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HomeMy WebLinkAbout2021-184 PO 20210305- Extreme Access Inc. C l- ' RECORDER Purchase Order W41 Fiscal Year 2021 Page: 1 of: 1 t' t iriT _713 19 B City of Ashland rt��t; �A I_�yI r-110 Le ur I 1 „��. _1� ATTN:Accounts Payable. Purchase 20 E. Main L Ashland,OR 97520 - Order# 20210305 T Phone:541/552;.2010 • O Email:payable@ashland.or.us • V • H CIO Public Works Department E EXTREME ACCESS, INC I 51 Wnburn Way N PO BOX 1047 P Ashland, OR 97520 O BEND,OR 97709 Phone:541/488-5347 R T Fax:541/488-6006 - �.,--,----- --� - - —= Scott Fleu -- 03/22/2021 _ 3685 FOB ASHLAND OR/NET30 Ci - able = � f:r r J�lr,"r! i�1� -�� — �� -- e Vii!gars—PZ'a ET T Ii=i Moss Removal Hosier Dam e 1 Moss removal from the face of Hosier Dam 1.0 $13,000.00 $13,000.00 Goods and Services Agreement(Less than$25,000) Completion date: May 1,2021 Project Account: • ***************GL SUMMARY*************** 081500-604100 i 13 000.00 • I ` J • • „2-/ ' ' 1 By: U "1 _ i;ate; A horiz d Signature '13 000.00 FORM#3 • CITY OF A t'c-.q tar„a for a {''tti't.;Fifa ,c: i0 ',. � U fr/P o ASHLAND• REQUISITION Date of request: 03/18/2021 Required date for delivery: Vendor Name Extreme Access,Inc. Address,City,State,Zip PO Box 1047 Bend,OR 97709 Contact Name&Telephone Number Scott Hibbs 541-385-7783 Email address SOURCING METHOD ❑ Exempt from Competitive Bidding 0 Invitation to Bid ❑ Emergency ❑ Reason for exemption: Date approved by Council: 0 Form 013,Written findings and Authorization ❑ AMC 2.50 (Attach copy of council communication) ❑ Written quote or proposal attached ❑ Written quote or proposal attached (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 0 • ❑ VerbaWlritten bid(s)or proposal(s) ❑ Request for Qualifications(Public Works) ❑ Slate of Washington Date approved by Council: Contract II _(Attach copy of council communication) ❑ Other government agency contract Intermediate Procurement ❑ Sole Source Agency GOODS&SERVICES 0 Applicable Form(05,6,7 ore) Contract,/ Greater than$5,000 and less than$100.000 0 Written quote or-proposal attached Intergovernmental Agreement ( I (3)Written bids&solicitation attached 0 Form 64,Personal Services$51(to$75K Agency • PERSONAL SERVICES Date approved by Council: ❑ Annual cost to City does not exceed$25,000. Greater than$5,000 and less than$75,000 Valid Until: (Date) Agreement approved by Legal and approved/signed by ❑ Less than$35,000,by direct appointment ❑ Special Procurement City Administrator.AMC 2.50.070(4) • ❑ (3)Written proposals&solicitation attached ❑ Forme,Request for Approval 0 Annual cost to City exceeds$25,000,Council • ❑ Form 04,Personal Services$5K to$75K 0 Written quote or proposal attached approval required.(Attach copy of council communication) Date approved by Council: Valid until:_ (Date) Description of SERVIiCES Total Cost Moss removal from the face of Hosier Dam 13.000.00 Item# Quantity Unit Description of MATERIALS Unit Price Total Cost ❑■ Per attached quotelproposal TOTAL COST Project Number • Account Number 0_a 1 5 0 0.6 0 4 1 0 0 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 Dates Supper-Yes/No By signing this requisition form,I cartrty that the Cities public contracting requirements have been satisfied. rr� p (i • ..- Department l 02 Employee:+,�� I O �YA�I,� ,Q� Head: r4 alt or greater than$5,000) Department ManagerlSupervlsor: City Man.r• �� • /�. •• ® (Equa •orgreater than$25,000) Funds appropriated for current fiscal year: Y NO ......-/Z, , . _..(1 ./ Gee , ss_ F'ance Director-(Equaltoorgr:erthan':,off) Da e Comments: Form 113-Requisition GOODS AND SERVICES AGREEMENT (LESS THAN$25,000) PROVIDER: Extreme Access, Inc. CITY OF PROVIDER'S CONTACT: Scott Hibbs ASHLAND 20 East Main Street ADDRESS: P.O. Box 1047 Ashland, Oregon 97520 Bend, OR 97709 Telephone: 541/488-5587 PHONE: 541-385-7783 Fax: 541/488-6006 This Goods and Services Agreement (hereinafter "Agreement") is entered into by and between the City of Ashland, an Oregon municipal corporation (hereinafter "City") and Extreme Access Inc., (a domestic business corporation) ("hereinafter"Provider"), for Moss removal from the face of Hosler Dam. 1. PROVIDER'S OBLIGATIONS 1.1 Provide Moss removal from the face of Hosler Dam 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: Goods and Services Agreement between the City of Ashland and Extreme Access,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 $22,002.43 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 sum of$13,000.00 (thirteen thousand and zero dollars) 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$13,000.00 (thirteen thousand and zero dollars) 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 of 5: Goods and Services Agreement between the City of Ashland and Extreme Access,Inc. 3.2 Provider is an independent contractor and not an employee or agent of the City for any purpose. 3.3 Provider is not entitled to, and expressly waives all claims to City benefits such as health and disability insurance,paid leave, and retirement. 3.4 This Agreement embodies the full and complete understanding of the parties respecting the subject matter hereof. It supersedes all prior agreements,negotiations, and representations between the parties, whether written or oral. 3.5 This Agreement may be amended only by written instrument executed with the same formalities as this Agreement. 3.6 The following laws of the State of Oregon are hereby incorporated by reference into this Agreement: ORS 279B.220, 279B230 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. Page 3 of 5: Goods and Services Agreement between the City of Ashland and Extreme Access,Inc. 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 City's written Invitation To Bid dated 3/5/2021. • The Provider's complete written Proposal dated 3/6/2021. 5. REMEDIES 5.1 In the event Provider is in default of this Agreement, City may, at its option, pursue any or all of the remedies available to it under this Agreement and at law or in equity, including, but not limited to: 5.1.1 Termination of this Agreement; 5.1.2 Withholding all monies due for the Work that Provider has failed to deliver within any scheduled completion dates or any Work that have been delivered inadequately or defectively; 5.1.3 Initiation of an action or proceeding for damages, specific performance, or declaratory or injunctive relief; 5.1.4 These remedies are cumulative to the extent the remedies are not inconsistent,and City may pursue any remedy or remedies singly, collectively, successively or in any order whatsoever. 5.2 In no event shall City be liable to Provider for any expenses related to termination of this Agreement or for anticipated profits. If previous amounts paid to Provider exceed the amount due, Provider shall pay immediately any excess to City upon written demand provided. 6. TERM AND TERMINATION 6.1 Term This Agreement shall be effective from the date of execution on behalf of the City as set forth below , (the "Effective Date"), and shall continue in full force and effect until May 1, 2021, 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: Kevin Caldwell 20 E. Main Street Ashland, Oregon 97520 Phone: (541)488-5587 Page 4 of 5: Goods and Services Agreement between the City of Ashland and Extreme Access,Inc. • With a copy to: City of Ashland—Legal Department 20 E. Main Street Ashland, OR 97520 Phone: (541)488-5350 If to Provider: Extreme Access, Inc. Attn: Scott Hibbs P.O. Box 1047 Bend, OR 97709 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. Page 5 of 5: Goods and Services Agreement between the City of Ashland and Extreme Access,Inc. CITY OF ASHLAND: EXTREME ACCESS,INC. (PROVIDER): By: �� _ By: fed— Signature Sefl'lruii-Y Scott Hibbs Printed Name Printed Name tL �, p¢tc.TOL Secretary Title Title sile1Zo2.1 3/16/2021 Date Date (W-9 is to be submitted with this signed Agreement) Purchase Order No. e Page 6 of 5: Goods and Services Agreement between the City of Ashland and Extreme Access,Inc. OEXTREME ACCESS INC Saturday, March 6, 2021 Attn: Kevin Caldwell PMP, Senior Project Manager City of Ashland, Public Works 20 East Main