Loading...
HomeMy WebLinkAboutPW12-001 - Original - A & M Consulting - SE 256th Street Improvements Utility Coordination - 02/15/2012 Records Mand'"g6e- meriti-A KENO Document WASNINGTGN a CONTRACT COVER SHEET This is to be completed by the Contract Manager prior to submission to City Clerks Office. All portions are to be completed. If you have questions, please contact City Clerk's Office. Vendor Name: A & M Consulting Vendor Number: ID Edwards Number Contract Number: This is assigned by City Clerk's Office Project Name: SE 256th Street Improvements Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ® Contract ❑ Other: Contract Effective Date: Date of the Mayor's Signature Termination Date: 12/31/13 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Mark Howlett Department: Engineering Detail: (i.e. address, location, parcel number, tax id, etc.): Provide public and-Private utility coordination for the project. ___ S Public\aecordsManagement\Forms\ContractCover\adcc7832 1 11/08 KEN T WAS HIM1 GT GN CONSULTANT SERVICES AGREEMENT between the City of Kent and A & M Consulting THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and A & M Consulting organized under the laws of the State of Washington, located and doing business at 18119 NE 30th St., Redmond, WA 98052, Phone: ; (206) 276-3635/Fax: (425) 833-1739, Contact: Arnold Tomac (hereinafter the "Consultant"). I. DESCRIPTION OF WORK. Consultant shall perform the following services for the City in accordance with the following described plans and/or specifications: The Consultant shall provide public and private utility coordination for the SE 256" Street Improvements project. For a description, see the Consultant's Scope of Work which is attached as Exhibit A and incorporated by this reference. Consultant further represents that the services furnished under this Agreement will be performed in accordance with generally accepted professional practices within the Puget Sound region in effect at the time those services are performed. II. TIME OF COMPLETION. The parties agree that work will begin on the tasks described in Section I above immediately upon the effective date of this Agreement. Upon the effective date of this Agreement, Consultant shall complete the work described in Section I by December 31, 2013. III. COMPENSATION. A. The City shall pay the Consultant, based on time and materials, an amount not to exceed Nineteen Thousand, Nine Hundred Sixty Five Dollars ($19,965.00), plus applicable Washington State sales tax, for the services described in this Agreement. This is the maximum amount to be paid under this Agreement for the work described in Section I above, and shall not be exceeded without the prior written authorization of the City in the form of a negotiated and executed amendment to this agreement. The Consultant agrees that the hourly or flat rate charged by it for ; its services contracted for herein shall remain locked at the negotiated rate(s) for a period of one (1) year from the effective date of this Agreement. The Consultant's billing rates shall be as delineated in Exhibit B. CONSULTANT SERVICES AGREEMENT - 1 (Over$10,000) B. The Consultant shall submit monthly payment invoices to the City for work performed, and a final bill upon completion of all services described in this Agreement. The City shall provide payment within forty-five (45) days of receipt of an invoice. If the City objects to all or any portion of an invoice, it shall notify the Consultant and reserves the option to only pay that portion of the invoice not in dispute. In that event, the parties will immediately make every effort to settle the disputed portion. IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor-Employer Relationship will be created by this Agreement. By their execution of this Agreement, and in accordance with Ch. 51.08 RCW, the parties make the following representations: A. The Consultant has the ability to control and direct the performance and details of its work, the City being interested only in the results obtained under this Agreement. B. The Consultant maintains and pays for its own place of business from which Consultant's services under this Agreement will be performed. C. The Consultant has an established and independent business that is eligible for a business deduction for federal income tax purposes that existed before the City retained Consultant's services, or the Consultant is engaged in an independently established trade, occupation, profession, or business of the same nature as that involved under this Agreement. D. The Consultant is responsible for filing as they become due all necessary tax documents with appropriate federal and state agencies, including the Internal Revenue Service and the state Department of Revenue. E. The Consultant has registered its business and established an account with the state Department of Revenue and other state agencies as may be required by Consultant's business, and has obtained a Unified Business Identifier (UBI) number from the State of Washington. F. The Consultant maintains a set of books dedicated to the expenses and earnings of its business. V. TERMINATION. Either party may terminate this Agreement, with or without cause, upon providing the other party thirty (30) days written notice at its address set forth on the signature block of this Agreement. After termination, the City may take possession of all records and data within the Consultant's possession pertaining to this project, which may be used by the City without restriction. If the City's use of Consultant's records or data is not related to this project, it shall be without liability or legal exposure to the Consultant. VI. DISCRIMINATION. In the hiring of employees for the performance of work under this Agreement or any subcontract, the Consultant, its subcontractors, or any person acting on behalf of the Consultant or subcontractor shall not, by reason of race, religion, color, sex, age, sexual orientation, national origin, or the presence of any sensory, mental, or physical disability, discriminate against any person who is qualified and available to perform the work to which the employment relates. Consultant shall execute the attached City of Kent Equal Employment CONSULTANT SERVICES AGREEMENT - 2 (Over $10,000) Opportunity Policy Declaration, Comply with City Administrative Policy 1.2, and upon completion of the contract work, file the attached Compliance Statement. VII. INDEMNIFICATION. Consultant shall defend, indemnify and hold the City, its officers, officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or suits, including all legal costs and attorney fees, arising out of or in connection with the Consultant's performance of this Agreement, except for that portion of the injuries and damages caused by the City's negligence. The City's inspection or acceptance of any of Consultant's work when completed shall not be grounds to avoid any of these covenants of indemnification. Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the Consultant and the City, its officers, officials, employees, agents and volunteers, the Consultant's liability hereunder shall be only to the extent of the Consultant's negligence. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONSULTANT'S WAIVER OF IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER. In the event Consultant refuses tender of defense in any suit or any claim, if that tender was made pursuant to this indemnification clause, and if that refusal is subsequently determined by a court having jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the Consultant's part, then Consultant shall pay all the City's costs for defense, including all reasonable expert witness fees and reasonable attorneys' fees, plus the City's legal costs and fees incurred because there was a wrongful refusal on the Consultant's part. The provisions of this section shall survive the expiration or termination of this Agreement. VIII. INSURANCE. The Consultant shall procure and maintain for the duration of the Agreement, insurance of the types and in the amounts described in Exhibit G ttached and incorporated by this reference. IX. EXCHANGE OF INFORMATION. The City will provide its best efforts to provide reasonable accuracy of any information supplied by it to Consultant for the purpose of completion of the work under this Agreement. X. OWNERSHIP AND USE OF RECORDS AND DOCUMENTS. Original documents, drawings, designs, reports, or any other records developed or created under this Agreement shall belong to and become the property of the City. All records submitted by the City to the Consultant will be safeguarded by the Consultant. Consultant shall make such data, documents, and files available to the City upon the City's request. The City's use or reuse of any of the documents, data and files created by Consultant for this project by anyone other than Consultant on any other project shall be without liability or legal exposure to Consultant. XI. CITY'S RIGHT OF INSPECTION. Even though Consultant is an independent contractor with the authority to control and direct the performance and details of the work CONSULTANT SERVICES AGREEMENT - 3 (Over$10,000) authorized under this Agreement, the work must meet the approval of the City and shall be subject to the City's general right of inspection to secure satisfactory completion. XII. WORK PERFORMED AT CONSULTANT'S RISK. Consultant shall take all necessary precautions and shall be responsible for the safety of its employees, agents, and subcontractors in the performance of the contract work and shall utilize all protection necessary for that purpose. All work shall be done at Consultant's own risk, and Consultant shall be responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with the work. XIII. MISCELLANEOUS PROVISIONS. A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City requires its contractors and consultants to use recycled and recyclable products whenever practicable. A price preference may be available for any designated recycled product. B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of any of the covenants and agreements contained in this Agreement, or to exercise any option conferred by this Agreement in one or more instances shall not be construed to be a waiver or relinquishment of those covenants, agreements or options, and the same shall be and remain in full force and effect. C. Resolution of Disputes and Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the State of Washington. If the parties are unable to settle any dispute, difference or claim arising from the parties' performance of this Agreement, the exclusive means of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the parties' performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or award provided by law; provided, however, nothing in this paragraph shall be construed to limit the City's right to indemnification under Section VII of this Agreement. d D. Written Notice. All communications regarding this Agreement shall be sent to the parties at the addresses listed on the signature page of the Agreement, unless notified to the contrary. Any written notice hereunder shall become effective three (3) business days after the date of mailing by registered or certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this Agreement or such other address as may be hereafter specified in writing. E. Assignment. Any assignment of this Agreement by either party without the written consent of the non-assigning party shall be void. If the non-assigning party gives its consent to any assignment, the terms of this Agreement shall continue in full force and effect and no further assignment shall be made without additional written consent. F. Modification. No waiver, alteration, or modification of any of the provisions of this Agreement shall be binding unless in writing and signed by a duly authorized representative of the City and Consultant. G. Entire Agreement. The written provisions and terms of this Agreement, together with any Exhibits attached hereto, shall supersede all prior verbal statements of any officer or 3 CONSULTANT SERVICES AGREEMENT - 4 (Over$10,000) other representative of the City, and such statements shall not be effective or be construed as entering into or forming a part of or altering in any manner this Agreement. All of the above documents are hereby made a part of this Agreement. However, should any language in any of the Exhibits to this Agreement conflict with any language contained in this Agreement, the terms of this Agreement shall prevail. H. Compliance with Laws. The Consultant agrees to comply with all federal, state, and municipal laws, rules, and regulations that are now effective or in the future become applicable to Consultant's business, equipment, and personnel engaged in operations covered by this Agreement or accruing out of the performance of those operations. I. Counterparts. This Agreement may be executed in any number of counterparts, each of which shall constitute an original, and all of which will together constitute this one Agreement. IN WITNESS, the parties below execute this Agreement, which shall become effective on the last date entered below. CONSULTANT: CITY OF KENT: By: gsjIM (stg azure) (signature) Print Name: ita�l��� �dtG uzette Cooke Its w n4✓ a or rt/e) DATE: :1 DATE: NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: CONSULTANT: CITY OF KENT: Arnold Tomac Timothy J. LaPorte, P.E. A & M Consulting City of Kent 18119 NE 30th St. 220 Fourth Avenue South Redmond, WA 98052 Kent, WA 98032 (206) 276-3635 (telephone) (253) 856-5500 (telephone) (425) 833-1739 (facsimile) (253) 856-6500 (facsimile) APP S T FORM: 1 OVED Kent Law Depa rta A 6 M Consulting-25e`"3/Howlett CONSULTANT SERVICES AGREEMENT - 5 (Over$10,000) • t DECLARATION CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY The City of Kent is committed to conform to Federal and State laws regarding equal opportunity. As such all contractors, subcontractors and suppliers who perform work with relation to this Agreement shall comply with the regulations of the City's equal employment opportunity policies. The following questions specifically identify the requirements the City deems necessary for any contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative response is required on all of the following questions for this Agreement to be valid and binding. If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the directives outlines, it will be considered a breach of contract and it will be at the City's sole determination regarding suspension or termination for all or part of the Agreement; The questions are as follows: 1. I have read the attached City of Kent administrative policy number 1.2. 2. During the time of this Agreement I will not discriminate in employment on the basis of sex, race, color, national origin, age, or the presence of all sensory, mental or physical disability. 3. During the time of this Agreement the prime contractor will provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 4. During the time of the Agreement I, the prime contractor, will actively consider hiring and promotion of women and minorities. 5. Before acceptance of this Agreement, an adherence statement will be signed by me, the Prime Contractor, that the Prime Contractor complied with the requirements as set forth above. By signing below, I agree to fulfill the five requirements referenced above. Dated this day of t-t 1j , 20,,. By: For: L Title: l/ t e-,e Date: 2_� Sf�2012 EEO COMPLIANCE DOCUMENTS - 1 CITY OF KENT ADMINISTRATIVE POLICY NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998 SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996 CONTRACTORS APPROVED BY Jim White, Mayor POLICY: Equal employment opportunity requirements for the City of Kent will conform to federal and state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee equal employment opportunity within their organization and, if holding Agreements with the City amounting to $10,000 or more within any given year, must take the following affirmative steps: 1. Provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 2. Actively consider for promotion and advancement available minorities and women. Any contractor, subcontractor, consultant or supplier who willfully disregards the City's nondiscrimination and equal opportunity requirements shall be considered in breach of contract and subject to suspension or termination for all or part of the Agreement. Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public Works Departments to assume the following duties for their respective departments. 1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these regulations are familiar with the regulations and the City's equal employment opportunity policy. 2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines. EEO COMPLIANCE DOCUMENTS - 2 CITY OF (CENT EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the Agreement. I, the undersigned, a duly represented agent of A_& M Conqultiing Company, hereby acknowledge and declare that the before-mentioned company was the prime contractor for the Agreement known as that was entered into on the FebEuary f (date) between the firm I represent and the City of Kent. I declare that I complied fully with all of the requirements and obligations as outlined in the City of Kent Administrative Policy 1.2 and the Declaration City of Kent Equal Employment opportunity Policy that was part of the before-mentioned Agreement. By: For: Title. 