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PW17-043 - Original - R.F. Duncan & Associates, Inc. - 132nd Ave SE Sidewalk Improvements Appraisal Review - 01/26/2017
i1a 'l' I' +P UI s lUiirk e c o e m fiA Usa11 u1ry "J `�° 9 i a,,,n cri� ii i c f.✓a✓ ,/el r i l 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: R. F. Duncan & Associates, Inc. Vendor Number: JD Edwards Number Contract Number: PAW 1 -1 - o t-w This is assigned by City Clerk's Office Project Name: 132nd Ave. SE Sidewalk Improvements Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment [z Contract ❑ Other: {Contract Effective Date: 1/26/17 Termination Date: 12/31/17 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Drew Holcomb Department: Engineering Contract Amount: $10,400.00 Approval Authority: (CIRCLE ONE) Department DPrector Mayor City Council Detail: ('i.e. address, location, parcel number, tax id, etc.): Provide appraisal review services for 13 parcels. As of: 08/27/14 d KENT W A S H I H O T O N PROFESSIONAL SERVICES AGREEMENT between the City of Kent and R. F. Duncan & Associates, Inc. THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and R. F. Duncan & Associates, Inc. organized under the laws of the State of Washington, located and doing business at PO Box 12300, Olympia, WA 98508, Phone: (360) 951-8258, Contact: Richard Duncan (hereinafter the "Contractor"). I. DESCRIPTION OF WORK. Contractor shall perform the following services for the City: The Contractor shall provide appraisal review services for 13 parcels for the 132"d Ave. SE Sidewalk Improvements Project. For a description, see the Contractor's Scope of Work which is attached as Exhibit A and incorporated by this reference. Contractor 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, and Contractor shall complete the work by December 31, 2017. III. COMPENSATION. The City shall pay Contractor a total amount not to exceed Ten Thousand, Four Hundred Dollars ($10,400.00) for the services described in this Agreement. The Contractor shall invoice the City monthly based on time and materials incurred during the preceding month. The hourly rates charged for Contractor's services shall be as delineated in the attached and incorporated Exhibit A. All hourly rates charged shall remain locked at the negotiated rates throughout the term of this Agreement. IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor- Employer Relationship will be created by this Agreement. By their execution of this Agreement, and in accordance with Ch. 51.08 RCW, the parties make the following representations: A. The Contractor 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 Contractor maintains and pays for its own place of business from which Contractor's services under this Agreement will be performed. C. The Contractor has an established and independent business that is eligible for a business deduction for federal income tax purposes that existed before the City retained Contractor's services, or the Contractor is engaged in an independently established trade, occupation, profession, or business of the same nature as that involved under this Agreement. D. The Contractor 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. PROFESSIONAL SERVICES AGREEMENT - 1 ($20,000 or Less) E. The Contractor has registered its business and established an account with the state Department of Revenue and other state agencies as may be required by Contractor's business, and has obtained a Unified Business Identifier (UBI) number from the State of Washington. F. The Contractor 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 seven (7) calendar days written notice at its address set forth on the signature block of this Agreement. VI. DISCRIMINATION. In the hiring of employees for the performance of work under this Agreement or any subcontract, the Contractor, its subcontractors, or any person acting on behalf of the Contractor or subcontractor shall not discriminate against any person who is qualified and available to perform the work to which the employment relates as provided for by the City of Kent's Equal Employment Opportunity Policy. Contractor 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. Contractor 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 Contractor'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 Contractor's work when completed shall not be grounds to avoid any of these covenants of indemnification. The provisions of this section shall survive the expiration or termination of this Agreement. In the event Contractor 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 Contractor's part, then Contractor 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 Contractor's part. VIII. INSURANCE. The Contractor 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. CONTRACTOR'S WORK AND RISK. The Contractor agrees to comply with all federal, state, and municipal laws, rules, and regulations that are now effective or in the future become applicable to Contractor's business, equipment, and personnel engaged in operations covered by this Agreement or accruing out of the performance of those services. All work shall be done at Contractor's own risk, and Contractor 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. X. 