Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
2020-055 PO 20200414-Viking Conrete Cutting Inc
• • MY RECORDER Purchase Order ,ai Fiscal Year 2020 Page:1 of: 1 1r1�1-'LaTcla 9� B City of Ashland ATTN:Accounts Payable 20 E.Main Purchase 20200414 L Ashland,OR 97520 Order T Phone:541/552-2010 O Email:payable@ashland.or.us • ✓ H C/O Public Works Department E VIKING CONCRETE CUTTING INC i 51 Winburn Way N 186 AYRES STREET p Ashland,OR 97520 D EAGLE POINT,OR 97524 Phone:541/488-5347 R T Fax:541/488-6006 • =, ini .-'et t t- .il 1- i_t_t i t.� '_i= c--7=1-77-‘15.. t- = . Jason Robustelli � _ -- .0 .-_ � �___-�__.-.s�elTl= -*€�'la.,. '__�r="".,�T�. t-.. - .- 04/30/2020 5072 FOB ASHLAND OR/NET30 City Accounts Payable io� �_— -'� _ �-_ ,�,�Q���,l'1'`a .. - -- _-^- —• _-"'-- -,�- � ]4'I;i-r-iJlg�d�ci=_ _ ter. Pavement Cutting 1 Pavement cutting of 14"asphalt and provide vacuum trailer for 1 $2,003.0000 `$2,003.00 slurry Goods and Services Agreement(Less than$25,000) Completion date: 06/30/2020 Project Account: • ***************GL SUMMARY*************** 086000-602400 $2,003.00 • Date: By:Authorized ignature i 2 003.00 • FORM #3 CITY OF 1:•0' oa `74D/ ASHLAND A request for a Purchayz; Ormr REQUISITION Date of request: i- Required date for delivery: Vendor Name Viking Concrete Address,City,State,Zip 186 Ayres Street Eagle Point,OR 97524 Contact Name&Telephone Number Bryson Steiner-541-773-2420 Email address SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Emergency O Reason for exemption: 0 Invitation to Bid ❑ Form#13,Written findings and Authorization O AMC 2.50 Date approved by Council:_ 0 Written quote or proposal attached ❑ Written quote or proposal attached (Attach copy of council communication) _(If council approval required,attach copy of CC) ❑ Small Procurement ❑ 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 bid(s)or proposal(s) ❑ Request for Qualifications(Public Works) 0 State of Washington Date approved by Council:_ Contract# _(Attach copy of council communication) 0 Other government agency contract Intermediate Procurement 0 Sole Source Agency GOODS&SERVICES ❑ Applicable Form(#5,6,7 or 8) Contract# Greater than$5,000 and less than$100,000 0 Written quote or proposal attached Intergovernmental Agreement ❑ (3)Written bids&solicitation attached ❑ Form#4,Personal Services$5K to$75K Agency PERSONAL SERVICES 0 Special Procurement 0 Annual cost to City does not exceed$25,000. Greater than$5,000 and less than$75,000 0 Form#9,Request for Approval Agreement approved by Legal and approved/signed by ❑ Less than$35,000,by direct appointment ❑ Written quote or proposal attached City Administrator.AMC 2.50.070(4) ❑ (3)Written proposals&solicitation attached Date approved by Council:_ 0 Annual cost to City exceeds$25,000,Council ❑ Form#4,Personal Services$5K to$75K Valid until: (Date) approval required.(Attach copy of council communication) Description of SERVICES Total Cost Pavement cutting of 14" asphalt and provide vacuum trailer for slurry $2;003 Q0. .. Item# Quantity Unit Description of MATERIALS Unit Price Total Cost ❑� Per attached quotelproposal TOTAL COST Project Number _ _ _ Account Number 086000 • 602400 Account Number Account Number *Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. IT Director in collaboration with department to approve all hardware and software purchases: IT Director Date Support-Yes/No By signing this requisition form,orI certify that the Cit 's public contracting requirements have been satisfied. Employee:LfCIlf Y1J�J _Cod jytpv Department Head: i3o.MZ►. (Equal to or greater than$5,000) Department Manager/Supervisor: 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 GOODS AND SERVICES AGREEMENT (LESS THAN$25,000) PROVIDER: Viking Concrete Cutting, Inc. CITY OF PROVIDER'S CONTACT: Bryson Steiner ►SHLAND 20 East Main Street ADDRESS: 186 Ayres St. Ashland, Oregon 97520 Eagle Point, OR 97524 Telephone: 541/488-5587 PHONE: 541-884-1399 Fax: 541/488-6006 This Services Agreement (hereinafter "Agreement") is entered into by and between the City of Ashland, an Oregon municipal corporation (hereinafter "City") and Viking Concrete Cutting, Inc., (a domestic business corporation) ("hereinafter"Provider"), for Ashland Street asphalt cutting and hauling. 1. PROVIDER'S OBLIGATIONS 1.1 Provide Ashland Street asphalt cutting and hauling 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 liability insurance including commercial general liability insurance with a combined single limit, or the equivalent, of not less than $2,000,000 (two million dollars)per occurrence for Bodily Injury and Property Damage. 1.2.1 The insurance required in this Article shall include the following coverages: • Comprehensive General or Commercial General Liability, including personal injury, contractual liability, and products/completed operations coverage; and • Automobile Liability. 1.2.2 Each policy of such insurance shall be on an "occurrence" and not a"claims made" form, and shall: • Name as additional insured "the City of Ashland, Oregon, its officers, agents and employees" with respect to claims arising out of the provision of Work under this Agreement; • Apply to each named and additional named insured as though a separate policy had been issued to each,provided that the policy limits shall not be increased thereby; • Apply as primary coverage for each additional named insured except to the extent that two or more such policies are intended to "layer" coverage and, taken together, they provide total coverage from the first dollar of liability; • Provider shall immediately notify the City of any change in insurance coverage • Provider shall supply an endorsement naming the City, its officers, employees and agents as additional insureds by the Effective Date of this Agreement; and • Be evidenced by a certificate or certificates of such insurance approved by the City. Page 1 of 5: Agreement between the City of Ashland and Viking Concrete Cutting,Inc. 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 enterprise,minority-owned business,woman-owned business, a business that a service-disabled veteran owns or an emerging small business enterprise certified under ORS 200.055, in awarding subcontracts as required by ORS 279A.110. 1.5 In all solicitations either by competitive bidding or negotiation made by Provider for work to be performed under a subcontract, including procurements of materials or leases of equipment, each potential subcontractor or supplier shall be notified by the Providers of the Provider's obligations under this Agreement and Title VI of the Civil Rights Act of 1964 and other federal nondiscrimination laws. 1.6 Living Wage Requirements: If the amount of this Agreement is $21,507.75 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. 2. CITY'S OBLIGATIONS 2.1 City shall pay Provider the sum of$2,003.00 as provided herein as full compensation for the Work 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$2,003.00 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. 3.2 Provider is an independent contractor and not an employee or agent of the City for any purpose. 3.3 Provider is not entitled to, and expressly waives all claims to City benefits such as health and disability insurance,paid leave, and retirement. 3.4 This Agreement embodies the full and complete understanding of the parties respecting the subject matter hereof. It supersedes all prior agreements,negotiations, and representations between the parties, whether written or oral. Page 2 of 5: Agreement between the City of Ashland and Viking Concrete Cutting,Inc. 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 a reduced price, as negotiated. If Provider does not cure any defects within a reasonable time, the City may reject the Goods and cancel this Agreement in whole or in part. This paragraph does not affect or limit the City's rights, including its rights under the Uniform Commercial Code, ORS Chapter 72 (UCC). 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 The following documents are,by this reference,expressly incorporated in this Agreement,and are collectively referred to in this Agreement as the "SUPPORTING DOCUMENTS:" • The Provider's complete written Estimate dated 03/16/2020. Page 3 of 5: Agreement between the City of Ashland and Viking Concrete Cutting,Inc. • 5. REMEDIES 5.1 In the event Provider is in default of this Agreement, City may, at its option, pursue any or all of the remedies available to it under this Agreement and at law or in equity, including, but not limited to: 5.1.1 Termination of this Agreement; 5.1.2 Withholding all monies due for the Work that Provider has failed to deliver within any scheduled completion dates or any Work that have been delivered inadequately or defectively; 5.1.3 Initiation of an action or proceeding for damages, specific performance, or declaratory or injunctive relief; 5.1.4 These remedies are cumulative to the extent the remedies are not inconsistent,and City may pursue any remedy or remedies singly, collectively, successively or in any order whatsoever. 5.2 In no event shall City be liable to Provider for any expenses related to termination of this Agreement or for anticipated profits. If previous amounts paid to Provider exceed the amount due,Provider shall pay immediately any excess to City upon written demand provided. 6. TERM AND TERMINATION 6.1 Term This Agreement shall be effective from the date of execution on behalf of the City as set forth below (the "Effective Date"), and shall continue in full force and effect until June 30, 2020, 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 any reason deemed appropriate in its sole discretion. 