71 7 Date: EEO COMPLIANCE DOCUMENTS - I EXHIBIT A A & M Consulting SE 256th Street Improvements Scope of Work The Consultant shall provide consultation services to the City for public and private utility coordination for the SE 256" Street Improvement Project. These services shall include the following: • Evaluate impacts of City's project on private utilities' equipment. • Coordinate with Puget Sound Energy to execute a Schedule 74 Conversion Agreement for undergrounding of overhead power. • Coordinate with private property owners to facilitate conversion of their private services from overhead to underground. • Coordinate with other utilities and City staff for construction of a joint utility trench and conversion of services from overhead to underground. • Coordinate with other private utility companies for relocation of their facilities that conflict with City's proposed project. • Coordinate with private utilities, prepare agreements and cost estimates for utility relocations. • Provide construction coordination and provide advice on resolution of conflicts related to private utilities during construction of City's public works projects. EXHIBIT B A & M Consulting SE 256`h Street Improvements Budget Project Hours Billing Total Mileage Mileage Total Total Rate Labor Rate Mileage SE 256th Street 300 66.00 191800 300 .55 165.00 $19,965 Improvements EXHIBIT C INSURANCE REQUIREMENTS FOR CONSULTANT SERVICES AGREEMENTS Insurance The Consultant shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Consultant, their agents, representatives, employees or subcontractors. A. Minimum Scope of Insurance Consultant shall obtain insurance of the types described below: 1. Automobile Liability insurance covering all owned, non-owned, hired and leased vehicles. Coverage shall be written on Insurance Services Office (ISO) form CA 00 01 or a substitute form providing equivalent liability coverage. If necessary, the policy shall be endorsed to provide contractual liability coverage. 2. Commercial General Liability insurance shall be written on ISO occurrence form CG 00 01. The City shall be named as an Additional Insured under the Consultant's Commercial General Liability insurance policy with respect to the work performed for the City using ISO additional insured endorsement CG 20 10 11 85 or a substitute endorsement providing equivalent coverage. 3. Workers' Compensation coverage as required by the Industrial Insurance laws of the State of Washington. B. Minimum Amounts of Insurance Consultant shall maintain the following insurance limits: 1. Automobile Liability insurance with a minimum combined single limit for bodily injury and property damage of $1,000,000 per accident. 2. Commercial General Liability insurance shall be written with limits no less than $1,000,000 each occurrence, $2,000,000 general aggregate. EXHIBIT C (Continued) C. Other Insurance Provisions The insurance policies are to contain, or be endorsed to contain, the following provisions for Automobile Liability and Commercial General Liability insurance: 1. The Consultant's insurance coverage shall be primary insurance as respect the City. Any Insurance, self-insurance, or insurance pool coverage maintained by the City shall be excess of the Consultant's insurance and shall not contribute with it. 2. The Consultant's insurance shall be endorsed to state that coverage shall not be cancelled by either party, except after thirty (30) days prior written notice by certified mail, return receipt requested, has been given to the City. 3. The City of Kent shall be named as an additional insured on all policies (except Professional Liability) as respects work performed by or on behalf of the Consultant and a copy of the endorsement naming the City as additional insured shall be attached to the Certificate of Insurance. The City reserves the right to receive a certified copy of all required insurance policies. The Consultant's Commercial General Liability insurance shall also contain a clause stating that coverage shall apply separately to each insured against whom claim is made or suit is brought, except with respects to the limits of the insurer's liability. D. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best rating of not less than ANII. E. Verification of Coverage Consultant shall furnish the City with original certificates and a copy of the amendatory endorsements, including but not necessarily limited to the additional insured endorsement, evidencing the insurance requirements of the Consultant before commencement of the work. F. Subcontractors Consultant shall include all subcontractors as insureds under its policies or shall furnish separate certificates and endorsements for each subcontractor. All coverages for subcontractors shall be subject to all of the same insurance requirements as stated herein for the Consultant. 7 a DATE(MM/DD/YYYYI ACC)IR" CERTIFICATE OF LIABILITY INSURANCE 09-21-2011 THIS CERTIFICATEIS 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 ADDITIONALINSURED,the policy(ies)must be endorsed If SUBROGATIONIS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s) PRODUCER CONTACT AJ GALLAGHER RSK MGMT SVCS INC/PHS NAME FAX 812490 P: (866) 467-8730 F• (877) 905-0457 A oExtl (866) 467-8730 Iac,No) (877) 905-045 ADDRESS PO BOX 33015 PRODUCE SAN ANTONIO TX 78265 CUSTOMER 10# INSURER(S)AFFORDING COVERAGE NAICd INSURED INSURER Hartford Casualty Ins Co ARNOLD TOMAC DBA A & M CONSULTING INSURER B 18119 NE 3 0TH ST INSURER C REDMOND WA 98052 INSURER NSURER E NSURER F COVERAGES CERTIFICATE NUMBER- 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 LTR TYPE OF INSURANCE INSR (MM'D POLIDN WVD POLICY NUMBER C PODLIMITS EFF ( ICY N XFYI GENERAL LIABILITY EACH OCCURRENCE $ 1, 000, 000 COMMERCIAL GENERAL LIABILITY I PREMISES (Ea occurrence) 5 300, 000 A CLAIMS-MADE lI OCCUR MED EXP(Any one person) $ 10, 000 X General Liab X 52 SBM UK5025 11/01/2011 11/01/2012 PERSONAL&ADV INJURY $ 1, 000, 000 GENERAL AGGREGATE S 2 , 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG S 2, 000, 000 Li POLICY L , PRO- X LOC $ ECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT IEa accident) 8 1, 000, 000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY leer accident)15 SCHEDULED AUTOS PROPERTY DAMAGE A X HIRED AUTOS 52 SBM UK5025 11/01/2011 11/01/2012 (Per accident) $ X NON-OWNED AUTOS $ $ ' UMBRELLA UAB u OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE It DEDUCTIBLE S RETENTION $ $ WORKERS COMPENSATION WC STATU OTH AND EMPLOYERS LIABILITY Tv RY LIMITS I ER YIN ANY PROPRIETOR'PARTNER/EXECUTIVE N i A E L EACH ACCIDENT $ 1, 000, 000 A OFFICERWEMBER EXCLUDED? Li (Mandatory in NHI 52 SBM UK5025 11/01/2011 11/01/2012 EL DISEASE -EA EMPLOYE $ 1, 000, 000 If yes,describe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ 1, 000, 000 DESCRIPTION OF OPERATIONS f LOCATIONS!VEHICLES(Attach ACORD 101,Addilional Remarks Schedule,if more space Is required) Those usual to the Insured' s Operations . CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED The City of Kent BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE Public Works Engineering DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS AUTHORIZE PRESENTATIVE 222 Fourth Ave . S . Kent WA 98032 �<-- � �`�� c'1988-2009 ACORD CORPORATION All rights reserved ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD AJ GALLAGHER RSK MGMT SVCS IN0PHS PO BOX 33015 SAN ANTONIO TX, 78265 05737 The City of Kent Public Works Engineering 222 Fourth Ave . S . Kent WA 98032 # N N pL m y N N N ACORD 25 (2009/09) BUSINESS LIABILITY COVERAGE FORM Form SS 00 08 04 05 © 2005,The Hartford QUICK REFERENCE BUSINESS LIABILITY COVERAGE FORM READ YOUR POLICY CAREFULLY BUSINESS LIABILITY COVERAGE FORM Beginning on Page A. COVERAGES 1 Business Liability 1 Medical Expenses 2 Coverage Extension-Supplementary Payments 2 B. EXCLUSIONS 3 C. WHO IS AN INSURED 10 D. LIABILITY AND MEDICAL EXPENSES LIMITS OF INSURANCE 14 E. LIABILITY AND MEDICAL EXPENSES GENERAL CONDITIONS 15 1. Bankruptcy 15 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit 15 3. Financial Responsibility Laws 16 4. Legal Action Against Us 16 5. Separation Of Insureds 16 6. Representations 16 7. Other Insurance 16 8. Transfer Of Rights Of Recovery Against Others To Us 17 F. OPTIONAL ADDITIONAL INSURED COVERAGES 18 Additional Insureds 18 G. LIABILITY AND MEDICAL EXPENSES DEFINITIONS 20 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage Read the entire policy carefully to determine rights,duties and what is and is not covered Throughout this policy the words "you" and "your" refer to the Named Insured shown in the Declarations. The words "we", "us"and"our"refer to the stock insurance company member of The Hartford providing this insurance. The word 'insured"means any person or organization qualifying as such under Section C.-Who Is An Insured. Other words and phrases that appear in quotation marks have special meaning Refer to Section G - Liability And Medical Expenses Definitions. A. COVERAGES (a) The "bodily injury" or "property 1. BUSINESS LIABILITY COVERAGE (BODILY damage" is caused by an "occurrence" that takes place in the INJURY, PROPERTY DAMAGE, PERSONAL "coverage territory"; AND ADVERTISING INJURY) Insuring Agreement (b) The "bodily injury" or "property damage" occurs during the policy a. We will pay those sums that the insured period, and becomes legally obligated to pay as (c) Prior to the policy period, no insured damages because of "bodily injury", listed under Paragraph 1. of Section "property damage" or "personal and C. — Who Is An Insured and no advertising injury" to which this insurance "employee"authorized by you to give applies We will have the right and duty to or receive notice of an "occurrence" defend the insured against any "suit" or claim, knew that the"bodily injury" seeking those damages However, we will or "property damage" had occurred, have no duty to defend the insured against in whole or in part If such a listed any "suit" seeking damages for "bodily insured or authorized "employee" injury", "property damage" or "personal and knew, prior to the policy period, that advertising injury" to which this insurance the "bodily injury" or "property does not apply damage" occurred, then any We may, at our discretion, investigate any continuation, change or resumption "occurrence" or offense and settle any claim of such "bodily injury" or "properly or"suit"that may result But damage" during or after the policy (1) The amount we will pay for damages is period will be deemed to have been limited as described in Section D. - known prior to the policy period Liability And Medical Expenses Limits (2) To "personal and advertising injury" Of Insurance;and caused by an offense arising out of your (2) Our right and duty to defend ends when business, but only if the offense was we have used up the applicable limit of committed in the "coverage territory" insurance in the payment of judgments, during the policy period. settlements or medical expenses to which c. "Bodily injury" or "property damage" will be this insurance applies. deemed to have been known to have No other obligation or liability to pay sums or occurred at the earliest time when any perform acts or services is covered unless insured listed under Paragraph 1.of Section explicitly provided for under Coverage C. —Who Is An Insured or any "employee" Extension-Supplementary Payments authorized by you to give or receive notice b. This insurance applies- of an"occurrence"or claim (1) Reports all, or any part, of the "bodily damage"(1) "bodily injury" and "properly injury" or "property damage" to us or damage only if any other insurer, Form SS 00 08 04 05 Page 1 of 24 © 2005,The Hartford BUSINESS LIABILITY COVERAGE FORM (2) Receives a written or verbal demand or b. We will make these payments regardless of claim for damages because of the "bodily fault These payments will not exceed the injury"or"properly damage",or applicable limit of insurance We will pay (3) Becomes aware by any other means that reasonable expenses for "bodily injury" or "property damage" has (1) First aid administered at the time of an occurred or has begun to occur accident; d. Damages because of "bodily injury" include (2) Necessary medical, surgical, x-ray and damages claimed by any person or dental services, including prosthetic organization for care, loss of services or devices;and death resulting at any time from the "bodily (3) Necessary ambulance, hospital, injury" professional nursing and funeral e. Incidental Medical Malpractice services (1) "Bodily injury" arising out of the 3. COVERAGE EXTENSION - rendering of or failure to render SUPPLEMENTARY PAYMENTS professional health care services as a a. We will pay, with respect to any claim or physician, dentist, nurse, emergency "suit" we investigate or settle, or any "suit" medical technician or paramedic shall against an insured we defend- be deemed to be caused by an "occurrence", but only if. (1) All expenses we incur (a) The physician, dentist, nurse, (2) Up to $1,000 for the cost of bail bonds emergency medical technician or required because of accidents or traffic paramedic is employed by you to law violations arising out of the use of provide such services; and any vehicle to which Business Liability Coverage for"bodily injury" applies We (b) You are not engaged in the do not have to furnish these bonds business or occupation of providing such services (3) The cost of appeal bonds or bonds to release attachments, but only for bond (2) For the purpose of determining the amounts within the applicable limit of limits of insurance for incidental medical insurance We do not have to furnish malpractice, any act or omission these bonds together with all related acts or omissions in the furnishing of these (4) All reasonable expenses incurred by the services to any one person will be insured at our request to assist us in the considered one"occurrence" investigation or defense of the claim or 2. MEDICAL EXPENSES "suit", including actual loss of earnings up to $500 a day because of time off Insuring Agreement from work a. We will pay medical expenses as described (5) All costs taxed against the insured in below for "bodily injury" caused by an the "suit" accident (6) Prejudgment interest awarded against (1) On premises you own or rent; the insured on that part of the judgment (2) On ways next to premises you own or we pay If we make an offer to pay the rent; or applicable limit of insurance, we will not (3) Because of your operations, pay any prejudgment interest based on that period of time after the offer provided that. (7) All interest on the full amount of any (1) The accident takes place in the judgment that accrues after entry of the "coverage territory" and during the judgment and before we have paid, policy period, offered to pay, or deposited in court the (2) The expenses are incurred and reported part of the judgment that is within the to us within three years of the date of applicable limit of insurance the accident,and Any amounts paid under (1) through (7) (3) The injured person submits to above will not reduce the limits of insurance examination, at our expense, by physicians of our choice as often as we reasonably require. Page 2 of 24 Form SS 00 08 04 05 - x BUSINESS LIABILITY COVERAGE FORM b. If we defend an insured against a "suit" So long as the above conditions are met, and an indemnitee of the insured is also attorneys' fees incurred by us in the named as a party to the "suit", we will defense of that indemnitee, necessary defend that indemnitee if all of the litigation expenses incurred by us and following conditions are met necessary litigation expenses incurred (1) The "suit" against the indemnitee by the indemnitee at our request will be seeks damages for which the insured paid as Supplementary Payments has assumed the liability of the Notwithstanding the provisions of indemnitee in a contract or agreement Paragraph 1.b.