Loading...
HomeMy WebLinkAboutPW16-204 - Original - Noel Inc. - Flood Control & Emergency Flood Fight - 05/16/2016 NP ecords M a, g,, W0.SnGT'Uea. KENT DoCui"'i'1Ent 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: Noel Inc. Vendor Number: JD Edwards Number Contract Number: VWIU This is assigned by City Clerk's Office Project Name: Flood Control & Emergency Flood Fight Description: ❑ Interlocal Agreement Il Change Order El Amendment 0 Contract D Other: Contract Effective Date: 5/16/16 Termination Date: 1 :/31./16 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager:-Toby Hallock Department: Engineering Contract Amount: $19,800.00 Approval Authority: (CIRCLE ONE) Department Director Mayor City Council Detail: (i.e. address, location, parcel number, tax id, etc.): Provide engineering and environmental services for flood control projects and emergency flood fight. As of: 08/27/14 • KENT wnsi. Hota.+ CONSULTANT SERVICES AGREEMENT between the City of Kent and Noel Inc. THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Noel Inc. organized under the laws of the State of Washington, located and doing business at 7359 23rd Ave. NW, Seattle, WA 98117, Phone: (206) 784-6635, Contact: Noel Gilbrough (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 engineering and environmental services for flood control projects and emergency flood fight. 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. Consultant shall complete the work described in Section I by December 31, 2016. III. COMPENSATION. A. The City shall pay the Consultant, based on time and materials, an amount not to exceed Nineteen Thousand, Eight Hundred Dollars ($19,800.00), 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. 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: CONSULTANT SERVICES AGREEMENT - 1 ($20,000 or Less) 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 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 CONSULTANT SERVICES AGREEMENT - 2 ($20,000 or Less) 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 B attached 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 Consultant acknowledges that the City is a public agency subject to the Public Records Act codified in Chapter 42.56 of the Revised Code of Washington. As such, the Consultant agrees to cooperate fully with the City in satisfying the City's duties and obligations under the Public Records Act. 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 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 CONSULTANT SERVICES AGREEMENT - 3 ($20,000 or Less) 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. 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 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. Public Records Act. The Consultant acknowledges that the City is a public agency subject to the Public Records Act codified in Chapter 42.56 of the Revised Code of Washington and documents, notes, emails, and other records prepared or gathered by the Consultant in its performance of this Agreement may be subject to public review and disclosure, even if those records are not produced to or possessed by the City of Kent. As such, the Consultant agrees to cooperate fully with the City in satisfying the City's duties and obligations under the Public Records Act. J. City Business License Required. Prior to commencing the tasks described in Section I, Contractor agrees to provide proof of a current city of Kent business license pursuant to Chapter 5.01 of the Kent City Code. CONSULTANT SERVICES AGREEMENT - 4 ($20,000 or Less) K. Counterparts and Signatures by Fax or Email. 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, Further, upon executing this Agreement, either party may deliver the signature page to the other by fax or email and that signature shall have the same force and effect as if the Agreement bearing the original signature was received in person. IN WITNESS, the parties below execute this Agreement, which shall become effective on the last date entered below. CONSULTANT: CITY KENT: By: By;,X at � V (sl`gnature) >on Print Na Print Name: Timothy J. LaPorte, P.E. Its: <2tvL,maIL— Its: Public Works Director (title) DATE: DATE: NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: CONSULTANT: CITY OF KENT: Noel Gil'brough Timothy J. LaPorte, P.E. Noel Inc. City of Kent 7359 23rd Ave, NW 220 Fourth Avenue South Seattle, WA 98117 Kent, WA 98032 (206) 784-1894 (telephone) (253) 856-5500 (telephone) 253 6500 (facsimile Noel Inc-FP�oad Contrcl&Flucd Fight/Hallack CONSULTANT SERVICES AGREEMENT 5 ($20,000 or Less) 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. By:For: /4—/tw- L-- C Title: ((9�,206IL/ Date: k4kioLl 901/„ 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 KENT 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 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 (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: Date: EEO COMPLIANCE DOCUMENTS - 3 EXHIBIT A J/Z 5 h(v SCOPE OF WORK FOR PROFESSIONAL ENGINEERING AND ENVIRONMENTAL SERVICES i FLOOD CONTROL PROJECTS • Assist the City in all actions leading up to Full FEMA Certification of the City's Levees • Assist the City in the development of Levee Vegetation Variances • Provide river levee consultation to city staff on the city's Green River Levee projects including: Horseshoe Bend, Hawley Road, SR516 to S 231"Way, Russell Road Lower/Lowest, Boeing, and Briscoe/Desimone. • Engage in meetings and conference calls to help resolve planning and design issues • Provide guidance on Corps contacts and processes relating to levee designs and i permitting j • Prepare follow-up correspondence which documents recommendations and findings EMERGENCY FLOOD FIGHT j • Provide consultation to city staff to discuss the city's planning and response to emergency flood fighting for the Green River. This work includes consultation for: o During flood events work as a technical advisor to the City and assist with its coordination with King County and Corps of Engineers o Flood containment and protection for levees, and i o Repair and reconstruction of damaged levees • Provide guidance on documents regarding Standard Operating Procedures for flood fighting for the Green River. • Provide guidance on Corps contacts for services relating to flood fights • Provide guidance on Corps contacts and federal processes relating to funding • Prepare follow-up correspondence which documents recommendation and findings Contact Information: Noel Gllbrough, PE 7359 23rd Ave NW Seattle WA 98117 206-784-1894 gilbrough@comcast.net I I f I i I I f E � LU o § k E S 8 d d d 7 U 8 k i� ® e u - � 2 0 0 7 ¥ e d i \ k ? 9 2 cr E 2 / m w 2 $ ®IA z .2 2 [ 2 2 cl ui cc § k Q. § ui §§ .) m 2 / z 0 « § / { » z z � g k c o a V) o '� E o 2 LL § § £ E § / / � 'c > § / \/ / ƒ V) cr ? m _ / / � k 2 ® 2 > L � '§ t m / 2 § 7 § 3 tkoo\_ § 0 / uj \ ±w M 1k/ ® Rc> ^ / E § / \ a R � \ k g e m 2 ktu § . k } u } \ \ Fj I � . , � EXHIBIT B 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 B (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. ® DATE(MWDD(YYYY) A�o CERTIFICATE OF LIABILITY INSURANCE 05l11l2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Pearl Insurance PHONE FAX _( C.No.Extl@ --- 1200 E Glen Ave EMAIL ADDRESS: _,_-_.__._._ INSURER(S)AFFORDING COVERAGE NAIC# Peoria Heights IL 61616 INSURER A: Underwriters at Lloyd's of London AA-1122000 INSURED INSURER B: RLI Insurance Company 13056 Noel,Inc. INSURER C: 7359 23rd Ave NW INSURER D: INSURER E: Seatlle WA 98117-5661 INSURER 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. INSR TYPE OF INSURANCE A POLICY EFF POLICY EXP LIMITS LTR I POLICY NUMBER MMIDD(YYYY MMIDDfYYYY GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 D 1,000,000 COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence S CLAIMS-MADE ®OCCUR MED EXP(Any one person) S 10,000 B Y Y PSB0005516 07/01/2015 07/01/2016 PERSONAL BADVINJURY s GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG $ 2,000,000 POLICY N PRO- JECT LOC S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 _ (Eaaccident) S ANY AUTO BODILY INJURY(Per person) $ B ALL OWNED SCHEDULED Y Y PSB0005516 07/01/2015 07/01/2016 BODILY INJURY(Per accident) S AUTOS AUTOS NON-OWNED PROPERTY DAMAGE X $ I HIRED AUTOS AUTOS Per accident 5 UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTIONS S WORKERS COMPENSATION WC STATUS OTH- AND EMPLOYERS'LIABILITY Y(N ANY PROPRIETORIPARTNERIEXECUTIVE ElE.L.EACH ACCIDENT S OFFICERIMEMBER EXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S Eyes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S Professional Liability $1,000,000 Per Claim,$1,000,000 Aggregate A Retro date:03/11/2013 N N 2200524-03 03/11/2016 03/11/2017 $5,000 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS(VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) The City of Kent Public Works Engineering is is afforded General Liability Additional Insured coverage,waiver of subrogation under Additional Insured Endorsement PPB 304 02 12 and Liability Enhancement endorsement PPB 316 11 13 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Kent Public Works Engineering THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 220 Fourth Avenue South ACCORDANCE WITH THE POLICY PROVISIONS. A THORIZE EP ENTA7IVE Kent WA 98032 �j I ACORD 25(2010105) ©1988-2010 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD Policy Number: PSB0005516 RLI Insurance Company Named Insured:Noel, Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. RLIPack° FOR PROFESSIONALS BLANKET ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM-SECTION II—LIABILITY 1. C. WHO IS AN INSURED is amended to include as additional insured under this policy must apply on a an additional insured any person or organization that primary basis, or a primary and non-contributory you agree in a contract or agreement requiring basis, this insurance is primary to other insurance insurance to include as an additional insured on this that is available to such additional insured which policy, but only with respect to liability for "bodily covers such additional insured as a named insured, injury", "property damage" or "personal and and we will not share with that other insurance, advertising injury" caused in whole or in part by you provided that: or those acting on your behalf: a. The "bodily injury" or "property damage" for a. In the performance of your ongoing operations; which coverage is sought occurs after you have b. In connection with premises owned by or rented entered into that contract or agreement; or to you; or b. The "personal and advertising injury" for which c. In connection with "your work" and included coverage is sought arises out of an offense committed after you have entered into that within the "product-completed operations hazard". contractor agreement. 2. The insurance provided to the additional insured by 4. The following is added to SECTION III K. 2. this endorsement is limited as follows: Transfer of Rights of Recovery Against Others to Us — COMMON POLICY CONDITIONS (BUT a. This insurance does not apply on any basis to APPLICABLE TO ONLY TO SECTION II — any person or organization for which coverage LIABILITY) as an additional insured specifically is added by We waive any rights of recovery we may have another endorsement to this policy. against any person or organization because of b. This insurance does not apply to the rendering payments we make for "bodily injury", "property of or failure to render any "professional damage" or "personal and advertising injury" arising services". out of "your work" performed by you, or on your c. This endorsement does not increase any of the behalf, under a contract or agreement with that limits of insurance stated in D. Liability And person or organization. We waive these rights only Medical Expenses Limits of Insurance. where you have agreed to do so as part of a contract or agreement with such person or 3. The following is added to SECTION III H.2. Other organization entered into by you before the "bodily Insurance — COMMON POLICY CONDITIONS injury"or"property damage" occurs, or the "personal (BUT APPLICABLE ONLY TO SECTION II — and advertising injury"offense is committed. LIABILITY) However, if you specifically agree in a contract or agreement that the insurance provided to an ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. PPB 304 02 12 Page 1 of 1 Policy Number: PSB0005516 RLI Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. RLIPack° FOR DESIGN PROFESSIONALS LIABILITY ENHANCEMENT SCHEDULE OF COVERAGES ADDRESSED BY THIS ENDORSEMENT A. First Aid And Good Samaritan Services B. Supplementary Payments C. Reasonable Force—Bodily Injury Or Property Damage D. Non-Owned Watercraft E. Canoes Or Rowboats F. Damage To Premises Rented To You G. Aircraft Chartered With Crew H. Electronic Data Liability I. Who Is An Insured—Newly Acquired Or Formed Organizations J. Who Is An Insured—Unnamed Partnership Or Joint Venture K. Additional Insured—Owner, Manager Or Lessor Of Premises Or Leased Equipment L. Additional Insured—State Or Political Subdivisions—Permits Related To Premises Or Operations M. General Aggregate Limit—Per Project Or Per Location N. Knowledge And Notice Of Occurrence Or Offense O. Amended Bodily Injury Definition P. Amended Insured Contract Definition—Construction Or Demolition Operations Within 50' Of Railroad Q. Amended Personal And Advertising Injury Definition—Electronic Material R. Unintentional Omission S. Waiver Of Transfer Of Rights Of Recovery Against Others To Us PPB 316 11 13 Page 1 of 7 This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM—SECTION II—LIABILITY AND SECTION III AS IT PERTAINS TO LIABILITY ONLY A. First Aid And Good Samaritan Services a. Expected or Intended Injury 1. The following is added to Section II A.1. "Bodily Injury" or "property damage" ex- Business Liability Coverages pected or intended from the standpoint of We will pay those sums that the insured the insured.This exclusion does not apply to becomes legally obligated to pay as damages "bodily injury"or"property damage"resulting because of"bodily injury"arising out of either the from the use of reasonable force to protect rendering of or failure to render, "First Aid" or persons or property. "Good Samaritan Services" to any person. For D. Non-Owned Watercraft the purposes of this coverage grant, "First Aid" 1. Section II B.1.g. Exclusions, Aircraft, Auto Or or"Good Samaritan Services"will be deemed to Watercraft Subparagraph (2) is deleted and meet the definition of 'occurrence". For the replaced by the following: purposes of determining the applicable limits of insurance, any act or omission together with all (2) A watercraft you do not own that is: related acts or omissions in the rendering of (a) Up to seventy-five (75)feet long; and "First Aid" or "Good Samaritan Services" to any one person will be deemed one"occurrence". (b) Not being used to carry persons or a. "First Aid" means initial care for medical property for a charge; attention immediately following a "bodily 2. Only as respects to the insurance provided by injury". this provision C. Who Is An Insured is b. "Good Samaritan Services" means medical amended to include as an insured any person attention provided in an emergency and for who, with your express consent uses the which no remuneration is demanded or watercraft. received. 