurance Services Office,II c.,used with its permission. Page 2 of 2 � I � 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. .. .. ......:.. WAIVER;O.F,SUBROGATION TRANSFER OF RIGHTS.':.OF;;RECOVERY AGAINST;;OTHERS,TO;US) .. .......... .... ... ....... ,.:::.;;�; ::::::::::::::.::.,,..,:....,..-:.. ST TUS:--:COU RAGEA :B &.D.:':::�..:�:;: ;`;;`:;: ';:,:,;:: ,;:. `.•>. ; :'�. ;�' Policy Number Policy Effective Date Policy Expiration Date Endorsement Effective Date ECP2004533-19 1/31/2021 1/3i1/2022 1/31/2021 This endorsement modifies insurance provided under the following: ENVIRONMENTAL COMBINED POLICY I. The following is added to Paragraph 17.Subrogation of SECTION VII'-CONDITIONS: We waive any right of recovery against any person(s) or organizations) because of payments we make under COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY, COVERAGE B — PERSONAL AND ADVERTISING INJURY LIABILITY,and COVERAGE D—CONTRACTORS POLLUTION LIABILITY under this policy. Such waiver by us applies only if: I I 1. The insured has agreed in writing in a contract or agreement with such person(s) or organization(s)to waive its right of recovery; and 2. The insured has waived its right of recovery against such persons)or organization(s)prior to loss. This waiver does not apply in any jurisdiction where such waiver is held to be illegal or against public policy or in any situation where the person(s) or organization(s) against whom subrogation is to be waived is found to be solely negligent. I This endorsement does not apply to any person(s) or organization(s) designated in a SCHEDULE of person(s) or organization(s)against whom rights of recovery have been waived. ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED. • t I it ECP 1260 01 21 Includes copyrighted material of Insurance Services Office,Inc.,used with its permission. Page 1 of 1 SCHEDULE OF FORMS AND ENDORSEMENTS Policy Number: FFX2004534-19 Named Insured: Viking Automatic Sprinkler Co. FORMS'ATTACHED TO AND MADE APART OF T-HIS POLICY FORM NUMBER FORM TITLE i E001J 07 20 Nautilus Policy Jacket ENV DIR CLAIMS 01 20 Policyholder Notice-Claim Reporting Information FFX DEC 07 18 Excess Liability Policy Declarations ENV FORMS 09 10 Schedule of Forms and Endorsements FFX 8000 03 20 Excess Liability Insurance Policy BSUM-1200(11-18) Waiver of Transfer of Rights of Recovery Against Others to Us—Hoffman Corporation Projects BSUM-1200 (11-18) Waiver of Transfer of Rights of Recovery Against Others to Us—Skanska Projects BSUM-1200 (11-18) Waiver of Transfer of Rights of Recovery Against Others to Us—BNB Builders Inc. Projects BSUM-1200(11-18) Waiver of Transfer of Rights of Recovery Against Others to Us—Lease Crutcher Lewis WA LLC Projects BSUM-1200 (11-18) Waiver of Transfer of Rights of Recovery Against Others to Us—Venture General Contracting LLC Projects BSUM-1200(11-18) Waiver of Transfer of Rights of Recovery Against Others to Us—Schuchart Corporation Projects IL 12 02 01 16 Office of Foreign Asset Control (OFAC)Exclusion Endorsement S020(04-05) Service of Suit ENV 2012 01 12 Earned Premium and Flat Rate ENV 2013 06 18 Waiver of Subrogation-Scheduled Entities ENV 2216 11 16 Named Insured Endorsement ENV 2217 06 18 Notice of Cancellation to Designated Entities ENV 2225 10 18 Exclusion of Certified Acts of Terrorism FFX 8002 07 18 Schedule of Underlying Insurance I j FFX 8010 07 18 Exclusion-Cross Suits Liability FFX 8055 05 19 Order of Coverage and Contribution-Other Insurance Condition FFX 8056 05 20 Exclusion-Communicable Disease ENV FORMS 09 10 Page 1 of 1 SCHEDULE OF FORMS AND ENDORSEMENTS Policy Number: ECP2004533-19 Named Insured: Viking Automatic Sprinkler Co Co. TOAND MADI;A PART OF THIS POLICY m 1 F FORM NUMBER FORM TITLE E001J 07 20 Nautilus Policy Jacket ENV DIR CLAIMS 01 20 Policyholder Notice-Claim Reporting information I � ENV DEC 08 12 Common Policy Declarations ECP SUPP DEC 01 21 Environmental Combined Policy Supplemental Declarations ENV FORMS 09 10 Schedule of Forms and Endorsements ECP 1200 01 21 Environmental Combined Policy Insuring Agreement BSUM-1200 (11-18) Additional Insured—Owners, Lessees or'Contractors—Completed Operations— Schuchart Corporation Projects BSUM-1200 (11-18) Additional Insured—Owners, Lessees orContractors—Scheduled Person or Organization—Schuchart Corporation Projects BSUM-1200 (11-18) Waiver of Transfer of Rights of RecoveryAgainst Others to Us—BNB Builders Inc. Projects BSUM-1200 (11-18) Additional Insured Owners, Lessees on Contractors—Completed Operations— Hoffman Corporation Projects BSUM-1200(11-18) Additional Insured-Owners,Lessees ori Contractors-Scheduled Person or Organization/Sellen Construction Projects BSUM-1200(11-18) Additional Insured—Owners, Lessees onj Contractors—Scheduled Person or Organization—Hoffman Corporation Projects BSUM-1200(11-18) Waiver of Transfer of Rights of Recovery Against Others to Us—Schuchart Corporation Projects - BSUM-1200(11-18) Additional Insured—Owners, Lessees ori Contractors—Completed Operations— BNBuilders Inc. Projects BSUM-1200(11-18) Waiver of Transfer of Rights of Recovery Against Others to Us—Skanska Projects BSUM-1200 (11-18) Waiver of Transfer of Rights of Recovery Against Others to Us—Hoffman Corporation Projects BSUM-1200(11-18) Additional Insured—Owners, Lessees or Contractors—Completed Operations— BNBuilders Inc.I SMC Cherry Hill Seclusion Room Project BSUM-1200(11-18) Additional Insured-Owners, Lessees or Contractors-Completed Operations/Sellen Construction Projects BSUM-1200 (11-18) Waiver of Transfer of Rights of Recovery Against Others to Us—Lease Crutcher Lewis WA LLC Projects BSUM-1200(11-18) Additional Insured—Owners, Lessees or, Contractors—Scheduled Person or Organization—BNBuilders Inc./SMC Cherry Hill Seclusion Room Project BSUM-1200(11-18) Additional Insured—Owners, Lessees or Contractors—Scheduled Person or Organization—BNBuilders Inc. Projects BSUM-1200 (11-18) Additional Insured—Owners, Lessees or Contractors—Scheduled Person or Organization—Lease Crutcher Lewis LL!C Projects BSUM-1200 (11-18) Additional Insured—Owners, Lessees or Contractors—Completed Operations — Lease Crutcher Lewis LLC Projects BSUM-1200(11-18) Waiver of Transfer of Rights of Recovery Against Others to Us-Venture General Contracting LLC Projects IL 12 02 01 16 Office of Foreign Asset Control (OFAC)Exclusion Endorsement S020 (04-05) Service of Suit ECP 1205 01 21 Contractual Liability-Railroads ECP 1207 01 21 Employee Benefits Liability ENV FORMS 09 10 Page 1 of 2 ECP 1208 01 21 Stop