6.2.3 Either party may terminate this Agreement,with cause, by not less than fourteen (14) days' prior written notice if the cause is not cured within that fourteen (14) day period after written notice. Such termination is in addition to and not in lieu of any other remedy at law or equity. 7. NOTICE Whenever notice is required or permitted to be given under this Agreement, such notice shall be given in writing to the other party by personal delivery, by sending via a reputable commercial overnight courier, or by mailing using registered or certified United States mail, return receipt requested, postage prepaid, to the address set forth below: If to the City: City of Ashland—Public Works Department Attn: Jason Robustelli 20 E. Main Street Ashland, Oregon 97520 Phone: (541)488-5587 With a copy to: City of Ashland—Legal Department 20 E.Main Street Ashland, OR 97520 Phone: (541)488-5350 Page 4 of 5: Agreement between the City of Ashland and Viking Concrete Cutting,Inc. If to Provider: Viking Concrete Cutting, Inc. 186 Ayres St. Eagle Point, OR 97524 8. WAIVER OF BREACH One or more waivers or failures to object by either party to the other's breach of any provision,term,condition, or covenant contained in this Agreement shall not be construed as a waiver of any subsequent breach,whether or not of the same nature. 9. PROVIDER'S COMPLIANCE WITH TAX LAWS 9.1 Provider represents and warrants to the City that: 9.1.1 Provider shall, throughout the term of this Agreement, including any extensions hereof, comply with: (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS chapters 316, 317, and 318; (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Provider; and (iii) Any rules, regulations, charter provisions, or ordinances that implement or enforce any of the foregoing tax laws or provisions. 9.1.2 Provider, for a period of no fewer than six(6) calendar years preceding the Effective Date of this Agreement, has faithfully complied with: (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS chapters 316, 317, and 318; (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Provider; and (iii) Any rules, regulations, charter provisions, or ordinances that implement or enforce any of the foregoing tax laws or provisions. 9.2 Provider's failure to comply with the tax laws of the State of Oregon and all applicable tax laws of any political subdivision of the State of Oregon shall constitute a material breach of this Agreement. Further, any violation of Provider's warranty, as set forth in this Article 9, shall constitute a material breach of this Agreement. Any material breach of this Agreement shall entitle the City to terminate this Agreement and to seek damages and any other relief available under this Agreement,at law,or in equity. IN WITNESS WHEREOF the parties have caused this Agreement to be signed in their respective names by their duly authorized representatives as of the dates set forth below. • CITY OF ASHLAND: VIKING CONCRETE CUTTING,INC. (PROVIDER): • By: By: 13Ac4"--- Signature Signature P.aur.4- - 5c9,°` &-'A r e Printed Name Printed Name fid aleeseatie., Title Title .4702 Z q Imo/ Date Date (W-9 is to be submitted with this signed Agreement) � Purchase Order No. v a D O �� Page 6 of 5: Agreement between the City of Ashland and Viking Concrete Cutting,Inc. • Viking Concrete Cutting Inc. ESTIMATE "Professional Concrete Sawing&Drilling in Southern Oregon&Northern California" FLAT SAWING - CORING - WALL SAWING - BOBCAT - DUMP TRUCKS • Date Estimate# Billing Office: 186 Ayres Street 3/16/2020 1674 Eagle Point OR 97524 Klamath Office(541) 884-1399 TERMS: ESTIMATE VALID 90 DAYS Medford Office(541) 773-2420 OR LIC#162173-CA LIC#568236 Job Name/Address Ashland Street Ashland Wastewater Treatment Ashland OR 1195 Oak Street Attn:Jason Robustelli Ashland OR 97520 Description Total Bid Price Flat Saw 240'of 14"Asphalt 2,003.00 Flat Saw 280'of 12"Asphalt Vacuum Slurry&Haul Off-Site Dump and/or Recycle Fee(s) *EXCLUSIONS: 1. Layout 2. Capping,Disconnecting and/or Damage to ANY Type of Utilities 3. Damage to ANY Objects In and/or Under Work Area(s) 4. Overtime(Before 7:00am and after 3:30pm on any weekdays,any weekends,any holidays) 5. Traffic Control 6. Standby and/or ANY Contractor Delays 7. More Than(1)Mobilization Member of th&CortcreteScuwi $Dral ri -rtooceat",,n, Viking Concrete Cutting Inc. Date Total Bid Price $2,003.00 Accepted By Date VIKING CONCRETE CUTTING INC.will not be responsible for layout or damage to utilties or any object under the surface being cut,cored or excavated. Due to difficult working conditions,heavy reinforced steel,wire or scattered work,VIKING CONCRETE CUTTING INC.reserves the right to bill all jobs on an hourly basis. Prices may vary if the description of work varies(ie:depth of cut,footage,access,water,power,etc.) All invoices for commercial accounts are due in full 30 days after completion of work or they are subject to 1.5%interest per month. All residential invoices are due in full upon completion. In the event of suit to enforce collection of any sums due under this invoice,purchaser agrees to pay attorney fees and all costs of suits. 4/14/2020 Business Registry Business Name Search Business Registry Business Name Search New Search Business Entity Data o4-11 :20o i:2o Registry Nbr Entity Entity Jurisdiction Registry Date Next Renewal Renewal Due? Type Status Date 248212-90 DBC ACT OREGON 10-22-2004 10-22-2020 Entity Name 'VIKING CONCRETE CUTTING INC. Foreign Name I New Search Associated Names Type PPB PRINCIPAL PLACE OF BUSINESS Addr 1 186 AYRES ST Addr 2 CSZ EAGLE POINT IOR 197524 I I Country 'UNITED STATES OF AMERICA Please clickhere for general information about registered agents and service of process. Type IAGT REGISTERED AGENT Start Date 10-22- Resign Date 2004 Name 'MORGAN I 'STEINER I I Addr 1 186 AYRES ST Addr 2 CSZ 'EAGLE POINT IOR 197524 I I Country 'UNITED STATES OF AMERICA Type IMALIMAILING ADDRESS I I 1 Addr 1 186 AYRES ST Addr 2 CSZ 'EAGLE POINT IOR 197524 I Country (UNITED STATES OF AMERICA Type IPRE 'PRESIDENT I Resign Date I Name 'MORGAN I 'STEINER I I Addr 1 186 AYRES ST Addr 2 CSZ 'EAGLE POINT IOR 197524 I I Country 'UNITED STATES OF AMERICA Type SEC SECRETARY I I Resign Date I Name ELLEN STEINER Addr 1 186 AYRES ST Addr 2 CSZ EAGLE POINT IOR 197524 �_ I Country IIUNITED STATES OF AMERICA New Search Name History egov.sos.state.or.us/br/pkg_web_name_srch_inq.show detl?p_be_rsn=1066293&p_srce=BR_INQ&p print=TRUE 1/2 4/14/2020 Business Registry Business Name Search IVBusiness Entity Name Name Name Start Date End.Date Type Status - IKING CONCRETE CUTTING INC. EN CUR 10-22-2004 Please read before ordering Copies. New Search Summary History Image Transaction Effective Name/Agent Available Date Date Change Dissolved By Action Status AMENDED ANNUAL 09-29-2019 FI REPORT AMENDED ANNUAL 09-13-2018 FI REPORT AMENDED ANNUAL 10-02-2017 FI REPORT AMENDED ANNUAL 8 10-19-2016 FI REPORT 46 AMNDMT TO ANNUAL ,. RPT/INFO STATEMENT 10-17-2016 FI AMENDED ANNUAL 10-08-2015 FI Mav REPORT AMENDED ANNUAL 10-08-2014 FI REPORT ANNUAL REPORT 09-19-2013 SYS PAYMENT ANNUAL REPORT 09-13-2012 SYS PAYMENT ANNUAL REPORT 09-16-2011 SYS PAYMENT ANNUAL REPORT 09-16-2010 SYS PAYMENT ANNUAL REPORT 09-15-2009 SYS PAYMENT ANNUAL REPORT 09-18-2008 SYS PAYMENT ANNUAL REPORT 09-11-2007 SYS PAYMENT ANNUAL REPORT 09-14-2006 SYS PAYMENT AMENDED ANNUAL 09-22-2005 FI REPORT ARTICLES OF 10-22-2004 FI Agent INCORPORATION © 2020 Oregon Secretary of State. All Rights Reserved. egov.sos.state.or.us/br/pkg_web_name_srch_inq.show detl?p_be_rsn=1066293&p_srce=BR_INQ&p_print=TRUE 2/2 A 9 o® , CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 3/31/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject,to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME:CONTACT Kum Schnetzky Ward Insurance Agency Inc. PHONE FAX PO Box 10167 (A/C.No.Ext):541-687-1117 (A/C.No):541-342-8280 • Eugene OR 97440 ADDRESS: kim@wardinsurance.net INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Cincinnati Insurance Company 10677 INSURED VIKICON-01 INSURER B: Viking Concrete Cutting, Inc. 186 Ayres St INSURER C: • Eagle Point OR 97524 INSURER D: • INSURER E: INSURER F: • COVERAGES CERTIFICATE NUMBER:261415030 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP W /YLIMITS LTR INSD VD POLICY NUMBER (MM/DDYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY Y Y EPP 0135156 4/25/2020 4/25/2021 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $500,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY X ' LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY Y Y EBA 0135156 4/25/2020 4/25/2021 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY _ AUTOS ONLY (Per accident) $ A X UMBRELLA LIAB X OCCUR EPP 0135156 4/25/2020 4/25/2021 EACH OCCURRENCE $1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000,000 DED RETENTION$ $ WORKERS COMPENSATION - PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVEN/A E.L.EACH ACCIDENT $ • OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Scheduled Equipment EPP 0135156 4/25/2020 4/25/2021 Limit:See Schedule Ded:$500 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate holder and all entities required by written contract are included as additional insureds on a primary and non-contributory basis with waiver of subrogation as respects to the general liability including completed operations and auto liability as required by written contract per attached endorsements. Subject to policy limits,terms,conditions and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland 20 E Main Street AUTHORIZE REPRESENTATIVE Ashland OR 97520 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. However,any°auto"that is leased, a. Is effective on the date of acquisition hired,rented or borrowed with a driver or formation,and is afforded for 180 is not a covered"auto". days after such date; CinciPlus E. Audio,Visual and Data Electronic Equip- b. Does not apply to"bodily injury'or BUSINESS AUTO XC+® ment "property damage"resulting from an SECTION III-PHYSICAL DAMAGE "accident"that occurred before you (EXPANDED COVERAGE PLUS) acquired or formed[her organization: COV- ERAGE,C.Limit of Insurance is amended ENDORSEMENTby adding the following: c. Does not apply to any newly acquired or formed organization that is a joint • 4. The most we will pay for all"loss"to au- venture or partnership;and dio,visual or data electronic equipment This endorsement modes insurance provided by the following: and any accessories used with this d. Does not apply to an insured under equipment as a result of any one"acct- any other automobile liability policy, BUSINESS AUTO COVERAGE FORM dent°is the lesser of: or would be an insured under such a a. The actual cash value of the dam- policy but far the termination of such aged or stolen property as of the time policy or the exhaustion of such poll- • With respect to the coverage provided by this endorsement,the provisions of the Coverage Form apply unless of the°accident`, cys limits of insurance. modified by this endorsement. 