3. The insurance provided by this provision shall 2. The insurance provided by this provision shall be excess over any valid and collectible other insurance available to the insured, whether be excess over any valid and collectible other i primary, excess, contingent or on any other insurance available to any insured whether primary, excess, contingent or any other basis, basis, except for the insurance purchased specifically by you to apply in excess of the except for insurance purchased specifically by you to apply in excess of the limits of Insurance Limits of Insurance shown in the declarations for this Coverage Part. shown in the declarations for Business Liability. B. Supplementary Payments E. Canoes Or Rowboats Section II A.1.f. Coverage Extension — The following is added to the exceptions contained Supplementary Payments Paragraphs 1.(b) and in Section II B.1.g_ Exclusions, Aircraft, Auto Or 1.(d)are deleted and replaced with the following: Watercraft: (b) Up to $2,500 for the cost of bail bonds required (6) Any non-motorized canoe or rowboat owned by because of accidents or traffic violations arising the insured. Only as respects to the insurance out of any vehicle to which Business Liability provided by this provision C. Who Is An Coverage for "bodily injury" applies. We do not Insured is amended to include as an insured have to furnish these bonds. any person who, with your express consent, uses any such canoe or rowboat. (d) All reasonable expenses incurred by the insured F. Damage to Premises Rented to You at our request to assist in the investigation or defense of the claim or "suit", including actual 1. The last paragraph of Section II B.1. Ex- loss of earnings up to $500 a day because of clusions — Applicable To Business Liability time off work. Coverage is deleted and replaced by the C. Reasonable Force — Bodily Injury Or Property following: Damage Exclusions c., d., e.,f., g., h., L, k., I., m., n. and Section II B.1.a. Exclusions, Expected Or o. in SECTION II — LIABILITY do not apply to Intended Injury, is deleted and replaced by the damage by water, fire, explosion, lightning, or following: smoke resulting from fire to premises while PPB 316 11 13 Page 2 of 7 rented to you, or temporarily occupied by you cells, data processing devices or any other with permission by the owner. A separate media which are used with electronically Damage To Premises Rented To You Limit of controlled equipment. Insurance applies to this coverage as described 3. For the purposes of the coverage provided by in paragraph D. Liability And Medical this endorsement, Section II F. Liability And Expenses Limits of Insurance in SECTION 11— LIABILITY. Medical Expenses Definitions, Paragraph 17. is deleted and replaced by the following: 2. Section II F.9.a. Liability And Medical 17. "Property damage" means: Expenses Definitions, is deleted and replaced by the following: a. Physical injury to tangible property, including all resulting loss of use of that a. A contract for a lease of premises. However, property. All such loss of use shall be that portion of the contract for a lease of deemed to occur at the time of the premises that indemnifies any person or physical injury that caused it; organization for damage by water, fire, explosion, lightning, or smoke resulting from b. Loss of use of tangible property that is fire to premises while rented to you or not physically injured. All such loss of temporarily occupied by you with permission use shall be deemed to occur at the of the owner is not an"insured contract"; time of the "occurrence" that caused it; or 3. This provision does not apply if coverage for c. Loss of, loss of use of, damage to, Damage To Premises Rented To You is ex- cluded by another endorsement to this policy. corruption of, inability to access, or in- ability to manipulate "electronic data", G. Aircraft Chartered With Crew resulting from physical injury to tangible 1. The following is added to the exceptions property. All such loss of "electronic contained in Section II B.1.g. Exclusions, data" shall be deemed to occur at the Aircraft, Auto or Watercraft: time of the"occurrence"that caused it. d. Property damage does not mean dis- (6) Any non-owned aircraft chartered to you closure of, display of, or theft or mis- with a crew including a pilot. appropriation of electronic data however 2. The insurance provided by this provision shall caused. be excess over any valid and collectible other For the purposes of this insurance, insurance available to the insured whether "electronic data" is not tangible property. primary, excess, contingent or on any other basis, except for insurance purchased specif- I. Who Is An Insured — Newly Acquired Or Formed ically by you to apply in excess of the Limits of Organizations Insurance shown in Declarations. The following is added to Section II C. Who Is An H. Electronic Data Liability Insured: 1. Section II B.1.q. Exclusions is deleted and Any organization you newly acquire or form, other replaced by the following: than a partnership, joint venture or limited liability company, over which you maintain ownership or q. Electronic Data majority interest, will qualify as a Named Insured if Damages arising out of the loss of, loss of there is no other similar insurance available to that use of, damage to, corruption of, inability to organization. However: access, disclosure of, display of, theft or 1. Coverage under this provision is afforded only misappropriation of or inability to manipulate until the one hundred eightieth (180`h) day after "electronic data". However this exclusion you acquire or form the organization or the end does not apply to"Property Damage". of the policy period, whichever is earlier; 2. The following definition is added to Section II F. 2. Coverage does not apply for "bodily injury" or Liability And Medical Expenses Definitions: "property damage" that occurred before you "Electronic data" means information, facts or acquired or formed the organization. programs stored as or on, created or used on, or 3. Coverage does not apply for "personal and transmitted to or from computer software advertising injury" arising out of an offense (including systems and applications software), committed before you acquired or formed the hard or floppy disks, CD-ROMS, tapes, drives, organization. PPB 316 11 13 Page 3 of 7 4. This provision does not apply to any (1) Only if the "bodily injury", "property dam- organization for which coverage is excluded by age" or "personal and advertising injury" another endorsement to this policy. is caused, in whole or in part, by you or J. Who Is An Insured — Unnamed Partnership Or any person or organization performing Joint Venture operations on your behalf, and arises out of the ownership, maintenance or 1. The last paragraph of Section II C. Who Is An use of that part of any premises leased Insured is deleted and replaced by the to you under that contract or agreement; following: or No person or organization is an insured with (2) The"bodily injury", "property damage" or respect to the conduct of any current or past "personal and advertising injury" is partnership, joint venture or limited liability caused, in whole or in part, by you or company that is not shown as a Named Insured any person or organization performing in the Declarations. However this limitation does operations on your behalf, and arises not apply to your liability with respect to your out of the maintenance, operation or use conduct of the business of any current or past of equipment leased to you by such partnership or joint venture: additional insured. a. That is not shown as a Named Insured in 2. The insurance provided to such additional in- the Declarations; and sured under this provision is subject to the b. In which you are a member or partner but following: only if: a. The limits of insurance afforded to such (i) Each and every member or partner in additional insured shall be the limits which that joint venture or partnership is not a you agreed to provide in the contract or construction contractor; and agreement, or the limits shown in the Declarations, whichever are less; and (11) The joint venture or partnership is not providing construction contracting b. The insurance afforded to such additional services. insured does not apply: 2. This provision does not apply to any person or (1) To any "bodily injury' or "property dam- organization for which coverage is excluded by age" that occurs, or "personal and another endorsement to this policy. advertising injury' caused by an offense 3. The insurance provided by this provision shall committed, after you cease to be a be excess over any valid and collectible other tenant in that premises; insurance, whether primary, excess, contingent (2) To any structural alterations, construc- or on any other basis, which is available tion or demolition operations performed covering your liability with respect to your by or on behalf of such additional conduct of the business of any current or past insured; partnership or joint venture that is not shown as a Named Insured in the Declarations and which (3) To any premises for which coverage is is issued to such partnership or joint venture. excluded by another endorsement to K. Additional Insured — Owner, Manager Or Lessor this Coverage Part; Of Premises Or Leased Equipment (4) To any "bodily injury" or "property dam- Section 11 C. Who Is An Insured is amended to age" that occurs, or "personal and include as an insured: advertising injury' caused by an offense committed, after the equipment lease 1. Any person or organization that you have expires; or agreed in a contract or agreement to include as an additional insured on this policy, but: (5) If the equipment is leased with an operator. a. Only with respect to liability for"bodily injury" or "property damage" that occurs, or 3. This provision does not apply on any basis to "personal and advertising injury' caused by any person or organization for which coverage an offense committed, after you have as an additional insured specifically is added by entered into that contract or agreement; and another endorsement to this policy. PPB 316 11 13 Page 4 of 7 L. Additional Insured — State Or Political is twice the Liability and Medical Expenses Subdivisions — Permits Related To Premises Or limit. Operations The aggregate limit for all "bodily injury" and Section II C. Who Is An Insured is amended to "property damage", medical expenses and include as an insured: "personal and advertising injury" other than 1. Any state or political subdivision that has issued "bodily injury" or "property damage" included in a permit in connection with premises owned or the "products-completed operations hazard" occupied by, or rented or loaned to, you, but applies separately to each of your "projects" only with respect to "bodily injury', "property away from premises owned by or occupied by damage", "personal and advertising injury" you or to each of your "locations" owned by or arising out of the existence, ownership, use, occupied by you. maintenance, repair, construction, erection or "Projects" mean an area away from premises removal of advertising signs, awnings, canopies, owned by or rented to you at which you are cellar entrances, coal holes, driveways, man- performing operations pursuant to a contract or holes, marquees, hoist away openings, sidewalk agreement. For the purposes of determining the vaults, elevators, street banners or decorations applicable aggregate limit of insurance, each for which that state or political subdivision has "project" at the same "location" shall be issued such permit. considered a single"project". 