Gap-Employers Liability Coverage ECP 1231 01 21 Earned Premium and Composite Rate-Subject to Premium Audit ECP 1233 01 21 Named Insured Schedule ECP 1234 01 21 Notice of Cancellation to Designated Person or Organization ECP 1239 01 21 Additional Insured-Lessor of Leased Equipment-Automatic Status-Coverage A& B ECP 1246 01 21 Additional Insured-Owners, Lessees or Contractors-Automatic Status-Ongoing Operations-Coverage A, B, D.1 and D.41 ECP 1248 01 21 Additional Insured-Owners,Lessees or Contractors-Automatic Status-Completed Operations-Coverage A, D.1 &D.4 ECP 1250 01 21 Additional Insured-Architects, Engineers or Surveyors Not Engaged by the Named Insured-Coverage A&B ECP 1260 01 21 Waiver of Subrogation-Automatic Status,-Coverage A, B& D ECP 1272 01 21 Exclusion-Financial Services ECP 1274 01 21 Exclusion-Exterior Insulation and Finish!Systems(EIFS) ECP 1275 01 21 Exclusion of Certified Acts of Terrorism I ECP 1280 01 21 Sprinklerpro Changes ECP 1289 01 21 Per Project Aggregate Limits of Insurance-Automatic Status ECP 1291 01 21 Microbial Substance Contractors Pollution Liability-Claims Made and Reported { ENV FORMS 09 10 Page 2 of 2 f � it � I THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ,, OR ..::: ..:..: .......... ........:.................. Policy Number Policy Effective Date Policy Expiration Date Endorsement Effective Date ECP2004533-19 1/31/2021 1/31/2022 1/31/2021 This endorsement modifies insurance provided under the following: ENVIRONMENTAL COMBINED POLICY I The following is added to SECTION VII—CONDITIONS 2. Cancellation: SCHEDULE Number of Days Advance Notice Of Cancellation: Thirty(30)Days Designated Person(s) or Organization(s): Per written request(s) of the named insured on file with the company. Additional Premium: $150 In consideration of the payment of an additional premium, and notwithstanding anything contained in the policy to the contrary,itis understood and agreed that if we cancel this policy on or before the expiration date set forth in the Declarations, we will mail or deliver to the first Named Insured at the last known address, and the person(s) or organization(s) at the address designated in the SCHEDULE above,written notice of cancellation not less than the number of days shown in the SCHEDULE before the effective date of cancellation. Proof of mailing of notice shall be sufficient proof of notice. The effective date and hour of cancellation stated in the notice shall be the end of the policy period. This endorsement shall not apply if: 1. We cancel due to non-payment of premium,or 2. The policy is non-renewed for any reason. ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED. i I E fi ECP 1234 01 21 Includes copyrighted material of Insurance Services Office,Inc.,used with its permission. Page 1 of 1 •- THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ;::P.ER PROJECTAGGREGATE LIMITSOF,INSURANCE AUTOMATIC:STATUS Endorsement Effective Policy Number Policy Effective Date Policy Expiration Date Date ECP2004533-19 1/31/2021 1/3[11 /2022 1/31/2021 This endorsement modifies insurance provided under the following: ENVIRONMENTAL COMBINED POLICY ti I. For all sums which the insured becomes legally obligated to pay as damages caused by occurrences under SECTION I—COVERAGE A—BODILY INJURY AND PROPERTY DAMAGE LIABILITY, and for all medical expenses caused by accidents under SECTION I— COVERAGE C—MEDICAL PAYMENTS, which can be attributed only to covered operations at a single project: 1. A separate Per-Project Aggregate Limit applies to each project,and that limit is equal to the lesser of: a. The General Aggregate Limit shown in the Declarations; or , b. $2,000,000. 2. The Per-Project Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A—BODILY INJURY AND PROPERTY DAMAGE LIABILITY except damages because of bodily injury or property damage included in the products-completed operations hazard, and for medical expenses under COVERAGE C— MEDICAL PAYMENTS regardless of the number of: a. Insureds; b. Claims made or suits brought; or c. Persons or organizations making claims or bringing suits. 3. Any payments made under COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY for damages or under COVERAGE C — MEDICAL PAYMENTS for medical expenses shall reduce the Per-Project Aggregate Limit for that particular project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Per-Project Aggregate Limit for any other project. 4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations,such limits will be subject to the applicable Per-Project Aggregate Limit. II. For all sums which the insured becomes legally obligated to pay as damages caused by occurrences under SECTION I — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGES LIABILITY which cannot be attributed only to covered operations: 1. Any payments made under SECTION I —COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY for damages shall reduce the amount available under the General Aggregate Limit or the Products Completed Operations Aggregate Limit,whichever is applicable; and 2. Such payments shall not reduce any Per-Project Aggregate Limit. III. When coverage for liability arising out of the products-completed operations hazard is provided, any payments for damages because of bodily injury or property damage included in the products-completed operations hazard will reduce the Products-Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Per- - Project Aggregate Limit. IV. If the applicable project has been abandoned,delayed,or abandoned and then restarted,or if the authorized contracting parties deviate from plans, blueprints, designs,specifications or timetables,the particular project will still be deemed to be the same project. V. The provisions of SECTION V—LIMITS OF INSURANCE not otherwise modified by this endorsement shall continue to apply as stipulated. ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED. ECP 1289 01 21 Includes copyrighted material of Insurance Services Office,Inc.,used with its permission. Page 1 of 1 S • THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. MICROBIAL SUBSTANCE CONTRACTORS POLLUTION LIABILITY ....:..... ...........:.....:. ........... ... . . ... ......... :........,......CLAI MS.MADE.ANpIRE RO. Endorsement Effective Policy Number Policy Effective Date Policy Expiration Date Date ECP2004533-19 1/31/2021 1/31/2022 1/31/2021 THIS FORM PROVIDES CLAIMS MADE COVERAGE. PLEASE READ THE ENTIRE FORM CAREFULLY. This endorsement modifies insurance provided under the following: ENVIRONMENTAL COMBINED POLICY I. Coverage D.4—Microbial Substance Contractors Pollution Liability is deleted in its entirety and replaced with the following: COVERAGE D.4—Microbial Substance Contractors Pollution Liability—Claims Made a. We will pay those sums that the insured becomes legally obligated to pay for loss for bodily injury or property damage in excess of the deductible or self-insured retention, directly caused by microbial substances that result from your covered operations or completed operations to which this insurance applies. We will have the right and duty to defend the insured against any suit seeking payment for loss directly caused by microbial substances that result from your covered operations or completed operations; however,we will have no duty to defend any insured against any suit seeking payment for loss to which this insurance does not apply. We may, at our discretion, investigate any microbial substances and settle any claim or suit that may result. But: (1) The amount we will pay for loss and defense costs is limited as described in SECTION V- LIMITS OF INSURANCE; and (2) Our right and duty to defend ends under Coverage D.4 f Microbial Substance Contractors Pollution Liability when we have used up the applicable limit of insurance in the payment of judgments,settlements, or loss under COVERAGES A, B, D, or E or medical expenses under COVERAGE C, or defense costs under COVERAGES D or E. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under SECTION IV—SUPPLEMENTARY PAYMENTS—COVERAGES A, B, D,AND E. b. This insurance applies to bodily injury and property damage to the extent directly caused by microbial substances only if: (1) The bodily injury or property damage is directly caused by microbial substances resulting from an occurrence that takes place in the coverage territory, and (2) The microbial substances that cause the bodily injury or property damage result from your covered operations or completed operations;and (3) The claim or suit alleging bodily injury or property damage is first made against the insured during the policy period, and first reported to us, in writing, during the policy period or where applicable, the Extended Reporting Period; and (4) Your covered operations, or completed operations of those covered operations, that resulted in the claim commenced on or after the retroactive date shown in the Declarations, if any, and before the end of the policy period. Notwithstanding the above, this policy will not respond to loss or defense costs covered in whole or in part by other valid and collectible insurance in force prior to this policy period. ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED. ECP 1291 01 21 Includes copyrighted material of Insurance Services Office,Inc.,used with its permission. Page 1 of 1 ENDORSEMENT This endorsement forms a part of the policy to which it is attached. Please read it carefully. •It is agreed that the Company, in the event of any payment under this policy, waives its right of recovery against the person(s) or organization(s) shown in the schedule below, but only at the specific written request of the Named Insured either before or after loss, wherein such waiver of subrogation has been included before loss as part of a written contractual undertaking by the Named Insured. This waiver of subrogation shall apply only with respect to losses occuring due to operations undertaken as per the specific contract existing between the Named Insured and such person(s) or organization(s)shown in the schedule below and shall not be construed to be a waiver of subrogation with respect to other operations of such person(s) or organization(s)shown in the schedule below in which the Named Insured has no contractual interest. No waiver of subrogation shall directly or indirectly apply to any employee, employees or agents of either the Named Insured or of the person(s) or organization(s) shown in the schedule below, and the Company reserves its right or lien to be reimbursed from any recovery funds obtained by any injured employee.I I � This waiver of subrogation does not apply in any jurisdiction or situation where such waiver is held to be illegal or against public policy or in any situation wherein the person(s) or organization(s) shown in the schedule below against whom subrogation is to be waived is found to be solely negligent. SCHEDULE Name of Person(s)or Organization(s): Any person or organization that you are required by written contract or ag eement to provide a waiver of subrogation. � I { ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED. • • •� I ENV 2013 06 18 Page 1 of 1 ENDORSEMENT This endorsement forms a part of the policy to which it is attached. Please read it carefully. ::.::::;;; :`:O.RD,ER,OF.CO.VERAGE„AND CONTRIBUTION=;`.OTHERINSU:RANCE COND,ITION,:::,:;:, This endorsement modifies insurance provided under the following: FOLLOW FORM EXCESS LIABILITY COVERAGE FORM ! I SCHEDULE Name Of Additional Insured Person(s)Or Organization(s): Any person or organization that you are required by written contract or agreement to include as an additional insured. Additional Premium: $1,438 Paragraph 8. Of Section III—Conditions is deleted and replaced by the following: 8. Other Insurance i a. This insurance is excess over, and shall not contribute with any of the other insurance, whether primary, excess, contingent or on any other basis. However: (1) This condition will not apply to other insurance specifically written as excess over this Coverage Form. (2) If you specifically agree in a written contract or written agreement, in effect during this policy period, that the insurance provided to any person or organization that qualifies as an insured under this insurance must apply on a primary basis, or a primary and noncontributory basis, then insurance under this policy is subject to the following provisions: (a) This insurance will apply before any other insurance that is available to such additional insured which covers that person or organization as a Named Insured;and (b) We will not seek contribution from that other insurance, provided that the injury or damage for which coverage is sought is caused by an event that takes place or is committed subsequent to the signing of that contract or agreement by you. This insurance, In all cases, will always apply after the Commercial Liability Coverages shown in the Schedule of Underlying Insurance. When this insurance is excess, if no other insurer defends, we may undertake to do so, but we will be entitled to the insured's rights against all those other insurers. b. When this insurance is excess over other insurance, we will pay only our share of the ultimate net loss that exceeds: (1) The total amount that all such other insurance would pay for the loss in the absence of the insurance provided under this Coverage Form; plus (2) The total of all deductible and self-insured amounts under all that other insurance. ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED. FFX 8055 05 19 Page 1 of 1 7 i www.saif.com salhr:11. If Carrier no: 20001 Endorsement no: WC000313 SAIF policy: 763948 Viking Automatic Sprinkler Company Waiver of Our Right to Recover from Others Endorsement We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. f{3 This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Description: ALL OPERATIONS Contractor name: Persons and/or organizations with whom the insured-employer is required by written contract to waive subrogation rights. This endorsement does not alter the rights of an injured worker to pursue recovery from another party or SAW to receive a statutory share of recoveries by an injured worker, even from the party listed in the schedule. The premium charge for this endorsement is based on one(1) percent of your manual premium. Effective date: October 01, 2020 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. Countersigned September 09, 2020 at Salem, Oregon l � Kerry Barnett President and Chief Executive Officer 1 it 400 High Street SE Salem,OR 97312 • P:800.285.8525 F:503.373.8020 • Pol PC1 E4308 This page has been left blank intentionally. I I 1 1 ' � I i ! � I WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANC !E,POLICY WC 00 0313 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule ANY PERSON OR ORGANIZATION FOR WHOM YOU ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT TO OBTAIN THIS WAIVER OF RIGHTS FROM US IN THE STATE OF IDAHO. �! I I 3 { { i This endorsement changes the policy to which it is attached and Is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Policy No. Endorsement No. Insured Premium$ Insurance Company Countersigned By WC 00 03 13 (Ed.4-84) Copyright 1983 National Council on Compensation Insurance • This page has been left blank intentionally. I ' i_. I • i �� II �a I is I h i 1 1 COMMERCIAL AUTO CL CA 01 49 06 17 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTOMOBILE EXPANSION ENDORSEMENT - PLATINUM This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM I.. With respect to the coverages provided by this endorsement, the provisions of the Business Auto Coverage Form apply unless modified by this endorsement. I A. NEWLY ACQUIRED OR FORMED "property damage": because of the conduct of ORGANIZATIONSani"insured"under Paragraphs a. or b. under Paragraph A.1.Who Is An Insured of Section The following is added to Paragraph A.1.Who Is II i Covered Autos Liability Coverage,caused An Insured of Section II - Covered Autos Liability by an "accident" and resulting from the Coverage: ownership, maintenance or use of a covered 1 Any organization you newly acquire or form, other "a to'; than a partnership,joint venture or limited liability 2. The written contract or agreement described company or any organization excluded either by above must have been executed prior to the this Coverage Part or by endorsement, and over "accident" that caused the "bodily injury" or which you maintain ownership or majority interest "property damage"and be in effect at the time of more than 50 percent will qualify as a Named of1such"accident"; Insured. However: 1. This insurance does not apply to any newly 3. The insurance afforded to any such additional acquired or formed organization that is an "insured" does not apply to any "accident" beyond the period "insured"under any other automobile policy or of time required by the would be an "insured" under such policy but bitten contract or agreement described a for its termination or the exhaustion of its Limit above; of Insurance. 4. The most we will pay on behalf of such 2. Coverage does not apply to "bodily injury" or additional"insured(s)"is the lesser of: "property damage" that occurred before you a. The Limits of Insurance specified in the acquired or formed the organization. written contract or agreement described 3. Coverage under this provision is afforded only above; or until the 180th day after you acquire or form b. The Limits of Insurance shown in the the organization or the end of the policy Declarations. period,whichever is earlier. This provision shall not increase the Limit of B. ADDITIONAL INSURED BY CONTRACT OR Insurance shown In the Declarations in this AGREEMENT policy or coverage part; and li The following is added to Paragraph A.1.,Who Is 5. The following changes are made to Paragraph l? An Insured of Section II- Covered Autos Liability 51 Other Insurance of B. General Conditions li Coverage: under Section IV-Business Auto Conditions: t When you have agreed in a written contract or a: The following is added to Paragraph 5.a.: agreement to include a person or organization as If required by the written contract or an additional "insured", such person or organization is included as an"insured"subject to agreement described above, the the following: insurance afforded to the additional Insured under this provision will be 1. Such person or organization is an additional primary to, and will not seek contribution N "Insured" only to the extent such person or from, the additional insured's own organization is liable for "bodily injury" or insurance. t s CL CA 01 49 06 17 Includes copyrighted material ofI Insurance Services Page 1 of 5 vOffice, Inc.,with its permission j b. Paragraph 5.c. is deleted in its entirety. 2. We will also pay reasonable and necessary 6. Paragraph A.1.c. under Section II - Covered expenses to facilitate the return of the stolen "auto"to you, Autos Liability Coverage is deleted in its entirety. 