3. Any of your"employees"while using a b. The cost of repairing or replacing the covered"auto"in your business or your A. Blanket Waiver of Subrogation This provision does not apply unless the valid damaged or stolen property with oth- personal affairs,provided you do not own, written contract has been: er property of like kind and quality;or hire or borrow that"auto". SECTION IV-BUSINESS AUTO CONDI- c. $2,500. TIONS,A.Loss Conditions,5.Transfer of 1. Executed prior to the accident causing G. Liability Coverage Extensions - Supple- Rights of Recovery Against Others to Us is "bodily injury"or"property damage,and Provided the equipment,at the time of the mentary Payments-Higher Limits amended by the addition of the fallowing: 2. Is still in force at the time of the"accident" 'loss"is: SECTION II -LIABILITY COVERAGE, A. We waive any right of recovery we may have causing"bodily injury"or"property dam- a. Permanently Installed in or upon the Coverage,2.Coverage Extensions,a.Sup- against any person or organization because of age". covered"auto"in a housing,opening plementary Payments is amended by: payments we make for "bodily injury" or D. Em I Hired Auto or other location that is not normally 1. Replacing the$2,000 Limit of Insurance "property damage"arising out of the operation p oyee used by the"auto"manufacturer for for bail bonds with$4,000 in(2);and of a covered"auto"when you have assumed 1. Changes in Liability Coverage the installation of such equipment; liability for such"bodily injury"or°property 2. Replacing the$250 Limit of Insurance for damage"under an"insured contract",provid- The following Is added to the Section II- b. Removable from a permanently in- reasonable expenses with$500 in(4). ed the"bodily injury"or"property damage"oc- Liability Coverage, A. Coverage, 1. stalled housing unit as described in curs subsequent to the execution or the°in- Who Is an Insured: Paragraph 2.a.above;or H. Amended Fellow Employee Exclusion sured contract". An°employee"of yours is an"insured" c. An integral part of such equipment. SECTION II-LIABILITY COVERAGE,B.Ex- B. Noncontributory Insurance while operating an"auto"hired or rented F. Who is an Insured-Amended clusions,5.Fellow Employee is modified as under a contract or agreement In that follows: SECTION IV- BUSINESS AUTO CONDI- "employee's"name,with your permission, SECTION II- LIABILITY COVERAGE,A. Exclusion 5.Fellow Employee is deleted. TIONS,B.General Conditions,5.Other In- while performing duties related to the Coverage,1.Who is an Insured is amended plo surance c.is replaced by the following: conduct of your business. by adding the following: I. Hired Auto-Physical Damage c. Regardless of the provisions of Par- 2. Changes In General Conditions The following are"insureds": If hired"autos"are covered"autos"for Liability agraph a. above, this Coverage Coverage,then Comprehensive and Collision Form's Liability Coverage Is primary SECTION IV-BUSINESS AUTO CON- 1. Any subsidiary which is a legally incorpo- Physical Damage Coverages as provided un- and we will not seek contribution DITIONS, B. General Conditions, 5. rated entity of which you own a financial der SECTION III - PHYSICAL DAMAGE from any other insurance for any Iia- Other Insurance is amended by replac- Interest of more than 50%of the voting COVERAGE of this Coverage Part are ex- bility assumed under an "insured ing Paragraph 5.b.with the following: stock on the effective date of this cover- tended to"autos'you hire,subject to the fol- contract"that requires liability to be age form. assumed on a primary noncontributo- b. Far Hired Auto Physical Damage lowing: ry basis. Coverage the following are deemed However,the insurance afforded by this 1. The most we will pay for"loss"to any to be covered"autos"you own: provision does not apply to any subsidiary hired"auto"is$50,000 or the actual cash C. Additional Insured by Contract that Is an"insured"under any other au- (1) Any covered"auto"you lease, value or cost to repair or replace.which- SECTION II- LIABILITY COVERAGE, A. hire,rent ar borrow:and tomobile liability policy,or would be an ever is the least,minus a deductible. • Coverage,I.Who Is an Insured is amended °Ir urea"under such policy but for of to include as an insured any person or organi- (2) Any covered "auto" hired or nation of such policy or the exhaustionion of 2. The deductible will be equal to the largest nation with which you have agreed in a valid rented by your"employee"under such policys limits of insurance. deductible applicable to any owned"auto" written contract to provide insurance as is af- a contract in that individual"em- 2. Any organization that is newly acquired or less.for at coverage,or$1,000,whichever is forded by this policy. ployee's"name.with your per- formed by you and over which you main- mission.while performing duties fain majority ownership.The insurance 3. Hired Auto-Physical Damage coverage This provision is limited to the scope of the related to the conduct of your provided by this provision: is excess over any other collectible insur- valid written contract. business. ance. Includes copyrighted material of ISO Includes copyrighted material of ISO AA 288 01 16 Properties,Inc.,with its permission. Page 1 of 4 AA 288 01 16 Properties,Inc,with its permission. Page 2 of 4 4. Subject to the above limit,deductible,and K. Transportation Expense-Higher Limits 2. SECTION V-DEFINITIONS Is amended P. Unintentional Failure to Disclose Hazards excess provisions we will provide cover- SECTION III-PHYSICAL DAMAGE COV- by adding the following,but only for the SECTION IV- BUSINESS AUTO CONDI- age equal to the broadest coverage appli- purposes of this Loan or Lease Gap cable to any covered"auto"you own in- ERAGE,A.Coverage,4.Coverage Exten- Coverage: TIONS,B.General Conditions,2.Conceal- sured under this policy. sions is amended by replacing$20 per day men; Misrepresentation or Fraud is with$50 per day,and$600 maximum with °Total loss"means a"loss'in which the amended by adding the following: Coverage includes loss of use of that hired au- $1,500 maximum in Extension a.Transpor- cost of repairs plus the salvage value ex- However,if you unintentionallyfail to disclose to,provided it results from an"accident"for tattoo Expenses. coeds the actual cash value. which you are legally liable and as a result of any hazards existing on the effective date of which a monetary loss Is sustained by the L. Airbag Coverage N. Glass Repair-Waiver of Deductible this Coverage Form,we will not deny cover- leasing or rental concem.The most we will SECTION III-PHYSICAL DAMAGE COV- SECTION III-PHYSICAL DAMAGE COV- age under this Coverage Form because of pay for any one"accident°Is$3,000. ERAGE,B.Exclusions,3.a.Is amended by ERAGE,D.Deductible is amended by adding such failure. If a limit for Hired Auto-Physical Damage is adding the following: the following: Q. Mental Anguish Resulting from Bodily Inju- shown in the Schedule,then that limit replac- However, the mechanical and electrical •No deductible applies to glass damage if the ry es,and is not added to,the$50,000 limit indi- breakdown portion of this exclusion does not glass is repaired in a manner acceptable to us SECTION V-DEFINITIONS,C."Bodily inju- cated above. apply to the accidental discharge of an airbag. rather than replaced. ry"is deleted in its entirety and replaced by J. Rental Reimbursement This coverage for airbags is excess over any O. Duties In the Event of an Accident,Claim, the following: other collectible insurance or warranty. Suit or Loss-Amended "Bodilyinjury"means bodilyinjury,sickness or • SECTION III i PHYSICAL DAMAGE is 1 rY" 1 ry. amended by adding the following: M. Loan or Lease Gap Coverage SECTION IV-BUSINESS AUTO CONDI- disease sustained by a person,including men- 1. SECTION III - PHYSICAL DAMAGE TIONS,A.Loss Conditions,2.Duties In the tel son anguish and death sustained by the same 1. pen will pay for rental ufor the rental ex- COVERAGE,C.Limit of Insurance is Event of Accident,Claim,Suitor Loss,a.is Person that results from such bodily injury, penses"incurred by you for the covered deleted in its entiretyand replaced bythe amended byaddingthe following: sickness or disease."Bodily injury"does not °ana"auto"because pia"loss" a t 9: include mental anguish or death that does not °auto".Payment applies in addition to the following,but only for private passenger otherwise applicable amount of each con. type"autos"with an original loan or lease, This or"less" applies only when the"acci- dent" accF result from bodily injury,sickness or disease. and onlyin the event of a'total loss°to dent"or"loss"is known to: R. Coveragefor Certain Operations In Con- deductible you pli on a covered r"auto".No such a passengertype"auto": nection ith Railroads P deductible applies to this coverage. privateP 9 1. you,if you are an individual; 2. We will pay only for those expenses in- a. The most we will pay for"loss°in any 2. A partner,'d you are a partnership: With respect to the use of a covered°auto"In cuned during the policy period beginning one accident is the greater of: operations for or affecting a railroad: 24 hours after the°loss°and ending,re- 3. An executive officer or insurance manag- eryou are a co (1) The amount due under the terms ,if oration:or 1. Section V-Definitions,H."Insured con- tract",1.c.Is amended to read: the lesser of the following number of your covered private passenger 4. A member or manager,If you are a lim- days: type"auto"is subject,but will not iced liability company. c. An easement or license agreement; a. The number of days reasonably re- Include: 2. Section V-Definitions,H."Insured con- quired to repair the covered'auto°.If (a) Overdue lease or loan pay- tract",2.a.is deleted. 