2. Any state or political subdivision that has issued For the purposes of this provision, "location" a permit, but only with respect to "bodily injury", means "property damage", "personal and advertising 1, Premises involving the same or connecting injury" arising out of operations performed by lots; you or on your behalf for which that state or political subdivision has issued such permit. 2. Premises where connection is interrupted However, no such state or political subdivision is only by a street, roadway, waterway or right- an insured for: of-way of a railroad; or a. "Bodily injury", "property damage", "personal 3. Premises where operations are performed in and advertising injury" arising out of op- sections, stages or phases as a continuation erations performed for that state or political of the same contract or agreement, even if subdivision; or the premises do not involve connecting lots. b. "Bodily injury" or"property damage"included Subject to Paragraph a. or b. above, whichever within the "products-completed operations applies, the Damage To Premises Rented To hazard". You Limit is the most we will pay for damages because of "property damage" to any one M. General Aggregate Limit — Per Project Or Per premises, while rented to you, or in the case of Location fire; explosion; lightning; smoke resulting from Section II D. Liability And Medical Expenses such fire, explosion or lightning; or water while Limits of Insurance, Paragraph 4. Aggregate rented to you or temporarily occupied by you Limits. is deleted and replaced by the following: with permission of the owner. 4. Aggregate Limits The Limits of Insurance of SECTION II — The most we will pay for: LIABILITY apply separately to each consecutive annual period and to any remaining period of a. All"bodily injury"and "property damage"that less than twelve (12) months, starting with the is included in the "products-completed beginning of the policy period shown in the operations hazard" is twice the Liability and Declarations, unless the policy period is Medical Expenses limit. extended after issuance for an additional period b. All: of less than twelve(12) months. In that case, the additional period will be deemed part of the last (1) "Bodily injury" and "property damage" preceding period for purposes of determining the except damages because of "bodily in- Limits of Insurance. jury" or "property damage" included in the "products-completed operations N. Knowledge And Notice Of Occurrence Or hazard"; Offense (2) Plus medical expenses; The following is added to Section 11 E. 2. Liability and Medical Expenses General Conditions, (3) Plus all "personal and advertising injury" Duties In The Event of Occurrence, Offense, caused by offenses committed; Claim Or Suit: PPB 316 11 13 Page 5 of 7 Notice of an "occurrence" or of an offense which Protective Liability insurance available to an may result in a claim must be given as soon as insured , whether primary, excess, contingent or practicable after knowledge of the "occurrence" or on any other basis, except for the insurance offense has been reported to you, one of your purchased specifically by you to apply in excess "executive officers" (if you are a corporation), one of of the Limits of Insurance shown in the your partners who is an individual (if you are a declarations for this Coverage Part. partnership), one of your managers (if you are a Q. Amended Personal And Advertising Injury limited liability company), one of your trustees who is Definition—Electronic Material an individual (if you are a trust), or an "employee" (such as an insurance, loss control or risk manager 1. The definition of "personal and advertising or administrator) designated by you to give such injury" in Section II F.14.d. Liability And notice. Medical Expenses Definitions is deleted and Knowledge by any other "employee" of an "occur- replaced by the following: rence" or offense does not imply that you also have d. Oral, written or electronic publication, in any such knowledge. manner, of material that slanders or libels a person or organization or disparages a Notice of an "occurrence" or of an offense which person's or organization's goods, products may result in a claim will be deemed to be given as or services; soon as practicable to us if it is given in good faith as soon as practicable to your workers' compensation, 2. The definition of "personal and advertising accident, or health insurer. This applies only if you injury" in Section II F.14.e. Liability And subsequently give notice of the "occurrence" or Medical Expenses Definitions is deleted and offense to us as soon as practicable after you, one replaced by the following: of your"executive officers" (if you are a corporation), e. Oral, written or electronic publication, in any one of your partners who is an individual (if you are manner, of material that violates a person's a partnership), one of your managers (if you are a right of privacy; limited liability company),one of your trustees who is an individual (if you are a trust), or an "employee" 3. Section II B.1.p.(2) Exclusions for Personal (such as an insurance, loss control or risk manager And Advertising Injury is deleted and replaced or administrator) designated by you to give such by the following: notice discovers that the "occurrence" or offense (2) Arising out of oral, written or electronic may involve this policy. publication of material if done by or at the O. Amended Bodily Injury Definition direction of the insured with knowledge of its falsity; The definition of "bodily injury" in Section II F.3. Liability And Medical Expenses Definitions is 4. Section II B.1.p.(2) Exclusions for Personal deleted and replaced by the following: And Advertising Injury is deleted and replaced by the following: "Bodily injury" means injury to the body, sickness, disease, or death. "Bodily ' also means mental (3) Arising out of oral, written or electronic pub- disease, injury" lication of material whose first publication injury, mental anguish, emotional distress, pain and suffering, or shock resulting from injury to the body, took place before the beginning of the policy sickness,disease or death of any person. period; P. Amended Insured Contract Definition — R. Unintentional Omission Construction Or Demolition Operations Within The following is added to SECTION III — COMMON 50'Of Railroad POLICY CONDITIONS Paragraph C. Concealment, 1. The definition of "insured contract" in Section II Misrepresentation Or Fraud (BUT APPLICABLE F.9.c. Liability And Medical Expenses Defi- ONLY TO SECTION II—LIABILITY) nitions is deleted and replaced by the following: However as it pertains to Business Liability Cover- age only, the unintentional omission of, or uninten- tional error in, any information provided by you 2. The definition of "insured contract" in Section II which we relied upon in issuing this policy shall not F.91.(1) Liability And Medical Expenses prejudice your rights under this insurance. This pro- Definitions is deleted. vision does not affect our right to collect additional premium or to exercise our right of cancellation or 3. The insurance provided by this provision shall nonrenewal in accordance with applicable insurance be excess over any valid and collectible Railroad laws or regulations. PPB 316 11 13 Page 6 of 7 S. Waiver Of Transfer Of Rights Of Recovery b. Ongoing and completed operations per- Against Others To Us formed by you, or on your behalf, under a SECTION III — COMMON POLICY CONDITIONS contract or agreement with that person or Paragraph K.2. Transfer of Rights of Recovery organization; Against Others to Us (BUT APPLICABLE ONLY c. Your"work"; or TO SECTION II — LIABILITY) is deleted and d. "Your products". replaced by the following: 2. Applicable to Business Liability Coverage: We waive these rights only where you have agreed to do so as part of a contract or agree- We waive any rights of recovery we may have ment entered into by you before the "bodily against any person or organization because of injury" or "property damage" occurs or the payments we make for "bodily injury", "property "personal and advertising injury" offense is damage", "personal injury and advertising injury" committed. arising out of: a. Premises owned by you, temporarily occu- pied by you with permission of the owner, or leased or rented to you; ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. PPB 316 11 13 Page 7 of 7 EVIDENCE OF INSURANCE CIVIL ENGINEERS PROFESSIONAL LIABILITY INSURANCE OLICYHOLDER-ISSUED TO THE POLICY NO.NAISPL03 ERICAN SOCIETY OF CIVIL ENGINEERS UMR#.B0572NAl5PL03 EVIDENCE NO.2200524-03 ITEM 1: NAMED INSURED: EFFECTED WITH Noel.Inc. UNDERWRITERS AT LLOYD'S OF LONDON (NOT INCORPORATED) ITEM 2: MAILING ADDRESS OF NAMED INSURED: LLOYD'S ILLINOIS,INC. 7359 23rd Ave NW 181 W.MADISON STREET Seattle,WA 98117-5661 SUITE 3870 CIiICAGO,IL 60602-4541 ITEM 3: COVERAGE PERIOD: BOTH DAYS AT 12:01 A.M.LOCAL STANDARD TIME INCEPTION:03/11/2016 EXPIRATION: 03/11/2017 AT THE MEMBERS MAILING ADDRESS ITEM 4: RETROACTIVE DATE: 03/11/2013 ITEM 5: LIMIT OF LIABILITY: A)L1MIT IN ALL(INCLUDING COSTS, $1,000,000 CHARGES AND EXPENSES)IN RESPECT OF EACH CLAIM B)LIMIT IN THE AGGREGATE(INCLUDING $1,000,000 COSTS,CHARGES AND EXPENSES)FOR EACH ANNUAL PERIOD ITEM 6: DEDUCTIBLE EACH CLAIM: $5,000 ITEM 7: TOTAL PREMIUM: $1.779.00 ITEM 8: ENDORSEMENTS AT COVERAGE PERIOD INCEPTION DATE: • AIF 2385(07/08) • N.M.A. 1256 • N.M.A. 1477 • AIF2657(10/05) • AIF23850(04/99)General Purpose Endorsement-Deductible o AIF23850(04/99)Operation of a Drone e AIF23850(04/99)EPLI e AIF23850(04/99)Privacy Breach v AIF23850(04/99)Regulatory,Loss of Earnings,and Reputation Management THIS DOCUMENT(EVIDENCE OF INSURANCE)IS ISSUED AS NOTICE OF INSURANCE FOR INFORMATION ONLY I-F DOES NOl CONS1'1lUTL A LEGAI. CONTRACT OF INSURANCE. THE MASTER POLICY AND THE APPLICATION OF THE INSURED.IF ANY,FORM THE ENTIRE CONTRACT. THIS EVIDENCE WHICH IS FURNISHED IN ACCORDANCE WITH,AND 1N ALL RESPECTS IS SUBIEC' T0,THE TERMS OF THE MASTER POLICY.A COPY OF WHICH IS ATTACHED HERETO FOR INFORMATION PURPOSES ONLY AND REPLACES ANY OTHER EVIDENCE PREVIOUSLY ISSUED COVERING THE INSURANCE- DESCRIBED HEREIN AIF 2385 EVI (04/08) LSW1135b LLOYD'S PRIVACY POLICY STATEMENT UNDERWRITERS AT LLOYD'S, LONDON The Certain Underwriters at LIoyd's, London want you to know how we protect the confidentiality of your non-public personal information. We want you to know how and why we use and disclose the information that we have about you. The following describes our policies and practices for securing the privacy of our current and former customers. INFORMATION WE COLLECT The non-public personal information that we collect about you includes,but is not limited to: • Information contained in applications or other forms that you submit to us, such as name,address,and social security number • Information about your transactions with our affiliates or other third-parties, such as balances and payment history • Information we receive from a consumer-reporting agency, such as credit-worthiness or credit history INFORMATION WE DISCLOSE We disclose the information that we have when it is necessary to provide our products and services. We may also disclose information when the law requires or permits us to do so. CONFIDENTIALITY AND SECURITY E I Only our employees and others who need the information to service your account have access to your personal information. We have measures in place to secure our paper files and computer systems. RIGHT TO ACCESS OR CORRECT YOUR PERSONAL INFORMATION You have a right to request access to or correction of your personal information that is in our possession. CONTACTING US If you have any questions about this privacy notice or would like to learn more about how we protect your privacy,please contact the agent or broker who handled this insurance. We can provide a more detailed statement of our privacy practices upon request. i I i I I i I U.S.A. NUCLEAR INCIDENT EXCLUSION CLAUSE-LIABILITY-DIRECT(BROAD) (Approved by Lloyd's Underwriter's Non-Marine Association) For attachment to insurances of the following classifications in the U.S.A., its Territories and Possessions,Puerto Rico and Canal Zone: Owners,Landlords and Tenants Liability, Contractual Liability,Elevator Liability, Owners or Contractors(including railroad)Protective Liability,Manufacturers and Contractors Liability,Product Liability,Professional and Malpractice Liability, Storekeepers Liability, Garage Liability,Automobile Liability(including Massachusetts Motor Vehicle or Garage Liability), not being insurances of the classification to which the Nuclear Incident Exclusion Clause-Liability- Direct(Limited)applies, This oolicy* does not apply: 1. Under any Liability Coverage,to injury,sickness,disease,death or destruction (a) with respect to which an insured under the policy is also an insured under a nuclear energy liability policy issued by Nuclear Energy Liability Insurance Association, Mutual Atomic Energy Liability Underwriters or Nuclear Insurance Association of Canada,or would be an insured under any such policy but for its termination upon exhaustion of its limit of liability;or (b) resulting from the hazardous properties of nuclear material and with respect to which (1)any person or organization is required to maintain financial protection pursuant to the Atomic Energy Act of 1954,or any law amendatory thereof,or(2)the insured is, or had this policy not been issued would be,entitled to indemnity from the United States of America,or any agency thereof,under any agreement entered into by the United States of America,or any agency thereof,with any person or organization. li. Under any Medical Payments Coverage,or under any Supplementary Payments Provision relating to immediate medical or surgical relief,to