Street, Ashland OR 97520 (541) 552-2414, TTY 800-735-2900 Fax: (541) 488-6006 ' Subject: Hosier Dam Moss Removal Dear Mr. Caldwell: Please accept this scope proposal for the pressure washing on the Hosler Dam. This letter is our proposal to perform the scope of work as indicated in the March 5th Invitation to Bid from the City of Ashland. It includes a brief summary of cost. We are basing our fixed bid on past experience at the site. We intend to perform this work beginning April 20, 2021. Proposed Scope of Work The intent of our proposed services is to pressure wash the areas of moss as shown in the ITB photos: • We will provide a certified rope access team to accomplish the items listed below. • We will provide a comprehensive safety plan for the activities in this scope. • We will provide the pressure washers and the city is providing the pump and a hose as indicated in the ITB. Safety Clause: Extreme Access personnel shall have the right to suspend performance of the contract at any time if, in their absolute discretion, they determine that the working conditions or tasks directed by the client or any other persons presents an unreasonable risk of physical injury to any of their staff. Extreme Access shall immediately notify the client of this suspension of work for safety reasons. The client shall thereafter have a reasonable amount of time, not to exceed five (5) days, within which to correct the condition giving rise to the Extreme Access's safety Extreme Access Incorporated,P.O.Box 1047,Bend,Oregon 97709 Phone 541-385-7783 Fax 360-453-0008 1 EXTREME ACCESS INC concerns, or to reach agreement with Extreme Access regarding modification of the task or tasks to be performed by Extreme Access. If after the expiration of a reasonable time or five (5) days which ever expires first, Extreme Access is not satisfied that the safety concerns have been alleviated, Extreme Access may, at their option, immediately terminate the contract. Extreme Access shall have no liability for suspension, delay, or termination pursuant to this paragraph and shall be entitled to the agreed upon compensation up to the effective date of termination. Cost and Schedule Extreme Access's Fixed Bid costs for the above outlined services are $13.000. We appreciate the opportunity to be of service on this project. If there are any questions please call me at 360-901-9694. Sincerely EXTREME ACCESS INC By � Scott Hibbs Extreme Access Incorporated,P.O.Box 1047,Bend,Oregon 97709 Phone 541-385-7783 Fax 360-453-0008 • • • Client:City of Ashland Public Works Dept EA Budget Estimate Job Name:Hosier Dam at Reeder Reservoir Project Estimate of Hours -3 People for 2 days. . • Principal PM Lead Lead Senior Technician Technician Admin - Hours/ Direct Labor %of total Description Le-adlnsp Climb Tech FHWA Climb Tech Climb Tech Climb Tech Task peiTask hours Item Task Assumptions Heather Hibbs Lowry Keller Vulcano Ross Hibbs Bladow 1 Task management and coordination Including liaison with client 2 2 $286.00 2% 2 $0.00 0% 3 Field Preparation $0.00 0% 4 Inspection NONE 00.00 0% 5 Pressure washing 32 32 32 96 010,43200 86% 6 Travel 12 of actual 3.5 3,5 3.5 11 01,141.00 9% 7 Reporting NA,no Inspection 00.00 0% 8 BOLI paperwork 1 1 $143.00 1% 11 Safety Plan 2 2 $286.00 2% 12 $0.00 0% 13 $0.00 0% 14 $0.00 0% 15 Reporting NA $0.00 0% 16 QA/QC _ NA $0.00 0% 17 Admin billing,etc. $0.00 0% • Consultant Hours 0 5 0 35.5 35.5 0 35.5 0 112 06560.50 . 100% Caveats Hourly Rate $144.00 $143.00 5118.00 $115.00 $106.00 $106.00 5105.00 $73.00 Day 1,client should be at the top of the Overtime Hours 0.00 0.00 0.00 0.00 • 0.00 0.00 0.00 0.00 Darn to explain operation of pump Overtime Pay $26.48 $24.10 $21.23 $20.68 ' $16.75 $16.75 $10.00 $12.50 Scope Overtime Burden $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 See ITB March 5,2021 Burdened Labor Subtotal 00.00 0715.00 $0.00 34,08250 $3,763.00 $0.00 $3,727.50 $0.00 $12288.00 Direct Expenses $2,360.41 ESTIMATE TOTAL . _ $14,648.41 Cost_ $14,648.41 • Fixed Bid $13,000 DIRECT EXPENSES Item Description Quant. Unit Unit Price Total Miles 695 ea. $0.535 $371.83 Airfare ea. $0.00 $0.00 ea. $0.00 $0.00 Roam 9 ea. $125.00 $1,125.00 _ Board 12 ea. $5200 $624.00 Miscellaneous Job Expendables ea. 50.00 00.00 Photography and Copying lump-sum $0.00 $0.00 Report production lump-sum $0.00 $0.00 Communication ea. $0.00 50.00 Coordination 1 fax/etc. $25.00 $25.00 ea. $0.00 $0.00 ea. _ $_0.00 sass • Subtotal $2.145.83 Subconsuhant Description • 1 lump-sum $0.00 1 lump-sum Total Subconsultant Services $0.00_ Subtotal Direct Expenses $2,145.83 Fee on Direct Expenses $214.58 Total Direct Expenses $2,360.41 • l�,.L/ / • ' • .Overhead Rate '195.00% This Estimate is valid for 30 days - j"-Irik- /! �f155 Date 3/6/2021' Fixed Fee Rate 15.00% Direct Expense Fee Rate' 10% I • My Documents/ Page 1 3/62021 A�DDATE(MM/DD/YYYY)® CERTIFICATE OF LIABILITY INSURANCE 3/17/2021 _ 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(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). CONT PRODUCER Brown& Brown Northwest NAMEACT Julie Hammond 1160 SW Simpson Ave Ste. 100 (n/c°.No.Ext): 541-749-4958 FAX No): 541-385-3231 Bend, OR 97702 E-MAIL ADDRESS: lham mond Abbnw.com INSURER(S)AFFORDING COVERAGE NAIC# www.bbnw.com INSURERA: Admiral Insurance Company 24856 INSURED INSURER B: Mutual of Enumclaw 14761 Extreme Access Inc INSURER c: Landmark American Ins Co 33138 POBox1047 Bend OR 97709 INSURER D: Liberty Mutual Insurance Co 23043 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 60705170 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. ITR ADDL SPOLICY EFF POLICY EXP TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDD/YYYY) (MMIDD/YYYY) LIMITS A \/ COMMERCIAL GENERAL LIABILITY ✓' CA00003415502 4/15/2020 4/15/2021 EACH OCCURRENCE $1,000,000 DAMAGE CLAIMS-MADE I OCCUR PREM SESO(a occcu RENTED $300,000 ✓ Washington Stop Gap 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 ✓ JEC LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: B AUTOMOBILE LIABILITY ✓ CP P0018267 4/15/2020 4/15/2021 (Ea aBINEDtl INGLE LIMIT $1,000,000 ✓ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ ✓ AUTOS ONLY ✓ AUTOS ONLY (Per accident) ✓ Hired AutoPD Comp/Coll Deductibles $100/500 C UMBRELLA LIAB \/ OCCUR LHA249246 4/15/2020 4/15/2021 EACH OCCURRENCE $5,000,000 \/ EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED RETENTION$ $ D WORKERS COMPENSATION WC539S322087020 7/7/2020 - 7/7/2021 \/ STATUTE OTH- ER AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBEREXCLUDED7 y N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 A Professional Liability-Claims Made E000004894202 4/15/2020 4/15/2021 Each Claim$1,000,000 retro date 4/15/1994 Aggregate $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:All operations of the insured Forms CG2010 04/2013,CG2037 04/2013 AD6893 01/2017,EA9911 03/2018 attached Subject to policy terms,conditions and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 East Main St ACCORDANCE WITH THE POLICY PROVISIONS. Ashland OR 97520 AUTHORIZED REPRESENTATIVE rn� Julie Hammond ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 60705170 120-21 GL AU UMB PROF WC I Julie Hammond 13/17/2021 7:16:26 PM (PDT) I Page 1 of 23 This certificate cancels and supersedes ALL previously issued certificates. Policy Number: CA00003415502 AD 68 93 0117 Admiral Insurance Company Effective Date: 04/15/2020 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS ENHANCED COVERAGE (Commercial General Liability Coverage Form) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM I. AMENDED EXCLUSIONS NON-OWNED WATERCRAFT COVERAGE-Up to 55 feet SECTION I—COVERAGES—COVERAGE A—BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Exclusion g.Air- craft,Auto or Watercraft, Paragraph (2) is deleted in its entirety and replaced by the following: (2) A watercraft you do not own that is: (a) Less than 55 feet long;and (b) Not being used to carry persons or property for a charge; MEDICAL PAYMENTS— PRODUCTS-COMPLETED OPERATIONS HAZARD SECTION I—COVERAGES—COVERAGE C—MEDICAL PAYMENTS Exclusion f. Products-Completed Operations Hazard is deleted in its entirety. CONSOLIDATED (WRAP-UP) INSURANCE PROGRAM EXCLUSION (LIMITED EXCEPTION FOR OPERATIONS AWAY FROM PROJECT LOCATION) AD 68 93 0117 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 13 0 with its permission,2009,2012 &2013. 