'loss°is caused by theft,this number meets; of days Is added to the number of days it takes to locate the covered (b) Financial penalties imposed °auto"and return it to you;or under the lease due to high mileage,excessive use or b. 30 days. abnormal wear and tear; 3. Our payment is limited to the lesser of the following amounts: (c) Security deposits not re- funded by the lessor, a. Necessary and actual expenses in- (d) Costs for extended wanan- curred;or ties,Credit Life Insurance, b. $50 per day. Health,Accident or Disabil- ity Insurance purchased 4. This coverage does not apply while there with the loan or lease;and are spare or reserve"autos"available to you far your operations. (e) Carry-aver balances irom previous loans or leases,or 5. We will pay under this coverage only that amount of your rental reimbursement ex- (2) Actual cash value of the stolen penses which is not already provided for or damaged property. under SECTION III-PHYSICAL DAM- b. An adjustment for depreciation and AGE COVERAGE, A. Coverage, 4. physical condition will be made in de- Coverage Extensions. termining actual cash value at the time of"loss". Includes copyrighted material of ISO Includes copyrighted material of ISO AA 288 01 16 Properties,Inc.,with its permission. Page 3 of 4 AA 288 01 16 Properties,Inc.,with its permission. Page 4 of 4 • y THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. 6. Voluntary Property Damage(Coverage a.)and Care,Custody or Control Liability Coverage (Coverage b.) OREGON CONTRACTORS'COMMERCIAL GENERAL LIABILITY Limits of Insurance(Each Occurrence) BROADENED ENDORSEMENT coverage a.$1,000Coverage b.$5,000 unless otherwise stated $ Deductibles(Each Occurrence) This endorsement modifies insurance provided under the following: Coverage a.$250 Coverage b.$250 unless otherwise stated $ COMMERCIAL GENERAL LIABILITY COVERAGE PART _ A. Endorsement-Table of Contents: COVERAGE PREMIUM BASIS RATE ADVANCE PREMIUM (a) Area (For Limits in Excess of (For Limits in Excess of Coverage: Begins on Page' ) Payroll les $5,000) $5,000) 1. Employee BenefR Liability Covem9e........._........_..._..._.........._..._..._..._..._..................._..._.......2 rUnits 2. Unimentianal Failure to Disclose Hezerds...._..._..._.............__..._........_........_..._..............._..._....8 ) Other 3. Damage to Premises Remed to You.................._..._..._.........._..._..._........_....._.................._..._..8 b. Care, Custody 4. Supplementary Peyments...._..._..._..._..._...__..._..._............._..._...................._..._..._....._..._..._..9 or Control $ 5. Medical Paymerts...._..._.................._.........._..._..._..._...__..._..._..._.............__..._............._..._..10 - - TOTAL ANNUAL PREMIUM $ 6. Voluntary Property Damage(Coverage a.)and Care,Custody or Control Liability Coverage(Coverage b.)...._........_..._..._..._..................._..._.........._..._..._.............__..._10 11.Property Damage to Borrowed Equipment 7. 180 Day Coverage for Newly Formed or Acquired Organizations .................._..._...10 . 8. Waiver of Subrogation........._..._..._..._.........._..._..._.............__....................._..._.........._..._..._10 Each Occurrence Limit $10,000 9. Automatic Addtional Insured-Specified Relationships:...._..._..._..._........__..._..._..._............._..11 Deductible: $ 250 x Managers or Lessors of Premises; x Lessor of Leased Equipment; x Vendors; C. Coverages: x State or Political Subdivisions-Permits Relating to Premises; 2) Our right and duty to x State or Political Subdivisions-Permits;end 1. Employee Benefit Liability Coverage defend ends when we x Contractors'Operations have used up the appli- 10.Broadened Contractual Liability-Work Within 50'of Railroad Property...._..._..._..._..._...__..._....16 a. The following is added to SECTION I cable limit of insurance 11.Property Damage to Bortowed Equipment...._..._..._. .._.16 -COVERAGES:Employee Benefit In the payment of .._ ....__..._..._................._....._..._..._. 12.Employees as Insureds-Specified Health Care Services:........................................................_...16 Liability Coverage. judgments or settle- x Nurses; (1) Insuring Agreement menta. x Emergency Medea]Technicians;and No other obligation or 1:0W- x Paramedics (a) We will pay those sums that 13.Broadened Notice of Omurtence...._..._............._..._...................._..._..._....._..._............._..._......16 the insured becomes legally ity to pay sums or perform obligated to pay as dam- ads or services is covered ages caused by any act,er- unless explicitly provided for B. Limits of Insurance: or or omission of the in- ndolts Supplementary Pay- wed,or of any other per- The Commerdai General Liability Limits of Insurance applyto the insurance provided by this endorsement, son for whose acts the in- (b) This insurance applies to except as provided below. steed Is legally liable, to damages only if the act,er- whidh this insurance m>- ror or omission, Is negli- 1. Employee Benefit Liability Coverage plies.We will have the right and du to defend the in- "administration" committed in the Each Employee Limit: $ 1,000,000 duty 'administration' of your Aggregate Limit $ 3,000,000 steed against any "suit' "employee benefit program"; Deductible: $ 1,000 seeking those damages. end However,we will have no 3. Damage to Premises Rented to You duty to defend against any 1) Occurs during the pol- The lesser of: which this Insurance ies to cyPeriod;or does not apply We may,at our 2) Occurred prior to the a. The Each Omrrrence Limit shown In the Declarations;or discretion, investigate any effective date of this b. $500,000 unless otherwise stated$ report of an act,error or endorsement provided: 4. Supplementary Payments claim or or"suit"that may re-on and settle any a) too rid not have suit.But: knowledge of n a. Bail bonds: $ 1,000 claimr"suit'an or b. Loss of earnings: $ 350 he ef- 1) The amount we will pay {edivef dateore r of this for damages is limited 5. Medical Payments asdescribed in SEC- endorsement. TION III-Medical Expense Limit $ 10,000 INSURANCE;and OTS P You WI! be deemed to have Includes copyrighted material of Insurance Includes copyrighted material of Insurance GA 233 OR 09 10 Services Office,Inc.,with its permission. Page 1 of 16 GA 233 OR 09 10 Services Office,Inc.,with its permission. Page 2 of 16 knowledge of a 1) Failure of any invest- (3) Coercion, demotion, tors are insureds,but only claim or "suit" ment to perform; evaluation, reassign- with rasped to their duties when any"author- ment,discipline,dela- as your officers or directors. ized represents- 2) Errors in providing in- oration, harassment, Your stockholders are also live"-, formation on past per- humiliation, dscsmine- insureds,but only with re- formance of investment tion or other employ sped to their liability as i) Reports all,or vehicles;or ment-related any part,of the ads or omissions;practices, stockholders. act, error or 3) Advice given to any (a) A trust,you are an insured. omission to us person with respect to (4) Consequential Lability Your trustees are also in- or any other that person's decision as a result of(1),(2)or sureds,but only with respect insurer; to participate or not to (3)above. to their duties as trustees. participate in any plan ii) Receives a induded in the "em- This exduslon applies (2) Each of the following is also an written or ver- ployee benefit pro- whether the insured may be insured: hal demand or gram", held liable as an employer claim for dam- or in any other capacity and (a) Each of your"employees" ages because (f) Workers' Compensation to any obligation to share who Is or was authorized to of the ad,error and Similar Laws damages with or repay administer your"employee or omission; Any claim arising out of your someone else who must benefit program". and failure to comply with the pay damages because of (b) Any persons,organizations b) There is no other mandatory provisions of any the Injury. or "employees" having applicable incur- workers'cempensation,un- (3) Supplementary Payments proper temporary authorize- ance. employment compensation• lion to administer your"em- insurance,soda)security or SECTION I - COVERAGES, ployee benefit program"If (2) Exclusions disability benefrts law or any SUPPLEMENTARY PAY- you de,but only until your This insurance does not apply to: similar law. MENTS-COVERAGES A AND legal represntatiue is ep- (g) ERISA B also apply to this Coverage. pointed. (a) Bodily Injury, Property b. Who is en Insured (e) Your legal representative if Damage or Personal and Damages for which any in- you die,but only with re- Advertising Injury cured is liable because oft- As respects Employee Benefit Uabil- sped to duties as such. 