(b) of Section B. — that is an "insured contract", Exclusions, such payments will not be (2) This insurance applies to such liability deemed to be damages for "bodily assumed by the insured, injury" and "property damage" and will (3) The obligation to defend, or the cost of not reduce the Limits of Insurance the defense of, that indemnitee, has Our obligation to defend an insured's also been assumed by the insured in indemnitee and to pay for attorneys' fees the same"insured contract", and necessary litigation expenses as (4) The allegations in the "suit" and the Supplementary Payments ends when. information we know about the (1) We have used up the applicable limit "occurrence" are such that no conflict of insurance in the payment of appears to exist between the interests judgments or settlements, or of the insured and the interest of the (2) The conditions set forth above, or the indemnitee, terms of the agreement described in {5) The indemnitee and the insured ask Paragraph(6)above,are no longer met us to conduct and control the defense B. EXCLUSIONS of that indemnitee against such "suit" 1. Applicable To Business Liability Coverage and agree that we can assign the same counsel to defend the insured This insurance does not apply to- and the indemnitee, and a. Expected Or Intended Injury (6) The indemnitee (1) "Bodily injury" or "property damage" (a) Agrees in writing to expected or intended from the (i) Cooperate with us in the standpoint of the insured This exclusion does not apply to bodily investigation, settlement or defense of the"suit", injury" or "property damage" resulting from the use of reasonable force to (11) Immediately send us copies of protect persons or property; or any demands, notices, (2) "Personal and advertising injury" ansing summonses or legal papers out of an offense committed by, at the received in connection with direction of or with the consent or the "suit", acquiescence of the insured with the (it!) Notify any other insurer whose expectation of inflicting "personal and coverage is available to the advertising injury". indemnitee, and b. Contractual Liability (Iv) Cooperate with us with (1) "Bodily injury"or"property damage",or respect to coordinating other applicable insurance available (2) "Personal and advertising injury" to the indemnitee, and for which the insured is obligated to pay (b) Provides us with written damages by reason of the assumption of authorization to liability in a contract or agreement. (i) Obtain records and other This exclusion does not apply to liability information related to the for damages because of "suit", and (a) "Bodily injury", "property damage"or (11) Conduct and control the "personal and advertising injury"that defense of the indemnitee in the insured would have in the such "suit". absence of the contract or agreement;or Form SS 00 08 04 05 Page 3 of 24 BUSINESS LIABILITY COVERAGE FORM (b) "Bodily injury"or"property damage" (b) Performing duties related to the assumed in a contract or agreement conduct of the insured's business,or that is an "insured contract", (2) The spouse, child, parent, brother or provided the "bodily injury" or sister of that "employee" as a "property damage" occurs consequence of(1)above. subsequent to the execution of the This exclusion applies contract or agreement Solely for the purpose of liability assumed in (1) Whether the insured may be liable as an "insured contract", reasonable an employer or in any other capacity; attomeys' fees and necessary and litigation expenses incurred by or for (2) To any obligation to share damages a party other than an insured are with or repay someone else who must deemed to be damages because of pay damages because of the injury "bodily injury" or"property damage" This exclusion does not apply to liability provided. assumed by the insured under an "insured (I) Liability to such party for, or for contract" the cost of, that party's defense f. Pollution has also been assumed in the same"insured contract",and (1) "Bodily injury", "property damage" or "personal and advertising injury" (tt) Such attorneys' fees and arising out of the actual, alleged or litigation expenses are for threatened discharge, dispersal, defense of that party against a seepage, migration, release or escape civil or alternative dispute of"pollutants" resolution proceeding in which damages to which this (a) At or from any premises, site or insurance applies are alleged location which is or was at any c. Liquor-Liability time owned or occupied by, or rented or loaned to any insured. "Bodily injury" or "property damage" for However, this subparagraph does which any insured may be held liable by not apply to, reason of (I) "Bodily injury"if sustained within (1) Causing or contributing to the a budding and caused by intoxication of any person, smoke, fumes, vapor or soot (2) The furnishing of alcoholic beverages to produced by or onginating from a person under the legal drinking age or equipment that is used to heat, under the influence of alcohol;or cool or dehumidify the building, or equipment that is used to (3) Any statute, ordinance or regulation relating to the sale, gift, distnbution or heat water for personal use, by use of alcoholic beverages. the building's occupants or their guests, This exclusion applies only if you are in the (ii) "Bodily injury" or "property business of manufacturing, distnbutng' damage" for which you may be selling, serving or furnishing alcoholic held liable, if you are a beverages contractor and the owner or d. Workers' Compensation And Similar lessee of such premises, site or Laws location has been added to your Any obligation of the insured under a policy as an additional insured workers' compensation, disability benefits with respect to your ongoing or unemployment compensation law or operations performed for that any similar law additional insured at that e. Employer's Liability premises, site or location and "Bodily injury"to such premises, site or location is not and never was owned or (1) An "employee" of the insured arising occupied by, or rented or out of and in the course of. loaned to, any insured, other (a) Employment by the insured, or than that additional insured,or Page 4 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM (III) "Bodily injury" or "property released as part of the damage" arising out of heat, operations being performed smoke or fumes from a by such insured, contractor or "hostile fire", subcontractor, (b) At or from any premises, site or (ii) "Bodily injury" or "property location which is or was at any damage sustained within a time used by or for any insured or building and caused by the others for the handling, storage, release of gases, fumes or disposal, processing or treatment vapors from materials brought of waste, into that budding in connection (c) Which are or were at any time with operations being performed transported, handled, stored, by you or on your behalf by a treated, disposed of, or processed contractor or subcontractor,or as waste by or for, (lii) "Bodily injury" or "property (1) Any insured, or damage" arising out of heat, n An person or organization for smoke or fumes from a O y p g hostile fire";or whom you may be legally responsible, (e) At or from any premises, site or d At or from an remises, site or location on which any insured or any ( ) y p contractors or subcontractors location on which any insured or working directly or indirectly on any any contractors or subcontractors insured's behalf are performing working directly or indirectly on operations if the operations are to any insured's behalf are test for, monitor, clean up, remove, performing operations if the contain, treat, detoxify or neutralize, "pollutants" are brought on or to or in any way respond to, or assess the premises, site or location in the effects of,"pollutants" connection with such operations by such insured, contractor or (2) Any loss, cost or expense arising out subcontractor However, this of any. subparagraph does not apply to: (a) Request,demand,order or statutory (1) "Bodily injury" or "property or regulatory requirement that any damage" ansing out of the insured or others test for, monitor, escape of fuels, lubricants or clean up, remove, contain, treat, other operating fluids which are detoxify or neutralize, or in any way needed to perform the normal respond to, or assess the effects of, electrical, hydraulic or "pollutants",or mechanical functions (b) Claim or suit by or on behalf of a necessary for the operation of governmental authority for "mobile equipment"or its parts, damages because of testing for, if such fuels, lubricants or other monitoring, cleaning up, removing, operating fluids escape from a containing, treating, detoxifying or vehicle part designed to hold, neutralizing, or in any way store or receive them This responding to, or assessing the exception does not apply if the effects of, "pollutants". "bodily injury" or "property However, this paragraph does not damage" arises out of the apply to liability for damages because intentional discharge, dispersal of "property damage" that the insured or release of the fuels, would have in the absence of such lubricants or other operating request, demand, order or statutory or q � rY fluids, or if such fuels, regulatory requirement, or such claim lubricants or other operating or "suit" by or on behalf of a fluids are brought on or to the governmental authority premises, site or location with the intent that they be discharged, dispersed or Form SS 00 08 04 05 Page 5 of 24 BUSINESS LIABILITY COVERAGE FORM g. Aircraft,Auto Or Watercraft (2) The use of "mobile equipment" in, or "Bodily injury" or "property damage" arising while in practice or preparation for, a out of the ownership, maintenance, use or prearranged racing, speed or entrustment to others of any aircraft, "auto" demolition contest or in any stunting or watercraft owned or operated by or rented activity. or loaned to any insured Use includes 1. War operation and"loading or unloading" "Bodily injury", "property damage" or This exclusion applies even if the claims "personal and advertising injury", however against any insured allege negligence or caused, ansing,directly or indirectly,out of other wrongdoing in the supervision, hiring, (1) War, including undeclared or civil war, employment, training or monitoring of others by that insured, if the "occurrence" which (2) Warlike action by a military force, caused the "bodily injury" or "property including action in hindering or damage" involved the ownership, defending against an actual or maintenance, use or entrustment to others of expected attack, by any government, any aircraft, "auto" or watercraft that is sovereign or other authority using owned or operated by or rented or loaned to military personnel or other agents, or any insured (3) Insurrection, rebellion, revolution, This exclusion does not apply to: usurped power, or action taken by (1) A watercraft while ashore on premises governmental authority in hindering or defending against any of these. you own or rent, Professional Services (2) A watercraft you do not own that is: ) "Bodily injury", "property damage" or (a) Less than 51 feet long, and "personal and advertising injury" arising (b) Not being used to carry persons out of the rendering of or failure to render for a charge, any professional service This includes (3) Parking an "auto" on, or on the ways but is not limited to next to, premises you own or rent, (1) Legal, accounting or advertising provided the "auto" is not owned by or services; rented or loaned to you or the insured, (2) Preparing, approving, or failing to (4) Liability assumed under any "insured prepare or approve maps, shop contract" for the ownership, drawings, opinions, reports, surveys, maintenance or use of aircraft or field orders, change orders, designs or watercraft, drawings and specifications, (5) "Bodily injury" or "property damage" (3) Supervisory, inspection, architectural arising out of the operation of any of or engineering activities; the equipment listed in Paragraph f.(2) (4) Medical, surgical, dental, x-ray or or f.(3) of the definition of "mobile nursing services treatment, advice or equipment", or instruction, (6) An aircraft that is not owned by any (5) Any health or therapeutic service insured and is hired, chartered or loaned treatment, advice or instruction; with a paid crew However, this (6) Any service, treatment, advice or exception does not apply if the insured instruction for the purpose of has any other insurance for such "bodily appearance or skin enhancement, hair injury" or "property damage", whether removal or replacement or personal the other insurance is primary, excess, grooming, contingent or on any other basis h. Mobile Equipment (7) Optical or hearing aid services including the prescribing, preparation, "Bodily injury" or "property damage" fitting, demonstration or distribution of arising out of ophthalmic lenses and similar (1) The transportation of"mobile equipment' products or hearing aid devices, by an "auto" owned or operated by or rented or loaned to any insured,or Page 6 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM (8) Optometry or optometric services Paragraphs (1), (3) and (4) of this including but not limited to examination exclusion do not apply to "property of the eyes and the prescribing, damage' (other than damage by fire) to preparation, fitting,demonstration or premises, including the contents of such distribution of ophthalmic lenses and premises, rented to you for a period of 7 or similar products, fewer consecutive days A separate Limit (9) Any of Insurance applies to Damage To Premises Rented To You as described in (a) Body piercing (not including ear Section D.- Limits Of Insurance. piercing), b Tattooing, including but not limited Paragraph (pr of this exclusion does not ( ) g g apply if the premises are "your work" and to the insertion of pigments into or were never occupied, rented or held for under the skin, and rental by you (c) Similar services, Paragraphs(3)and(4) of this exclusion do (10) Services in the practice of pharmacy; not apply to the use of elevators. and Paragraphs (3), (4), (5) and (6) of this (11) Computer consulting, design or exclusion do not apply to liability assumed programming services, including web under a sidetrack agreement site design Paragraphs(3) and (4)of this exclusion do Paragraphs (4) and (5)of this exclusion do not apply to "property damage" to not apply to the Incidental Medical borrowed equipment while not being used Malpractice coverage afforded under to perform operations at a job site Paragraph 1.e. in Section A.-Coverages Paragraph (6) of this exclusion does not k. Damage To Property apply to "property damage" included in the "Property damage"to. "products-completed operations hazard" (1) Property you own, rent or occupy, I. Damage To Your Product including any costs or expenses "Property damage" to "your product" incurred by you, or any other person, arising out of it or any part of it. organization or entity, for repair, m. Damage To Your Work replacement, enhancement, restoration or maintenance of such "Property damage" to "your work" arising property for any reason, including out of it or any part of it and included in the prevention of injury to a person or "products-completed operations hazard". damage to another's property, This exclusion does not apply if the (2) Premises you sell, give away or damaged work or the work out of which abandon,if the"property damage"arises the damage arises was performed on your out of any part of those premises, behalf by a subcontractor (3) Property loaned to you, n. Damage To Impaired Property Or (4) Personal property in the care, custody Property Not Physically Injured or control of the insured, "Property damage" to "impaired property" or property that has not been physically (5) That particular part of real property on which you or any contractors or injured, arising out of subcontractors working directly or (1) A defect, deficiency, inadequacy or indirectly on your behalf are performing dangerous condition in "your product" operations, if the "property damage" or"your work", or arises out of those operations,or (2) A delay or failure by you or anyone (6) That particular part of any property acting on your behalf to perform a that must be restored, repaired or contract or agreement in accordance replaced because "your work" was with its terms. incorrectly performed on it. This exclusion does not apply to the loss of use of other property arising out of sudden and accidental physical injury to "your product" or "your work" after it has been put to its intended use Form SS 00 08 04 05 Page 7 of 24 BUSINESS LIABILITY COVERAGE FORM o. Recall Of Products, Work Or Impaired (c) Title of any literary or artistic work; Property (8) Arising out of an offense committed by Damages claimed for any loss, cost or an insured whose business is expense incurred by you or others for the (a) Advertising, broadcasting, loss of use, withdrawal, recall, inspection, publishing or telecasting; repair, replacement, adjustment, removal (b) Designing or determining content or disposal of of web sites for others, or (1) "Your product"; (c) An Internet search, access, (2) "Your work", or content or service provider. (3) "Impaired property", However, this exclusion does not if such product, work or property is apply to Paragraphs a., b. and c. withdrawn or recalled from the market or under the definition of "personal and from use by any person or organization advertising injury" in Section G. — because of a known or suspected defect, Liability And Medical Expenses deficiency, inadequacy or dangerous Definitions condition in it For the purposes of this exclusion, p. Personal And Advertising Injury placing an "advertisement" for or "Personal and advertising injury" linking to others on your web site, by (1) Arising out of oral, written or electronic itself, is not considered the business publication of material, if done by or at of advertising, broadcasting, the direction of the insured with publishing or telecasting, knowledge of its falsity, (9) Arising out of an electronic chat room (2) Arising out of oral, written or electronic or bulletin board the insured hosts, owns, or over which the insured publication of material whose first exercises control, publication took place before the beginning of the policy period, (10) Arising out of the unauthorized use of (3) Arising out of a criminal act committed another's name or product in your e-mail by or at the direction of the insured, address, domain name or metatags, or any other similar tactics to mislead (4) Arising out of any breach of contract, anther's potential customers, except an implied contract to use (11) Arising out of the violation of a another's "advertising idea" in your "advertisement"; person's right of privacy created by any state or federal act (5) Arising out of the failure of goods, However, this exclusion does not products or services to conform with apply to liability for damages that the any statement of quality or insured would have in the absence of performance made in your such state or federal act, "advertisement"; (6) Arising out of the wrong description of (12) Arising out of the price of goods,products or services, (a) An "advertisement" for others on (7) Arising out of any violation of any your web site, intellectual property rights such as (b) Placing a link to a web site of copyright, patent, trademark, trade others on your web site, name, trade secret, service mark or (c) Content from a web site of others other designation of origin or displayed within a frame or border authenticity on your web site Content includes However, this exclusion does not information, code, sounds, text, apply to infringement, in your graphics or images,or "advertisement", of (d) Computer code, software or (a) Copyright, programming used to enable (b) Slogan, unless the slogan is also (i) Your web site, or a trademark, trade name, service (ii) The presentation or functionality mark or other designation of origin of an "advertisement" or other or authenticity, or content on your web site, Page 8 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM (13) Arising out of a violation of any anti- (a) May be awarded or