3. It is agreed and understood and it is our stated 7. The definition of "insured contract" under intent that expenses incurred by you under the Transportation Expenses Coverage Section V- Definitions is amended to add the following:. Extension will not also be covered or paid under the Rental Reimbursement Coverage An "insured contract" does not include that provided by this endorsement or any rental part of any contract or agreement: reimbursement coverage added by separate That pertains to the ownership, maintenance endorsement to this policy. or use of an "auto" and which indemnifies a H. EXTENDED COVERAGE-AIRBAGS person or organization for other than the The following is added to Exclusion B.3.a. of vicarious liability of such person or Section organization for "bodily injury" or "property Ill-Physical Damage Coverage: damage" caused by your operation or use of However, this exclusion does not apply to the a covered"auto". unintended discharge of an airbag. However, a person or organization is an This coverage is excess over any other collectible additional "insured" under this provision only insurance or warranty providing such airbag to the extent such person or organization is coverage. not named as an "insured" by separate I. AUTO LOAN/LEASE GAP COVERAGE endorsement to this policy. C. EMPLOYEES AS INSUREDS The following is added to Section Ill - Physical Damage Coverage, Paragraph C. Limits of The following is added to Paragraph A.1.Who Is Insurance. An Insured Section II - Covered Autos Liability 4. In the event of a total "loss" to a covered Coverage: "auto",we will pay the lesser of: Any "employee" of yours is an "insured" while a. Any unpaid amount due on the lease or using a covered "auto" you don't own, hire or loan for a covered"auto", less: borrow in your business or your personal affairs. D. INCREASED COVERAGE-BAIL BONDS D. The amount under the Physical Damage Coverage section of the The Supplementary Payments Coverage policy;and Extension of Section II - Covered Autos Liability O 2 Any: Coverage is amended as follows: The Limit of Insurance in paragraph A.2.a.(2) is (a) Overdue leaselloan��payments at increased to$5,000. the time of the loss , E. INCREASED COVERAGE - LOSS OF (b) Financial penalties imposed EARNINGS under a lease for excessive use, abnormal wear and tear or high The Supplementary Payments Coverage mileage; Extension of Section II - Covered Autos Liability (c) Security deposits not returned by Coverage is amended as follows: the lessor; The Limit of Insurance in paragraph A.2.a.(4) is increased to$1,000. (d) Costs for extended warranties, Credit Life Insurance, Health, F. FELLOW EMPLOYEE COVERAGE Accident or Disability Insurance The Fellow Employee Exclusion contained in and purchased with the loan or lease; Section II-Covered Autos Liability Coverage does not apply. This coverage is excess over any other (e) Carry-over balances from collectable insurance. previous loans or leases;or G. COVERAGE EXTENSION-TRANSPORTATION b.' $5,000, EXPENSES However, this provision does not apply to the Paragraph A.4.a. Transportation Expenses of extent loan/lease gap coverage has been Section III-Physical Damage Coverage is provided by separate endorsement to this amended as follows: policy. 1. The Limits of Insurance are increased to $75 per day to a maximum of$2,500. Page 2 of 5 Includes copyrighted material of Insurance Services CL CA 01 49 06 17 Office, Inc.,with its permission • J. GLASS REPAIR-NO DEDUCTIBLE When fire extinguishers are kept in your covered The following is added to Paragraph D.Deductible "auto" and any are discharged in an attempt to of Section III-Physical Damage Coverage: extinguish a fire, we will pay the lesser of the actual f�cost of recharging or replacing such fire Any Comprehensive Coverage deductible shown extingdisher(s). in the Declarations does not apply to "loss" to No deductible applies to this coverage. glass when you elect to patch or repair rather than replace the glass. O. HIRED AUTO PHYSICAL DAMAGE K. INCREASED COVERAGE - ELECTRONIC COVERAGE EQUIPMENT The following is added to Paragraph A.4. Coverage Extensions of Section III - Physical The $1,000 limit indicated in Paragraph C.1.b. Damage Coverage: under Section Ill - Physical Damage Coverage is increased to $2,500. If hired "autos" are covered "autos" for Covered Autos Liability Coverage and if Physical Damage L. EXTENDED COVERAGE - PERSONAL Coverage is provided for any"auto"you own,then PROPERTY the Physical Damage coverages provided are The following is added to Paragraph A.4. extended to"autos"you lease, rent,hire or borrow Coverage Extensions of Section III - Physical from someone other than your "employees", Damage Coverage: partners or members of their households subject Physical Damage Coverage on a covered "auto" to the following: may be extended to "loss" to your personal 1. The most we will pay in any one"loss" is the property or, if you are an individual, the personal lesser of: property of a family member,that is in the covered "auto" at the time of "loss" and caused by an a. The actual cash value of the"auto"; "accident" and resulting from the ownership, b. The cost to repair or replace the"auto";or maintenance or use of a covered"auto". c. $100,000. The insurance provided by this coverage 2. Paragraph 1.above is subject to a deductible. extension is excess over any other collectible Th'e deductible shall be equal to the amount of insurance. The most we will payfor any one"loss" the highest deductible shown for any owned under this coverage extension is$500. However, "auto" of the same classification for that our payment for "loss" to personal property will only be for the account of the owner of the coverage. In the event there is no owned auto of the same classification, the highest property. deiductible for any owned "auto"will apply for Under this provision, personal property does not that coverage. include and we will not pay for"loss"of currency, No deductible will apply to "loss" caused by coins,securities or contraband. fire or lightning. No deductible applies to this coverage extension. 