'Bodily injury', "property ability imposed on a fidue- Ity Coverage,SECTION II-WHO IS That representative will ary by the Employee Re- AN INSURED Is deleted in Its entirety have all your tights and du- damage"or"personal end tirement Income Security and replaced by the following: ties under this Coverage advertising Flury'. Act of 1974, as now or b Dishonest, Fraudulent, hereafter amended, or by (1) If you are designated In the Deo- Part. () any similar federal,state or location as: (3) Any organization you newly ao- Criminal or Malicious Act local laws. (a) An Individhal,you and your quire or form,other than a part- Damages arising out of anyAvailable Benefits spouse are insureds, but nersHp,joint venture or limited intentional, dshaned, (h) Availablewith respect to the con ' . liability company,and over which fraudulent,criminal or mall- Any daim for benefits to the duct of a business of whish you maintain ownership or ma- sons act,error or omission, extent that such benefits are you are the sale owner. jority interest,win quali y as a committed by any insured, available, with reasonable Named Insured if no other simi- including the willful or reek- effort and cooperation of the (b) A partnership or joint yn- 'tar insurance applies to that or- less violation of any statute. Insured,from the applicable lure, you are an insured. ganizaton. However, coverage e Failure to Perform a Con- funds accrued or other ed- Your members,your part- .under this provision: () nem,and Their spouses are tract !edible insurance. Is afforded onlyuntil insureds but only with (a) the Damages arising out of fan- (i) Taxes,Fines or Penalties respect to the conduct of 180th day after you acquire 9 or form the organization or ure of performance of ern- your business, Taxes, fines or penalties, the end of the policy period, trail by arty insurer. inducting those Imposed (e) A limited liability company, whichever is easier,and (d) Insufficiency of Funds under the Internal Revenue you are an insured.Your Code or any similar state or members are also Insureds, (b) Does not apply to any act, Damages arising out of an local law. but only with respect to the error or omission that was Insufficiency of funds to conduct of your business. committed before you ac- meet o-meet any obligations under (j) Employment-Related Your managers are incur- quires or formed the organl- any plan induded in the Practices eds,but only with respect to zation. "employee benefit program". Any liability arising out of their duties as your manag- c. Limits of Insurance . (e) Inadequacy of Perform- any: ars. As respects Employee Benefit Llabll- ance of Investment/Ad- (1) Refusal to employ; (d) An organization other than a ity Coverage,SECTION III-IJMITS vice Given With Respect partnership,joint venture or OF INSURANCE is deleted in its en- to Participation (2) Termination of em- limited Iisbitty company,you tirety and replaced by the following: ployment, are an Insured.Your"ex- Any daim based upon: endive officers"and direc- - Includes copyrighted material of Insurance Indudes copyrighted material of Insurance GA 233 OR 09 10 Services Office,Inc,with Its permission. Page 3 of 16 GA 233 OR 0910 Services Office,Inc.,with Its permission. Page 4 of 16. (1) The Limits of Insurance shown in amount stated in the Dada- may result in a daim. surance may also Section B.Limits of Insurance, rations as applicable to To the extent possible, apply. 1.Employee Benefit Liability Each Employee.Thelimits notice should include: Pd. No insured will,except Coverage and the rules below of insurance shall not be re- fix the most we will pay regard- duced by the amount of this (1) What the act,error at that insureds own less of the number of deductible. or omission was cost,voluntarily make a • and when it oc- payment,assume any (a) Insureds; (b) The deductible amount cured;and obligation,or incur any (h) Claims made or "suits' stated in the Declarations expense vritheut our brought; applies to all damages sus- (2) addresses of The names and consent. tailed by any one "em- any- (c) Persons or organizations plows", Including such one who may sur- (2) Item 5.Other Insurance is de- making claims or bringing "employee-" dependents ler damages as a toted In its entirety and replaced "suits"; and beneficiaries,because result of the ad, by the following: of all ads,errors or orris- error or omission, 5. Other Insurance (d) Acts,errors or omissions;or cions to which this Incur- b. If a daim is made or mice applies. Ifagainst If other valid and collectible Is brought (e) Benefits included in your "employee benefit program". (a),The terms of this insurance, any insured,you must: insurance is available to the Insured for a loss we cover including those with respell (1) Immediatelyre- under this Coverage Part, (2) The Aggregate Limit shown in to: cad the s orifice our obligations g Section B.Limits of Insurance, po gz Ions are limited 1.Employee Benefit Liability 1) Our right and duty to of the daim or as follows: Coverage of this endorsement is dMend the Insured 'suit"and the date the most we will pay for all dam- against any 'suits" received;and a. Primary Insurance ages because of ads,errors or seeking those dam- (2) Notify us as soon This insurance is pri- omssions negligently committed ages;and as practicable. maty except when c. in the"administration"of your below applies.If this in- "employee benefit program". 2) Your duties, and the You must see to it that surance is primary,our duties of any other In- we receive written no- obligations are not af- (3) Subject to the limit described In volved insured, in the lice of the daim or faded unless any of the (2)above,the Each Employee event of an act,error or Limit shown In Section B.Limits omission,or daim, "suit"as soon as pracG- otherInsurance Then, is also of Insurance, 1. Employee hie. primary.Then, will share nce all that other Benefit Liability Coverage of apply irrespective o1 Me ap- c. You and any other in- Insurance 'h the this endorsement is the most we plication of the deductible volved insured must: method described in b. will pay for all damages sus- amount. tabled by any one"em (d) ployee", We may pay any part or all (1) Immediately send below. es including damages sustained by of the deductible amount to us copies of any b. Method of Sharing such "employee's' dependents effect settlement of any demands,notices, and beneficiaries,as a result of: , claim or"suit"and,upon no- summonses or le- If all of the other Insur- c tifiratian of the action taken, al papers re- once permits contrib..ars, (a) An act,error or omission;or - caved in connec- tion by equal shares, you shall promptly reim tion with the daim we will follow this (b) A series of related ads,er- burse us for such part of the or"suit'; method also.Under tit's cors or omissions, regard- deductible amount as we less of the amount of time have paid. (2) Authorize us to obi approach each issuer that lapses between such fain records and contributes equal ads,errors or omissions, d. Additional Conditions other information; amounts until It has paid its appficable limit negligently committed In the As respects Employee Benefit Li- (3) Cooperate with us of Insurance or none of "administration" f your "em ability Coverage, SECTION N - the loss remains, a ya o the Investigation on ployee benefit program'. COMMERCIAL GENERAL UABIL- or settlement f whichever comes first. ITY CONDITIONS is amended as tris the daim or de- However,the amount paid under lows: Tense against the If any of the other in- However, endorsement shall not ex- i surance does not(1) per- Item 2.Duties in the Event of 'suit";and mit contribution b limed,and will lit subject to the by limits and restrictions that apply OcSucus deletedein itse,Claim or (4) Assist us, upon equal ute shares, we will to the payment of benefits in any Suit is in its entirety and our request,in the Under contribute by limits. plan Included In the"employee replaced by the following: enforcement of Under this method, benefit program". 2. Duties in the Event of an any right against each Insurers share is (4) Deductible Amount Act,Error or Omission,or any person or or- based on the ratio of is Claim or Suit ganization which applicable limit of ap- (a) in- Our obligation to pay dam may be liable to surance to the total ages on behalf of the in- e. You must see to It that the insured be- plirable limits of insur- sued applies only to the we are notified as soon cause of an Oct, once of al issuers. amount of damages In ex- as practicable of an ad, error or omission c. No Coverage cess of the deductible error or omission which to which this in- Includes copyrighted material of Insurance Includes copyrighted material of Insurance GA 233 OR 0910 Services Office,Inc.,with its permission. Page 5 of 16 GA 233 OR 09 10 Services Office,Inc.,with its permission. Page 6 of 16 • This insurance shall not providing some or all of the ages are claimed.and The exclusions under SECTION cover any loss for following benefits to "em- to which the Insured I-COVERAGES,COVERAGE which the insured is en- ployees",whether provided must submit or does A. BODILY INJURY AND titled to recovery under through a"cafeteria plan"or submit with our con- PROPERTY DAMAGE LIABIL- any other insurance in otherwise: sent; ITY,2.Exclusions,other than i. force previous to the et- War and the Nuclear Energy • festive date of this a. Group life insurance; b. My other alternative Liability Exclusion,are deleted Coverage Part. group aoddent ar dispute resolution pro- and the following are added: health insurance;den- seeding in which such e. Additional Definitions tat,vision and hearing damages are claimed This insurance does not apply to: lan% the In- As respects Employee Benefit U. spending andacco nits; suredflodble andt subm�itts with our (a) 'Property damage". ability Coverage, SECTION V - provided that no one consent;or 1) Assumed in any con- DEFINITIONS is amended as fol- other than an "em- lows: ploys°"may subscribe c. An appeal of a civil pro- tract;or (1) The following definitions are to such benefits and seeding. 