incurred by trust law, reason of any claim or suit (14) Arising out of the fluctuation in price or alleging actual or threatened injury value of any stocks, bonds or other or damage of any nature or kind to securities, or persons or property which would 15 Arising out of discrimination or not have occurred in whole or in ( ) 9 part but for the asbestos hazard"; humiliation committed by or at the direction of any "executive officer", (b) Anse out of any request, demand, director, stockholder, partner or order statutory regulatory member of the insured. requirement that anyy insured or others test for, monitor, clean up, q. Electronic Data remove, encapsulate, contain, Damages arising out of the loss of, loss of treat, detoxify or neutralize or in use of, damage to, corruption of, inability any way respond to or assess the to access, or inability to manipulate effects of an"asbestos hazard", or "electronic data". (c) Anse out of any claim or suit for r. Employment-Related Practices damages because of testing for, "Bodily injury" or"personal and advertising monitoring, cleaning up, removing, injury"to- encapsulating, containing, treating, (1) A person arising out of any: detoxifying or neutralizing or in any way responding to or assessing the (a) Refusal to employ that person, effects of an"asbestos hazard" (b) Termination of that person's t. Violation Of Statutes That Govern E- employment, or Mails, Fax, Phone Calls Or Other (c) Employment-related practices, Methods Of Sending Material Or policies, acts or omissions, such as Information coercion, demotion, evaluation, "Bodily injury", "property damage", or reassignment, discipline, "personal and advertising injury" arising defamation, harassment, humiliation directly or indirectly out of any action or or discrimination directed at that omission that violates or is alleged to person,or violate: (2) The spouse, child, parent, brother or (1) The Telephone Consumer Protection sister of that person as a Act (TCPA), including any amendment consequence of "bodily injury" or of or addition to such law, "personal and advertising injury"to the (2) The CAN-SPAM Act of 2003, including person at whom any of the any amendment of or addition to such employment-related practices law, or described in Paragraphs(a), (b), or(c) above is directed. (3) Any statute, ordinance or regulation, This exclusion applies. other than the TCPA or CAN-SPAM Act of 2003, that prohibits or limits the (1) Whether the insured may be liable as sending, transmitting, communicating or an employer or in any other capacity; distribution of material or information and Damage To Premises Rented To You — (2) To any obligation to share damages Exception For Damage By Fire, Lightning with or repay someone else who must or Explosion pay damages because of the injury. Exclusions c. through h. and k. through o. do S. Asbestos not apply to damage by fire, lightning or (1) 'Bodily injury", "property damage" or explosion to premises rented to you or "personal and advertising injury" temporarily occupied by your with permission arising out of the"asbestos hazard" of the owner. A separate Limit of Insurance (2) Any damages, judgments, settlements, applies to this coverage as described in loss,costs or expenses that. Section D. - Liability And Medical Expenses Limits Of Insurance. Form SS 00 08 04 05 Page 9 of 24 BUSINESS LIABILITY COVERAGE FORM 2. Applicable To Medical Expenses Coverage e. A trust, you are an insured Your trustees We will not pay expenses for"bodily injury" are also insureds, but only with respect to a. Any Insured their duties as trustees To any insured,except"volunteer workers". 2• Each of the following is also an insured: b. Hired Person a. Employees And Volunteer Workers To a person hired to do work for or on behalf Your "volunteer workers" only while of any insured or a tenant of any insured. performing duties related to the conduct of c. Injury On Normally Occupied Premises your business, or your"employees", other than either your"executive officers" (if you To a person injured on that part of are an organization other than a premises you own or rent that the person partnership,joint venture or limited liability normally occupies company) or your managers (if you are a d. Workers' Compensation And Similar limited liability company), but only for acts Laws within the scope of their employment by To a person, whether or not an you or while performing duties related to "employee" of any insured, if benefits for the conduct of your business. the "bodily injury" are payable or must be However, none of these "employees" or provided under a workers' compensation "volunteer workers"are insureds for or disability benefits law or a similar law (1) "Bodily injury" or "personal and e. Athletics Activities advertising injury To a person injured while practicing, (a) To you, to your partners or instructing or participating in any physical members (if you are a partnership exercises or games, sports or athletic or joint venture), to your members contests (if you are a limited liability f. Products-Completed Operations Hazard company), or to a co-"employee" while in the course of his or her Included with the "products-completed employment or performing duties operations hazard" related to the conduct of your g. Business Liability Exclusions business, or to your other Excluded under Business Liability Coverage "volunteer workers" while C. WHO IS AN INSURED performing duties related to the conduct of your business; 1. If you are designated in the Declarations as- (b) To the spouse, child, parent, a. An individual, you and your spouse are brother or sister of that co- insureds, but only with respect to the "employee" or that "volunteer conduct of a business of which you are the worker" as a consequence of sole owner Paragraph (1)(a)above; b. A partnership or joint venture, you are an (c) For which there is any obligation insured Your members, your partners, and to share damages with or repay their spouses are also insureds,but only with someone else who must pay respect to the conduct of your business damages because of the injury c. A limited liability company, you are an described in Paragraphs (1)(a) or insured Your members are also insureds, (b)above, or but only with respect to the conduct of your (d) Arising out of his or her providing business Your managers are insureds, but or failing to provide professional only with respect to their duties as your health care services managers If you are not in the business of d. An organization other than a partnership, providing professional health care joint venture or limited liability company, you services, Paragraph (d) does not apply are an insured Your"executive officers"and to any nurse, emergency medical directors are insureds, but only with respect technician or paramedic employed by to their duties as your officers or directors you to provide such services Your stockholders are also insureds,but only (2) "Property damage"to property: with respect to their liability as stockholders (a) Owned, occupied or used by, Page 10 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM (b) Rented to, in the care, custody or b. Coverage under this provision does not control of, or over which physical apply to- control is being exercised for any (1) "Bodily injury" or "property damage" purpose by you, any of your that occurred, or "employees", "volunteer workers", (2) "Personal and advertising injury" any partner or member (if you are a partnership or joint venture), or arising out of an offense committed any member (d you are a limited before you acquired or formed the liability company) organization. b. Real Estate Manager 4. Operator Of Mobile Equipment Any person (other than your"employee"or With respect to "mobile equipment" registered In .volunteer worker"), or any organization your name under any motor vehicle registration while acting as real estate manager. law, any person is an insured while driving such your c. Temporary Custodians Of Your equipment along a public highway with your Property permission. Any other person or organization responsible for the conduct of such person is Any person or organization having proper also an insured, but only with respect to liability temporary custody of your property if you arising out of the operation of the equipment, and die, but only. only if no other insurance of any kind is available (1) With respect to liability arising out of the to that person or organization for this liability. maintenance or use of that property,and However,no person or organization is an insured (2) Until your legal representative has with respect to. been appointed. a. "Bodily injury" to a co-"employee" of the d. Legal Representative If You Die person driving the equipment, or Your legal representative if you die, but b. "Property damage" to property owned by, only with respect to duties as such That rented to, in the charge of or occupied by representative will have all your rights and you or the employer of any person who is duties under this insurance an insured under this provision e. Unnamed Subsidiary 5. Operator of Nonowned Watercraft Any subsidiary and subsidiary thereof, of With respect to watercraft you do not own that Y legally incorporated ours which is a le all inco orated entity is less than 51 feet long and is not being used of which you own a financial interest of to carry persons for a charge, any person is an more than 50% of the voting stock on the insured while operating such watercraft with effective date of this Coverage Part. your permission. Any other person or The insurance afforded herein for any organization responsible for the conduct of subsidiary not shown in the Declarations such person is also an insured, but only with respect to liability arising out of the operation as a named insured does not apply to injury or damage with respect to which an iof nsurance the watercraft, and only if no other insured under this insurance is also an n any kind i insured under another olic or would be person or organization anization for this liability. t available to that P Y an insured under such policy but for its However, no person or organization is an termination or upon the exhaustion of its insured with respect to: limits of insurance. a. "Bodily injury" to a co-"employee" of the 3. Newly Acquired Or Formed Organization person operating the watercraft, or Any organization you newly acquire or form, b. "Property damage" to property owned by, other than a partnership, joint venture or rented to, in the charge of or occupied by limited liability company, and over which you you or the employer of any person who is maintain financial interest of more than 50% of an insured under this provision the voting stock, will qualify as a Named 6. Additional Insureds When Required By Insured if there is no other similar insurance Written Contract, Written Agreement Or available to that organization However Permit a. Coverage under this provision is afforded The person(s) or organization(s) identified in only until the 180th day after you acquire Paragraphs a. through f. below are additional or form the organization or the end of the insureds when you have agreed, in a written policy period,whichever is earlier; and Form SS 00 08 04 05 Page 11 of 24 BUSINESS LIABILITY COVERAGE FORM contract, written agreement or because of a (e) Any failure to make such permit issued by a state or political inspections, adjustments, tests or subdivision, that such person or organization servicing as the vendor has be added as an additional insured on your agreed to make or normally policy, provided the injury or damage occurs undertakes to make in the usual subsequent to the execution of the contract or course of business, in connection agreement,or the issuance of the permit. with the distribution or sale of the A person or organization is an additional products; insured under this provision only for that (f) Demonstration, installation, period of time required by the contract, servicing or repair operations, agreement or permit except such operations performed at the vendor's premises in However, no such person or organization is an connection with the sale of the additional insured under this provision if such person or organization is included as an product, additional insured by an endorsement issued (g) Products which, after distribution by us and made a part of this Coverage Part, or sale by you, have been labeled including all persons or organizations added or relabeled or used as a as additional insureds under the specific container, part or ingredient of any additional insured coverage grants in Section other thing or substance by or for F.—Optional Additional Insured Coverages the vendor,or a. Vendors (h) "Bodily injury" or "property damage" arising out of the sole Any person(s)or organization(s) (referred to below as vendor), but only with respect to negligence of the vendor for its own acts or omissions or those "bodily injury" or "property damage" arising out of "your products" which are distributed its employees or anyone else acting on its behalf However, this or sold in the regular course of the vendor's exclusion does not apply to business and only if this Coverage Part provides coverage for "bodily injury" or (i) The exceptions contained in "property damage" included within the Subparagraphs(d) or(0, or "products-completed operations hazard" (ii) Such inspections, adjustments, (1) The insurance afforded to the vendor tests or servicing as the vendor is subject to the following additional has agreed to make or normally exclusions undertakes to make in the usual course of business, in This insurance does not apply to, connection with the distribution (a) "Bodily injury" or "property or sale of the products damage" for which the vendor is (2) This insurance does not apply to any obligated to pay damages by insured person or organization from reason of the assumption of whom you have acquired such products, liability in a contract or agreement or any ingredient, part or container, This exclusion does not apply to entering into, accompanying or liability for damages that the containing such products vendor would have in the absence of the contract or agreement, b. Lessors Of Equipment (b) Any express warranty (1) Any person or organization from unauthorized by you; whom you lease equipment; but only with respect to their liability for"bodily (c) Any physical or chemical change " in the product made intentionally injury", property damage" or by the vendor, "personal and advertising injury" caused, in whole or in part, by your (d) Repackaging, except when maintenance, operation or use of unpacked solely for the purpose of equipment leased to you by such inspection, demonstration, testing, person or organization or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container, Page 112 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM (2) With respect to the insurance afforded e. Permits Issued By State Or Political to these additional insureds, this Subdivisions insurance does not apply to any (1) Any state or political subdivision, but "occurrence" which takes place after only with respect to operations you cease to lease that equipment, performed by you or on your behalf for c. Lessors Of Land Or Premises which the state or political subdivision (1) Any person or organization from has issued a permit. whom you lease land or premises, but (2) With respect to the insurance afforded only with respect to liability arising out to these additional insureds, this of the ownership, maintenance or use insurance does not apply to: of that part of the land or premises (a) "Bodily injury", "property damage" leased to you or "personal and advertising (2) With respect to the insurance afforded injury" arising out of operations to these additional insureds, this performed for the state or insurance does not apply to municipality; or (a) Any "occurrence" which takes (b) "Bodily injury' or"property damage" place after you cease to lease that included within the "products- land or be a tenant in that completed operations hazard" premises,or f. Any Other Party (b) Structural alterations, new (1) Any other person or organization who construction or demolition is not an insured under Paragraphs a. operations performed by or on through a above, but only with behalf of such person or respect to liability for "bodily injury", organization. "property damage" or "personal and d. Architects, Engineers Or Surveyors advertising injury" caused, in whole or (1) Any architect, engineer, or surveyor, but in part, by your acts or omissions or only with respect to liability for "bodily the acts or omissions of those acting injury", "property damage" or "personal on your behalf: and advertising injury" caused, in whole (a) In the performance of your or in part, by your acts or omissions or ongoing operations; the acts or omissions of those acting on (b) In connection with your premises your behalf owned by or rented to you, or (a) In connection with your premises; (c) In connection with "your work"and or included within the "products- (b) In the performance of your completed operations hazard", but ongoing operations performed by only if you or on your behalf. (1) The written contract or written (2) With respect to the insurance afforded agreement requires you to to these additional insureds, the provide such coverage to following additional exclusion applies such additional insured, and This insurance does not apply to (ii) This Coverage Part provides "bodily injury", "property damage" or coverage for "bodily injury" or "personal and advertising injury" "property damage" included arising out of the rendering of or the within the "products- failure to render any professional completed operations hazard". services by or for you, including (2) With respect to the insurance afforded (a) The preparing, approving, or to these additional insureds, this failure to prepare or approve, insurance does not apply to: maps, shop drawings, opinions, "Bodily injury", "property damage" or reports, surveys, field orders, "personal and advertising injury" change orders, designs or arising out of the rendering of, or the drawings and specifications; or failure to render, any professional (b) Supervisory, inspection, architectural, engineering or surveying architectural or engineering services, including. activities Form SS 00 08 04 05 Page 13 of 24 BUSINESS LIABILITY COVERAGE FORM (a) The preparing, approving, or This General Aggregate limit does not failure to prepare or approve, apply to "property damage" to premises maps, shop drawings, opinions, while rented to you or temporarily reports, surveys, field orders, occupied by you with permission of the change orders, designs or owner, arising out of fire, lightning or drawings and specifications,or explosion (b) Supervisory, inspection, 3. Each Occurrence Limit architectural or engineenng Subject to 2.a. or 2.15 above, whichever activities applies, the most we will pay for the sum of all The limits of insurance that apply to additional damages because of all "bodily injury", insureds are described in Section D. — Limits "property damage" and medical expenses Of Insurance arising out of any one "occurrence" is the How this insurance applies when other Liability and Medical Expenses Limit shown in insurance is available to an additional insured the Declarations, is described in the Other Insurance Condition The most we will pay for all medical expenses in Section E.