60685966 120-21 GL AU UMB PROF WC � Julie Hammond I3/16/2021 10:43:10 PM (PDT) Page 2 of 23 This certificate cancels and supersedes ALL previously issued certificates. The following exclusion is added to paragraph 2., Exclusions of COVERAGE A—BODILY INJURY AND PROPERTY DAMAGE LIABILITY(Section I-Coverages): This insurance does not applyto "bodily injury" or"property damage"arising out of either your ongoing opera- tions or operations included within the"products-completed operations hazard"at any location for which a con- solidated (wrap-up) insurance program has been provided by the prime contractor/project manager or owner of the construction project in which you are involved. This exclusion applies whether or not the consolidated (wrap-up) insurance program: (1) Provides coverage identical to that provided by this Coverage Form; (2) Has limits adequate to cover all claims;or (3) Remains in effect. However, if the consolidated (wrap-up) insurance program does not provide coverage for your operations that are performed away from the location of the construction project,this exclusion will not apply. AD 68 93 01 17 Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 13 0 with its permission, 2009,2012& 2013. 60605966 120-21 OL AU UMB PROF WC Julie Hammond 3/16/2021 10:43:10 PM (PDT) Page 3 of 23 This certificate cancels and supersedes ALL previously issued certificates. II. AMENDED COVERAGES KNOWLEDGE OF OCCURRENCE The following paragraph is added to Section IV—Commercial General Liability Conditions Paragraph 2. Duties In The Event Of Occurrence, Offense,Claim or Suit: Notice of an "occurrence"which may result in a claim under this insurance shall be given as soon as practicable after knowledge of the "occurrence" has been reported to you,one of your"executive officers",or any"em- ployee" authorized by you to give or receive notice of an"occurrence". UNINTENTIONAL ERRORS AND OMISSIONS The following paragraph is added to Section IV—Commercial General Liability Conditions Paragraph 6. Represen- tations: However,the unintentional omission of, or unintentional error in, any information given or provided by you shall not prejudice your rights under this insurance. However,this,provision does not affect our right to collect additional premium or to exercise our right of cancellation or non-renewal. III. ADDED COVERAGES PERSONAL PROPERTY OF OTHERS IN YOUR CARE,CUSTODY OR CONTROL— LIMITED COVERAGE SCHEDULE Sub-Limits of Insurance: $10,000 Each Occurrence (Included in the Each Occurrence Limit shown in the Declarations) $10,000 Aggregate(Included in the General Aggregate Limit shown in the Declarations) The Sub-Limits of Insurance shown aboveare included within and not in addition to the Each Occurrence Limit and the General Aggregate Limit shown in the Declarations. Supplementary Payments will reduce the Each Occurrence and Aggregate Sub-Limits of Insurance shown above. It is agreed COMMERCIAL GENERAL LIABILITY COVERAGE FORM -SECTION I—COVERAGE A Exclusion j.(4) is de- leted, but only with respect to personal property of others in the care,custody or control of the Named Insured, subject to the following exclusions, conditions and limitations. 1. Exclusions This insurance does not apply to: a. "Property damage"arising out of operations performed on behalf of the Named Insured by others; AD 68 93 01 17 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 13 0 with its permission,2009, 2012&2013. 60685966 120-21 OL AUa UMB PROF WC Julie Hammond 3/16/2021 10:43:10 PM (PDT) Page 4 of 23 This certificate cancels and supersedes ALL previously issued certificates. b. "Property damage" arising out of an"occurrence" at premises owned, rented, leased, operated, occu- pied or used by you; c. "Property damage"toproperty while in transit; d. "Property damage"arising out of any error,omission or deficiency in the design,specifications,work- manship or materials of the personal property in the Named Insured's care, custody or control; e. "Property damage"arising out of delay, loss of market, loss of use, loss of profits,or any similar indirect or consequential loss of any kind; f. "Property damage" included within the"products-completed operations hazard";or g. Damages exceeding the actual cash value of the personal property in the care, custody or control of the Named Insured at the time of the"occurrence." 2. Conditions Our right and duty to defend ends when we have used up the applicable sub-limit of insurance in the pay- ment of judgments or settlements or Supplementary Payments under the insurance provided by this en- dorsement. 3. Limits of Insurance a. The amount we will pay for damages is limited as described below with respect to damages covered un- der this endorsement: (1) The Aggregate Limit shown in the Schedule is the most we will pay for the sum of all damages be- cause of"property damage"; (2) The Each Occurrence Limit shown above is the most we will pay for the sum of all damages because of"property damage"arising out of any one"occurrence"; (3) Supplementary Payments will reduce the Each Occurrence and Aggregate Limits of Insurance shown in the Schedule;and (4) All sums we pay for damages or Supplementary Payments under this endorsement will reduce the Each Occurrence:Limit and the General Aggregate Limit shown in the Declarations. 4. Other Insurance This insurance is excess over any other valid and collectible Property or Inland Marine insurance available to you,either as a Named Insured or an Additional Insured,whether primary,excess,contingent or any other basis. AD 68 93 0117 Includes copyrighted material of Insurance Services Office, Inc., Page 4 of 13 0 with its permission,2009, 2012&2013. 60685966 20-21 GL AUa UMC PROF WC Julie Hammond I 3/16/2021 10:43:10 PM (PDT) � Page 5 of 23 This certificate cancels and supersedes ALL previously issued certificates. PRIMARY AND NONCONTRIBUTORY— OTHER INSURANCE CONDITION (Insurance Services Office Endorsement CG 20 01 04 13) The following is added to the Other Insurance Condition and 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 an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance;and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek con- tribution from any other insurance available to the additional insured. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (Insurance Services Office Endorsement CG 24 04 05 09) SCHEDULE Name Of Person Or Organization: Any person or organization, but only if the following conditions are met: (1) You have expressly agreed to the waiver in a written contract;and (2). The injury or damage first occurs subsequent to the execution of the written contract. Information required to complete this Schedule, if not shown above,will be shown in the Declarations. The following is added to Paragraph 8.Transfer Of Rights Of Recovery Against Others To Us of Section IV—Con- ditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or"your work" done under a contract with that person or organization and included in the"products-completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. • AD 68 93 0117 Includes copyrighted material of Insurance Services Office, Inc., Page 5 of 13 0 with its permission, 2009,2012 &2013. 