expenses incurred with respect to bodily I' injury,sickness,disease or death resulting from the hazardous properties of nuclear material and arising out of the operation of a nuclear facility by any person or organization. III. Under any Liability Coverage,to injury,sickness,disease,death or destruction resulting from the hazardous properties of nuclear materials,if j i (a) the nuclear material(1)is at any nuclear facility owned by,or operated by or on j behalf of,an insured or(2)has been discharged or dispersed therefrom; (b) the nuclear material is contained in spent fuel or waste at any time possessed, handled,used,processed,stored,transported or disposed of by or on behalf of an insured;or (c) the injury,sickness,disease,death or destruction arises out of the furnishing by an insured of services,materials,parts or equipment in connection with the planning, construction maintenance,operation or use by any nuclear facility,but if each facility j is located within the United States of America,its territories or possessions or I I i- Canada,this exclusion(c)applies only to injury to or destruction of property at such nuclear facility. IV. As used in this endorsement: "hazardous properties"include radioactive,toxic or explosive properties;"nuclear material'means source material,special nuclear material or byproduct material;"source material', "special nuclear material',and"byproduct material'have the meanings given them in the Atomic Energy Act 1954 or in any law amendatory thereof;"spent fuel' i means any fuel element or fuel component,solid or liquid,which has been used or exposed to radiation in a nuclear reactor;"waste"means any waste material(1)containing byproduct material and(2)resulting from the operation by any person or organization of any nuclear facility included within the definition of nuclear facility under paragraph(a)or(b)thereof; "nuclear facility"means (a) any nuclear reactor, (b) any equipment or device designed or used for(1)separating the isotopes of uranium or plutonium,(2)processing or utilizing spent fuel,or(3)handling,processing or packaging waste, f (c) any equipment or device used for the processing, fabricating or alloying of special nuclear material if at any time the total amount of such material in the custody of the insured at the premises where such equipment or device is located consists of or contains more than 25 grams of plutonium or uranium 233 or any combination thereof,or more than 250 grams of uranium 235, (d) any structure,basin,excavation,premises or place prepared or used for the storage or disposal of waste, and includes the site on which any of the foregoing is located,all operations conducted on such site and all premises used for such operations;"nuclear reactor"means any apparatus designed or used to sustain nuclear fission in a self-supporting chain reaction or to contain a critical mass of fissionable material. r With respect to injury to or destruction of property,the word"injury"or"destruction" includes all forms of radioactive contamination of property. I It is understood and agreed that,except as specifically provided in the foregoing to the contrary,this clause is subject to the terms,exclusions,conditions and limitations of the Policy to i which it is attached. i *NOTE: As respects policies which afford liability coverage and other€orris of coverage in addition, the words underlined should be amended to designate the liability coverage to which this clause is to apply. 17/3/60 N.M.A. 1256 i i i i i 1 :r U.S.A. RADIOACTIVE CONTAMINATION EXCLUSION CLAUSE-LIABILITY-DIRECT (Approved by Lloyd's Underwriter's Non-Marine Association) For attachment(in addition to the appropriate Nuclear Incident Exclusion Clause-Liability-Direct) to liability insurances affording worldwide coverage. In relation to liability arising outside the U.S.A., its Territories or Possessions,Puerto Rico or the Canal Zone, this Policy does not cover any liability of whatsoever nature directly or indirectly caused by or contributed to by or arising from ionising radiations or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel. 13/2/64 N.M.A. 1477 I i I i i I i I i I i I I I WAR AND TERRORISM EXCLUSION ENDORSEMENT Notwithstanding any provision to the contrary within this insurance or any endorsement thereto it is agreed that this insurance excludes loss, damage, cost or expense of whatsoever nature directly or indirectly caused by,resulting from or in connection with any of the following regardless of any other cause or event contributing concurrently or in any other sequence to the loss; 1. war, invasion, acts of foreign enemies,hostilities or warlike operations(whether war be declared or not), civil war, rebellion, revolution, insurrection, civil commotion assuming the proportions of or amounting to an uprising,military or usurped power;or 2. "an act of terrorism". However, this exclusion 2 shall apply only when one or more of the following are attributed to such act of terrorism. (i) The total of "insured damage'' to all types of property exceeds US$25,000,000. In determining whether the US$25,000,000 threshold is exceeded,Underwriters will include all insured damage sustained by property of all persons and entities affected by the terrorism and business interruption losses sustained by owners or occupants of the damaged property. For the purpose of this provision,"insured damage"means damage that is covered by any insurance plus damage that would be covered by any insurance but for the application of any terrorism exclusions;or (ii)Fifty or more persons sustain death or "serious physical injury". For the purposes of this provision,"serious physical injury"means: (a) Physical injury that involves a substantial risk of death;or (b) Protracted and obvious physical disfigurement;or (c) Protracted loss of or impairment of the function of a bodily member or organ;or (iii) The terrorism is carried out by means of the dispersal or application of radioactive material, or through the use of a nuclear weapon or device that involves or produces a nuclear reaction,nuclear radiation or radioactive contamination;or (iv) Radioactive material is released, and it appears that one purpose of the terrorism was to release such material;or (v)The terrorism is carried out by means of the dispersal or application of pathogenic or poisonous biological or chemical materials;or (vi) Pathogenic or poisonous biological or chemical materials are released, and it appears that one purpose of the terrorism was to release such materials. With respect to this exclusion 2, paragraphs (i) and (ii) describe the thresholds used to measure the magnitude of an incident of "an act of terrorism" and the circumstances in which the threshold will apply for the purpose of determining whether this exclusion will apply to that incident. For the purpose of this endorsement, "an act of terrorism" means a violent act or an act that is dangerous to human life, property or infrastructure that is committed by an individual or individuals and that appears to be part of an effort to coerce a civilian population or to influence the policy or affect the conduct of any goverment by coercion. Multiple incidents of"an act of terrorism''which AIF 2657 (10/05) occur within a seventy-two hour period and appear to be carried out in concert or to have a related purpose or common leadership shall be considered to be one incident, for the purpose of determining whether the thresholds in paragraphs 2(i) or 2(ii)are exceeded. This endorsement also excludes loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with any action taken in controlling, preventing, suppressing or in any way relating to 1 and/or 2 above. If the Underwriters allege that by reason of this exclusion, any loss, damage, cost or expense is not covered by this insurance the burden of proving the contrary shall be upon the Assured. In the event any portion of this endorsement is found to be invalid or unenforceable, the remainder shall remain in full force and effect. AIF 2657 (10/05) This document is to notify the Insured whose name is on the Schedule attached that the following insurance has been effected with certain Underwriters at Lloyd's (not incorporated) (the"Underwriters") for the Period of Coverage specified in the Schedule under the Policy specified in the Schedule issued to the American Society of Civil Engineers (the"Policyholder") in the State of Illinois. The benefits under the Policy are summarized in this Evidence of Insurance. The coverage is subject to the terms of the Policy. The original Policy may be inspected at the offices of the Policyholder. The respective names of and proportions underwritten by the Underwriters can be ascertained from the office of the Policyholder. I. INSURANCE PROVIDED (Coverage is provided on a Claims made and reported basis. Claim Expenses will reduce the limit of liability available to pay loss.) A. Coverage -Professional Liability and Claims Made Clause 1) Subject to the terms of the Policy, Underwriters agree to pay on behalf of the Insured all sums,in excess of the deductible,which the Insured shall become legally obligated to pay as Loss(including Claim Expenses)as a result of any claim alleging Wrongful Act occurring after the Retroactive Date, provided such CLAIM IS FIRST MADE AGAINST THE INSURED DURING THE COVERAGE PERIOD and reported to the Correspondent as soon as practicable and not more than 60 days after such claim is first made. 2)Underwriters shall reimburse the Insured up to$10,000 per Coverage Period for Claim Expenses resulting from the defense of a proceeding before a state licensing board or governmental regulatory body incurred as the result of a notice of a proceeding first received by the Insured during the Coverage Period.This coverage applies only to such Claim Expenses. It does not apply to any monetary awards of any kind,judgments, fines or settlements relating to, or directly or indirectly resulting from the institution of disciplinary proceedings. Underwriters shall not be required to provide any coverage to appeal any adverse ruling or judgement by such board or regulatory body. The deductible shall not apply to this coverage A(2). However, any payments made by Underwriters under this clause A (2)shaIl be included within the applicable limits of liability and not in addition to. 3) Up to $500 for loss of earnings to each Insured for each day or part of a day of such Insured's attendance; at the Company's request, at a trial, deposition, hearing, mediation or arbitration proceeding involving a civil suit against such Insured for covered Claim Expenses or Loss, but the amount so payable for any one or series of trials, depositions, hearings or arbitration proceedings arising out of the same or related Wrongful Act shall in no event exceed $7,500 nor shall the total amount paid in any coverage period exceed $7,500. Underwriters will defend any claim or suit against the Insured seeking such amounts. Underwriter's obligation to pay for Claims Expenses is limited as described under DEFENSE AND SETTLEMENTS- B. Territory and Coverage Period Provision This insurance applies to CLAIMS arising out of Wrongful Acts, which are committed or alleged to have been committed anywhere in the world, provided that the Insured, prior to the effective date of the Coverage Period, did not know or could not have reasonably foreseen, that such Wrongful Acts might give rise to a Claim. C. Definitions Certain words are defined in this Evidence of Insurance as follows: 1. "Policyholder" means the American Society of Civil Engineers. 2. "Schedule" means the schedule at the beginning of this Evidence of Insurance. 3. "Insured" and "you" mean: a) (i) any person or entity named as the Insured in the Schedule, or (ii)the member(s) of the Society named as the Insured in the Schedule; and 1 AIF 2385 (07/08) b) any current or former principal, partner or employee of the entity or individual(s) named as the Insured in the Schedule, but only with respect to Professional Services performed or failed to have been performed by such principal, partner or employee on behalf of the insured entity or individual(s). No one is an Insured for Professional Services performed on behalf of any current or past employer, partnership or joint venture if such current or past employer, partnership or joint venture is not specified as an Insured in the Schedule. 4. The word "Loss" shall mean damages, judgments, settlements and Claim Expenses, provided that such subject of Loss shall not include any matters which may be deemed uninsurable under the law pursuant to which this insurance shall be construed. 5. "Correspondent" means Pearl Insurance, 1200 E Glen Avenue,Peoria Heights, Illinois 61616. 6. "Claim Expenses,"wherever used in this Policy, shall mean: reasonable and necessary costs, charges, fees and expenses incurred in the defense of any Claim, but shall not include wages, salaries or expenses of employees or officers of the Insured or of the Underwriters. The determination by Underwriters as to the reasonableness of Claim Expenses shall be conclusive on the Insured. 7. The words "Coverage Period" shall mean the period specified in the Schedule. 8. The word "Claim" shall mean a demand received by the Insured for money or Professional Services, including but not limited to the service of suit or institution of arbitration proceedings or other alternative dispute resolution proceedings against the Insured, alleging a Wrongful Act. One or more claims arising out of any one single Wrongful Act, or out of a series of causally related Wrongful Acts, shall be treated as a single Claim for the purpose of determining the applicable limit of liability and deductible amount. 