—Liability And Medical Expenses because of "bodily injury" sustained by any General Conditions one person is the Medical Expenses Limit No person or organization is an insured with shown in the Declarations. respect to the conduct of any current or past 4. Personal And Advertising Injury Limit partnership, joint venture or limited liability Subject to 2.115. above, the most we will pay for company that is not shown as a Named Insured in the sum of all damages because of all the Declarations "personal and advertising injury" sustained by D. LIABILITY AND MEDICAL EXPENSES any one person or organization is the Personal LIMITS OF INSURANCE and Advertising Injury Limit shown in the Declarations 1. The Most We Will Pay 5. Damage To Premises Rented To You Limit The Limits of Insurance shown in the Declarations and the rules below fix the most The Damage Premises Rented You we will pay regardless of the number of. Limit the mosstt we r will pay under Business iness Liabilittyy Coverage for damages because of a. Insureds, "property damage" to any one premises, while b. Claims made or"suits"brought;or rented to you, or in the case of damage by fire, c. Persons or organizations making claims or lightning or explosion, while rented to you or bringing"suits". temporarily occupied by you with permission of 2. Aggregate Limits the owner The most we will pay for: In the case of damage by fire, lightning or explosion, the Damage to Premises Rented To a. Damages because of "bodily injury" and You Limit applies to all damage proximately "property damage" included in the caused by the same event, whether such "products-completed operations hazard"is damage results from fire, lightning or explosion the Products-Completed Operations or any combination of these Aggregate Limit shown in the Declarations. 6. How Limits Apply To Additional Insureds b. Damages because of all other "bodily The most we will pay on behalf of a person or injury", "property damage" or "personal organization who is an additional insured and advertising injury", including medical under this Coverage Part is the lesser of expenses, is the General Aggregate Limit a. The limits of insurance specified in a shown in the Declarations written contract, written agreement or This General Aggregate Limit applies permit issued by a state or political separately to each of your "locations" subdivision, or owned by or rented to you b. The Limits of Insurance shown in the "Location" means premises involving the Declarations same or connecting lots, or premises Such amount shall be a part of and not in whose connection is interrupted only by a addition to the Limits of Insurance shown in street, roadway or right-of-way of a the Declarations and described in this Section railroad Page 14 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM If more than one limit of insurance under this (1) Immediately send us copies of any policy and any endorsements attached thereto demands, notices, summonses or applies to any claim or "suit", the most we will pay legal papers received in connection under this policy and the endorsements is the with the claim or"suit", single highest limit of liability of all coverages (2) Authorize us to obtain records and applicable to such claim or "suit" However, this other information, paragraph does not apply to the Medical Expenses (3) Cooperate with us in the investigation, limit set forth in Paragraph 3.above settlement of the claim or defense The Limits of Insurance of this Coverage Part apply against the"suit", and separately to each consecutive annual period and to (4) Assist us, upon our request, in the any remaining period of less than 12 months,starting enforcement of any right against any with the beginning of the policy period shown in the person or organization that may be Declarations, unless the policy period is extended liable to the insured because of injury after issuance for an additional period of less than 12 or damage to which this insurance months In that case, the additional period will be may also apply. deemed part of the last preceding period for purposes d. Obligations At The Insured's Own Cost of determining the Limits of Insurance E. LIABILITY AND MEDICAL EXPENSES co insured will, except at that ins s own GENERAL CONDITIONS cost, voluntarily make a paymentt,, assume any obligation, or incur any expense, other 1. Bankruptcy than for first aid,without our consent Bankruptcy or insolvency of the insured or of e. Additional Insured's Other Insurance the insured's estate will not relieve us of our If we cover a claim or "suit" under this obligations under this Coverage Part Coverage Part that may also be covered 2. Duties In The Event Of Occurrence, by other insurance available to an Offense, Claim Or Suit additional insured, such additional insured a. Notice Of Occurrence Or Offense must submit such claim or "suit" to the other insurer for defense and indemnity. You or any additional insured must see to it that we are notified as soon as However, this provision does not apply to the extent that you have agreed in a practicable of an "occurrence" or an offense which may result in a claim To written contract, written agreement or the extent possible, notice should include permit that this insurance is primary and non-contributory with the additional (1) How, when and where the "occurrence" Insured's own insurance or offense took place, f. Knowledge Of An Occurrence, Offense, (2) The names and addresses of any Claim Or Suit injured persons and witnesses, and Paragraphs a. and b. apply to you or to (3) The nature and location of any injury any additional insured only when such or damage arising out of the "occurrence", offense, claim or "suit" is "occurrence" or offense. known to b. Notice Of Claim (1) You or any additional insured that is If a claim is made or "suit" is brought an individual; against any insured, you or any additional (2) Any partner, if you or an additional insured must. insured is a partnership, (1) Immediately record the specifics of the (3) Any manager, if you or an additional claim or "suit" and the date received, insured is a limited liability company, and (4) Any "executive officer" or insurance (2) Notify us as soon as practicable. manager, if you or an additional You or any additional insured must see to insured is a corporation; it that we receive a written notice of the (5) Any trustee, if you or an additional claim or"suit" as soon as practicable. insured is a trust, or c. Assistance And Cooperation Of The (6) Any elected or appointed official, if you Insured or an additional insured is a political You and any other involved insured must: subdivision or public entity Form SS 00 08 04 05 Page 15 of 24 BUSINESS LIABILITY COVERAGE FORM This Paragraph f. applies separately to (3) We have issued this policy in reliance you and any additional insured. upon your representations 3. Financial Responsibility Laws b. Unintentional Failure To Disclose a. When this policy is certified as proof of Hazards financial responsibility for the future under If unintentionally you should fail to disclose the provisions of any motor vehicle all hazards relating to the conduct of your financial responsibility law, the insurance business at the inception date of this provided by the policy for "bodily injury" Coverage Part, we shall not deny any liability and "property damage" liability will coverage under this Coverage Part comply with the provisions of the law to because of such failure the extent of the coverage and limits of 7, Other Insurance insurance required by that law If other valid and collectible insurance is b. With respect to "mobile equipment' to available for a loss we cover under this which this insurance applies, we will Coverage Part, our obligations are limited as provide any liability, uninsured motorists, follows underinsured motorists, no-fault or other coverage required by any motor vehicle a. Primary Insurance law We will provide the required limits for This insurance is primary except when b. those coverages below applies If other insurance is also 4. Legal Action Against Us primary, we will share with all that other No person or organization has a right under insurance by the method described in c. this Coverage Form below a. To loin us as a party or otherwise bring us b. Excess Insurance into a "suit" asking for damages from an This insurance is excess over any of the insured, or other insurance, whether primary, excess, b. To sue us on this Coverage Form unless contingent or on any other basis all of its terms have been fully complied (1) Your Work with That is Fire, Extended Coverage, A person or organization may sue us to recover Builder's Risk, Installation Risk or on an agreed settlement or on a final judgment similar coverage for"your work", against an insured; but we will not be liable for (2) Premises Rented To You damages that are not payable under the terms of this insurance or that are in excess of the That fire, premises or explosion insurance applicable limit of insurance An agreed ce for prremises rented to you or temporarily occupied by you with settlement means a settlement and release of liability signed by us, the insured and the permission of the owner, claimant or the claimant's legal representative. (3) Tenant Liability 5. Separation Of Insureds That is insurance purchased by you to Except with respect to the Limits of Insurance, cover your liability as a tenant for and any rights or duties specifically assigned "property damage" to premises rented i in this policy to the first Named Insured, this w you or temporarily occupied by you insurance applies with permission of the owner, a. As if each Named Insured were the only (4) Aircraft,Auto Or Watercraft Named Insured,and If the loss arises out of the maintenance b. Separately to each insured against whom or use of aircraft, "autos"or watercraft to a claim is made or"suit' is brought the extent not subject to Exclusion g. of Section A.—Coverages S. Representations (5) Property Damage To Borrowed a. When You Accept This Policy Equipment Or Use Of Elevators By accepting this policy, you agree, If the loss arises out of "property (1) The statements in the Declarations damage" to borrowed equipment or are accurate and complete, the use of elevators to the extent not (2) Those statements are based upon subject to Exclusion k of Section A. — representations you made to us, and Coverages. Page 16 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM (6) When You Are Added As An When this insurance is excess over other Additional Insured To Other insurance, we will pay only our share of Insurance the amount of the loss, if any, that That is other insurance available to exceeds the sum of: you covering liability for damages (1) The total amount that all such other arising out of the premises or insurance would pay for the loss in the operations, or products and completed absence of this insurance,and operations, for which you have been (2) The total of all deductible and self- added as an additional insured by that insured amounts under all that other insurance,or insurance (7) When You Add Others As An We will share the remaining loss,if any,with Additional Insured To This any other insurance that is not described in Insurance this Excess Insurance provision and was not That is other insurance available to an bought specifically to apply in excess of the additional insured. Limits of Insurance shown in the However, the following provisions Declarations of this Coverage Part apply to other insurance available to c. Method Of Sharing any person or organization who is an If all the other insurance permits additional insured under this Coverage contribution by equal shares,we will follow Part this method also Under this approach, (a) Primary Insurance When each insurer contributes equal amounts Required By Contract until it has paid its applicable limit of This insurance is primary if you insurance or none of the loss remains, have agreed in a written contract, whichever comes first written agreement or permit that If any of the other insurance does not permit this insurance be primary If other contribution by equal shares, we will insurance is also primary, we will contribute by limits Under this method,each share with all that other insurance insurer's share is based on the ratio of its by the method described in c. applicable limit of insurance to the total below applicable limits of insurance of all insurers (b) Primary And Non-Contributory 8. Transfer Of Rights Of Recovery Against To Other Insurance When Others To Us Required By Contract a. Transfer Of Rights Of Recovery If you have agreed in a written If the insured has rights to recover all or contract, written agreement or part of any payment, including permit that this insurance is Supplementary Payments, we have made primary and non-contributory with under this Coverage Part, those rights are the additional msured's own transferred to us The insured must do insurance, this insurance is nothing after loss to impair them At our primary and we will not seek request, the insured will bring "suit" or contribution from that other transfer those rights to us and help us insurance. enforce them This condition does not Paragraphs (a) and (b) do not apply to apply to Medical Expenses Coverage other insurance to which the additional b. Waiver Of Rights Of Recovery (Waiver insured has been added as an Of Subrogation) additional insured. If the insured has waved any rights of When this insurance is excess, we will recovery against any person or have no duty under this Coverage Part to organization for all or part of any payment, defend the insured against any"suit"if any including Supplementary Payments, we other insurer has a duty to defend the have made under this Coverage Part, we insured against that "suit". If no other also waive that right, provided the insured insurer defends, we will undertake to do waived their rights of recovery against so, but we will be entitled to the insured's such person or organization in a contract, rights against all those other insurers agreement or permit that was executed prior to the injury or damage. Form SS 00 08 04 05 F Page 17 of 24 F BUSINESS LIABILITY COVERAGE FORM F. OPTIONAL ADDITIONAL INSURED 3. Additional Insured -Grantor Of Franchise COVERAGES WHO IS AN INSURED under Section C. is If listed or shown as applicable in the Declarations, amended to include as an additional insured one or more of the following Optional Additional the person(s) or organization(s) shown in the Insured Coverages also apply. When any of these Declarations as an Additional Insured - Optional Additional Insured Coverages apply, Grantor Of Franchise, but only with respect to Paragraph 6. (Additional Insureds When Required their liability as grantor of franchise to you by Written Contract, Written Agreement or Permit) 4. Additional Insured - Lessor Of Leased of Section C., Who Is An Insured, does not apply Equipment to the person or organization shown in the a. WHO IS AN INSURED under Section C. is Declarations. These coverages are subject to the amended to include as an additional terms and conditions applicable to Business insured the person(s) or organization(s) Liability Coverage in this policy, except as shown in the Declarations as an Additional provided below. Insured — Lessor of Leased Equipment, 1. Additional Insured - Designated Person Or but only with respect to liability for "bodily Organization injury", "property damage" or "personal WHO IS AN INSURED under Section C. is and advertising injury" caused, in whole or amended to include as an additional insured in part, by your maintenance, operation or the person(s) or organization(s) shown in the use of equipment leased to you by such Declarations, but only with respect to liability person(s)or organization(s). for "bodily injury", "property damage" or b. With respect to the insurance afforded to "personal and advertising injury" caused, in these additional insureds, this insurance whole or in part, by your acts or omissions or does not apply to any 'occurrence" which the acts or omissions of those acting on your takes place after you cease to lease that behalf. equipment a. In the performance of your ongoing 5. Additional Insured - Owners Or Other operations;or Interests From Whom Land Has Been b. In