3. Hired Auto Physical Damage Coverage is M. TOWING subject to the following: Paragraph A.2. Towing of Section III - Physical a. If symbol 8 Is shown In the Covered Auto Damage Coverage, is replaced by the following: section of the Declarations page for any of If a private passenger type "auto" or light truck the Physical Damage coverages,then the "auto" (0-10,000 Lbs. GVW) is provided both Hired Auto Ph Comprehensive and Collision Coverage, we will described in this endorsement Physical does not Damage coverage pay up to$150 for towing and labor costs incurred apply' each time such "auto" is disabled. If a medium, b. Other than indicated in Paragraphs a. heavy or extra-heavy truck or extra-heavy Truck- directly above, coverage provided under tractor"auto" (greater than 10,000 Lbs. GVW) is this provision will be excess over any provided both Comprehensive and Collision other collectible insurance or coverage. Coverage, we will pay up to $250 for towing and 4. In addition to the limit set forth in Paragraph 1. labor costs incurred each time such "auto" is above we will pay up to $500 per day, toa disabled. However, the labor must be performed maximum of$3,500 per"loss"for: at the place of disablement. N. FIRE EXTINGUISHER RECHARGE a. Any costs or fees associated with the "loss"to a hired"auto";and The following is added to Paragraph A.4. b. Loss of use of the hired"auto", provided it Coverage Extensions of Section IV - Physical Damage Coverage: Is the consequence of an "accident" for which you are legally liable, and as a CL CA 01 49 06 17 Includes copyrighted material of Insurance Services Page 3 of 5 Office, Inc.,with its permission I ` •N result of which a monetary loss is (1) You, if you are designated in the sustained by the leasing or rental Declarations as an individual; concern. (2) Your partners or members, if you are However, Paragraph A.4.b. Loss of Use designated in the Declarations as a Expenses under Section III - Physical Damage partnership or joint venture; Coverage of the Business Auto Coverage Form (3) Your members or managers, if you does not apply. are designated in the Declarations as P. RENTAL REIMBURSEMENT COVERAGE a limited liability company; We will pay for rental reimbursement expenses (4) Your executive officers if you are incurred by you for the rental of an"auto"because designated in the Declarations as an of"loss"to a covered "auto". organization other than an individual, applies in addition to the otherwise partnership, joint venture or limited 1. Payment p liability company; and applicable amount of each coverage you have on the covered"auto". (5) The spouse of any person named in 2. No deductible applies to this coverage. Paragraphs 1.a.(1.). through 1.a.(4) while a resident of the same 3. We will pay only for those expenses incurred household; during the policy period beginning 24 hours Except: after the "loss" and ending, regardless of the expiration date of the policy,with the lesser of (a) Any "auto" owned by that the following number of days: individual or by any member of his a. The number of days when the covered or her household. "auto"has been repaired or replaced, or (b) Any"auto"used by that individual or his or her spouse while working b. 45 days, rin a business of selling, servicing, 4. Our payment is limited to the lesser of the repairing or parking"autos". following amounts: 2. Changes In Auto Medical Payments And a. Necessary and actual expenses incurred; Uninsured And Underinsured Motorists or Coverages b. Not more than $75 for any one day; The following is added to Who Is An Insured: 5. We will pay up to an additional $300 for the Any individual named in 1.a above and his or reasonable and necessary expenses you her "family members" are "insured" while incur to remove your materials and equipment "oiccupying" or while a pedestrian when being from the covered "auto" and replace such struck by any"auto"you don't own except: materials and equipment on the rental"auto". Any"auto"owned by that individual or by any 6. This coverage does not apply while there are "family member". spare or reserve "autos" available to you for 3. Changes In Physical Damage Coverage your operations. 7. If"loss"results from the total theft of a covered Any private passenger type "auto" you don't "auto" of the "private passenger type", we will own, hire or borrow is a covered "auto" while pay under this coverage only that amount of in�the care,custody or control of any individual your rental reimbursement expenses which is named in Q.1.a.deabove or his or her spouse not already provided for under the Physical while a resident of the same house-hold except: Damage Coverage Extension of the Business 1 Auto Coverage Form or any endorsements a I Any"auto" owned by that individual or by thereto. any member of his or her household; or However, this provision does not apply to the b. Any"auto"used by that individual or his or extent that rental reimbursement is provided her spouse while working in a business of by separate endorsement to this policy. selling, servicing, repairing or parking Q. DRIVE OTHER CAR COVERAGE "autos". 1. The following is added to Section II-Covered 4, The most we will pay for the total of all Autos Liability Coverage: damages under Covered Autos Liability Uninsured Motorists Coverage and a. Any"auto"you don't own, hire or borrow Underinsured Motorists Coverage is the Limit is a covered "auto"for Liability Coverage Of Insurance shown in the Declarations as while being used by: applicable to owned"autos". Page 4 of 5 Includes copyrighted material of Insurance Services CL CA 01 49 06 17 Office, Inc.,with its permission • • 5. Our obligation to pay for, repair, return or T. UNINTENTIONAL OMISSIONS replace damaged or stolen property under The following is added Paragraph B.2. of Section Physical Damage Coverage, will be reduced by a deductible equal to the amount of the IV-Business Auto Conditions: highest deductible shown for any owned If you fail to disclose any hazards existing at the private passenger type "auto" applicable to inception date of this policy, such failure will not that coverage. If there are no owned private prejud;ce the coverage provided to you. However, passenger type "autos", the deductible shall this provision does not affect our right to collect be $250 for Comprehensive Coverage and additional premium or exercise our right of $500 for Collision Coverage. No deductible cancellation or nonrenewal. will apply to"loss"caused by fire or lightning. U. LIBERALIZATION 6. Additional Definition If we revise this endorsement to provide greater As used in this DRIVE OTHER CAR coverage without additional premium charge, we Provision: will automatically provide the additional coverage "Family member means a person related to to all endorsement holders as of the day the the individual named in 1.a. by blood, revision is effective in your state. marriage or adoption who is a resident of the individual's household, including a ward or foster child. R. KNOWLEDGE OF AN ACCIDENT,CLAIM,SUIT ' OR LOSS The following is added to Paragraph A.2. of Section IV-Business Auto Conditions: Your obligation to provide prompt notice of an � "accident", claim,"suit"or"loss"is satisfied if you or a person designated by you to be responsible for insurance matters Is notified of, or in any manner made aware of an"accident", claim,"suit" or"loss" and provides us such notice as soon as practicable S. WAIVER OF SUBROGATION BY CONTRACT OR AGREEMENT The following is added to Paragraph A.5 of Section IV-Business Auto Conditions: We waive any right of recovery we may have against a person or organization because of payments we make for"bodily injury"or"property damage" when you and such person or organization have agreed in writing in a contract or agreement to waive such right of recovery, provided: 1. Such written contract or agreement was: a. Made prior to the "accident" or "loss" resulting in the covered "bodily injury" or "property damage";and b. Was in effect at the time of the covered "bodily injury"or"property damage". 