9. "Professional Services"means those services which the Insured is legally qualified to perform for others in the Insured's capacity as an engineer or surveyor, whether in private business or as an employee of a governmental entity or a university or research organization. 10. "Retroactive Date" shall mean the date as specified in the Schedule, on or after which any Wrongful Act must have occurred in order for Claims first made arising therefrom to be considered for coverage. Claims first made arising from any Wrongful Act prior to this date are not covered by this Evidence of Insurance. 11. "Wrongful Act" means any actual or alleged act, error, or omission in the rendering of or failure to render Professional Services. D. Limit of Liability 1. Limit of Liability - Each Claim: Underwriters shall, subject to their aggregate limit of liability as set forth in paragraph (3) below, be liable for all Loss (including Claim Expenses) in excess of the amount of the deductible up to the applicable limit of liability specified in the Schedule for each Claim. 2. If a single Claim is made in different Coverage Periods, the limit of liability shall not exceed the amount stated for the Coverage Period in which the single Claim is first made. 3. Limit of Liability -Aggregate: The total liability of the Underwriters for all Loss (including Claim Expenses) shall not exceed the applicable amount set forth in the Schedule, "Limit in the aggregate for each Annual Period," as a result of all Claims first made against the Insured during the Coverage Period. 4. The inclusion herein or the making of Claims or the bringing of suits by more than one person or organization shall not operate to increase the Underwriters' limit of liability for each Claim and in the aggregate. E. Deductible The amount designated as the deductible in the Schedule shall be paid by the Insured and shall apply to all Loss and Claim Expense for each and every Claim whether or not loss payment is made. Underwriters shall not have any obligation to make payments under this policy for Loss or Claim Expenses until the deductible has been paid. Such deductible shall not reduce Underwriters Limits of Liability. F. Defense, Consent, Settlement and Cooperation Underwriters shall have the right and duty to appoint counsel to defend any CLAIM seeking Loss payable under the policy. The Insured shall not admit liability for or settle any Claim or incur any Claim Expenses without the written consent of Underwriters, however, the Insured must take reasonable action within its power to prevent or mitigate any Claim which would be covered under this Policy. AIF 2385 (07/08) Underwriters have the right to make any investigation, conduct negotiations and, with the written consent of the Insured, enter into such settlement of any Claim as Underwriters deem reasonable. If the Insured refuses to consent to any settlement recommended by Underwriters and acceptable to the party(ies) making Claim and elects to continue to contest the Claim, Underwriters' liability shall not exceed the amount for which Underwriters would have been liable for Loss including Claim Expenses if the Claim had been so settled, when and as so recommended, and Underwriters shall have the right to withdraw from the further defense of the Claim by tendering control of the defense thereof to the Insured. Underwriters shall not be obligated to pay any Loss including Claim Expenses, or to undertake or continue the defense of any Claim after the applicable limit of Underwriters' liability has been exhausted by payment of Loss including Claims Expenses. The Insured shall cooperate with Underwriters and, upon Underwriters' request, shall submit to examination and interrogation by a representative of Underwriters, under oath if required, and shall attend hearings, depositions, and trials and shall assist in effecting settlement, securing and giving evidence, obtaining the attendance of witnesses and in the conduct of suits, as well as in the giving of a written statement or statements to Underwriters' representative and meetings with such representatives for the purpose of investigation, and/or defense, and all without charge to Underwriters. The Insured shall take such action as may be necessary to secure and effect any rights of indemnity, contribution or apportionment which the Insured may have. II. EXCLUSIONS Underwriters shall not be liable to make payment for Loss or Claim Expenses for any Claim made against the Insured.- A. Arising out of any Loss caused intentionally by or at the direction of the Insured. B. Arising out of any Loss caused by dishonest, fraudulent, criminal or malicious acts, errors, or omissions of any Insured; whether acting alone or in collusion with others. Notwithstanding the foregoing, Underwriters shall defend the Insured under the terms of this insurance until a judgment in the trial court, for Claims which may be brought by reason of any alleged dishonest, fraudulent, criminal or malicious act or omission. C. Based upon or arising out of bodily injury, personal injury, disease or death to any employee of the Insured arising out of and in the course of his or her employment by the Insured; or any obligation for which the Insured or any carrier as his insurer may be liable under any workers compensation, unemployment compensation, disability law or under any similar law. D. Arising out of Bodily injury to: 1. An employee of the Insured arising out of and in the course of employment by the Insured; or 2. The spouse, child, parent, brother or sister of that employee as a consequence of 1. above. This exclusion applies: a. Whether the Insured may be liable as an employer or in any other capacity; and b. To any obligation to share damages with or repay someone else who must pay damages because of the injury- E. Arising out of the insolvency or bankruptcy of the Insured. F. Arising out of damage to: 1. Property owned, occupied or used by the Insured or rented or leased to the Insured; 2. Property in the Insured's care, custody or control or over which the Insured is for any purpose exercising physical control- G. Arising out of a default by or on behalf of the Insured with respect to the performance of any contract or agreement, but this exclusion does not apply if such default is the result of a Wrongful Act, in the performance of or failure to perform Professional Services for others. AIF 2385 (07/08) H Arising out of the cost guarantees; or estimates of probable costs or cost estimates being exceeded unless arising or alleged to arise from the Insured's Professional Services I. Arising out of express warranties or guarantees not being complied with or met. J. Arising out of infringement of copyright, trademark or patent; unfair competition or piracy; theft or wrongful taking of concepts or other intellectual property; or unauthorized activities in connection with trade secrets K. Arising out of any liability assumed by the Insured under any contract, but this exclusion does not apply if the Insured would have been liable even in the absence of such contract. L. Arising out of any Claim or lawsuit directly or indirectly arising from or related to: 1. Asbestos or any material containing asbestos or any disease directly or indirectly related to asbestos; or 2. Any act, error or omission, professional or otherwise, involving the existence, use, detection, removal, elimination of or exposure to asbestos or any material containing asbestos. M. Based upon the Employee Retirement Income Security Act of 1974 Public Law 93-406, commonly referred to as the Pension Reform Act of 1974, and amendments thereto, or similar provisions of any Federal, state, or local statutory law or common law. N. By one Insured under this Policy against another Insured under this Policy, or by any person or entity owned in part or wholly by any person or entity insured under this Policy, or by any person or entity which owns the Insured wholly or in part. O. Arising out of the ownership, rental, leasing, maintenance, operation, loading or unloading, use of any real or personal property, including but not limited to automobiles, mobile equipment, aircraft, watercraft or other kinds of conveyances. P. For punitive or exemplary damages, fines, penalties, or any multiple of compensatory damages, except, that if a suit shall have been brought against the Insured for a Claim falling within the coverage hereof, seeking both compensatory and either punitive or exemplary damages, fines, penalties or any multiple of compensatory damages, then Underwriters will afford a defense until a judgment in the trial court, for such action, without liability, however, for such punitive or exemplary damages, fines, penalties, or any multiple of compensatory damages. Q. Arising out of: 1. Selling, renting or lending any software design; or 2. Operating computer programs for others; or 3. Lending or renting computer hardware to or for others; Except this exclusion shall not apply if these services are performed by the Insured in connection with the Insured's own engineering activities. R. Arising from the cost to repair or replace faulty workmanship on any construction, erection, fabrication, installation, assembly, manufacture or remediation including any materials, parts or equipment furnished in connection therewith performed by: 1) the Insured or a subsidiary of the Insured; 2) any "entity" under common ownership, management or control with the Insured; 3) any "entity" acting in the capacity of the Insured's subcontractor; or 4) any "entity" that owns the Insured. S. Alleging injury, sickness, disease, death, or destruction of property resulting from: 1. the hazardous properties of nuclear material, nuclear waste or spent fuel; or 4 AIF 2385 (07/08) 2. the furnishing of services, materials, parts or equipment in connection with the planning, construction, maintenance, operation or use of any nuclear facility. As used in this exclusion: "Hazardous properties" include radioactive, toxic or explosive properties. "Nuclear material" means source material, special nuclear material or byproduct material. "Source material,""special nuclear material," and "byproduct material' have the meanings given them in the Atomic Energy Act of 1954 or in any law amendatory thereof. "Spent fuel' means any fuel element or fuel component, solid or liquid, which has been used or exposed to radiation in a nuclear reactor. "Nuclear Waste" means any waste material (1)containing byproduct material and (2) resulting from the operation by any person or organization of any nuclear facility. "Nuclear facility" means: i) Any nuclear reactor, ii) Any equipment or device designed or used for(1) separating the isotopes of uranium or plutonium, (2) processing or utilizing spent fuel, or(3) handling, processing or packaging waste. iii) Any equipment or device used for the processing, fabricating or alloying of special nuclear material if at any time the total amount of such material in the custody of the Insured at the premises where such equipment or device is located consists of or contains more than 25 grams of plutonium or uranium 233 or any combination thereof, or more than 250 grams of uranium 235. iv) Any structure, basin, excavation, premises or place prepared or used for the storage or disposal of waste and includes the site on which any of the foregoing is located, all operations conducted on such site and all premises used for such operations. "Nuclear reactor" means any apparatus designed or used to sustain nuclear fission in a self-supporting chain reaction or to contain a critical mass of fissionable material. With respect to injury to or destruction of property, the word "injury"or"destruction" includes all forms of radioactive contamination of property. T. Arising out of any Claim directly or indirectly relating to the actual, potential, alleged or threatened presence of any mold, mildew, fungi, spores or any other growth or organic matter of any kind whatsoever. U For loss including costs, charges and expenses arising out of any claim based upon or arising out of work performed for any project, corporation, fund, trust, association, partnership, limited partnership, business enterprise or other venture, of any kind or nature in which any insured or members of such insured's immediate family has a pecuniary or beneficial interest. III. CONDITIONS A. Application: By acceptance of this insurance, the Insured reaffirms as of the inception date of this insurance that (1) the statements in the Application attached to the Policy and made a part thereof are the Insured's agreements and representations; and (2) this insurance is issued in reliance upon the truth and accuracy of such representations; and (3) the Policy embodies all agreements existing between the Insured and Underwriters relating to this insurance. B. Notice of Potential Claim: If during the Coverage Period, an Insured first becomes aware of any Wrongful Act which might reasonably be expected to give rise to a Claim against any Insured and the Insured gives written notice of the Wrongful Act to Underwriters via the Correspondent as soon as possible and such notice is received by Underwriters during the Coverage Period, then any Claim subsequently made against an Insured arising out of such Wrongful Act will be considered to be a Claim first made during the Coverage Period. Written report of a potential Claim shall state: 5 AIF 2385 (07/08) 1. the specific Wrongful Act including the date(s) thereof, and