connection with your premises owned Leased by or rented to you a. WHO IS AN INSURED under Section C. is 2. Additional Insured - Managers Or Lessors amended to include as an additional Of Premises insured the person(s) or organization(s) shown in the Declarations as an Additional a. WHO IS AN INSURED under Section C. is Insured —Owners Or Other Interests From amended to include as an additional insured Whom Land Has Been Leased, but only the person(s)or organization(s)shown in the with respect to liability arising out of the Declarations as an Additional Insured - ownership, maintenance or use of that part Designated Person Or Organization,but only of the land leased to you and shown in the with respect to liability arising out of the Declarations ownership,maintenance or use of that part of the premises leased to you and shown in the b. With respect to the insurance afforded to Declarations these additional insureds, the following additional exclusions apply b. With respect to the insurance afforded to these additional insureds, the following This insurance does not apply to, additional exclusions apply (1) Any 'occurrence" that takes place This insurance does not apply to: after you cease to lease that land, or (1) Any 'occurrence" which takes place (2) Structural alterations, new after you cease to be a tenant in that construction or demolition operations premises;or performed by or on behalf of such (2) Structural alterations, new person or organization construction or demolition operations 6. Additional Insured - State Or Political performed by or on behalf of such Subdivision—Permits person or organization a. WHO IS AN INSURED under Section C. is amended to include as an additional insured the state or political subdivision shown in the Declarations as an Additional Page 18 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM Insured — State Or Political Subdivision - (e) Any failure to make such Permits, but only with respect to inspections, adjustments, tests or operations performed by you or on your servicing as the vendor has agreed behalf for which the state or political to make or normally undertakes to subdivision has issued a permit make in the usual course of b. With respect to the insurance afforded to business, in connection with the these additional insureds, the following distribution or sale of the products, additional exclusions apply. (f) Demonstration, installation, This insurance does not apply to: servicing or repair operations, except such operations performed (1) "Bodily injury", "property damage" or at the vendor's premises in "personal and advertising injury" connection with the sale of the arising out of operations performed for product, the state or municipality, or (g) Products which, after distribution (2) "Bodily injury" or "property damage" included in the "product-completed or sale you, have been labeled or relabeled or used as a operations"hazard. container, part or ingredient of any 7. Additional Insured—Vendors other thing or substance by or for a. WHO IS AN INSURED under Section C.is the vendor,or amended to include as an additional (h) "Bodily injury" or "property insured the person(s) or organization(s) damage" arising out of the sole (referred to below as vendor)shown in the negligence of the vendor for its Declarations as an Additional Insured - own acts or omissions or those of Vendor, but only with respect to "bodily its employees or anyone else injury" or "property damage" arising out of acting on its behalf. However,this "your products" which are distributed or exclusion does not apply to: sold in the regular course of the vendor's (i) The exceptions contained in business and only if this Coverage Part Subparagraphs (d)or(f), or provides coverage for "bodily injury" or "property damage" included within the (ii) Such inspections, "products-completed operations hazard" adjustments, tests or servicing as the vendor has agreed to b. The insurance afforded to the vendor is make or normally undertakes subject to the following additional exclusions: to make in the usual course of (1) This insurance does not apply to. business, in connection with (a) "Bodily injury" or "property the distribution or sale of the damage" for which the vendor is products. obligated to pay damages by (2) This insurance does not apply to any reason of the assumption of insured person or organization from liability in a contract or agreement. whom you have acquired such This exclusion does not apply to products, or any ingredient, part or liability for damages that the container, entering into, vendor would have in the absence accompanying or containing such of the contract or agreement; products, (b) Any express warranty 8. Additional Insured—Controlling Interest unauthorized by you; WHO IS AN INSURED under Section C. is (c) Any physical or chemical change amended to include as an additional insured in the product made intentionally the person(s) or organization(s) shown in the by the vendor, Declarations as an Additional Insured — (d) Repackaging, unless unpacked Controlling Interest, but only with respect to solely for the purpose of inspection, their liability arising out of- demonstration, testing, or the a. Their financial control of you, or substitution of parts under b. Premises they own, maintain or control instructions from the manufacturer, while you lease or occupy these premises. and then repackaged in the original container, Form SS 00 08 04 05 Page 19 of 24 BUSINESS LIABILITY COVERAGE FORM This insurance does not apply to structural The limits of insurance that apply to additional alterations, new construction and demolition insureds are described in Section D. — Limits Of operations performed by or for that person or Insurance organization How this insurance applies when other insurance 9. Additional Insured — Owners, Lessees Or is available to an additional insured is described in Contractors — Scheduled Person Or the Other Insurance Condition in Section E. — Organization Liability And Medical Expenses General a. WHO IS AN INSURED under Section C. is Conditions amended to include as an additional G. LIABILITY AND MEDICAL EXPENSES insured the person(s) or organization(s) DEFINITIONS shown in the Declarations as an Additional Insured —Owner, Lessees Or Contractors, 1. "Advertisement" means the widespread public but only with respect to liability for "bodily dissemination of information or images that injury", "property damage" or "personal has the purpose of inducing the sale of goods, and advertising injury" caused, in whole or products or services through- in part, by your acts or omissions or the a. (1) Radio; acts or omissions of those acting on your (2) Television, behalf. (3) Billboard, (1) In the performance of your ongoing (4) Magazine, operations for the additional ( insured(s); or 5) Newspaper; (2) In connection with 'your work" b. The Internet, but only that part of a web performed for that additional insured site that is about goods, products or and included within the "products- services for the purposes of inducing the completed operations hazard", but sale of goods, products or services,or only if this Coverage Part provides c. Any other publication that is given coverage for "bodily injury" or widespread public distribution. "property damage" included within the However, "advertisement" does not include- "products-completed operations a. The design, printed material, information hazard" or images contained in, on or upon the b. With respect to the insurance afforded to packaging or labeling of any goods or these additional insureds, this insurance products, or does not apply to "bodily injury", "property damage" or "personal an advertising b. An interactive conversation between or injury" arising out of the rendering of, or among persons through a computer network the failure to render, any professional 2. "Advertising idea" means any idea for an architectural, engineering or surveying "advertisement". services, including 3. "Asbestos hazard" means an exposure or (1) The preparing, approving, or failure to threat of exposure to the actual or alleged prepare or approve, maps, shop properties of asbestos and includes the mere drawings, opinions, reports, surveys, presence of asbestos in any form field orders, change orders, designs or 4. "Auto" means a land motor vehicle, trailer or drawings and specifications, or semi-trailer designed for travel on public (2) Supervisory, inspection, architectural roads, including any attached machinery or or engineering activities. equipment But "auto" does not include 10. Additional Insured — Co-Owner Of Insured "mobile equipment" Premises 5. "Bodily injury" means physical. WHO IS AN INSURED under Section C. is a. Injury, amended to include as an additional insured b. Sickness;or the person(s) or Organization(s) shown in the c. Disease Declarations as an Additional Insured — Co- Owner Of Insured Premises, but only with sustained by a person and, if arising out of the respect to their liability as co-owner of the above, mental anguish or death at any time premises shown in the Declarations 6. "Coverage territory" means Page 20 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM a. The United States of America(including its b. You have failed to fulfill the terms of a territories and possessions), Puerto Rico contract or agreement, and Canada, if such property can be restored to use by: b. International waters or airspace, but only if a. The repair, replacement, adjustment or the injury or damage occurs in the course removal of "your product" or "your work"; of travel or transportation between any or places included in a. above, b. Your fulfilling the terms of the contract or c. All other parts of the world if the injury or agreement damage arises out of 12. "Insured contract" means: (1) Goods or products made or sold by you in the territory described in a.above; a. A contract for ti lease of premises. However, that portion of the contract for a (2) The activities of a person whose home lease of premises that indemnifies any is in the territory described in a. person or organization for damage by fire, above, but is away for a short time on lightning or explosion to premises while your business, or rented to you or temporarily occupied by (3) "Personal and advertising injury" you with permission of the owner is offenses that take place through the subject to the Damage To Premises Internet or similar electronic means of Rented To You limit described in Section communication D.— Liability and Medical Expenses Limits provided the insured's responsibility to pay of Insurance damages is determined in the United States of b. A sidetrack agreement; America (including its territories and c. Any easement or license agreement, possessions), Puerto Rico or Canada, in a including an easement or license "suit" on the merits according to the agreement in connection with construction substantive law in such territory, or in a or demolition operations on or within 50 settlement we agree to feet of a railroad, 7. "Electronic data" means information, facts or d. Any obligation, as required by ordinance, programs- to indemnify a municipality, except in a. Stored as or on; connection with work for a municipality; b. Created or used on;or e. An elevator maintenance agreement, or c. Transmitted to or from f. That part of any other contract or computer software, including systems and agreement pertaining to your business applications software, hard or floppy disks, (including an indemnification of a CD-ROMS, tapes, drives, cells, data municipality in connection with work processing devices or any other media which performed for a municipality) under which are used with electronically controlled you assume the tort liability of another equipment party to pay for"bodily injury" or "property 8. "Employee" includes a "leased worker". damage"to a third person or organization, "Employee" does not include a "temporary provided the "bodily injury" or "property worker". damage" is caused, in whole or in part, by you or by those acting on your behalf 9. "Executive officer" means a person holding Tort liability means a liability that would be any of the officer positions created by your imposed by law in the absence of any charter, constitution, by-laws or any other contract or agreement. similar governing document Paragraph f. includes that part of any 10. "Hostile fire" means one which becomes contract or agreement that indemnifies a uncontrollable or breaks out from where it was railroad for "bodily injury" or "property intended to be damage" arising out of construction or 11. "Impaired property" means tangible property, demolition operations within 50 feet of any other than "your product" or "your work", that railroad property and affecting any railroad cannot be used or is less useful because bridge or trestle, tracks, road-beds, tunnel, a. It incorporates "your product' or"your work" underpass or crossing that is known or thought to be defective, However, Paragraph f. does not include deficient, inadequate or dangerous,or that part of any contract or agreement. Farm SS 00 08 04 05 Page 21 of 24 BUSINESS LIABILITY COVERAGE FORM (1) That indemnifies an architect, (1) Power cranes, shovels, loaders, engineer or surveyor for injury or diggers or drills; or damage arising out of (2) Road construction or resurfacing (a) Preparing, approving or fading to equipment such as graders, scrapers prepare or approve maps, shop or rollers, drawings, opinions, reports, e. Vehicles not described in a., b., c., or d. surveys, Feld orders, change above that are not self-propelled and are orders, designs or drawings and maintained primarily to provide mobility to specifications,or permanently attached equipment of the (b) Giving directions or instructions, following types or fading to give them, if that is the (1) Air compressors, pumps and primary cause of the injury or generators, including spraying, damage;or welding, budding cleaning, (2) Under which the insured, if an geophysical exploration, lighting and architect, engineer or surveyor, well servicing equipment, or assumes liability for an injury or 2 damage arising out of the insured's ( ) Cherry pickers and similar devices used to raise or lower workers; rendering or failure to render professional services, including those f. Vehicles not described in a., b , c., or d. listed in (1) above and supervisory, above maintained primarily for purposes inspection, architectural or other than the transportation of persons or engineering activities cargo 13. "Leased worker" means a person leased to However, self-propelled vehicles with the you by a labor leasing firm under an following types of permanently attached agreement between you and the labor leasing equipment are not "mobile equipment" but firm, to perform duties related to the conduct of will be considered"autos": your business "Leased worker" does not (1) Equipment, of at least 1,000 pounds include a "temporary worker" gross vehicle weight, designed 14. "Loading or unloading" means the handling of primarily for. property. (a) Snow removal; a. After it is moved from the place where it is (b) Road maintenance, but not accepted for movement into or onto an construction or resurfacing; or aircraft,watercraft or"auto", (c) Street cleaning; b. While it is in or on an aircraft,watercraft or (2) Cherry pickers and similar devices "auto",or mounted on automobile or truck c. While it is being moved from an aircraft, chassis and used to raise or lower watercraft or"auto" to the place where it is workers;and finally delivered; (3) Air compressors, pumps and but "loading or unloading" does not include the generators, including spraying, movement of property by means of a mechanical welding, building cleaning, device, other than a hand truck, that is not geophysical exploration, lighting and attached to the aircraft,watercraft or"auto" well servicing equipment 15. "Mobile equipment" means any of the following 16. "Occurrence" means an accident, including types of land vehicles, including any attached continuous or repeated exposure to substantially machinery or equipment the same general harmful conditions a. Bulldozers, farm machinery, forklifts and 17. "Personal and advertising injury"means injury, other vehicles designed for use principally including consequential "bodily injury", arising off public roads, out of one or more of the following offenses. b. Vehicles maintained for use solely on or a. False arrest, detention or imprisonment; next to premises you own or rent, b. Malicious prosecution; c. Vehicles that travel on crawler treads; d. Vehicles, whether self-propelled or not, on which are permanently mounted: Page 22 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM c. The wrongful eviction from, wrongful entry Work that may need service, maintenance, into, or invasion of the right of private correction, repair or replacement, but occupancy of a room, dwelling or which is otherwise complete, will be premises that the person occupies, treated as completed committed by or on behalf of its owner, The "bodily injury" or "property damage" landlord or lessor, must occur away from premises you own d. Oral, written or electronic publication of or rent, unless your business includes the material that slanders or libels a person or selling, handling or distribution of "your organization or disparages a person's or product'for consumption on premises you organization's goods, products or services; own or rent. e. Oral, written or electronic publication of b. Does not include "bodily injury" or material that violates a person's right of "property damage" arising out of privacy, (1) The transportation of properly, unless f. Copying, in your "advertisement", a the injury or damage arises out of a person's or organization's "advertising condition in or on a vehicle not owned idea"or style of"advertisement", or operated by you, and that condition g. Infringement of copyright,slogan,or title of was created by the "loading or any literary or artistic work, in your unloading" of that vehicle by any "advertisement", or insured, or h. Discrimination or humiliation that results in (2) The existence of tools, uninstalled injury to the feelings or reputation of a equipment or abandoned or unused natural person. materials. 