2) Loss caused by or m- added: such benefits are made8suiting from any of the generally available to . 'Employee"means a person following: ad1. "Administration"means: those"employees" emplowho employ employed,formerly yed,on leave of ab- Providing Information to satisfy the plan's efisense re - a. Benor disabled, or - a) Wear end fiat; "employees", including hifiry requirements; tired.'Employee"Includes a b) Rust, corrosion, their dependents and b. Profit sharing plans, 'leased worker".'Employee" fungus,decay,de- benefidaries, with re- employee savings does not include a'tempo- terioration, hidden sped to eligibility for or plans,employee stack rary worker". or latent defect or scope of "employee ownership plans, pen- 2. Unintentional Failure to Disclose Haz- any quality in benefit programs"; don plans and stock ands property that subscription plans,pro- causes it to dam- b. Interpreting the "em- vided that no one other SECTION IV-COMMERCIAL GENERAL age or destroy it- ployee benefit pro- than an "employee" LIABILITY CONDITIONS,7.Represen- self, . grams', may subscribe to such tations is hereby amended by the add- e) Smog; c. Handling records in benefits and such tion of the following: break- connection with the benefits are made gen- d) Mechanical break- . "employee benefit pm- erally available to all Based on our dependence upon your rep- down including P P "employees" who are reseMatlons as to existing hazards,if un- rupture or bursting grams";or eligible under the plan intentionally you should fail to disclose all caused by sen- d. Effecting,continuing or for such benefits; such hazards at the Inception date of your trifugal force; terminating any "ern- policy,we will not reject coverage under ployee's" participation c. Unemployment insur- this Coverage Part based solely on such e) Settling, cracking, in any benefit.induded once, social security failure. shrinking or ex- in the"employee bene- benefits,mockers'corn- pension;or fitpragram" pensation and disability 3. Damage to Premises Rented to You Nesting rintesta- benefits;and I g° However, "administratlon' a. The last Subparagraph of Paragraph ton,or discharge does not arcWde. d. Vacation plans,indium- 2. SECTION I - COVERAGES, or release of waste Ing buy and sell pro- COVERAGE A.-BODILY INJURY products or sesta- a. Handling payroll deduc- grams; leave of ab- AND PROPERTY DAMAGE,2.U- lions, by insects, bons;or sence programs, in- ABILITY Exclusions is hereby do- birds, rodents or eluding military,mater- leted and replaced by the tenoning: other animals. b. The failure to effect or nity, family, and civil maintain any Insurance leave;tuition assistance Exclusions c.through q.do not apply (b) Lass caused directly or indi- or adequate limits of t°damage by fire,explosion,light- redlybyan coverage of insurance, plans; transportation 'ling, smoke or soot to premises ing. Y of the follow- 'ling,and health club subsi- while rented to you or temporarily oc- cupied but not limited dies. by you with permission of the 1) Earthquake, volcanic to unemployment In- surance,nodal security (2) The following definitions are de- owner. eruption, landslide or benefits,workers'corn leted in their entirety and re- b. The Insurance provided under SEC- any other earth move- pensation and disability placed by the following: TION I-COVERAGES,COVERAGE meet; benefits21.'Suit" means a civil pro- A. BODILY INJURY AND PROP- 2) Water that bad.up or 2. 'Cafeteria plans" means seeding in which money ERN DAMAGE LIABILITY applies overflows from a sewer, plan authorized by applira- damages because of an out, to"property damage"arising out of drain or sump; ble law to allow"em"employees" error or omission t°which water damage to premises that are P both rented to and aavpied by you. 3) Water under the ground to elect to pay for certain this insurance applies are benefits with re-tax dollars. alleged."Suit" surface pressing an, g p 9 (1) As respects Water Damage Para- dewing or seeping 3. 'Employee benefit pro- a. An arbitration proceed- gal Liability,as provided in Para- through: grams"means a program ing in which such dam- graph 3.b.above: Includes copyrighted material of Insurance Includes aopyrigfted materiel of Insurance GA 233 OR 0910 Services Office,Inc.,with its permission. Page 7 of 16 GA 233 OR 0910 Services Office,Inc.,with its permission. Page 8 of 16 • a) Foundations, one"occurrence"to which b. Care,Custody or Control Liability deductible amount as has been walls, floors or this insurance applies. Coverage paid by us paved surfaces; (3) The amount we will pay Is limited SECTION I-COVERAGES,COV- 7. 180 Day Coverage for Newly Formed or 6) Basements, as denoted in Section B.Lim- ERAGE A.BODILY INJURY AND Acquired Organizations whether paved or its of Insurance,3.Damage to PROPERTY DAMAGE LIABILITY,2. II-WHO IS AN INSURED Is not;or Premises Rented to You of this Exclusions,j.Damage to Property, SECTIONSEas follows: c) Doors,windows or endorsement. Subparagraphs(3),(4)and(5)do not other openings. 4. Supplementary Payments apply to"property damage"to the Subparagraph a. of Paragraph 4. is property of others desmoid therein, hereby deleted and replaced by the foi- e) Loss caused by or resulting Under SECTION I-COVERAGE,SUP- With respect to the Insurance provided by lowing: from water that leaks or PLEMENTARY PAYMENTS-COVER- this section of the endorsement,the fol- fiows from plumbing,heat- AGES A AND'B: lowing additional provisions appy: a. Insurance under this provision is af- firms air conditioning,or fire a. Paragraph pby forded only until the 180th day after p ya. The Limits of Insurance shown in the you acquire or form the organization protedion in tams reusedlowing: 2.Is replaced the f- or the end of the ti by or resitting from freezing, Declarations are replaced by the him- policy period, unless: Up to the limit shown in Section B. its designated in Section B.Limits of whichever is earlier, 1) You did your best to Limits of Insurance,4.a.Bail Bonds Insurance, 6.Voluntary Property 8. Waiver of Subrogation maintain heat In the of this endorsement for cost of bail Damage and Care, Custody or bu'ding or structure;or bonds required because of accidents Control Liability Coverage of this SECTION IV-COMMERCIAL GENERAL or traffic law violations arising out of endorsement with respect to cover- LIABILITY CONDITIONS,9.Transfer of 2) You drained the equip- the use of any vehicle to which the age provided by this endorsement. Rights of Recovery Against Others to ment and strut off the Bodily Injury Liability Coverage ap- These limits are inclusive of and not Us is hereby amended by the addition of water supply if the heat plies We do not have to furnishin addition to the limbs being re- the fdlwang: was not maintained. • these bonds. placed. The Limits of Insurance shown in Section B.Limits o}Insur- We waive any right of recovery we may (d) Loss to or damage to: 6. Paragraph 4.Is replaced by the fol- once,6.Voluntary Property Dam• have because of payments we make for Plumbing, heating, lowing: age and Care,Custody or Control injury or damage arising out of your ongo- 1) g, ng, air Liability Coverage of this endorse- Ing operations or your work"done under conditioning, fire pro- All reasonable expenses incurred by mint fix the most we will in y a written contract requiring such waiver tedion systems, or the insured at our request to assist us one"ocaarence"regardless of the with that person or organization end in- other equipment or ap- in the investigation or defense of the number of chided in the"products-completed opera- chances;or claim or"suit',including actual loss of tions hazard".However,our rights may 2) The interior of any earnings up to the'mit shown in Seo- (1) Insureds; only be waived prior to the"occurrence" Bon B.Limits of Insurance,4.b. Claims made or"suits"brought; giving rise to the Injury or damage for building or structure,or Loss of Earnings of this endorsement (2) which we make payment ander this Cos- ts personal property in per day because of time off from or erage Part.The insured must do nothing the building or structure work. after a loss to impair our rights.At our re- caused by or resiting (3) Persons or organizations making quest,the insured will brin "suit'or trans- from rain,snow,sleet 5. Medical Payments claims or hringing'cults' f r those rights to us and help us enforce or Ice,whether driven b. Deductible Clause thoserights. by wind or not. The Medical Expense Limit of Any One Person as stated in the Declarations Is (1) Our obligation to pay damages 9. Automatic Additional Insured-Speoi- c. Limit of Insurance amended to the limit shown in Section B. on your behalf apples only to the Tied Relationships Rimed to Limits of Insurance, 5.Medical Pay- amount of damages for each The Damage to Premises You Limit as thorn the Declare- mints of this endorsement. "occurrence" are"whichin excess a. The following is hereby added to of the deductible amount stated SECTION II-WHO IS AN INSURED: tions is amended as follows: 6. Voluntary Property Damage and Cate, in Section B:Limits of Insur- 2 Paragraph 6.of SECTION III- Custody or Control Liability Coverage once, o Volunta Pro (1) Any person or organization de- () LIMITS OF INSURANCE Is a. VoluntaryPm Damage Coy- Damage and Care,Custod Property salted In Paragraph red.