the Insureds involved; 2. the damage that may reasonably result; and 3. the date and circumstances by which any Insured became aware of the Wrongful Act. C. Claims Handling Clause: If a Claim is made or suit is brought against the Insured involving or likely to involve this insurance the Insured shall as a condition precedent to the Insured's right to recovery under this insurance, promptly forward to the Correspondent a copy of every demand, notice, summons or other process received by the Insured or its representative. D. Subrogation: In the event of any Claim under this insurance, Underwriters shall be subrogated to all of the Insured's right of recovery therefor against any person or organization and the Insured shall execute and deliver instruments and papers and do whatever else is necessary to secure such rights, the Insured shall do nothing after loss to prejudice such rights. E. Action against the Underwriters: No action shall lie against Underwriters unless, as a condition precedent thereto, the Insured shall have fully complied with all terms of this insurance. Nothing contained in this insurance shall give any person or organization any right to join Underwriters as a co-defendant in any action against the Insured to determine the Insured's liability. Bankruptcy or insolvency of the Insured or of the Insured's estate shall not relieve Underwriters of any of their obligations hereunder, F. Other Insurance: If an Insured has insurance provided by other insurers against a loss covered by this insurance, the underwriters shall not be liable under this insurance for a greater proportion of such loss and claims expense that the applicable limit of liability stated in the Schedule bears to the total applicable limit of liability of all valid and collectible insurance against such loss, provided, however, that if the Insured has insurance provided by other insurers whose insurance is stated as excess over any other insurance available to the insured, this insurance shall apply solely in excess of such insurance, unless such other insurance is written as specific excess over the limit of liability of this insurance. G. This insurance may not be assigned or transferred without the prior written consent of Underwriters. H. Changes: Notice to any Agent or knowledge possessed by any Agent or other person acting on behalf of Underwriters shall not effect a waiver or a change in any part of this insurance or stop Underwriters from asserting any right under the terms of this insurance, nor shall the terms of this insurance be waived or changed, except by endorsement issued to form a part of this insurance. I. Cancellation: This insurance may be cancelled by the Insured by surrender thereof to Underwriters or by mailing to the Correspondent written notice, by registered or certified mail, stating when thereafter such cancellation shall be effective. If cancelled by the Insured, Underwriters shall retain the earned premium plus the customary short rate penalty calculated as one hundred ten percent of pro rata. This insurance may be cancelled by Underwriters by mailing to the Insured written notice, by registered or certified mail, stating when, not less than sixty (60) days thereafter such cancellation shall be effective. However, if Underwriters cancel this insurance because the Insured has failed to pay a premium when due, this insurance may be cancelled by Underwriters by mailing, by registered or certified mail, a written notice of cancellation to the Insured stating when, not less than ten (10) days thereafter, such cancellation shall be effective. The mailing of notice as aforesaid shall be sufficient notice and the effective date of cancellation stated in the notice shall become the end of the Coverage Period. If cancelled by the Underwriters, earned premium shall be computed pro-rats. Any notices to the Insured under this clause shall be mailed to the Insured at the last mailing address known by Underwriters. The Correspondent shall maintain proof of mailing of such notice on a recognized U.S. Post Office form, and a copy of such notice shall be sent to the Insured's broker. Premium adjustment may be made at the time cancellation is effected or as soon as practicable thereafter. The check of Underwriters or any of their representatives, mailed or delivered, shall be sufficient tender of any refund due to the Insured. 6 AIF 2385 (07108) If this insurance has been in effect for 60 days, Underwriters can cancel only for one of the following reasons: (a) non-payment of premium; (b)the insurance was obtained through material misrepresentation; (c) the Insured violated any of the terms and conditions of the contract of insurance; (d) the risk originally accepted has measurably increased; (e) certification to the Director of Insurance of the State of Illinois of the loss of reinsurance by Underwriters which provided coverage to Underwriters for all or a substantial part of the underlying risk insured; or(f) a determination by the Director of Insurance of the State of Illinois that the continuation of this insurance could place Underwriters in violation of the insurance laws of the State of Illinois. J. Extended Reporting Period Options: If Underwriters or the Named Insured shall cancel or refuse to renew this insurance, or if this insurance is renewed with a Retroactive Date that is later than the Retroactive Date shown on the Schedule, then the Named Insured shall have the right to purchase an Extended Reporting Period or Non-Practicing Extended Reporting Period under the following terms and conditions: 1. The Named Insured must send written notice to Underwriters of the Named Insured's intention to purchase the Extended Reporting Period. The notice must be received by the Correspondent within thirty (30) days after the termination of the Coverage Period. The written notice must state the length of the period of extension desired and include the additional premium. EXTENDED REPORTING PERIOD TERM AND PREMIUM Term Additional Premium 12 months 100% of the annual premium set forth in the Schedule 24 months 150% of the annual premium set forth in the Schedule 36 months 185% of the annual premium set forth in the Schedule 2. In the event this insurance is non-renewed or cancelled due to the death, permanent retirement or permanent disability of the Named Insured, the Named Insured shall, upon payment of an additional premium, have the right to purchase a Non-practicing Extended Reporting Period. Written notice of the intent to purchase this option must be received by the Correspondent within thirty (30) days after the termination of the Coverage Period. This written notice must include the additional premium. NON-PRACTICING EXTENDED REPORTING PERIOD TERM AND PREMIUM Term Additional Premium 12 months 100% of the annual premium set forth in the Schedule 24 months 150% of the annual premium set forth in the Schedule 36 months 185%of the annual premium set forth in the Schedule Unlimited 300% of the annual premium set forth in the Schedule 3. The coverage during the Extended Reporting Period or Non-Practicing Extended Reporting Period applies only to Wrongful Acts which occurred prior to the termination of the Coverage Period and after the Retroactive Date, if any, provided that the Claim is first made during the Extended Reporting Period or Non-Practicing Extended Reporting Period and written notice of the Claim is received by Underwriters during the Extended Reporting Period or Non-Practicing Extended Reporting Period. 4. Separate or new limits do not apply to the Extended Reporting Period or Non-Practicing Extended Reporting Period. 5. Premium for these options is fully earned when payment is made. The Extended Reporting Period or Non-Practicing Extended Reporting Period cannot be cancelled. 7 AIF 2385 (07/08) IC. Audit: Underwriters may examine and audit the Insured's books and records at any time insofar as they relate to the subject matter of this insurance. L Misrepresentation and Fraud: The entire policy shall be void if, whether before or after a loss, the insured has willfully concealed or misrepresented any material fact or circumstance concerning this insurance or the subject thereof, or the interest of the insured therein, or in case of any fraud or false swearing of the insured relating thereto. M. Service of Suit Clause: It is agreed that in the event of the failure of the Underwriters to pay any amount claimed to be due hereunder, the Underwriters, at the request of the Insured, will submit to the jurisdiction of a court of competent jurisdiction within the United States. Nothing in this clause constitutes or should be understood to constitute a waiver of Underwriters' rights to commence an action in any court of competent jurisdiction in the United States, to move an action to a United States District Court, or to seek a transfer of a case to another court as permitted by the laws of the United States or of any state in the United States. In the event of any litigation arising out of insurance assumed hereunder, the Attorney-in-Fact as listed in the Schedule and the Director of Insurance of the State of Illinois and his successors in office are hereby appointed agents to accept service of process for Underwriters. N Complaints: If you have any complaints concerning your insurance, please contact the Correspondent. If the Correspondent is unable to resolve the matter, you may contact the Attorney-in-Fact. You may also seek the assistance of the Public Service Section, Illinois Department of Financial and Professional Regulation Division of Insurance,320 W.Washington Street, Springfield, Illinois 62767-0001, O. Correspondent and Attorney-in-Fact not Insurers: Neither the Correspondent nor the Attorney-in-Fact nor any Claim adjusting firm appointed by Underwriters at Lloyd's, London is an Insurer hereunder and neither is nor shall be liable for any Loss or Claim whatsoever. The Insurers hereunder are those individual Underwriters at Lloyd's, London, whose names can be ascertained as hereinbefore set forth. S AIF 2385 (07/08) GENERAL PURPOSE ENDORSEMENT Insured Evidence Number Endorsement Number Effective Date Noel,Inc. 200524- 03 2 3/11/2016 12:01 A.M. Operation of a Drone In consideration of the premium paid, it is hereby understood and agreed that Section I., Item A. is amended to include the following: 6) Underwriters agree to pay on behalf of the Insured up to $5,000 per Coverage Period which the Insured shall become legally obligated to pay as a result of any Claim alleging accidental property damage, trespass, bodily injury or breach of privacy to a third party caused by the Insured's operation of a Drone in the course of the Insured's performance of Professional Services. This coverage applies only to Loss or Claim Expenses. This coverage does not apply to fines,penalties,punitive or exemplary damages, or any multiple of compensatory damages arising from the operation of a Drone. The deductible shall not apply to this coverage A (6). However, any payments made by Underwriters under this clause A (6) shall be included within the applicable limits of liability and not in addition thereto. It is also hereby understood and agreed that Section I., Item C. is amended to include the following: 13. "Drone" means a remote-controlled pilotless aircraft. ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED. AV P ('? Authorized Representative AIr 2385 0 (04/99) GENERAL PURPOSE ENDORSEMENT Insured Evidence Number Endorsement Number Effective Date Noel, Inc. 200524- 03 3 3/11/2016 112:01 A.M. Employment Practices Liability Coverage In consideration of the premium paid,it is hereby understood and agreed that Section I,Item A is amended to include the following: 5)Subject to all other terms and conditions of this Policy,the Underwriters shall reimburse the Insured for Loss or Claims Expenses for up to$25,000 per Claim and in the aggregate for any Claim against the Insured which arises out of a Wrongful Employment Act. Wrongful Employment Act means any of the below,whether actual or alleged,but only if employment related and claimed by or on behalf of an Employee,and only if committed or allegedly committed by the Insured in its capacity as an employer: a. Wrongful discharge or termination,whether actual or constructive,of an employment relationship b. Defamation,infliction of emotional distress or mental anguish,humiliation,false imprisonment,invasion of privacy and other personal injury allegations which arise from the terminating,disciplining,promoting or demoting of an Employee; C. Breach of an implied employment contract and breach of the covenant of good faith and fair dealing in such implied employment contract; d. Discrimination; e. Harassment; f. Violation of the Family Medical Leave Act or similar law; g. Breach of an Employee's federal,state or local civil rights involving but not limited to any violation of the Civil Rights Act of 1886 or 42 U.S.C.Section 1983; h. Retaliation against any Insured; i. Wrongful deprivation of career opportunity,negligent evaluation,or failure to grant tenure. AIF 2385 0 (04/99) Page 1 of 2 For the purpose of this endorsement only,the following are defined terms: Claim(s)means: 1. a. a written demand; b. a civil or administrative proceeding;or c.alternative dispute resolution,including any arbitration or mediation,to which an Insured must submit. 