18. "Pollutants" means any solid, liquid, gaseous or 20. "Property damage" means: thermal irritant or contaminant, including smoke, a. Physical injury to tangible property, vapor, soot, fumes, acids, alkalis, chemicals and including all resulting loss of use of that waste. Waste includes materials to be recycled, property All such loss of use shall be reconditioned or reclaimed. deemed to occur at the time of the 19. "Products-completed operations hazard"; physical injury that caused it,or a. Includes all "bodily injury" and "property b. Loss of use of tangible property that is not damage" occurring away from premises physically injured All such loss of use you own or rent and arising out of "your shall be deemed to occur at the time of product"or"your work"except "occurrence"that caused it. (1) Products that are still in your physical As used in this definition, "electronic data" is possession, or not tangible property. (2) Work that has not yet been completed 21. "Suit" means a civil proceeding in which or abandoned However, "your work" damages because of "bodily injury", "property will be deemed to be completed at the damage" or "personal and advertising injury" earliest of the following times- to which this insurance applies are alleged. (a) When all of the work called for in "Suit"includes your contract has been completed. a. An arbitration proceeding in which such (b) When all of the work to be done at damages are claimed and to which the the job site has been completed if insured must submit or does submit with your contract calls for work at our consent, or more than one job site b. Any other alternative dispute resolution (c) When that part of the work done at proceeding in which such damages are a job site has been put to its claimed and to which the insured submits intended use by any person or with our consent organization other than another 22. 'Temporary worker" means a person who is contractor or subcontractor furnished to you to substitute for a permanent working on the same project. "employee" on leave or to meet seasonal or short-term workload conditions 23. "Volunteer worker"means a person who a. Is not your"employee"; Form SS 00 08 04 05 Page 23 of 24 BUSINESS LIABILITY COVERAGE FORM b. Donates his or her work; (2) The providing of or failure to provide c. Acts at the direction of and within the warnings or instructions. scope of duties determined by you,and c. Does not include vending machines or d. Is not paid a fee, salary or other other properly rented to or located for the compensation by you or anyone else for use of others but not sold. their work performed for you 25. "Your work" 24. "Your product" a. Means* a. Means: (1) Work or operations performed by you (1) Any goods or products, other than real or on your behalf, and property, manufactured, sold, handled, (2) Materials, parts or equipment distributed or disposed of by: furnished in connection with such work (a) You, or operations (b) Others trading under your name; b. Includes- or (1) Warranties or representations made at (c) A person or organization whose any time with respect to the fitness, business or assets you have quality, durability, performance or use acquired,and of"your work", and (2) Containers (other than vehicles), (2) The providing of or failure to provide materials, parts or equipment warnings or instructions furnished in connection with such goods or products b. Includes (1) Warranties or representations made at any time with respect to the fitness, quality, durability, performance or use of"your product', and Page 24 of 24 Form SS 00 08 04 05 IMPORTANT NOTICE TO OUR POLICYHOLDERS THANK YOU FOR RENEWING YOUR POLICY WITH THE HARTFORD. WITH THIS NOTICE WE ARE PROVIDING YOU ONLY WITH THE DECLARATIONS PAGE, WHICH OUTLINES YOUR COVERAGES, AND WITH THOSE POLICY FORMS, NOTICES, AND BROCHURES WHICH ARE DIFFERENT FROM THOSE WHICH WE PROVIDED WITH YOUR PREVIOUS POLICY. YOU SHOULD RETAIN ALL OF THESE DOCUMENTS AND THOSE PROVIDED WfTH YOUR PREVIOUS POLICY INDEFINITELY SO THAT YOU m WILL HAVE A COMPLETE SET OF POLICY FORMS AT ALL TIMES FOR YOUR REFERENCE. 0 IF YOU HAVE QUESTIONS, OR IF AT ANY TIME YOU NEED COPIES OF ANY OF THE FORMS LISTED ON o YOUR POLICY, PLEASE CALL YOUR HARTFORD AGENT OR BROKER, OR THE OFFICE OF THE o HARTFORD IDENTIFIED ON YOUR POLICY, AS APPROPRIATE. Ln N O Ln x a N N N O O 0 0 Form G-0187-0 HE HARRTFORD YOUR INSURANCE RENEWAL IS ENCLOSED. ITS TIME TO REVIEW YOUR POLICY. Policy Number: 52 SBM UK5025 Source Code: APR-COV-100 v2 LO rn C> Dear Customer. m As a business owner, you've seen your business change over time. These changes may take a number of ,C> different forms, for example, have you. N O LO o increased or decreased your workforce? N N o purchased or sold equipment? 0 o increased your sales? CD- 0 o expanded your business operations o moved or added locations? If the answer to any of these (or similar) questions is "yes", in all likelihood your insurance requirements have changed. In order to ensure that the coverage provided by your Hartford policy corresponds to your business today, make it a point to review your policy with a Hartford representative as soon as possible When you call, we'll review your current policy, discuss any changes to your business, and assist you in evaluating your business needs in relation to the latest products and coverage options that are available It is our goal to help you minimize your risk and '- perhaps even reduce your costs. It's easy, convenient...and very importantl Contact us any weekday from 7 A.M. to 7 P.M. CST for your comprehensive and complimentary Annual Policy Review. Call toll free (866) 467-8730, press 1 and extension 3030 It's that simple Your agent and The Hartford thank you for placing your insurance with us We look forward to speaking with you. Sincerely, Your Customer Service Team at The Hartford The Hartford-Select Customer Insurance Center o A IMPORTANT NOTICE TO POLICYHOLDERS REGARDING TERRORISM RISK INSURANCE ACT On December 26, 2007, legislation was enacted extending the federal Terrorism Risk Insurance Act until "TRIA" contained the following important December 31, 2014 (as amended, TRIA or the Program ) The extension g p changes which may reduce coverage provided under your policy Amendment of the definition of"Certified Acts of Terrorism" TRIA extended the reinsurance program within the United States Department of the Treasury, under which the � federal government and the insurance industry share the risk of loss from future "certified acts of terrorism". C> Previously,TRIA defined "certified acts of terrorism"to include only acts of terrorism committed by an individual or individuals "acting on behalf of any foreign persons or foreign interest" This was commonly referred to as"foreign o terrorism" Coverage for"domestic terrorism", or acts of terrorism perpetrated by persons with no ties to foreign o persons or interest, was provided in accordance with the terms and conditions of your policy, unless specifically N excluded. On policies effective on or after December 26, 2007, TRIA no longer distinguishes between foreign and ,> domestic terrorism in its definition of"certified acts of terrorism." D4 N For the duration of the Program, "certified acts of terrorism" will be defined in our policies as follows: Ln N o Any act that is certified by the Secretary of the Treasury, in concurrence with the Secretary of State and the o Attorney General of the United States, to be an act of terrorism pursuant to the federal Terrorism Risk Insurance * Act, as amended, (TRIA) The criteria contained in that Act for a "certified act of terrorism" include the following. 1. The act resulted in insured losses in excess of $5 million in the aggregate, attributable to all types of insurance subject to TRIA, and 2. The act resulted in damage within the United States, or outside the United States in the case of certain air carriers or vessels or the premises of a United States mission, and 3. The act is a violent act or an act that is dangerous to human life, property or infrastructure and is committed by an individual or individuals acting as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. Clarification on the $100 Billion Cap and Federal Participation For the duration of the Program, the federal share of losses, after the insurer satisfies its applicable deductible, is 85%" of insured losses under the Program If industry aggregate insured losses attributable to terrorist acts certified under TRIA exceed $100 billion in a Program Year (January 1 through December 31), and we have met our insurer deductible, we shall not be liable for the payment of any portion of the amount of such losses that exceeds $100 billion, and, in such case, insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasury Furthermore, if aggregate insured losses attributable to "certified acts of terrorism" under TRIA exceed $100 billion in a Program Year (January 1 through December 31) the Treasury will not make any payment for any losses that exceed $100 billion Policy Changes Pursuant to TRIA, we previously made coverage available to you for"certified acts of terrorism" in certain policies we offered, subject to the terms and conditions of your policy If you elected to reject such coverage, an exclusion(s) for "certified acts of terrorism" was made a part of your policy at the time of your rejection In accordance with the extension of TRIA, and due to, among other things, the inclusion of domestic terrorism in the _ definition of "certified acts of terrorism", we are required to again make terrorism coverage available to you, and such coverage is included in this renewal policy If you wish to reject coverage for "certified acts of terrorism", please contact your agent or broker and an exclusion(s) of"certified acts of terrorism"will be made part of your policy Please contact your agent, broker or representative if you have questions Form G-3433-0 Page 1 of 1 Direct Bill Information You will soon receive your first bill from The Hartford. Please do not make any payment until you receive your bill. Your insurance policy is in force as of the effective date shown on the policy. (if you do not wish to continue your coverage with The Hartford, you must contact your Hartford agent or broker immediately In addition, you must either return 14 your policy to The Hartford or submit to The Hartford a signed "Lost Policy Ln Release" form, which you can obtain from your agent or broker.) 0 Here's how you will be billed: Ln N in o Your total premium is displayed on the front of your policy You will be billed according to the payment plan under which you are enrolled. N L(l 0 o Please pay the exact amount of the "minimum due"shown on your bill or you may choose to o pay your total premium in full. Please note that a nominal service fee is added to each billing o Installment. To save on service fees, you may prepay future installments if you wish To avoid late payment fees, please pay the"minimum due"so that it is received by the due date shown on your bill Service and late payment fees do not apply in all states o If you are on the installment billing plan and a credit or additional premium is due as the result of a change made to your policy, the credit or additional premium will be spread equally over the future billing installments. o For your convenience, more than one policy maybe combined on a single monthly bill This means you can add eligible policies to your billing account at any time. if you have any questions about your bill, please call The Hartford's Customer Service toll- free number 1-666-467-8730. Options for Making a Payment: o Repetitive EFT Want a fast and easy way to make your scheduled payments to The Hartford?Then sign up for Electronic Funds Transfer(EFT) and save' By having your payments automatically deducted from your bank account, you don't have to write and mail a check or worry about your payment being received on time To learn more about EFT and to sign up today for this time saving service o Call customer service, toll-free at 1-866-467-8730 o Press 2 for"Payment or Billing Account Information" _ o Say"I'm a Policyholder" o Say"EFT' o Pay by Phone Call toll-free at 1-866-467-8730 to make a one-time payment. o Mail Check Send in a check with your remittance stub in the envelope enclosed with your bill 'EFT savings not applicable in LA,MT,TX,VA,&WA Form 100722 8th Rev. Printed in U.S A. POLICY NUMBER: 52 SBM UK5025 THIS ENDORSEMENT IS ATTACHED TO AND MADE PART OF YOUR POLICY IN RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT. DISCLOSURE PURSUANT TO TERRORISM RISK a INSURANCE ACT LO 0 C1 'i SCHEDULE 0 Ln N 0 in X N Terrorism Premium (Certified Acts): Ln o $ $5.00 0 A. Disclosure Of Premium However, if aggregate insured losses attributable to In accordance with the federal Terrorism Risk certified acts of terrorism under TRIA exceed $100 Insurance Act, as amended (TRIA), we are required billion in a Program Year (January 1 through to provide you with a notice disclosing the portion of December 31), the Treasury shall not make any your premium, if any, attributable to coverage for payment for any portion of the amount of such certified acts of terrorism under TRIA. The portion losses that exceeds $100 billion. of your premium attributable to such coverage is C. Cap On Insurer Participation In Payment Of shown in the Schedule of this endorsement Terrorism Losses B. Disclosure Of Federal Participation In Payment If aggregate insured losses attributable to certified Of Terrorism Losses acts of terrorism under TRIA exceed $100 billion in The United States Department of the Treasury will a Program Year (January 1 through December 31) pay a share of terrorism losses insured under the and we have met our insurer deductible under TRIA, federal program The federal share equals 85% of we shall not be liable for the payment of any portion that portion of such insured losses that exceeds the of such losses that exceeds $100 billion, and in applicable insurer deductible such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasury D. All other terms and conditions remain the same. Form SS 83 76 01 08 Page 1 of 1 © 2008, The Hartford (Includes copyrighted material of the Insurance Services Office, Inc ,with its permission } IMPORTANT NOTICE TO POLICYHOLDERS To help your insurance keep pace with increasing costs, we have increased your amount of insurance . . . giving you O better protection in case of either a partial,or total loss to your property. Ln If you feel the new amount is not the proper one, please contact your agent or broker. a, 0 rl O Ln N O Ln L[l N O O a-I Form PC-374-0 Printed in U S.A. IMPORTANT NOTICE TO POLICYHOLDERS N Ln o CIVIL AUTHORITY rn 0 0 Ln o NEW LIMITATIONS HAVE BEEN ADDED TO YOUR SPECTRUM POLICY. YOU SHOULD REVIEW YOUR POLICY AND CONTACT YOUR HARTFORD AGENT OR YOUR BROKER IF YOU HAVE ANY QUESTIONS. CV N O O Under the Standard Property Coverage Form,form SS 00 06,and the Special Property Coverage Form, form SS 00 07, * whichever applies to this policy, the Additional Coverage, Civil Authority, is revised to include a 72-hour waiting period. Coverage is restricted with coverage provided not until a 72-hour period has elapsed following the order of a Civil Authority. Please contact your agent or broker for further information. Form SS 83 7210 02 Page 1 of 1 0 2002,The Hartford 25 This Spectrum Policy consists of the Declarations, Coverage Forms, Common Policy Conditions and any 50 other Forms and Endorsements issued to be a part of the Policy This insurance is provided by the stock UK insurance company of The Hartford Insurance Group shown below. SBM INSURER: HARTFORD CASUALTY INSURANCE COMPANY HARTFORD PLAZA, HARTFORD, CT 06115 COMPANY CODE: 3 Policy Number: 52 SBM UK5025 DX THE HARTFORD SPECTRUM POLICY DECLARATIONS ORIGINAL N Named Insured and Mailing Address: ARNOLD TOMAC DBA A & M N L, (No , Street, Town, State, Zip Code) CONSULTING o, 0 18119 N.E. 30TH STREET REDMOND WA 98052 rn C�'i Policy Period: From 11/01/08 To 11/01/09 1 YEAR Ln 12.01 a m , Standard time at your mailing address shown above. Exception: 12 noon in New Hampshire. N Ln Name of Agent/Broker: AJ GALLAGHER RSK MGMT SVCS INC/PHS Code: 818120 N N Previous Policy Number: 52 SBM UK5025 0 0 Named Insured is: INDIVIDUAL Audit Period: NON-AUDITABLE Type of Property Coverage: NONE Insurance Provided: In return for the payment of the premium and subject to all of the terms of this policy, we agree with you to provide insurance as stated in this policy. TOTAL ANNUAL PREMIUM IS: $350 MP IN RECOGNITION OF THE MULTIPLE COVERAGES INSURED WITH THE HARTFORD, YOUR POLICY PREMIUM INCLUDES AN ACCOUNT CREDIT. Countersigned by 09/15/08 Authorized Representative Date Form SS 00 02 12 06 Page 001 (CONTINUED ON NEXT PAGE) Process Date: 09/15/08 Policy Expiration Date: 11/01/09 INSURED COPY SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 52 SBM UK5025 Location(s), Budding(s), Business of Named Insured and Schedule of Coverages for Premises as designated by Number below Location: 001 Building: 001 18119 N.E. 30TH STREET REDMOND WA 98052 Description of Business: REAL ESTATE APPRAISER Deductible: NO COVERAGE BUILDING AND BUSINESS PERSONAL PROPERTY LIMITS OF INSURANCE BUILDING NO COVERAGE BUSINESS PERSONAL PROPERTY REPLACEMENT COST NO COVERAGE PERSONAL PROPERTY OF OTHERS REPLACEMENT COST NO COVERAGE MONEY AND SECURITIES INSIDE THE PREMISES NO COVERAGE OUTSIDE THE PREMISES NO COVERAGE Form SS 00 02 12 06 Page 002 (CONTINUED ON NEXT PAGE) Process Date: 09/15/OB - Policy Expiration