60685966 I 20-21 GL AU UMB PROF WC I Julie Hammond I 3/16/2021 10:43:10 PM (PDT). I Page 6 of 23 This certificate cancels and supersedes ALL previously issued certificates. CONTRACTUAL LIABILITY—RAILROADS (Insurance Services Office Endorsement CG 24 17 10 01) SCHEDULE Scheduled Railroad: Designated Job Site: Any railroad, but only if the following conditions are Any job site covered by this insurance where you are met: performing operations for or affecting a Scheduled Railroad. a. You have expressly agreed to indemnify the rail- road in a written contract entered into by you; and b. The injury or damage occurs subsequent to the execution of the written contract. (If no entry appears above, information required to complete this endorsement will be shown in the Declara- tions as applicable to this endorsement.) With respect to operations performed for,or affecting,a Scheduled Railroad at a Designated Job Site,the defini- tion of"insured contract" in the Definitions section is replaced by the following: 9. "Insured Contract" means: a. A contract for a lease of premises. However,that portion of the contract for a lease of premises that in- demnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract"; b. A sidetrack agreement; c. Any easement or license agreement; d. An obligation,as required by ordinance,to indemnify a municipality,except in connection with work for a municipality; e. An elevator maintenance agreement; f. That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for"bodily injury"or"property damage"to a third person or organi- zation.Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f.does not include that part of any contract or agreement: (1) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a) Preparing,approving or failing to prepare or approve maps,shop drawings, opinions, reports, surveys,field orders, change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; (2) Under which the insured, if an architect,engineer or surveyor, assumes liability for an injury or dam- age arising out of the insured's rendering or failure to render professional services, including those listed in Paragraph(1) above and supervisory, inspection,architectural or engineering activities. AD 68 93 01 17 Includes copyrighted material of Insurance Services Office, Inc., Page 6 of 13 0 with its permission,2009,2012&2013. 60685966 20-21 GL AU UMB PROF WC I Julie Hammond I 3/16/2021 10:43:10 PM (PDT) Page 7 of 23 This certificate cancels and supersedes ALL previously issued certificates. DESIGNATED CONSTRUCTION PROJECT(S)GENERAL AGGREGATE LIMIT (WITH TOTAL AGGREGATE LIMIT FOR COVERAGES A,B AND C) SCHEDULE Designated Construction Projects: All construction projects covered by this insurance. (If no entry appears above, information required to complete this endorsement will be shown in the Declara- tions as applicable to this endorsement.) A. For all sums which the insured becomes legally obligated to pay as damages caused by"occurrences" under COVERAGE A(SECTION I),and for all medical expenses caused by accidents under COVERAGE C(SECTION I), which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. A separate Designated Construction Project General Aggregate Limit applies to each designated con- struction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Dec- larations. However,the most we will pay under the Designated Construction Project General Aggregate Limit for all Desig- nated Construction Projects combined is$5,000,000. 2. The Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A,except damages because of"bodily injury"or"property damage" included in the"products-completed operations hazard", and for medical expenses under COVERAGE C regard- less 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 for damages or under COVERAGE C for medical expenses shall reduce the Designated Construction Project General Aggregate Limit for that designated construction project.Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other desig- nated construction project shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence, Fire Damage 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 Designated Construction Project General Aggregate Limit. AD 68 93 01 17 Includes copyrighted material of Insurance Services Office, Inc., Page 7 of 13 0 with its permission, 2009, 2012&2013. 60685966 120-21 GL AU ure PROF WC Julie Hammond 3/16/2021 10:43:10 PM (PDT). Page 8 of 23 This certificate cancels and supersedes ALL previously issued certificates. B. For all sums which the insured becomes legally obligated to pay as damages caused by"occurrences" under COVERAGE A(SECTION I), and for all medical expenses caused by accidents under COVERAGE C(SECTION I), which cannot be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses 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 Designated Construction Project General Aggregate Limit. C. When coverage for liability arising out of the"products-completed operations hazard" is provided,any pay- ments 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 Designated Construction Project General Aggregate Limit. D. If the applicable designated construction project has been abandoned,delayed, or abandoned and then re- started,or if the authorized contracting parties deviate from plans, blueprints, designs,specifications or timetables,the project will still be deemed to be the same construction project. E. The provisions of Limits Of Insurance (SECTION III) not otherwise modified by this endorsement shall con- tinue to apply as stipulated. AD 68 93 01 17 Includes copyrighted material of Insurance Services Office, Inc., Page 8 of 13 0 with its permission, 2009,2012&2013. 60685966 20-21 OL AUa UMB PROF WC Julie Hammond 3/16/2021 10:43:10 PM (PDT) � Page 9 of 23 This certificate cancels ,and supersedes ALL previously issued certificates. IV. ADDITIONAL INSUREDS ADDITIONAL INSURED—LESSOR OF LEASED EQUIPMENT— AUTOMATIC STATUS WHEN REQUIRED IN LEASE AGREEMENT WITH YOU (Insurance Services Office Endorsement CG 20 34 04 13) A. Section II—Who Is An Insured is amended to include as an additional insured any person(s)or organiza- tion(s)from whom you lease equipment when you and such person(s)or organization(s) have agreed in writing in a contract or agreement that such person(s) or organization(s) be added as an additional insured on your policy.Such person(s) or organization(s) is an insured only with respect to liability for"bodily in- jury", "property damage"or"personal and advertising injury"caused, in whole or in part, by your mainte- nance, operation or use of equipment leased to you by such person(s) or organization(s). However,the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law;and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional in- sured. A person's or organization's status as an additional insured under this endorsement ends when their con- tract or agreement with you for such leased equipment ends. B. With respect to the insurance afforded to these additional insureds,this insurance does not apply to any "occurrence"which takes place after the equipment lease expires. • C. With respect to the insurance afforded to these additional insureds,the following is added to Section III— 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 you have entered into with the additional insured;or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. AD 68 93 01 17 Includes copyrighted material of Insurance Services Office, Inc., Page 9 of 13 0 with its permission, 2009,2012&2013. 60685966 1 20-21 GL AU UMB PROF WC 1 Julie Hammond 13/16/2021 10:43:10 PM (PDT) 1 Page 10 of 23 This certificate cancels and supersedes ALL previously issued certificates. ADDITIONAL INSURED—MANAGERS OR LESSORS OF PREMISES (Insurance Services Office Endorsement CG 20 11 04 13) SCHEDULE Designation Of Premises(Part Leased To You): All premises leased to you and covered by this insurance. Name Of Person(s)Or Organization(s) (Additional Insured): Any person or organization that is a manager or lessor of real property,but only if coverage as an additional insured is required by a written contract or written agreement that is an"insured contract", and provided the "bodily injury"or"property damage"first occurs, or the"personal and advertising injury"offense is first com- mitted, subsequent to the execution of the contract or agreement. Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section II—Who Is An Insured is amended to include as an additional insured the person(s) or organiza- tion(s)shown in the Schedule, but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Schedule and subject to the following addi- tional exclusions: This insurance does not apply to: 1. Any"occurrence"which takes place after you cease to be a tenant in that premises. 