(to bo- Pent g g Y low(hereinafter Insure)whom to as re the oll deletedand replaced by erage Control ient The iege of requiadditionalred Insured)whom you are• the following: this ceendorsement.nThelimits of Weo erll pay others perty ntdamage"to Insurance will not be reduced by h- insured n add as ez rage Pa t 6. Subject to 5. shave, the property of others arising out of op- the application of such deducfi- insured under this Coverage Part Damage to Premises erations incidental to the Insureds ble amount. by reason of. Rented to You Limit is the business when: agree- most will pay under (2) Condition 2.Duties in the Event (a) writen contract or COVERAGE A. BODILY (1) Damage Is caused by the In- of Occurrence,Offense,Claim ment;or INJURY AND PROPERTY cured;or or Suit,applies to each claim or (b) An oral agreement or om- DAMAGE LIABILITY, for 2 Damage "suit"irrespective of the amount. tract where a certitcete of damages because of"prop- () ge omurs while in the in- Insurance showing that per- sured'spossession. 3 We may a an art or all of the arty damage"to premises () deductible amount to effect set- con or organization as an set- while rented to you or tem- With your consent,we will make a l Insured has been porarily occupied by you these payments regardless of fault dement of any claim or"suit" issued, orith permission of the and,upon notification of the ac- owner, arising out of any Bon taken,you shall promptly re- is an insured,provided: . imburse us for such part of the Includes copyrighted material of Insurance Includes copyrighted material of Insurance GA 233 OR 09 10 Services Office,Inc.,with its permission. Page 9 0}16 GA 233 OR 0910 Services Office,Inc.,with its permission. Page 10 of 16 • (a) The written or oral contract or use of equipment leased e) Any failure to Part with respect or agreement is to you by such person(s)or make such inspec- to such products. organizations(s). However, lions,adjustments, 1) Currently in effect or this insurance does not cup- tests or servicing (d) Any state or political subdi- becomes effective dur- ply to any "occurrence" as the vendor has vision with which you have ing the policy pedal; which takes place after the agreed to make or agreed per Paragraph and equipment lease expires. normally under- 9.a.(1)above to provide In- t) Executed prior to an (c) takes to nuke of urance,subject to the fol- lowing or offense My person or organization the usual nurse of lowing additional provision: (referred to below as van- business, in Ion- to Wnich this Insurance This insurance apples only dor)with wham you have nectbn with the would apply;and agreedper Paragraph hazards rasped to the following 9 a9 P distribution or sale (b)Theyare not specifically 9.a.(1)above to provide in- of theproducts; orzpodafor ubdi the state sP Y or political subdivision has named nil en y other in- sped t but only jury re- vision under any other pro- sped to bodily Injury' or f) Demonstration,In- Issueda permit in amnee- vision of, or endorsement 'property damage' arising stsllatlen,servicing tion with premises you own, added to, this Coverage out of'your products"which or repair opera- rent or control and to which Part. are distributed or sold in the tions,except such this insurance applies: regular course of the van- operations per- 1) The existence,mainte- (2) Only the following persons or or- does business, subject to formed at the yen- nonce,repair,construe- ganizations are additional Insur- the following additional ex- does premises in Von, erection, or re- eds under tris endorsement,and elusions: connection with moval of advertising insurance overage provided to the sale of the signs, awnings, such additional Insureds is lire- 1) The insurance afforded product; gns, cgs, cano- eited as P rovided herein: the vendor does not pies, cellar nVances,apply to: g) Products which, (a) The manager or lessor a1 a after distributionnor coal holes, driveways,or manholes, marquees, premises leased to you with a) 'Bodily injury" or sale by you,have hoist away.openings, whom you have agreed per 'property damage' been labeled or re- sidewalk vaults,street Paragraph 9.a.(1)above to for which the ven- labeled or used as banners,or decorations provide insurance,but only dor Is obligated to a container,part or and similar exposures; with respect to Ikabiity ads- pay damages by Ingredient of any or ing out of the ownership, reason of the as- other thing or sub- 2) The construction,ereo- maintenance or use of that sumption of liability stance by or for part of a premises leased to in a contract or the vendor,or vators dor removal of ele- you,.subject to the following agreement. This additional exclusions: exclusion does not h) 'Bodily injury" or 3) The ownership, main- apply to lability for 'property damage" tenance,or use of any This Insurance does not op- damages that the arising out of the elevators covered by ply to: vendor would have negligence,acts or this insurance. In the absence of omissions of the 1) My"occurrence"which the contract or vendor, Its em- (e) Any state or political subdi- takes place after you agreement; ployees or anyone vision with which you have cease to bee tenant In else acting on its agreed per Paragraph that premises. h) My express war- behalf. 9.a.(1)above to provide in- Structural alterations, in- ranty unauthorized orance,subject to the fel- 2) by you; 2) This Insurance does not lowing provisions: new construction or • apply to any insured • demolition operations c) Any physical or performed or on be- chemical charge person or organization: 1) This insurance applies half of such additional in the product a) From whom you erationlyo s respect m to op- half orations performed bol by insured, made Intentionally have acquired y you hon your behalf h Any person or organization •by the vendor; such products,or for which the state or () g any ingredient, • from which you lease d) Repadwging, ex- part or container, Issued) permit. has equipment with whom you cept when un- entering into, ac- have o- a permit. have agreed per Paragraph packed solely for companying or 2) ThIs Insurance does not 9.a.(1)above to provide in- the purpose of in- containing such apply to'bodily injury", surance.Such person(s)or spedion, demon- products;or "property damage" or organizaticn(s)are insureds, stratlon,testing,or "personal and advertis- but only to the extent that the substitution of b) When liability In- ing Injury"arising out of • the liability for'bodily injury", . parts under In- eluded wither the operations performed "property damage"or'per- stmctians from the 'products for the state or political sonal and advertising injury" manufacturer,and completed opera- subdivision. is caused by your negli- then repackaged lions hazard"has Bence,acts or omissions In in the original can- been excluded un- (f) For'your work"performed the maintenance,operation twiner, der this Coverage in Oregon, any person or Incudes copyrighted material ofInsurance Incudes copyrighted material of Insurance GA 233 OR 09 10 Services Office,Inc.,with its permission. Page 11 0116 GA 233 OR 0910 . Services Office,Inc,with its permission. Page 12 of 16 • organization with which you (a) Subparagraphs(el(I)and chitectural or engl- primary to other insurance have agreed per Paragraph (g)do not apply to bodily m- neering activities available to the additional 9.e.(1)above to provide in- jury'or'property damage" Insured except surance,but only to the ex- included within the "prod- 3) Professional services tent that the liability Is ucts-completed operations do not Include services 1) As otherwise provided caused by'Your work.'per- hazard"; within construction in SECTION IV - formed for that adthe extent means,methods,tech- COMMERCIAL GEN- sured and only to the extent (b) Subparagraphs(a),(d),(e) piques,sequences and ERAL LIABILITY that such liabitty is caused and(g)do not apply to"bad- procedures employed CONDITIONS. 5. by your negligence or the ily injury', 'property darn- by you in connection Other Insurance. b. negligence of those acting age"or"personal and ed- with construction work Excess Insurance;or on your behalf.A person or vertising injury'arising out you perform. organization's status es an of the side negligence or 2) For any other valid and Insured under this provision willful misconduct of the ad- (d) Subparagraphs(f)and(g) collectible insurance of this endorsement contn- ditional insured or its"en- do not apply to"bodily in- available to the addi- jury'or'properly damage" bondInsured as an ad- ues for only the period of ployees";or required by the written arising out of"your work'for ditional insured by at- time time or agreement,but (c) Subparagraph(f)and(g)do whicha consolidated(wrap- tadhment of an en- contractin no event beyond the expi- not apply to'bodily injury", up)Insurance program has dorsernent to another ration date of this Coverage 'property damage"or"per- been provided by the prime insurance policy that Is Part.If there Is no written arising and advertising injury" contractor/project manager written on an excess arising out of or owner of the construction basis.In such case,the contract or agreement,or if no period of time is required 1) The rendering of, or project in which you are in- coverage providedndorseendorsement by the written contract or failure to render, any volved der this nexcess. agreement,a person or or- professional services b. Only with regard to Insurance pro- shall also be excess. ganization's status as an in- by you or en your be- sided to an additional insured desig- (2) Condition 11.Confomtanee to sured under this endorse- half,but only with re- noted under Paragraph 9.a.