2. Discrimination means the failure or refusal to hire or promote, wrongful demotion or discharge, wrongful failure to grant tenure,make partner or shareholder or any other wrongful treatment of Employees based solely on Employee's age,race,gender,religion,sexual orientation or preference,disability,marital status,pregnancy,or other class or status that is protected by applicable federal,state or local statutory law or common law. 3. Employee means any past, present, future or prospective individual engaged and directed by an Insured for labor or service on behalf of an Insured. The term Employee includes any part-time,seasonal, temporary,leased,or volunteer personnel employed by the Insured including any supervisors or managers. Independent contractors are not employees and no coverage shall be afforded to independent contractors under this Endorsement. 4. Harassment means any unwelcome advances, requests, or other verbal or physical conduct, whether sexual or non- sexual in nature, that is made as a condition of employment by or with the Insured,creates a work environment that interferes with an Employee's performance on behalf of the Insured, is used as a basis by the Insured for employment decisions,or creates a hostile,offensive,or intimidating work environment. No coverage shall be afforded under this endorsement for any actual or alleged violation of any of the following statutes:the Fair Labor Standards Act (except the Equal Pay Act), the Employee Retirement Income Security Act of 1974, the National Labor Relations Act,the Worker Adjustment and Retraining Notification Act,the consolidated Omnibus Budget Reconciliation Act,the Occupational Safety and Health Act, all as amended or any similar provisions of any federal, state, or local statutory law or common law. No coverage will be afforded for any workers compensation.unemployment insurance,social security. disability benefits or similar law,or wage and hour law claims. Coverage shall be excess of any other valid and collectible Employment Practice Liability coverage provided to the Insured under any other available insurance. The coverage under this endorsement is subject to the per Claim Policy deductible listed in the Schedule. For purposes of this endorsement only,the Retroactive Date listed in Item 4 of the Schedule is deleted and replaced with the following: 03/11/2015 In the event a Claim is made against any Insured under this endorsement,as a condition precedent to coverage..notification must be provided to the Insurers within 30 days of the Insured's first receipt of the Claim. ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED. �t P pr_e Authorized Representative AIF 2385 0 (04/99) Page 2 of 2 GENERAL PURPOSE ENDORSEMENT Insured Evidence Number Endorsement Number Effective Date Noel, Inc. 2200524- 03 4 03/11/2016 12:01 A.M. In consideration of the premium paid,it is hereby understood and agreed that Section 1.,Item D.is amended to include the following: 5. PRIVACY BREACH EXPENSES COVERAGE a) INDEMNITY AGREEMENT We shall pay on your behalf all damages and claims expenses that you become legally obliged to pay as a result of any claim first made against you and notified to us in writing during the policy period due to a privacy breach resulting Gom a covered incident,subject to Section b Limits of Insurance. b) Limits of Insurance During the policy period the most we will pay is USD 100,000 for any one claim and in the aggregate for all damages and claims expenses. c) Additional Exclusions i) Criminal investigations or proceedings or any civil investigations or proceedings initiated by a government agency or authority. ii) Any expense to investigate or correct a deficiency in your systems,employee management,vendor management,internal systems, procedures,computer network or system firewalls,computer net-work or system antivirus or any other physical or procedural security which may have contributed to the privacy breach. iii) Reimbursement,compensation,benefits,fees or expenses incurred by you or any of your employees. iv) Any other expenses or costs not included within claims expenses. v) Any consequential loss. vi) Any threat,extortion or blackmail including but not limited to,ransom payments and private security assistance. vii) Any expenses or costs incurred by a third parry. viii) Any alleged or actual privacy breach arising from lost hardware where any personally identifiable information stored was not encrypted. d) Definitions i) Claim is an actual privacy breach discovered by you resulting from a covered incident. ii) Clams Expenses means all necessary and reasonable legal fees,costs or expenses incurred by us,or by you with our prior UTincn consent,for investigation and defense of a covered claim. Claims expenses are pan of and not in addition to the Limit of Insurance. hi) Covered Incident means lost data or lost hardware containing personally identifiable information for the purpose of your professional services. A1F 2385 0 (04/99) Page 1 of 2 iv) Damages means monetary compensation,whether part of a settlement,award or judgment (including any award of pre judgment or post- judgment interest and attorneys'fees),for which you are legally obligated to pay on account of a covered claim. Damages does not include- (a) Civil or criminal fires,penalties,forfeitures,sanctions,taxes,punitive or exemplary damages,or other monetary awards deemed uninsurable under applicable law; (b) The multiplied portion of any multiplied awards; (c) The return,reduction or restitution of fees,premiums,commissions,expenses or costs for professional services performed or to be performed by you or any economic loss that is a consequence of any fees,commissions,expenses or costs charged by you; (d) Non-monetary relief,including any costs incurred in complying with a request,order,judgment or settlement agreement to provide non-monetary relief,or attorneys'fees or costs awarded to the party seeking non-monetary relief, (e) The costs of complying with any injunctive or declaratory relief;and, (f) Any legal fees,costs or expenses claimed by or awarded to a claimant that do not arise on account of a covered Claim. v) Lost Data means the loss or theft of electronic records which contain personally identifiable information for the purpose of your professional services but does not include destruction,damage or loss of such devices or the memory contained therein. vi) Lost Hardware means the loss or theft of portable devices containing personally identifiable information for the purposes of your professional services but does not include destruction,damage or loss of such devices or the memory contained therein. vii) Personally Identifiable Information means any information that relates to a person who can be identified,directly or indirectly,by reference to an identification number or one or more factors specific to their physical,physiological,mental,economic,cultural or social identity and any other applicable private information. viii) Privacy Breach means the loss or theft of personally identifiable information that was not authorized or consented to by the natural person to which such personally identifiable information relates,that was held by you for the purpose ofyour professional services. ix) Professional services are those services defined in the schedule of this policy. x) We/us means the insurer/unden+Titers providing this policy. xi) You/Your means the legal entity(s)specified in the Schedule acting within the scope of its duties in connection with its business. ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED. P G� Authorized Representative AIF 2385 0 (04/99) Page 2 of 2 GENERAL PURPOSE ENDORSEMENT Insured Evidence Number Endorsement Number Effective Date Noel, Inc. 2200524- 03 5 03/11/2016 12:01 A.M. Regulatory/Administrative Actions,Loss of Earnings,and Reputation Management Reimbursement In consideration of the premium paid,it is hereby understood and agreed that Section I,Item A is deleted and replaced with the following: A.Coverage-Professional Liability and Claims Made Clause 1)Subject to the terms of the Policy,Underwriters agree to pay on behalf of the Insured all sums,in excess of the deductible,which the Insured shall become legally obligated to pay as Loss(including Claim Expenses)as a result of any claim alleging Wrongful Act occurring after the Retroactive Date,provided such CLAIM 1S FIRST MADE AGAINST THE INSURED DURING THE COVERAGE PERIOD and reported to the Correspondent as soon as practicable and not more than 60 days after such claim is first made. 2)Subject to all other terms and conditions of this Policy,the Underwriters shall reimburse the Insured for Claim Expenses up to$30,000 per Claim and in the aggregate for the defense of a proceeding before a state or federal regulatory or administrative body,brought directly against the Insured during the Policy Period,under the Americans with Disabilities Act of 1990(ADA),the Fair Housing Act(FHA)or the Occupational Safety and Health Act(OSHA)or any similar laws or legislation of any state provided that the regulatory or administrative action incurred as a result of a proceeding first received by the Insured during the Coverage Period. This coverage only applies to Claim Expenses. It does not apply to any monetary awards of any kind,judgments,fines or settlements relating to,directly or indirectly resulting from the institution of a regulatory or administrative proceeding. Underwriters shall not be required to provide any coverage to appeal any adverse ruling or judgment by any such regulatory or administrative body. The deductible shall not apply to this coverage. However,any payments made by Underwriters under this clause shall be included within the applicable limits of liability and not in addition thereto. 3)Up to$500 for loss of earnings to each Insured for each day or part of a day of such Insured's attendance:at the Company's request,at a trial, deposition,hearing,mediation or arbitration proceeding involving a civil suit against such Insured for covered Claim Expenses or Loss,but the amount so payable for any one or series of trials,depositions,hearings or arbitration proceedings arising out of the same or related Wrongful Act shall in no event exceed$7,500 nor shall the total amount paid in any coverage period exceed$7,500. 4)Subject to all other terms and conditions of this Policy,the Underwriters will reimburse the Insured fifty percent(50%)of the first$30,000 in Reputational Management Expenses(up to$15,000 per Claim and in the aggregate)incurred by the Named Insured for Reputational Management Consulting services which are incurred in Connection with a Claim covered under this Policy that the Insured reasonably believes will have a material adverse effect upon the Named Insured's reputation. After the Underwriters have paid$15,000 under this Clause I.A.A.,the Underwriters shall not be obligated to pay any further Reputational Management Expenses. The deductible shall not apply to this coverage. However,any payments made by Underwriters under this clause shall be included within the applicable limits of liability and not in addition thereto. In consideration of the premium paid,it is further hereby understood and agreed that Section L.Item C.is amended to include: 12. "Reputational Management Expenses"means reasonable fees,costs and expenses incurred by the Named Insured for reputational management consulting services provided by a public relations firm to the Named Insured in response to a Claim. ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED. P ('? Authorized Representative AIF 2385 0 (04/99) GENERAL PURPOSE ENDORSEMENT Insured vidence Number ndorsement Number ffective Date Noel,Inc. 200524-03 1 3/11/2016 1,2:01 A.M. In consideration of the premium paid,it is hereby understood and agreed that Section I.,Item E.is deleted and replaced with the following: E.Deductible The amount designated as the deductible in the Schedule shall be paid by the Insured and shall apply to all Loss and Claim Expense for each and every Claim whether or not loss payment is made.Underwriters shall not have any obligation to make payments under this policy for Loss or Claim Expenses until the deductible has been paid. Such deductible shall not reduce Underwriters Limits of Liability. 