2. Structural alterations, new construction or demolition operations performed by or on behalf of the per- son(s)or organization(s)shown in the Schedule. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law;and 2. If coverage provided to the additional insured is required by a contract or agreement,the insurance af- forded 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. B. With respect to the insurance afforded to these additional insureds,the following is added to Section III— Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement,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 shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. AD 68 93 01 17 Includes copyrighted material of Insurance Services Office, Inc., Page 10 of 13 0 with its permission, 2009,2012& 2013. 60685966 20-21 GL AU ORB PROF WC Julie Hammond 13/16/2021 10.43:10 PM (PDT), Page 11 of 23 This certificate cancels and supersedes ALL previously issued certificates. ADDITIONAL INSURED—MORTGAGEE,ASSIGNEE OR RECEIVER (Insurance Services Office Endorsement CG 20 18 04 13) SCHEDULE Name Of Person(s)Or Organization(s) Designation Of Premises Any person or organization that is a mortgagee, assignee All premises covered by this insurance. or receiver for a premises shown in this Schedule,but only if coverage as an additional insured is required by a written contract or written agreement that is an"insured contract",and provided the"bodily injury"or"property damage"first occurs, or the"personal and advertising in- jury"offense is first committed, subsequent to the execu- tion of the contract or agreement. Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section II—Who Is An Insured is amended to include as an additional insured the person(s)or organiza- tion(s)shown in the Schedule, but only with respect to their liability as mortgagee, assignee, or receiver and arising out of the ownership, maintenance,or use of the premises by you and shown in the Schedule. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law;and 2. If coverage provided to the additional insured is required by a contract or agreement,the insurance af- forded 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. B. This insurance does not apply to structural alterations, new construction and demolition operations per- formed by or for that person or organization. C. With respect to the insurance afforded to these additional insureds,the following is added to Section III— Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement,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 shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. AD 68 93 0117 Includes copyrighted material of Insurance Services Office, Inc., Page 11 of 13 0 with its permission, 2009,2012&2013. 60685966 120-21 OL AUa UMB PROF WC Julie Hammond � 3/16/2021 10:43:10 PM (PDT) I Page 12 of 23 This certificate cancels and supersedes ALL previously issued certificates. ADDITIONAL INSURED—TRADE SHOW SPONSOR— AUTOMATIC STATUS WHEN REQUIRED IN WRITTEN AGREEMENT WITH YOU A. Section II—Who Is An Insured is amended to include as an additional insured any person or organization who is a sponsor of a trade show where you are operating a booth or displaying your product, but only: 1. For injury or damage occurring at the trade show;and 2. When you and such person or organization have agreed in writing in a contract or agreement executed prior to the beginning of the trade show that such person or organization be added as an additional in- sured on your policy. Such person or organization is an additional insured only with respect to liability for"bodily injury", "prop- erty damage" or"personal and advertising injury"caused, in whole or in part, by: 1. Your acts or omissions;or 2. The acts or omissions of those acting on your behalf; while attending the trade show sponsored by this additional insured. A person's or organization's status as an additional insured under this endorsement ends when your attend- ance at the trade show ends. B. With respect to the insurance afforded to these additional insureds,the following additional exclusion ap- plies: This insurance does not apply to"bodily injury" or"property damage" arising out of"your work" or"your product"and included in the"products-completed operations hazard". C. With respect to the insurance afforded to these additional insureds,the following is added to Section III— Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement,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 shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. AD 68 93 01 17 Includes copyrighted material of Insurance Services Office, Inc., Page 12 of 13 0 with its permission, 2009,2012&2013. 60685966 1 20-21 GL AU DMB PROF WC 1 Julie Hammond 1 3/16/2021 10:43:10 PM (PDT) 1 Page 13 of 23 This certificate cancels and supersedes ALL previously issued certificates. • ADDITIONAL INSURED—STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION—PERMITS OR AUTHORIZATIONS (INSURANCE SERVICES OFFICE ENDORSEMENT CG 20 12 04 13) SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: Any state or governmental agency or subdivision or political subdivision that has issued a permit or authoriza- tion for operations performed by you or on your behalf. ,Information required to complete this Schedule,if not shown above,will be shown in the Declarations. A. Section II—Who Is An Insured is amended to include as an additional insured any state or governmental agency or subdivision or political subdivision shown in the Schedule,subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. If coverage provided to the additional insured is required by a contract or agreement,the insurance afforded to such additional insured will not be broader than that which you are required by the con- tract or agreement to provide for such additional insured. 2. This insurance does not apply to: a. "Bodily injury","property damage" or"personal and advertising injury" arising out of operations performed for the federal government,state or municipality;or b. "Bodily injury" or"property damage" included within the"products-completed operations hazard". B. With respect to the insurance afforded to these additional insureds,the following is added to Section III— Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement,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 shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. AD 68 93 01 17 Includes copyrighted material of Insurance Services Office, Inc., Page 13 of 13 ❑ with its permission, 2009,2012&2013. 60685966 20-21 GL AUa UMB PROF WC Julie Hammond 3/16/2021 10:43:10 PM (PDT) � Page 14 of.23 This certificate cancels .and supersedes ALL previously issued certificates. • • Policy Number CA000034155-01 CG 2010 0413 Effective Date:04/15/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ•IT CAREFULLY.. ADDITIONAL INSURED OWNERS, LESSEES OR CONTRACTORS - SCHEDULED 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) Location(s)Of Covered Operations Any person or organization that is an owner or All locations'at which'the Named Insured,is manager of real property or personal property on . performing ongoing operations. which you are performing ongoing operations,or a contractor on whose behalf you are performing ongoing operations,but only if coverage as an additional insured is required by a written contract or written agreement that is an'"insured contract",and provided the"bodily injury"or"property damage" first occurs,or the"personal and advertising injury": offense is first.committed,subsequent to the execution of the contract or agreement _ . . _._. Information required to complete this Schedule,if riot shown above,will be shown in the Declarations. A. Section II-Who Is Ari Insured is amended to include as an additional insured the person(s)or organization(s)shown m the Schedule,but only with respect to liability for bodily injury", property damageor"personal and_advertising injury"caused,in whole or in part,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 for the additional insured(s)at the location(s)designated above.. However: 1. The insurance afforded to such additional insured only applies tothe extent permitted by law;and 2. If coverage provided to the additional insured is required by a contract or agreement,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. B. With respect to the insurance afforded to these additional insureds,the following additional exclusions apply: This insurance does not apply to"bodily injury"or"property damage"occurring after 1. All work,includingmaterials,parts or equipment furnished in connection with such work,on the project(other than service,maintenance or repairs)to be performed by or on behalf of the additional insured(s)at the location of the covered operations has been completed;or CG 2010 0413 ©Insurance Services Office,Inc.,2012. Page 1 of 2 60685966 120-21'GL AU URB PROF WC � Julie Hammond 3/16/2021 10:43:10 PM (PDT)..