(2)Sub- Specie Written Contract or Went ends when your cp- sped to either or both paragraphs(1)and(g)above,SEC- Agreement Is hereby added: eretions for that insured are of the following opera- TION III-LIMTS OINSURANCE is completed. tions: amended to include: 11.Contnnance to Specific Written Contract or (g) For"your work"performed a) Prodding engi- The limits applicable to the additional Agreement in the "coverage territory" neering. architec- insured are those specified In the but not In Oregon,any per- tura!or surveying written contract or agreement or in a. With respect to addi- son or organization with services to others; the Declarations of this Coverage tonal Insureds de- which you have agreed per and Part,Whichever are less.If no limits sorbed in Paragraph Paragraph 9.a.(1)above to are specified In the written contract or 9a.(2)(f)above only: provide insurance,but only b) Prodding,or hiring agreement,or if there is no written r with respect to liability aris- independent pro- contract or agreement,the limits ap- agreement wriencon etct n ing out of'your work.'per- fessionals to pro- pliable to the additional Insured are youanbetween formed for that additional n- vide, engineering, those specified in the Declarations of you and the fi additionalh cured barchitectural or Insured specifies that by no on rgur be- this Coverage Part.The limits a in- half.Aperson or organize- surveying services surance are inclusive of and not in coverage for the addi- tions status as an insured In connection with eddtion to the limits of insurance tonal insured: under tlis provision of this construction work shover in the Dedaretions. (1) Be provided by the endorsement continues for youperform. nly the period of time re- c. SECTION IV-COMMERCIAL GEN- Insurance Ser- o 2) Subject to Paragraph 3) ERAL LIABILITY CONDITIONS is vices OR addi- quired by the written con- below, professional hereby amended as follows: tional Insured form tract or agreement,but In no services include: number CG 32 61, event beyond the expiration (1) Condition to ncldr Insurance is 32 32; r or CO date this Coverage co Pact a) Preparing,angroto3263;or thereIfis no written contract Ing, or failing to amended Include: or agreement,or if no period prepare or ap- (a) Where required by a written (2) Include coverage of time is required by the prove,maps,shop contract or agreement,this for completed op- written contract or agree- drawings, opin- insurance is primary and/or erations;or ment,a person or organize- Ions,reports,sur- noncontributory as respells (3) Include coverage ken's status as an Insured wens,Odd orders, any other insurance policy under this endorsement change orders,or Issued to the additional in- for"your work": • when your operations drawings and sized,and such other in- and where the limits or for that insured are mor- spedfiratiens;and nuance policy shall be ex- coverage provided to plated. cess and/or nommntribut- the additional insured is b) Supervisory or in- ing,whichever applies,with more restrictive than (3) Any insurance provided to an or n activities this nra insurance. was specificallyre- additional insured designated performed as part performed quired in that written under Paragraph 9.a.)2): of any related ar- (b) Any insurance provided by this endorsement shall be contract or agreement, the terms of Para- Includes copyrighted material of Insurance Includes copyrighted material of Insurance GA 233 OR 09 10 Services Office,Inc.,with its permission. Page 13 of 16 GA 233 OR 0910 Services Office,Inc.,with its permission. Page 14 of 16 graphs S.a.(3)(a)or 9.b. agreement specifies (2) Deductible Clause a. Nurses; above,or any combine- the Insurance Services tion thereof,shall be In- Office additional in- (a) Our obligation to pay dam- b. Emergency Medrol Technicians;or terpreted as providing sured form number CG ages on your behalf applies the limits or coverage 20 10 but does not only to the amount of darn- c. Paramedics, required bythe terns of specifywhich edition,or ages for each"occurrence" in the jurisdiction where an"occurrence" the written contract or specifies an edition that which are in excess of the or offense to which this insurance applies agreement,but only to does not exist, Para- Deductible amount stated in takes place. the extent that such Dm- graphs 9.a.3.b. and Section B.Limits of Insur- its or coverage is in- 9.h. of this endorse- ansa,11.of this endorse- 13.Broadened Notice of Occurrence eluded within the terms ment shall not ment.The limits of Insur- ance will not be reduced byParagraph a.of Condition 2.Duties in of the Coverage Part ntto and Paragraph the application of such Dethe Event of Occurrence, Offense, is ott this endorsement dorsementea) of this y. ductible amount. Claim or Suit(SECTION IV-COMMER- CIALis attached. shall apply. GENERAL LIABILITY CONDI- b. With respect to adds- 10.Broadened Contractual Liability-Work (b) Condition 2.Duties in the TIONS)is hereby deleted and replaced by tonal Insureds de- Within 50'of Railroad Property _ Event of Occurrence,Of- the following: sorbed in Paragraphtense, Claim or Suit,ep- 9.a.(2)(g)above only: It is hereby agreed that Paragraph f.(1)of plies to each claim or"suit" a. You must see to it that we are notified Definition 12."Insured contract"(SEC- irrespective of the amount; as soon as practicable of.en"occur- If a written contract or TION V-DEFINITIONS)Is deleted. ranee"or an offense which may result agreement 'between (c) We may pay any part or all Ina claim.To the extent possible,no- you end the additional 11.Property Damage to Borrowed Equip- of the deductible amount to lice should include: insured specifies that ment effect settlement of any How,when and where the"oo- coverage for the add- a. The following is hereby added to 5r- claim or"suih and,upon no- (1) How.al"or offense trelt place; tonal insured: •elusion j.Damage to Property of tifioatim of the action taken, b shall a. Be provided by the Paragraph 2..Exclusions of SEC- you spa (2) The names and addresses of e us far such part of the Insurance Ser- TION I-COVERAGES,COVERAGE deductilie amount as has any Injured persons and wit- Insurance Office add- A. BODILY INJURY AND PROP- been paid by on rases;and tient insured farm ERN DAMAGE LIABILITY: (3) The nature and locator of any number CG 20 1012.Employees as Insureds - Specified • Injury or damage arising out of or CG 20 37 Paragraphs(3)and(4)of this ezdu- Health Care Services the"occurrence"or offense. (where editor Ion do not apply to tools or equip- ment loaned to you,provided they are It Is hereby agreed that Paragraph This requirement applies onlywhen specified);or not being used to perform operations 2.a.(1)(d of SECTION 11-WHO IS AN q pp b. Induce coverage at the time of loss. INSURE does not apply to your"em- the"occurrence"or offense is known • 9 to an'authorized representative'. for completed op- ployees"who provide professional health b. With,respect to the Insurance pre- care services on your behalf as dulyli- erations;or vided by this section of the endorse- tensed: c. Include coverage ment,the following additional provi- foryour wolf; sloes apply and where the limits or (1) The Limits of insurance shown in coverage provided to the Declarations are replaced by the additional Insured Is the Timis designated in Section more restrictive than B.Limits of Insurance,11.of was specifically re- this endorsement with respect to geired in that written coverage provided by this en- contract or agreement, dorsement.These limits are in- the terms of Pam- elusive of end not In addition to graphs 9.a.(3))a), the limits being replaced.The 9.a.(3)(b)or 9.13.above, Limits of Insurance shown in or any combination Section B.Limits of Insurance, thereof,shall be inter- 11.of this endorsement fix the preted as providing the most we will pay in any one"oo- limits or coverage re- ciarenes' regardless of the quired by the terms of number of. the written contract or (a) Insureds; agreement,but only to the extent that such tor- (h) Claims made or "suits" its or coverage is in- brought;or eluded within the terms of the Coverage Part to (c) Persons or organizations which this endorsement making claims or bring is attached.If,however, "suits". the written contact or Incudes copyrighted material of Insurance Incudes copyrighted material of Insurance GA 233 OR 09 10 Services Office,Inc.,with its permission. Page 15 of 16 GA 233 OR 09 10 Services Office,Inc.,with Is permission. Page 16 of 16 }vww.saif.com saiF : Oregon Workers' Compensation Certificate of Insurance Certificate holder: CITY OF ASHLAND PUBLIC WORKS DEPARTMENT 20 EAST MAIN STREET ASHLAND, OR 97520 The policy of insurance listed below has been issued to the insured named below for the policy period indicated.The insurance afforded by this policy is subject to all the terms,exclusions and conditions of such policy;this policy is subject to change or cancellation at any time. Insured Producer/contact Viking Concrete Cutting Inc Ward Insurance Agency Inc Viking Concrete Cutting Chris Christensen 186 Ayres Rd 541.687.1117 chris@wardinsurance.net Eagle Point, Or 97524-6526 Issued 04/20/2020 Limits of liability Policy 912438 Bodily Injury by Accident $1,000,000 each accident Period 10/01/2019 to 10/01/2020 Bodily Injury by Disease $1,000,000 each employee Body Injury by Disease $1,000,000 policy limit Description of operations/locations/special items All operations Important This certificate is issued as a matter of information only and confers no rights to the certificate holder.This certificate does not amend, extend or alter the coverage afforded by the policies above.This certificate does not constitute a contract between the issuing insurer, authorized representative or producer and the certificate holder. CANCELLATION: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED TO THE POLICYHOLDER AND CERTIFICATE HOLDER IN ACCORDANCE WITH THE POLICY PROVISIONS AND OREGON LAW. SAIF WILL ENDEAVOR TO PROVIDE WRITTEN NOTICE WITHIN 30 DAYS WHENEVER POSSIBLE. Authorized representative ) a10,(-- Kerry Barnett President and CEO 400 High Street SE Salem,OR 97312 P:800.285.8525 Policy_OLCA CertificateOflnsurance F:503.584.9812