1. We will reduce your deductible obligation for a single Claim by 25%,up to a maximum of$12,500,if, within one(1)year of a Claim being reported or being deemed to have been made in accordance with the Claim or potential Claim reporting requirements of this policy: a) The Claim is fully and finally resolved to the satisfaction of all parties,including us,and; b) All Loss and/or Claims Expenses arising from such Claim have been paid in full. 2. We will reduce your deductible obligation for a single Claim by 50%,up to a maximum of$25,000,if you settle a claim through mediation or arbitration_ However,if mediation or arbitration failes to resolve the Claim,and the Claim proceeds to litigation,the full deductible amount will apply without any reduction,in whole or in part. 3. We will reduce your deductible obligation for a single Claim by 50%,up to a maximum of$25,000,if, within 60 days of the date of our request,you provide us with a copy of the written agreement that was executed by you and your client prior to your performance of the agreed-to Professional Services giving rise to the Claim and you demonstrate,to our reasonable satisfaction,the existence of any two(2)of the following four(4)conditions: a) Prior to the performance of the agreed-to Professional Services giving rise to the Claim,you obtained certificates of insurance evidencing both professional liability and general liability from each architect, engineer,landscape architect,land surveyor,contractor,or construction manager you engaged or who engaged you_ b) Your written agreements included limitation of liability clauses in your favor. c) Your written agreement called for and outlined a schedule for you to conduct construction phase inspections on plans and designs to ensure intent of use,which you consistently followed and enforced, or documented your attempt to do so. d) Your written agreement with your client specified payment terns,including a schedule of when payments were to be paid to you,which you consistently followed and enforced,or documented your attempt to do so. If any combination of the deductible reduction incentives apply to a single Claim,in no event will the total amount of the deductible reduction for that Claim exceed 50%of the deductible shown in Item 6 of the Schedule ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGT P Authorized Representative A1F 2385 0(04/99) PAGE 1 MAIL MCH-M-I Y1392 FEB IARY 3, 2016 USAA® AUTOMOBILE POLICY PACKET MR NOEL L GILBROUGH 7359 23RD AVE NW SEATTLE WA 98117-5661 USAA 00087 32 36 7103 4 POLICY PERIOD: EFFECTIVE MAR 07 2016 TO SEP 07 2016 IMPORTANT MESSAGES Refer to your Declarations Page and endorsements to verify that coverages, limits, deductibles and other policy details are correct and meet your insurance needs. Required information forms are also enclosed for your review. Your Underinsured Motorists Coverage (UIM) and Underinsured Motorists Property Damage (UIMPD) selection/rejection remains in effect You may quote different coverage limits and make changes at any time to your policy on usaa.com. Or you may call us at 1-800-531—USAA (8722). TEXTING & DRIVING ... It Can Wait Join USAA in the movement against distracted driving by going to http://itcanwait.usaa.com to watch powerful videos and take the pledge to not text and drive! Coverage exclusions apply when your vehicle is used in ride sharing. If you need coverage for ride sharing activities, we're pleased to offer Ride Share Gap Protection. Please contact us for more information or to obtain a quote. USAA considers many factors when determining your premium. Maintaining safe driving habits is one of the most important steps you can take in keeping your premium as low as possible. A history of claim or driving activity and your USAA payment history may affect your policy premium. The depreciated value of your trailer may not justify continuation of physical damage insurance. Please contact us to discuss the physical damage coverages on your trailer. We have provided your ID cards in this packet. You can use the cards to show proof of insurance, if necessary. This is not a bill. Any premium charge or change for this policy will be reflected on your next regular monthly statement. Your current billing statement should still be paid by the due date indicated. To receive this document and others electronically, or manage your Auto Policy online, go to usaa.com. For U.S. calls: Policy Service (800) 531-8111. Claims (800) 531-8222. ACS1 49708-0406 PX;E 2 4 THIS PAGE INTENTIONALLY LEFT BLANK PACE 3 02/03/16 Automobile Insurance Identification Card We've issued an identification card as evidence of liability insurance for your vehicle(s). This card is valid only as long as liability insurance remains in force. You may be required to produce your identification card at vehicle registration or inspection, when applying for a driver's license, following an accident or upon a law enforcement officer's request. Keep a copy of the ID card in your vehicle at all times. For your convenience, additional copies are available on usaa.com. 53WA2 Rev. 6-13 55084-0513 01 - - -- - - -- - --- - - -- -- - - -- - --- - - -- - -- --- - - --- - --- - --- - -- - ---- - ---- - --- - --- - -- - ---- WASHINGTON INSURANCE IDENTIFICATION CARD i WASHINGTON INSURANCE IDENTIFICATION CARD UNIT® SERMCES AUTOMOBILE ASSN UNUM SEROCES AUTOMOBILE ASSN NAME OF INSURED NCE- L GLB:' i NAME OF INSURED NCB- L GU370JGH LLUNDA LEE GLEROUGi LUCINDA LEE C 10-i POLICY NUMBER 00087 32 36U 7103 4 ; POLICY NUMBER 00087 32 36U 7103 4 EFFECrIvEDATE03/07/16 EXPIRA`nONDATE 09/07/16 i EFFECTVEDATE 03/07/16 EXPIRATION DATE 09/07/16 VEHICLE DESCRIPTION i VEHQE DESCRIPTION YEAR MAKEMODEL YEAR MAKEA40DEL 1998 TOYOTA TAC XfRACAB 2012 TOYOTA PRIUS VEHICLE IDENTIFICATION NUMBER VEHICLE IDENTIFICATION NUMBER 4TAVL52NXWZ066&% JTDIDTB39C1523120 9800 Fredericksburg Road San Antonio,Texas 78288 1 9800 Fredericksburg Road San Antonio,Texas 78288 Additional copies available at usaa.com Additional copies available at usaa.com CONTACT US: 210-531-USAA(8722) CONTACT US: 210-531-USAA(8722) OR 800-531-USAA i OR 800-531 -USAA PX3E 4 UNITED SERVICES AUTOMOBILE ASSOCIATION ADDL INFO ON NEXT PAGE MAIL MCH-M-1 RENEWAL OF (A RECIPROCAL INTERINSURANCE EXCHANGE) State 2 0 21 122 1 1 vd, POLICY NUMBER 9800 Fredericksburg Road-San Antonio,Texas 78288 WA 6 4 6 412 6 4 TeR 0 0 0 8 7 32 3 6 U 7103 4 WASHINGTON AUTO POLICY POLICYPERIOD: (12:01 A.M. standard time) RENEWAL DECLARATIONS EFFECTIVE MAR 07 2016 TO SEP 07 2016 ATTACH TO PREVIOUS POLICY OPERATORS Named Insured and Address 01 MR NOEL L GILBROUGH 02 LUCINDA LEE GILBROUGH MR NOEL L GILBROUGH 7359 23RD AVE NW SEATTLE WA 98117-5661 escri tion o e is e s VEH USE* e WH TRADE NAME MIODEI LNUEAGE NTI BODYTYPE ANAL IDEFICATION NUMBER SYM MI 20 98 TOYOTA TAC XTRACAB 2+ DOOR 8000 4TAVL52NXWZ086856 P 21 85 BURRO 13 ' 0 B803300333916385K 22 12 TOYOTA PRIUS 4 DOOR 11000 JTDKDTB39C1523120 P The Vehicle(s)described herein is principally garaged at the above address unless otherwise stated. wlc-w-wsa,00l;e=B F=Fw-mP ,re VEH 20 SEATTLE WA 98117-5661 VEH 22 SEATTLE WA 98117-5661 VEH 21 SEATTLE WA 98117-5661 Is o icy provt es those coverages where a premium is shown below. a limits shown may pbe reduced by policy provisions and may not be combined regardless of the number of vehicles for which a premium is listed unless specifically authorized elsewhere in this Policy. VEH VEH VEH VEH COVERAGES LIMITS OF LIABILITY 20 6-MONTH 21 6-MONTH 22 6-MONTH ("ACV"MEANS ACTUAL CASH VALUE) D=DED PREMIUM D=DED PREMIUM D=DED PREMIUM D=DED PREMIUM AM OUN $ MOUNT $ 4MOUNT $ MOUNT $ PART A - LIABILITY BODILY INJURY EA PER $ 500, 00 EA ACC $1, 000, OOC 123 . 12 123 .4 PROPERTY DAMAGE EA ACC $ 50, OOC 88 . 63 70 . 1 PART B - PERSONAL INJURY PROTECTIOIS MEDICAL BENEFITS - EA PER $ 10, 00 INCOME CONTINUATION - $200 PER WEEK LOSS OF SERVICES BENEFITS - $40/DAY MAX, $200/WK MAX, $5, 000 MAXIMUM TOTAL FUNERAL EXPENSE -- $2, 000 19 . 67 22 . 0 PART C - UNDERINSURED MOTORISTS BODILY INJURY EA PER $ 500 , 00 EA ACC $1, 000 , OOC 45 .26 48 . 0 PROPERTY DAMAGE EA ACC $ 10, 00 5 .47 5 .8 PART D - PHYSICAL DAMAGE COVERAGE COMPREHENSIVE LOSS ACV LESS D 20 18 . 90 100 1 . 1 20 35 . 9 COLLISION LOSS ACV LESS D 200 93 .47D 100 13 . 03D 200 179 . 16 TOTAL PREMIUM - SEE FOLLOWING PAGE (S) ENDORSEMENTS: ADDED 03-07-16 - NONE REMAIN IN EFFECT (REFER TO PREVIOUS POLICY) - ACCFOR (01) A099 (01) RSGPWA(01) 5100WA(02) INFORMATION FORMS: 663WA(06) G3 20 RMF71 00 0 H 2 RMM71POOPOI I I I I I Ifl In WITNESS WHEREOF,the Subscribers at UNITED SERVICES AUTOMOBILE ASSOCIATION have caused these presents to be signed by their Attorney-in-Fact on this date FEBRUARY 3, 2016 f ;AT Laura Bishop President, USAA Reciprocal Attorney-in-Fact, Inc. 5000 U 07-11 53461-07-11 PACE 5 UNITED SERVICES AUTOMOBILE ASSOCIATION (A RECIPROCAL INTERINSURANCE EXCI-ANGE) State vkh POUC'Y NUMBER USAW 9800 Fredericksburg Road-San Antonio,Texas 78288 IWA Tert 00087 32 3 6U 7103 4 WASHINGTON AUTO POLICY POLIC.YPERRIOD: (12:01 A.M. standard time) RENEWAL DECLARATIONS EFFECTIVE MAR 07 2016 TO SEP 07 2016 ATTACH TO PREVIOUS POLICY Named Insured and Address MR NOEL L GILBROUGH 7359 23RD AVE NW SEATTLE WA 98117-5661 Description o e is e s VEH USE' VEH TRADE NAME MK)Da BODYTYPE IDWflRCATM NUMBER SYM The Vehicle(s)described herein is principally garaged at the above address unless otherwise stated. wic-wo&sdx)d:ems -F=Fa-r.TKP=Pwwre This ppolicy prove es ONLY those coverages where a premium is shown below. he limits shown may be reduced by policy provisions and may not be combined regardless of the number of vehicles for which a premium is listed unless specifically authorized elsewhere in this policy. VEH VEH VEH VEH COVERAGES LIMITS OF LIABILITY ("ACV"MEANS ACTUAL CASH VALUE) D=DED I PREMIUM D=DED PREMIUM D=DED I PREMIUM D=DED PREMIUM AMOUNTI $ AMOUNT $ AMOUNT1 $ AMOUNT $ VEHICLE TOTAL PREMIUM 394 . 52 14 . 13 484 . 54 6 MONTH PREMIUM $ 893 . 19 PREMIUM DUE AT INCEPTION. THIS IS NOT A BILL, STATEMENT 70 FOLLOW. EARNED ACCIDENT FORGIVENESS APPLIES WITH FIVE YEARS CLEAN DRI1jING WITH US PA. THE PREMIUM ON YOUR RENEWING POLIC IS 17 . 16 MORE THAN CN YO R EXPIRING FOLICY. THE FOLLOWING COVERAGE (S) DEFINED IN THIS POLICY ARE NOT PROVIDED FOR: VEH 20 - RENTAL REIMBURSEMENT, T WING AND LABOR VEH 22 - RENTAL REIMBURSEMENT, T WING AND LABOR C E E E N N N N In WITNESS WHEREOF,the Subscribers at UNITED SERVICES AUTOMOBILE ASSOCIATION have caused these presents to be signed by their Attorney-in-Fact on this date FEBRUARY 3 , 2016 2 - Laura Bishop President, USAA Reciprocal Attomey-in-Fact, Inc. 5000 U 07-11 53461-07-11 PAGE 6 USAA 00087 32 36 7103 SUPPLEMENTAL INFORMATION USAW EFFECTIVE MAR 07 2016 TO SEP 07 2016 The following approximate premium discounts or credits have already been applied to reduce your policy premium costs. NOTE: Age or senior citizen status, if allowed by your state/location, was taken into consideration when your rates were set and your premiums have already been adjusted. VEHICLE 20 ANNUAL MILEAGE DISCOUNT -$ 14 . 98 MULTI-CAR DISCOUNT -$ 63 . 35 PASSIVE RESTRAINT DISCOUNT -$ 3 . 03 PREMIER DRIVER DISCOUNT -$ 27 . 02 VEHICLE 22 DAYTIME RUNNING LIGHTS DISCOUNT -$ 5 .17 MULTI-CAR DISCOUNT -$ 79 . 25 PASSIVE RESTRAINT DISCOUNT -$ 3 .45 PREMIER DRIVER DISCOUNT -$ 33 . 80 SUPDECCW Rev. 7-95 FEBRUARY 3 , 2016 PAGE 7 USAA 00067 32 36 7103 Personal Injury Protection Coverage in Washington Below, you will find a brief explanation of Personal Injury Protection coverage. Please remember that this is designed to be a simple overview. Coverage is subject to all the provisions and exclusions described in your insurance policy. The decision you make regarding the level of coverage in this area may affect your insurance premium. When purchasing this coverage, it is important to understand that you will be reimbursed only for reasonable and necessary medical expenses. Bills are audited, and amounts charged which are not reasonable, or charges incurred for treatment which is not necessary, will not be reimbursed. Any amounts not qualifying for reimbursement are your responsibility. Please see your policy for details. If you have further questions, feel free to contact a member service representative by calling (800) 531-8111. Coverage Description Personal Injury Protection Coverage (PIP): • Is optional. • Written rejection is required. If rejected, future renewals will remain the same. • Provides a death benefit. • Provides an income continuation benefit, for up to one year, beginning 14 days from the date of the automobile accident, subject to the lesser of 85% of the actual income lost or the limit selected. • Provides Loss of Services Disability Benefits of $40 per day, subject to the limit selected. _= 52112-1006 663WA(06) Rev. 10-06 Page 1 of 4 PS.000873236.663WA.07103 PAGE 8 USAA 00087 32 36 7103 THIS PAGE INTENTIONALLY LEFT BLANK 663WA(06) Rev. 10-06 Page 2 of 4 PS.000873236.663WA.07103 PAGE 9 ^ USAA 00067 32 36 7103 Rejection/Selection Form If you do not wish to make any changes to your current policy, no action is required. If you would like to make changes to your policy, please complete, sign and return the form below. The premiums below reflect the total premium for this coverage for all vehicles insured on your policy. The coverage-limit combinations displayed in this form are examples. You can create other combinations of the coverage limits displayed in this example. PERSONAL INJURY PROTECTION COVERAGE Semi-annual premiums per policy Medical & Income Loss of Funeral Hospital Expenses Continuation Services Expenses Premium ❑ $ 10,000 $200 wk./$10,000 max. $200 wk./$5,000 max. $2,000 $ 41.74 ❑ $ 10,000 $200 wk./$10,000 max. $280 wk./$14,600 max. $2,000 $ 43.02 ❑ $ 10,000 $200 wk./$10,000 max. $200 wk./$5,000 max. $5,000 $ 44.31 ❑ $ 25,000 $200 wk./$10,000 max. $280 wk./$14,600 max. $5,000 $ 70.36 ❑ $ 35,000 $700 wk./$35,000 max. $200 wk./$5,000 max. $2,000 $ 80.87 ❑ $ 50,000 $700 wk./$35,000 max. $280 wk./$14,600 max. $2,000 $ 93 .79 ❑ $ 75,000 $700 wk./$35,000 max. $200 wk./$5,000 max. $5,000 $ 106.76 ❑ $100,000 $700 wk./$35,000 max. $280 wk./$14,600 max. $5,000 $ 123.66 Loss of Services: $ 5,000 has a $40 per day, $200 per week maximum $ 14,600 has a $40 per day, one year maximum Note: Your current limit selection is: Medical & Income Loss of Funeral Hospital Expenses Continuation Services Expenses Premium ❑ I reject Personal Injury Protection Coverages for this policy and all subsequent renewals, supplemental policies or replacement policies. USAA Number Signature of Named Insured ! 1 ( 1 Home Phone Alternate Phone Date Please fax your completed form to (800) 531-8877 or mail it to the following address: USAA, 9800 Fredericksburg Road, San Antonio, Texas 78288 If this form is sent by facsimile machine (fax), the sender adopts the document received by USAA as a duplicate original and adopts the signature produced by the receiving fax machine as the sender's original signature. 663WA(06) Rev. 10-06 �'� Page 3 of 4 PS.000873236.663WA.07103 LAST PAGE 10 . USAA 00087 32 36 7103 THIS PAGE INTENTIONALLY LEFT BLANK •yw ' 663WA(06) Rev. 10-06 '� Page 4 of 4 Ps.000873236.663WA.07103