� age 15 of 23 - This certificate cancels and supersedes ALL previously issued certificates. 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. C. With respect to the insurance afforded to these additional insureds,the following is added to Section III—Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement,the most we willpay 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 shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.- CG 2010 0413 ©Insurance Services Office,Inc.,2012 Page 2 of 2 0 60685966 1 20-21 GL AU UMB PROF WC 1 Julie'Hammond 1 3/16/2021 10:43:10 PM (PDT) 1 Page 16 of 23 .. This certificate cancelsand supersedes ALL previously issued certificates. Policy Number CA000034155=01 CG 20 37 0413 Effective Date:04/15/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED = OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART .- PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s)• . Location And Description Of Or Organization(s) Completed Operations Any person or organization that is an owner or manager All locations except locations where"your work"is or of real property or personal property for whom you was related to a job or project involving single-family work or have worked,or a contractor on whose behalf dwellings,multi-family dwellings(other than rental you work or have worked,but only if coverage as an apartments in an apartment building: (a)originally additional insured extending to"bodily injury" or constructed and at all times used for such.purpose,or "property damage" included in the"products- (b)converted from a commercial building), completed operations hazard" is required by a written condominiums,townhomes,townhouses,time-share contract or written agreement that is an"insured units,fractional-ownership units,cooperatives and/or contract"and provided that the"bodily injury"or any other structure or space used or intended to be used "property damage" first occurs subsequent to the as a residence. execution of the contract or agreement. -- • Information required to complete this Schedule,if not shown above,will be shown in the Declarations.: A. 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"or"property damage"caused,in whole or in part,by "your work"at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the"products-completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law;and 2. If coverage provided to the additional insured is required by a contract or agreement,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. B. With respect to the insurance afforded to these additional insureds,the following is added to Section III—Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement,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 shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 37 04 13 ©Insurance Services Office,Inc.,2011 Page 1 of 1 11 60685966 1 20-21 GL AU UMB PROF WC 1 Julie Hammond 1 3/16/2021 10:43:10 PM (PDT) 1 Page 17 of 23 This certificate cancels and supersedes ALL previously issued certificates. COMMERCIAL AUTO EA 99 11 03 18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SPECIAL BUSINESS AUTO ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. The following changes revise SECTION I — COVERED The coverage that applies is the same as the AUTOS coverage provided for the vehicle being replaced. Paragraph C.1. is deleted and replaced with the Physical Damage Coverage is extended to the following: temporary substitute auto for the lesser of the 1. Trailers following number of days: a. "Trailers" with a load capacity of 2,000 1. The number of days reasonably required to pounds or less designed primarily for travel repair or replace the covered "auto" that is out on public roads; or of service; or b. "Trailers" designed primarily for travel on 2. 30 days. public roads when: The following changes revise SECTION II — LIABILITY (1) Pulled by an owned private passenger COVERAGE auto specifically described in Item The following isadded to Paragraph A.1.: Three of the Declarations as a covered d. Blanket Additional Insured "auto" for Liability Coverage under this Coverage Form; and Any person or organization that you are (2) Not used for business, farming or required to include as an additional insured ranching purposes. on this Coverage Form in a written contract or agreement that is signed and executed Private passenger auto means a motor by you before the"bodily injury"or"property vehicle of the private passenger, station damage" occurs and that is in effect during wagon, pickup or van type designed for use the policy period is an "insured"for Liability on public highways and subject to motor Coverage, but only for damages to which vehicle registration. this insurance applies. The following is added: A person's or organization's status as an D. Temporary Substitute Autos—Physical Damage additional insured under this endorsement ends when your contract or agreement with If Physical Damage Coverage is provided by this such person or organization ends. Coverage Form, the following types of vehicles are also covered "autos" for Physical Damage The Limits of Insurance applicable to the Coverage: Additional Insured are those specified in the written contract or agreement but not more Any "auto" you do not own while used with the than the Limits of Insurance specified in the permission of its owner as a temporary substitute Declarations of this policy. The Limits of for a covered "auto" you own that is out of service Insurance applicable to the Additional because of its: Insured are inclusive of and not in addition 1. Breakdown; to the Limits of Insurance shown in the 2. Repair; declarations for the Named Insured. 3. Servicing; This Coverage does not apply to lessors of leased"autos". 4. "Loss"; or 5. Destruction. EA 9911 0318 Includes copyrighted material of Insurance Services Office,Inc.,with its permission Page 1 of 6 60685966 1 20-21 GL AU UMB PROF WC 1 Julie Hammond 1 3/16/2021 10:93:10 PM (PDT) 1 Page 18 of 23 This certificate cancels and supersedes ALL previously issued certificates. e. Broadened Named Insured 2. Towing Any business entity newly acquired or We will pay up to $200 for a covered "auto" for formed by you during the policy period towing and labor costs incurred each time the provided you own 51% or more of the covered "auto" is disabled. However, the labor business entity and the business is not must be performed at the place of disablement. separately insured for Business Auto This coverage is excess over Coverage. Coverage is extended up to a maximum of 180 days following acquisition a. any limit shown in the Declarations for or formation of the business entity or until towing and labor costs; and the end of the policy period, whichever b. any other collectible insurance. comes first. This coverage applies only for an "auto" f. Employee Hired Auto covered on this policy for An"employee"of yours is an"insured"while c. Comprehensive or Specified Causes of operating an "auto" hired or rented under a Loss Coverage; and contract or agreement in that "employee's" d. Collision Coverage. name, with your permission, while performing duties related to the conduct of The following is added to Paragraph A.3 your business. Glass Repair—Waiver of Deductible Paragraphs A.2.a.