2. The covered "bodily injury" or "property damage" must arise out of the operations specified in such written contract or agreement. 3. At our request you must provide us with a copy of the aforementioned written contract or agreement. CL CA 01 49 06 17 Includes copyrighted material of Insurance Services Page 5 of 5 Office, Inc.,with its permission 1 • a, l, 1 . l I 1 i 1 i i I This page has been left blank intentionally. j I 1 I I I 1 i j I 1 I 1 F. 1 I li � I " I COMMERCIAL GENERAL LIABILITY POLICY NUMBER: Policy# ISSUE DATE: 4/12/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Person(s)or Organization(s): City of Ashland 20 East Main Street Ashland OR 97520 • Section II—Who Is An Insured is amended to include as an additional insured the person(s)or organization(s) shown in the Schedule, but only with respect to liability for"bodily injury","property damage", "personal injury" or • "advertising injury"caused,in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: A. In the performance of your ongoing operations;or B. In connection with your premises owned by or rented to you. � I ti I I3t CG D4 11 04 08 ©200e The Travelers Companies,Inc. Page 1 of 1 Includes the copyrighted material of Insurance Services Office,Inc.with its permission. 48128859 128/19 9N8PLE CERTIFICATE I Sandy L. Orr 1 4/12/2019 4:21,06 PM (PM) 1 Page 2 OE 3 0 COMMERCIAL AUTO• THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED • This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM The following Is added to Paragraph c. In A.1., Who between you,and that person or organization, that is Is An Insured, of SECTION II—COVERED AUTOS signed by you before the"bodily Injury" or"property LIABILITY COVERAGE in the BUSINESS AUTO damage"occurs and that is in effect during the policy COVERAGE FORM and Paragraph e.in A.1.,Who Is period,to name as an additional Insured for Covered An Insured, of SECTION II — COVERED AUTOS Autos Liability Coverage, but only for damages to LIABILITY COVERAGE in the MOTOR CARRIER which this insurance applies and only to the extent of COVERAGE FORM, whichever Coverage Form is that person'si or organization's liability for the conduct part of your policy: of another"Insured". This Includes any person or organization who you are required under a written contract or agreement • I � d I CA T4 37 02 16 c 2018 The Travelers Indemnity Company.All rights reserved. Page 1 of 1 Includes copyrighted materiel of Insurance Services Office,Inc.with its permission. it 90126059 110/19 SAMPLE CERTIFICATE i Sandy L. Orr 14/12/2019 4,21,06 PM !PDT) I Page 1 or 1 6 9 i Kariann Olson • From: Natalie Thomason Sent: Wednesday,August 25,2021 10:12 AM To: Tami Campos Cc: Kariann Olson;Nicole Graham;David Arnold Subjecty- RE:Certificate-City of Ashland•/Viking Automatic Sprinkler Co ere is more clarification on this form Sandy at BBNW: s• rf. "It is unusual and I don't agree with Propel's interpretation, but since they demonstrated the additional insured endorsements exist and even showed proof those endorsements are on the forms list,then the box is not really required. I doubt we will see this again, unless it is another Propel client. You should continue to ask for it and expect copies of the Al endorsements." ;dam ' Natalie Thomason Administrative Assistant Risk Management Claims Intake City of Ashland I Finance 20 East Main Street,Ashland, OR 97520 541-552-2012 Direct'Voice,TTY 800-735-29001 541-552-2059 fax ' I This email transmission is official business of the City of Ashland, and itis subject to Oregon Public Records Law for disclosure and retention. If you have received this message in error,please contact me at(541)552-2012 From: Natalie Thomason Sent:Wednesday,August 25, 2021 8:19 AM To:Tami Campos<tami.campos@ashland.or.us> Cc(Kariann Olson<kari.olson@ashland.or.us>; Nicole Graham<nicole.graham@ashland.or.us>; David Arnold <david.arnold@ashland.or.us> Subject: RE:.Certificate-City of Ashland/Viking Automatic Sprinkler Co I was confused as well. Let me follow up again to get some more understanding. ' Thanks, i Natalie Thomason Administrative Assistant Risk Management Claims Intake City of Ashland I Finance 20 East Main Street,Ashland, OR 97520 541-552-2012 Direct I Voice,TTY 800-735-29001 541-552-2059 fax This email transmission is official business of the City of Ashland, and it is subject to Oregon Public Records Law for disclosure and retention. )f you have received this message in error,please contact me at(541)552-2012 From:Targi Campos<tami.campos@ashland.or.us> Sent:Wednesday,August 25, 2021 8:17 AM 1 To: Natalie Thomason<natalie.thomason@ashland.or.us> Cc: Kariann Olson<kari.olson@ashland.or.us>; Nicole Graham<nicole.graham@ashland.or.us>; David Arnold <david.arnold@ashland.or.us> Subject: RE: Certificate-City of Ashland/Viking Automatic Sprinkler Co Thank you for clarifying this one. I will add that Sandy's response does leave me a bit confused though.We have been told to reject the certificate if it doesn't have a check mark in the ADDL INSD box so it would be helpful to have this further clarified..I feel like lately, more than ever, I spend a lot of time playing'insurance agent'-haha! Thank you Q - TcTM'v De/Malei-Cantiook Administrative Analyst City of Ashland, Public Works Department 20 East Main Street,Ashland,OR 97520 541-552-2420 Fax: 541-488-6006,TTY: 1-800-735-2900 II Like Public Works on Facebook for updates and information! Leo Like Ashland Water Conservation on Facebook for updates and information! This email transmission is official business of the City of Ashland, and it is subject to Oregon Public Records law for disclosure and retention. If you have received this message in error,please contact me at 541-552-2420. Thank you. From: Natalie Thomason<natalie.thomason@ashland.or.us> .._.. Sent:We.dnesday,August 25, 2021 8:12 AM To:Tami Campos<tami.campos@ashland.or.us>; David Arnold<david.arnold@ashland.or.us> Cc:.Kariann