Dafe: 11/01/09' SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 52 SBM UK5025 BUSINESS LIABILITY LIMITS OF INSURANCE LIABILITY AND MEDICAL EXPENSES $1,000,000 MEDICAL EXPENSES -ANY ONE PERSON $ 10,000 PERSONAL AND ADVERTISING INJURY $1,000,000 DAMAGES TO PREMISES RENTED TO YOU $ 300, 000 N ANYONE PREMISES Ln o AGGREGATE LIMITS PRODUCTS-COMPLETED OPERATIONS $2, 000, 000 rn C)+ GENERAL AGGREGATE $2, 000, 000 0 o EMPLOYMENT PRACTICES LIABILITY Ln COVERAGE: FORM SS 09 Ol N N EACH CLAIM LIMIT $ 5, 000 0 0 `'� DEDUCTIBLE -EACH CLAIM LIMIT NOT APPLICABLE AGGREGATE LIMIT $ 5, 000 RETROACTIVE DATE: 11012005 This Employment Practices Liability Coverage contains claims made coverage Except as may be otherwise provided herein, specified coverages of this insurance are limited generally to liability for injuries for which claims are first made against the insured while the insurance is in force. Please read and review the insurance carefully and discuss the coverage with your Hartford Agent or Broker. = The Limits of Insurance stated in this Declarations will be reduced, and may be completely exhausted, by the payment of"defense expense" and, in such event, The Company will not be obligated to pay any further"defense expense" or sums which the insured is or may become legally obligated to pay as"damages". _ BUSINESS LIABILITY OPTIONAL COVERAGES HIRED/NON-OWNED AUTO LIABILITY $1, 000,000 FORM: SS 01 70 EMPLOYERS LIABILITY AND STOP GAP BODILY INJURY BY ACCIDENT EACH ACCIDENT $1,000,000 BODILY INJURY BY DISEASE EACH EMPLOYEE $1,000, 000 BODILY INJURY BY DISEASE POLICY LIMIT $1,000, 000 APPLICABLE TO LOCATIONS IN THE FOLLOWING STATE(S) : WASHINGTON Form SS 00 02 12 06 Page 003 (CONTINUED ON NEXT PAGE) Process Date: 09/15/08 Policy Expiration Date: 11/01/09 s SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 52 SBM UK5025 BUSINESS LIABILITY OPTIONAL COVERAGES LIMITS OF INSURANCE (Continued) WAIVER OF SUBROGATION: FORM 38 12 15 LOCATION: 001 BUILDING: 001 NAME: IF ANY a i 9 Form SS 00 D2 92 06 _. _ 4 Page 004 (CONTINUED ON NEXT PAGE) Process Date: 09/15/08 - Policy Expiration Date: 11/01/09 SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 52 SBM UK5025 ADDITIONAL INSUREDS: THE FOLLOWING ARE ADDITIONAL INSUREDS FOR BUSINESS LIABILITY COVERAGE IN THIS POLICY. LOCATION: 001 WILDING: 001 TYPE: MANAGER/LESSOR: Ln NAME: SEE FORM IS 12 00 rn 0 rn 0 11 0 N 0 L x N Ln O O 'i I � Form SS 00 02 12 06 Page 005 (CONTINUED ON NEXT PAGE) Process Date: 09/15/08 Policy Expiration Date: 11/01/09 SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 52 SBM UK5025 Form Numbers of Forms and Endorsements that apply: SS 00 01 04 93 SS 00 05 12 06 SS 00 08 04 05 SS 00 45 12 06 SS 01 28 06 03 SS 01 70 06 01 SS 01 85 11 93 SS 41 02 04 05 SS 05 03 03 00 SS 05 47 09 01 SS 09 01 09 00 SS 09 25 04 98 SS 09 42 07 99 SS 10 04 09 98 SS 12 15 03 00 SS 50 19 01 08 SS 83 76 01 08 IH 12 00 11 85 ADDITIONAL INSURED - MANAGER/LESSOR i Form SS 00 02 12 06 Page 006 Process Date: 09/15/08 _ ' Policy Expiration Date: 11/01/09 LO [V LO cn 0 0 li O Ln N O Ln x Cq N Ln ic O �-i i COMMON POLICY CONDITIONS Form SS 00 05 12 06 0 2006, The Hartford QUICK REFERENCE -SPECTRUM POLICY DECLARATIONS and COMMON POLICY CONDITIONS 1. DECLARATIONS Named Insured and Mailing Address Policy Period Description and Business Location Coverages and Limits of Insurance H. COMMON POLICY CONDITIONS Beginning on Page A. Cancellation 1 B. Changes 1 C. Concealment, Misrepresentation Or Fraud 2 D. Examination Of Your Books And Records 2 E. Inspections And Surveys 2 F. Insurance Under Two Or More Coverages 2 G. Liberalization 2 H. Other Insurance-Property Coverage 2 I. Premiums 2 J. Transfer Of Rights Of Recovery Against Others To Us 2 K. Transfer Of Your Rights And Duties Under This Policy 3 L. Premium Audit 3 1 Form SS 00 05 12 06 COMMON POLICY CONDITIONS All Coverages of this policy are subject to the following conditions. A. Cancellation (5) Failure to, 1. The first Named Insured shown in the (a) Furnish necessary heat, water, Declarations may cancel this policy by mailing sewer service or electricity for 30 or delivering to us advance written notice of consecutive days or more, except N cancellation. during a period of seasonal Ln 0 2. We may cancel this policy by mailing or unoccupancy, or delivering to the first Named Insured written (b) Pay property taxes that are owing notice of cancellation at least. and have been outstanding for o a. 5 days before the effective date of more than one year following the N date due, except that this cancellation if any one of the following LO conditions exists at any budding that is provision will not apply where you Covered Property in this policy: are in a bona fide dispute with the taxing authority regarding Ln (1) The budding has been vacant or payment of such taxes. ounoccupied 60 or more consecutive b. 10 days before the effective date of days This does not apply to- cancellation if we cancel for nonpayment rA * (a) Seasonal unoccupancy; or of premium (b) Buildings in the course of c. 30 days before the effective date of construction, renovation or cancellation if we cancel for any other addition. reason. Buildings with 65% or more of the rental 3. We will mail or deliver our notice to the first units or floor area vacant or unoccupied Named Insured's last mailing address known are considered unoccupied under this to us provision. 4. Notice of cancellation will state the effective (2) After damage by a Covered Cause of date of cancellation The policy period will end Loss, permanent repairs to the on that date building 5. If this policy is canceled, we will send the first (a) Have not started; and Named Insured any premium refund due (b) Have not been contracted for, Such refund will be pro rata The cancellation within 30 days of initial payment of will be effective even if we have not made or = offered a refund. loss (3) The building has 6• If notice is mailed, proof of mailing will be sufficient proof of notice (a) An outstanding order to vacate; 7. If the first Named Insured cancels this policy, (b) An outstanding demolition order; we will retain no less than $100 of the or premium. (c) Been declared unsafe by B. Changes governmental authority. This policy contains all the agreements between you (4) Fixed and salvageable items have and us concerning the insurance afforded_ The first been or are being removed from the Named Insured shown in the Declarations is budding and are not being replaced authorized to make changes in the terms of this This does not apply to such removal policy with our consent. This policy's terms can be that is necessary or incidental to any amended or waived only by endorsement issued renovation or remodeling by us and made a part of this policy Form SS 00 05 12 06 Page 1 of 3 © 2006, The Hartford COMMON POLICY CONDITIONS C. Concealment, Misrepresentation Or Fraud I. Premiums This policy is void in any case of fraud by you as it 1. The first Named Insured shown in the relates to this policy at any time. It is also void if you Declarations: or any other insured, at any time, intentionally a. Is responsible for the payment of all conceal or misrepresent a material fact conceming: premiums, and 1. This policy; 2. The Covered Property; b. Will pay the payee for any return premiums we 3. Your interest in the Covered Property;or 2. The premium shown in the Declarations was 4. A claim under this policy. computed based on rates in effect at the time D. Examination Of Your Books And Records the policy was issued If applicable, on each We may examine and audit your books and renewal, continuation or anniversary of the records as they relate to the policy at any time effective date of this policy, we will compute duringthe the premium in accordance with our rates and policy y period and up to three years rules then in effect afterward. E. Inspections And Surveys 3. With our consent, you may continue this policy in force by paying a continuation premium for We have the right but are not obligated to: each successive one-year period The 1. Make inspections and surveys at any time; premium must be. 2. Give you reports on the conditions we find;and a. Paid to us prior to the anniversary date, and 3. Recommend changes. b. Determined in accordance with Paragraph Any inspections, surveys, reports or 2. above recommendations relate only to insurability and the Our forms then in effect will apply. If you do premiums to be charged. We do not make safety not pay the continuation premium, this policy inspections. We do not undertake to perform the duty will expire on the first anniversary date that we of any person or organization to provide for the health have not received the premium. or safety of any person And we do not represent or 4. Changes in exposures or changes in your warrant that conditions business operation, acquisition or use of 1. Are safe or healthful; or locations that are not shown in the Declarations 2. Comply with laws, regulations, codes or may occur during the policy period If so, we standards may require an additional premium That This condition applies not only to us, but also to premium will be determined in accordance with an rating, advisory, our rates and rules then in effect y ry, rate service or similar organization which makes insurance inspections, J. Transfer Of Rights Of Recovery Against Others surveys, reports or recommendations To Us F. insurance Under Two Or More Coverages Applicable to Property Coverage: If two or more of this policy's coverages apply to If any person or organization to or for whom we the same loss or damage, we will not pay more make payment under this policy has rights to than the actual amount of the loss or damage. recover damages from another, those rights are G. Liberalization transferred to us to the extent of our payment If we adopt any revision that would broaden the That person or organization must do everything coverage under this policy without additional necessary to secure our rights and must do premium within 45 days prior to or during the nothing after loss to impair them. But you may policy period, the broadened coverage will waive your rights against another party in writing immediately apply to this policy 1. Prior to a loss to your Covered Property. H. Other Insurance -Property Coverage 2. After a loss to your Covered Property only if, at If there is other insurance covering the same loss time of loss,that party is one of the following. or damage, we will pay only for the amount of covered loss or damage in excess of the amount a. Someone insured by this insurance, due from that other insurance, whether you can b. A business firm collect on it or not But we will not pay more than (1) Owned or controlled by you, or the applicable Limit of Insurance. (2) That owns or controls you, or Page 2 of 3 - - Form SS 00 05 12 06 COMMON POLICY CONDITIONS c. Your tenant L Premium Audit You may also accept the usual bills of lading or a. We will compute all premiums for this policy in shipping receipts limiting the liability of carriers accordance with our rules and rates. This will not restrict your insurance. b. The premium amount shown in the K. Transfer Of Your Rights And Duties Under This Declarations is a deposit premium only. At the Policy close of each audit period we will compute the Your rights and duties under this policy may not be earned premium for that period. Any transferred without our written consent except in additional premium found to be due as a result the case of death of an individual Named Insured of the audit are due and payable on notice to the first Named Insured If the deposit If you die, your rights and duties will be transferred premium paid for the policy term is greater to your legal representative but only while acting than the earned premium, we will return the Ln o within the scope of duties as your legal excess to the first Named Insured. representative Until your legal representative is c. The first Named Insured must maintain all rn appointed, anyone having proper temporary a custody of your property will have your rights and records related to the coverage provided by duties but only with respect to that property, this policy and necessary to finalize the Ln premium audit, and send us copies of the N C) same upon our request. Ln N LO C 11 Our President and Secretary have signed this policy. Where required by law,the Declarations page has also been countersigned by our duly authorized representative. Richard G Costello, Secretary Neal S.Wolin, President Form SS 00 05 12 06 Page 3 of 3 it THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM m This endorsement modifies insurance provided under the following: N o BUSINESS LIABILITY COVERAGE FORM ? OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM o, SPECIAL PROPERTY COVERAGE FORM STANDARD PROPERTY COVERAGE FORM L UMBRELLA LIABILTY PROVISIONS N O Ln �4 N A. Disclosure Of Federal Participation In 3. The act is a violent act or an act that is Ln Payment Of Terrorism Losses dangerous to human life, property or N o The United States Department of the Treasury, infrastructure and is committed by an will pay a share of terrorism losses insured under will or individuals as part of an effort to * the federal program The federal share equals coerce the civilian population of the United 85% of that portion of such insured losses that States or to influence the policy or affect the exceeds the applicable insurer deductible conduct of the United States Government by However, if aggregate insured losses attributable coercion. to certified terrorist acts under Terrorism Risk If aggregate insured losses attributable to terrorist Insurance Act exceed $100 billion in a Program acts certified under the Terrorism Risk Insurance Year (January 1 through December 31), the Act exceed $100 billion in a Program Year Treasury shall not make any payment for any (January 1 through December 31) and we have portion of such losses that exceeds$100 billion. met our insurer deductible under the Terrorism B. Cap On Certified Terrorism Losses Risk Insurance Act, we shall not be liable for the payment of any portion of the amount of such A"Certified act of terrorism" means any act that is losses that exceeds $100 billion, and in such case certified by the Secretary of the Treasury, in insured losses up to that amount are subject to concurrence with the Secretary of State and the pro rota allocation in accordance with procedures Attorney General of the United States. The criteria established by the Secretary of the Treasury. contained in Terrorism Risk Insurance Act, as C. Application Of Exclusions amended, for a "certified act of terrorism" include the following. The terms and limitations of any terrorism exclusion, or the inapplicability or omission of a 1. The act resulted in insured losses in excess terrorism exclusion, do not serve to create of $5 million in the aggregate, attributable to coverage for any loss which would otherwise be all types of insurance subject to the Terrorism excluded under this Coverage Part or Policy, such Risk Insurance Act, and as losses excluded by the Nuclear Hazard 2. The act resulted in damage within the United Exclusion or the War And Military Action States, or outside the United States in the Exclusion. case of certain air carriers or vessels or the premises of an United States mission, and Form SS 50 19 01 08 Page 1 of 1 © 2008, The Hartford (Includes copyrighted material of Insurance Services Office, Inc with its permission) POLICY FACE SHEET 25 50 INSURED: UK HARTFORD CASUALTY INSURANCE COMPANY SBM POLICY NO. 52 SBM UK5025 DX RECORDS RETENTION - PERMANENT DECLARATIONS ITEMS 1. NAMED INSURED AND ARNOLD TOMAC DBA A & M m MAILING ADDRESS: CONSULTING �r 18119 N E. 30TH STREET REDMOND, KING WA 98052 N 2. POLICY PERIOD: 11/01/11 11/01/12 1 N INCEPTION EXPIRATION YEAR 0 x� N AGENT'S CODE: 812490 o AGENT'S 14AME: AJ GALLAGHER RSK MGMT SVCS INC/PHS 0 0 N PREVIOUS POLICY NO. 52 SBM UK5025 s _ 3. THE NAMED INSURED IS: INDIVIDUAL POLICY STATUS: ACTIVE LOB LEVEL OF SUPPORT: SP-S MARKET SEGMENTATION: 830 SELECT CUSTOMER AGENT SALES AGREEMENT (COMMISSION STATUS ) DIRECT ACCOUNT BILL NUMBER - 11511614 DEDUCTIBLE ADDITIONAL INSUREDS) AUTOMATICALLY BOOKED ABBREVIATED POLICY ISSUED AUTOMATICALLYZ RENEWED TRANS TYPE: RENL CNTL#: 001 POLICY FACE SHEET TERMINAL ID: UODCW37A PAGE 2 09/19/11 52 SBtit UK5025 DX (11/01/12) Nam ,f, f`1 WOM 7RTJ N j Ln Ln N O z ID OF C!} N H o PQ to U1 0 oz 'N" N M ul a o 24 O N O Ln , a N a w 0 O w w E� E+ w H POLICY NUMBER: 52 SBM UK5025 it THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MANAGER/LESSOR THE CITY OF KENT PUBLIC WCRKS ENGINEERING 222 FOURTH AVE. SO. KENT WA 98032 Form IH 12 00 1185 T SECT.NO. 002 Printed in U.S.A. Page 001 Process Date: 09/19/11 Expiration Date: 11/01/12 UW COPY 1 REQUEST FOR MAYOR'S SIGNATURE 400 Z • Please FIII in All Applicable Boxes KENT This form must he printed on cherry paper Routing Information (ALL REQUESTS MUST FIRST BE ROUTED THROUGH THE LAW DEPARTMENT) Originator Mark Howlett Phone (Originator) 5523 Date Sent 2/9/12 Date Required 2/16/12 Return Signed Document to Nancy Yoshitake CONTRACT TERMINATION DATE: 12/31/13 VENDOR NAME: A& M Consulting DATE OF COUNCIL APPROVAL: Brief Explanation of Document: The attached agreement is for A& M Consulting to provide public and private utility coordination for the SE 256th Street Improvements project For a explanation, see the attached prepared by Mark Howlett All Contracts Must Be Routed Through the Law Department (This Area to be Completed By the Law Depart ent) Received: Approval of Law Dept RECEIVED a Law Dept Comments FEB 0 9 2012 KENT LAW QEPT C;Ixy D7 h- n'r Date Forwarded to Mayor �'' t''' ' f Shaded Areas to Be Completed by Administration Staff Received: r 1 a III i � ;7 ra Recommendations & Comments: i Lv , n,3 Disposition. 40 iZ �2���oI�G'�'�Gfl����1 �,r.�-r✓�y Crrvp�;�.'',T'---J n Date Returned: Iage5870_templatebase • 2/07