(2) and A.2.a.(4) are deleted and No deductible will apply to glass breakage if replaced with the following: such glass is repaired in a manner acceptable 2. Coverage Extensions to us rather than replaced. a. Supplementary Payments Paragraph A.4.a. is deleted and replaced with the (2) Up to $5,000 for cost of bail bonds following: (including bonds for related traffic law 4. Coverage Extensions violations) required because of an a. Limited Rental Reimbursement or Travel "accident"we cover. We do not have to Expense furnish these bonds. We will pay up to $75 per day to a (4) All reasonable expenses incurred by maximum of $2,250 for rental the "insured" at our request, including reimbursement expenses for the rental of actual loss of earnings up to$500 a day an "auto" or other transportation expense because of time off from work. incurred by you because of "loss" to a Paragraph B.5. is deleted and replaced with the covered "auto" which is covered by following: Comprehensive, Specified Causes of Loss, 5. Fellow Employee or Collision coverage under this policy. No deductible applies to this coverage. "Bodily Injury"to: (1) We will pay only for those expenses a. Any fellow "employee" of the "insured" incurred as a result of a covered "loss" arising out of and in the course of the fellow occurring during the policy period "employee's" employment or while beginning 24 hours after the"loss" and performing duties related to the conduct of ending, regardless of the policy's your business. This exclusion does not expiration, with the lesser of the apply to an "insured" who occupies a following number of days: position as an officer, manager or supervisor.; or (a) The number of days reasonably required to repair or replace the b. The spouse, child, parent, brother or sister covered "auto". If"loss" is caused of that fellow"employee"as a consequence by theft, this number of days is of Paragraph a.above. added to the number of days it The following changes revise SECTION III—PHYSICAL takes to locate the covered "auto" DAMAGE COVERAGE and return it to you; or This coverage applies only for a covered "auto" for (b) 30 days. which Physical Damage Coverage is provided for on (2) Our payment under this Coverage this policy. Extension (4.a.) is limited to the lesser Paragraph A.2. is deleted and replaced with the of the necessary and actual expenses following: incurred or the maximum amount shown, $2,250. A. COVERAGE EA 99 11 03 18 Includes copyrighted material of Insurance Services Office,Inc.,with its permission Page 2 of 6 60605966 20-21 GL AU URB PROF WC Julie Hammond 3/16/2021 10,43,10 PM (PDT). Page 19 of 23 This certificate cancels and supersedes ALL previously issued certificates. (3) Coverage under this Coverage "loss", and such equipment is Extension (4.a.) does not apply while designed to be solely operated by there are spare or reserve "autos" use of the power from the "auto's" available to you for your operations. electrical system, in or upon the (4) If a covered "auto" is described or covered"auto". designated as a covered "auto" on (b) We will pay with respect to a endorsement EA 99 01, the coverage covered "auto" described in the provided by:this extension is excess Schedule for "loss" to any over coverage provided by accessories used with the endorsement EA 99 01. electronic equipment described in The following is added to paragraph A.4. Paragraph (1)(a) above. However, this does not include tapes, records c. Tapes, Records and Discs or discs. We will pay for "loss" to tapes, records, (2)Exclusions compact discs, or other similar devices used with audio, visual or data electronic The exclusions that apply to Physical devices. Damage Coverage, except for the (1) We will payonlyif the tapes, records, exclusion relating to Audio, Visual and p Data Electronic Equipment, also apply compact discs, or other similar devices: to coverage provided by this extension. (a) Are your property or that of a family In addition, the following exclusions member; or apply: (b) Are the property of an "employee" We will not pay, under this extension, using a, covered "auto" in your for either any electronic equipment or business affairs at the time of the accessories used with such electronic "loss"; and equipment that is: (c) Are in a covered "auto" which (a) Necessary for the normal operation sustains other covered "loss" under of the covered "auto" or the Comprehensive or Collision monitoring of the covered "auto's" coverage at the time of the"loss"to operating system; or tapes, records, compact discs, or (b) An integral part of the same unit other similar devices. housing any sound reproducing (2) The most we will pay for "loss" under equipment designed solely for the this Coverage Extension (4.c.) is$200. reproduction of sound if the sound (3) Physical Damage Coverage provisions reproducing equipment is permanently installed in the apply to this coverage, except that any deductible applicable to covered "auto"in the opening of the Comprehensive or Collision coverage dash or console normally used by does not apply to this Coverage the manufacturer for the installation Extension (4.c.). of a radio. d. Audio, Visual and Data Electronic (3) Limit of Insurance Equipment With respect to coverage under this (1) Coverage extension the Limit of Insurance provision of Physical Damage (a) We will pay with respect to a Coverage is replaced by the following: covered "auto" described in the (a) The most we will pay for all"loss"to Schedule for"loss"to any electronic audio, visual or data electronic equipment that receives or equipment and any accessories transmits audio, visual or data used with this equipment as a result signals and that is not designed of any one "accident" is the lesser solely for the reproduction of sound. of: This coverage applies only if the equipment is permanently installed (i) The actual cash value of the in the covered "auto" at the time of damaged or stolen property as the "loss" or the equipment is of the time of the"loss"; removable from a housing unit which is permanently installed in the covered'"auto" at the time of the EA 99 11 03 18 Includes copyrighted material of Insurance Services Office,Inc.,with its permission Page 3 of 6 60685966 120-21 GL AU UMB PROF WC � Julie Hammond 3/16/2021 10:93:10 PM (PDT) Page 20 of 23 This certificate cancels and supersedes ALL previously issued certificates. 1 (ii) The cost of repairing or g. Camper Bodies replacing the damaged or In the event of a "loss" to a detached stolen property with other "camper," physical damage coverage will property of like kind and quality; apply as if it were part of the covered "auto" or on which it is rated. (iii)$500. h. Contents of a Travel Trailer, Camper or (b) An adjustment for depreciation and Motor Home physical condition will be made in When a Travel Trailer, "Camper" or Motor determining actual cash value at Home is a scheduled auto for physical the time of the"loss". damage coverage, we will pay up to $1,000 (c) If a repair or replacement results in for"loss" to personal property belonging to better than like kind or quality, we you or a family member that is within the will not pay for the amount of Travel Trailer, "Camper" or Motor Home. betterment. We will pay up to$250 for"loss"to personal (4) Deductible property belonging to you or a family member that is outside the Travel Trailer, No deductible applies to this coverage. "Camper"or Motor Home. The insurance provided by this extension is (1) We will not pay for"loss"to: excess over any other collectible insurance. (a) Articles carried or held for sale, e. Custom Signs and Decorations storage or repairs, or for later Physical Damage coverage on a covered delivery; goods kept to show or sell; "auto" may be extended to "loss"to custom or theatrical wardrobes. signs and decorations including custom (b) Business, store of office furniture or murals, paintings or other decals or equipment. graphics. (c) Records or accounts, money, Our limit of liability for loss to custom