Olson<kari.olson@ashland.or.us>; Nicole Graham<nicole.graham@ashland.or.us> Subject: RE: Certificate-City of Ashland/Viking Automatic Sprinkler Co Hello all, -,;..a"" • P efrsee Sandy's response below: "If you are asking if it matters if the additional insured box is checked,then in this case, no. They have provided the , zt actual endorsements to show that you would have additional insured status under their policy." • ThjCi u, Natalie Thomason Administrative Assistant Risk Management Claims Intake City of Ashland I Finance - 20 East Main Street,Ashland,OR 97520 541-552-2012 Direct I Voice,TTY 800-735-29001 541-552-2059 fax This email transmission is official business Of the City of Ashland, and it is subject to Oregon Public Records Law for disclosure and retention. If you have received this message in error,please contact me at(541)552-2012 2 From:Tami Campos<tami.campos@ashland.or.us> Sent:Tuesday,August 24,2021 2:03 PM To: David Arnold<david.arnold@ashland.or.us> Cc: Natalie Thomason<natalie.thomason@ashland.or.us>; Kariann Olson<kari.olson@ashland.or.us>; Nicole Graham <nicole.graham@ashland.or.us> Subject: Re: Certificate-City of Ashland/Viking Automatic Sprinkler Co No problem Dave! I On Aug 24, 2021 at 1:39 PM,<David Arnold>wrote: Yikes! Here, I can speak lawyer too: Tibi gratias ago vobis pro omni auxilio tuo hoc? Translation: Thank you all for your help with this! Q Dave Dave Arnold, Facility Maintenance City of Ashland - Public Works 90 North Mountain Ave Ashland, OR 97520 541 552 2292 FAX: 541 552 2304 david.arnold@ashland.or.us - This email transmission is official business of the City of Ashland, i is subject to Oregon Public Records law for disclosure and retention. If you have received this message in error, please contact me at (541) 552 2292. Thank you. From:Tami Campos<tami.campos@ashland.or.us> Sent:Tuesday,August 24,2021 12:54 To: Natalie Thomason<natalie.thomason@ashland.or.us> Cc: Kariann Olson<kari.olson@ashland.or.us>; Nicole Graham<nicole.graham@ashland.or.us>; David Arnold <david.arnold@ashland.or.us> Subject: Re: Certificate-City of Ashland/Viking Automatic Sprinkler Co Thanks Natalie! On Aug 24, 2021 at 12:19 PM,<Natalie Thomason>wrote: I just sent this over to Sandy at Brown and Brown Northwest to advise on. Thank you, 3 4. Natalie Thomason Administrative Assistant Risk Management Claims Intake City of Ashland I Finance 20 East Main Street,Ashland, OR 97520 541-552-2012 Direct'Voice,TTY 800-735-29001 541-552-2059 fax This email transmission is official business of the City of Ashland, and it is subject to Oregon Public Records Law for disclosure and retention. If you have received this message in error,please contact me at(541)552-2012 From: Kariann Olson<kari.olson@ashland.or.us> Sent:Tuesday,August 24,2021 12:17 PM To: Natalie Thomason<natalie.thomason@ashland.or.us> Cc: Kariann Olson<kari.olson@ashland.or.us>;Tami Campos<tami.campos@ashland.or.us>; Nicole Graham <nicole.graham@ashland.or.us>; David Arnold <david.arnold@ashland.or.us> Subject: FW:Certificate-City of Ashland/Viking Automatic Sprinkler Co Hello Natalie, This is a 1St This company does not check the additional insured boxes on the certificate. Please refer to email from insurance company below and attached insurance certificate. Please advise. Thank you. Kariann Olson Purchasing Specialist City of Ashland 90 N. Mountain Ave. Ashland, Oregon 97520 Tel 541-488-5354 Fax 541-488-5320 TTY 800-735-2900 kari.olson@ashland.or.us Visit the City's web site at: www.ashland.or.us This email transmission is official business of the City of Ashland, and it is subject to Oregon Public Records law for disclosure and retention. If you have received this message in error, please contact me at(541)488-5354.Thank you. From:Tami Campos<tami.campos@ashland.or.us> Sent:Tuesday,August 24,2021 12:14 PM To: Natalie Thomason<natalie.thomason@ashland.or.us>; Kariann Olson<kari.olson@ashland.or.us> Cc: David Arnold<david.arnold@ashland.or.us>; Nicole Graham <nicole.graham@ashland.or.us> Subject: FW: Certificate-City of Ashland/Viking Automatic Sprinkler Co Good afternoon, Dave Arnold has a contract for Viking Automatic Sprinkler and the insurance certificate was missing the check mark in the ADDL INSD column,so they requested that.This was the email response received. Please advise. 4 • Thanks! rcwvw ve'M iflei-Ccwvpas- Administrative Analyst City of Ashland, Public Works Department 20 East Main Street,Ashland,OR 97520 541-552-2420 Fax:541-488-6006,TTY: 1-800-735-2900 Like Public Works on Facebook for updates and information! Like Ashland Water Conservation on Facebook for updates and information! This email transmission is official business of the City of Ashland,and it is subject to Oregon Public Records law for disclosure and retention. if you have received this message in error,please contact me at 541-552-2420. Thank you. From: Emily Sorem<Emily.Sorem@propelinsurance.com> Sent:Tuesday,August 24,2021 11:33 AM To: Nicole Graham <nicole.graham@ashland.or.us> Cc:Victory Alexander<Victory.Alexander@vikingsprinkler.net> Subject: Certificate-City of Ashland/Viking Automatic Sprinkler Co [EXTERNAL SENDER] Hi Nicole, ' Over the past several years many states have enacted statutes or administrative regulations or directives that expressly prohibit using the certificate of insurance to make modifications to the policies. For these reasons we must attach the specific coverage forms affording the requested coverage (ie, additional insured,waiver, aggregate etc) instead of typing language or checking boxes on the cert—that may or may not be affordrd by the insurance company. It is Acord procedures to refrain from checking the Additional Insured, Slubrogation and/or Aggregate boxes when the coverage is derived from a "blanket" coverage form. By checking the box we may be implying that the coverage is indeed afforded to the certificate holder when in fact the coverage is only triggered as outlined in said forms. Thanks, Emily Emily Sorem Propel Insurance Account Assistant Commercial Insurance 805 SW Broadway, Suite 2300 Portland, OR 97205 971.352.8542 Direct Unrelentingly Unconventional NOTICE: This communication including any attachments may contain privileged or confidential information. If you are not the intended recipient, or believe that you received this communication in error, please advise the sender 5 • • • immediately and delete or destroy the communication you received without copying or disclosing the contents.Thank you. • • • • 6