signs bullion, deeds, contracts, evidences and decorations shall be the least of: of debt, securities,tokens or tickets, (1) Actual cash value of the stolen or stamps in current use or damaged property; manuscripts. (2) Amount necessary to repair or replace (d) Animals, private passenger"autos," the property; or motorcycles, aircrafts, boats or any (3) $500. other motorized vehicles or their equipment, furnishings or f. Personal Effects Coverage appurtenances. (1) Physical Damage Coverage on a (e) Equipment or accessories while covered "auto" may be extended to your Travel Trailer, "Camper" or "loss" to your "personal effects" or, if Motor Home is leased or rented to you are an. individual, the "personal any organization or any person effects" of a family member, that are in other than you or a family member. the covered "auto" at the time of the (2) The maximum we will pay for "loss" is "loss". the lesser of: (2) "Personal effects" as used in this (a) The actual cash value of the extension means tangible property that is worn or carried by the "insured". personal property at the time of "Personal effects" does not include "loss"; tools, jewelry, money, securities, radar (b) The cost of repairing the damage; or laser detectors, or tapes, records, or discs or similar audio, visual or data (c) The cost of replacing the damaged electronic equipment. personal property with other (3) The most we will pay for any one "loss" personal property of like kind, under this coverage extension is$500. condition, quality and value. No deductible applies to this extension. The insurance provided by this extension is excess over any other collectible insurance. EA 99 11 03 18 Includes copyrighted material of Insurance Services Office,Inc.,with its permission Page 4 of 6 60685966 20-21 GL AU UMB PROF WC Julie Hammond 3/16/2021 10:93:10 PM (P . � Page 21 of 23 This certificate cancels and supersedes ALL previously issued certDT)ificates. 1 • 4 i. Vacation Expense Allowance If hired "autos" are covered "autos" for Liability We will pay you $50 per day to a maximum Coverage and if Comprehensive, Specified of $500 for extra expenses when a Travel Causes of Loss or Collision Coverages are Trailer, "Camper" or Motor Home is a provided under this coverage form for any "auto" you own, then the Physical Damage scheduled auto for physical damage Coverages provided are extended to "autos" coverage, and the Travel Trailer, "Camper" you hire of like kind and use, subject to the or Motor Home: following: (1) Is damaged or destroyed and is uninhabitable; and a. The most we will pay for any one "loss" is While beingused for vacation purposes $50,000 or the actual cash value or the cost (2) PrP to repair and replace, whichever is less, within the policy period. minus a deductible; Extra expenses must by supported by b. The deductible will be equal to the largest receipts or other valid evidence. deductible applicable to any owned "auto" The following is added to Paragraph A.: for that coverage; 5. Extra Expense—Broadened Coverage c. Hired Auto Physical Damage coverage is We will pay for the direct expense of returning a excess over any other collectible insurance; stolen covered "auto" to you. We will pay only and for those covered "autos" for which you carry d. Subject to the above limit, deductible and Comprehensive or Specified Causes of Loss excess provisions,we will provide coverage Coverage. This coverage will only apply to equal to the broadest coverage applicable vehicles recovered inside the 48 contiguous to any covered"auto"you own. United States. This coverage does not apply to If a limit for Hired Auto Physical Damage is an "auto"we deem a'total"loss". indicated in the Declarations, then that limit 6. Auto Loan/Lease Gap Coverage replaces, and is not in addition to, the $50,000 In the event of a covered total "loss" to a limit indicated above. covered "auto" described or designated in the The following is added to Paragraph B.3.a.: Schedule or in the Declarations, we will pay up Airbag Coverage—Accidental Deployment to $2,000 for any unpaid amount due on the lease or loan for covered"auto"less: However, this exclusion does not apply to the unintended inflation of an airbag if the inflation a. The Amount paid under the Physical is caused by mechanical or electrical Damage Coverage section A.1. of the breakdown. policy; and The following is added to Paragraph C.2. b. Any: New Vehicle Replacement Cost (1) Overdue lease/loan payments at the time of the"loss"; If, however, a "loss" occurs to your covered auto" within 180 days of your purchase of the"auto"and, (2) Financial penalties imposed under a we deem the covered "auto"to be a total"loss"and lease for excessive use, abnormal wear it has not been previously titled under the motor and tear or high mileage; vehicle law of any state,we will pay at your option: (3) Security deposits not returned by the a. the cost to replace the covered "auto" with a Lessor; new"auto"of like make, model and year; or (4) Costs for extended warranties, Credit b. an amount equal to the original purchase price Life Insurance, Health, Accident or you paid to acquire the vehicle, including taxes, Disability Insurance purchased with the but excluding any extended warranties and loan or lease; and licensing fees. (5) Carry-over balances from previous This coverage applies only to a covered "auto" of loans or leases. the private passenger, light truck or medium truck 7. Hired Auto Physical Damage Coverage type(20,000 lbs. or less gross vehicle weight). EA 99 11 03 18 Includes copyrighted material of Insurance Services Office,Inc.,with its permission Page 5 of 6 60605966 120-21 GL AUa URB PROF WC Julie Hammond 3/16/2021 10:43:10 PM (PDT) Page 22 of 23 This certificate cancels and supersedes ALL previously issued certificates. • J , The following changes revise SECTION IV — The following changes revise SECTION V — BUSINESS AUTO CONDITIONS DEFINITIONS The following is added to Paragraph A.2.a.: The following is added: Amended Duties in the Event of an Accident, Q. "Camper" means a portable dwelling unit without Claim, Lawsuit or Loss axles or wheels that has been manufactured for However, this duty is only required when the attachment on the bed of a pickup truck to be used "accident"is known to: for casual travel or camping. (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) A member, if you are.a limited liability company; or (4) An executive officer or insurance manager, if you are a corporation. The following is added to Paragraph A.: 6. Blanket Waiver of Subrogation We waive any right of recovery we may have against any person or organization to the extent required of you by a written contract executed prior to any"accident"because of payments we make for damages under this coverage form. The following is added to Paragraph B.2.: Unintentional Failure toDisclose Hazards Any unintentional failure to disclose all exposures or hazards existing as of the effective date of the Business Auto Coverage Form or at any time during the policy period will not invalidate or adversely affect the coverage for such exposure or hazard. However, you must report the undisclosed exposure or hazard to us as soon as reasonably possible after its discovery. Paragraph B.5.b. is deleted and replaced with the following: a. For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any "auto"that is leased, hired, rented or borrowed with a driver is not a covered"auto". The following is added to Paragraph B.5. d. To the extent required by an "insured contract", this insurance is primary on behalf of the additional insured, 'and any other insurance maintained by the additional insured is excess and not contributory with this insurance. If the "insured contract" does not require this provision, then Paragraph a.above will apply. EA 99 11 03 18 Includes copyrighted material of Insurance Services Office,Inc.,with its permission Page 6 of 6 60685966 120-21 GL AU UMB PROF WC � Julie Hammond � 3/16/2021 10,93,10 PM (PDT) � Page 23 of 23 This certificate cancels and supersedes ALL previously issued certificates.