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. PROFESSIONAL SERVICES AGREEMENT - 2 ($20,000 or Less) C. Resolution of Disputes and Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the State of Washington. If the parties are unable to settle any dispute, difference or claim arising from the parties' performance of this Agreement, the exclusive means of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the parties' performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or award provided by law; provided, however, nothing in this paragraph shall be construed to limit the City's right to indemnification under Section VII of this Agreement. D. 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. 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 Contractor. 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. 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. Public Records Act. The Contractor 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 Contractor 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 Contractor agrees to cooperate fully with the City in satisfying the City's duties and obligations under the Public Records Act. I. City Business License Reguired. 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. PROFESSIONAL SERVICES AGREEMENT - 3 ($20,000 or Less) r N J. 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. All acts consistent with the authority of this Agreement and prior to its effective date are ratified and affirmed, and the terms of the Agreement shall be deemed to have applied. CONTRACTOR: CITY-Of�K E N T: By: B or ire) y�- (si!Ynature) K) Print Name: -1�tC,6L.t\ Print Name: TTmothy J. LaPorte, P.E. Its: L)k,i Its: Public Works Director (itle) DATE: -7 DATE: Q z NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: CONTRACTOR: CITY OF KENT: Richard Duncan Timothy J. LaPorte, P.E. R. F, Duncan & Associates, Inc. City of Kent PO Box 12300 220 Fourth Avenue South Olympia, WA 98508 Kent, WA 98032 (360) 951-8258 (telephone) (253) 856-5500 (telephone) (360) 867-1059 (facsimile) (253) 856-6500 (facsimile) PROFESSIONAL SERVICES AGREEMENT - 4 ($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. Dated this day f , 20 ! . By: For: C� g � � Title* Date: 1 D--15— 1-7 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. Dated this day of , 20 By: For: Title: Date: EEO COMPLIANCE DOCUMENTS - 3 i EXHIBIT A R . F . DUNCAN & ASSOCIATES INC . A P P R A I S E R S & C O N S U L T A N T S I N R E A L E S T A T E January 17, 2017 E Mr. Drew Holcomb, Project Manager Design Engineering I Public Works Department I 220 Fourth Avenue South, Kent, WA 98032 RE: Review of Appraisal PW-2016(014); 132nd Avenue SE Sidewalk Improvements (Project I No. 16-3008) Dear Mr. Holcomb: My proposal to provide appraisal reviews on the above referenced project Is a total fee of 1$ 0,400 which is a rate of $800 per larger parcel. Please see page 2 of this proposal for an itemized list of each parcel. proposal The ro fee osal is at my rate of$100 per hour and includes all of my costs for the performing the review appraisal services. My deliverables will be a signed narrative appraisal review report (Review Certificate) that I will personally write and sign. My appraisal review report will meet or exceed all City of Kent, state, federal, WSDOT, USPAP, RCO, and TIB requirements. I will deliver the review appraisals within 7 business days of receiving each appraisal. Thank you for the opportunity to submit this proposal. I Sincerely, Richard F. Duncan, MAI TELEPHONE (360) 951-8258 • FAX (360) 867-1059 PO BOX 12300. OLYMPIA, WASHINGTON 98508 i The project includes the following parcels: Parcel No. Name Review Fee PW2016-001 Zion Lutheran Church 800 PW2016-002 Valdez $800 PW2016-003 Multani Custom Homes LLC $800 PW2016-004 Saechao and Saetern 800 PW2016-005 Henry800 PW2016-006 Borrero 800 PW2016-007 SD Construction 800 PW2016-008 Ruthruff 800 PW2016-009 Watson 800 PW2016-010 Ma sanoc 800 PW2016-011 Krantz 800 PW2016-012 Aaber 800 PW2016-013 Nonan 800 Total 10 400 I f TELEPHONE (360) 951-8258 FAX (360) 867-1059 PO BOX 12300. OLYMPIA, WASHINGTON 98508 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 and shall cover liability arising from premises, operations, independent contractors, products-completed operations, personal injury and advertising injury, and liability assumed under an insured contract. The City shall be named as an 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. 4. Professional Liability insurance appropriate to the Consultant's profession. 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 and a $1,000,000 products-completed operations aggregate limit. EXHIBIT B (Continued) 3. Professional Liability insurance shall be written with limits no less than $1,000,000 per claim and $1,000,000 policy aggregate limit. 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 Contractor 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(MMMWYYYY) CERTIFICATE OF LIABILIT`f INSURANCE 031M,3ni6 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CDDOFiALTERRRS NO RIGHTS COERAGE AFFORDED BY THE PON THE CERTIFICATE LICIES CER IFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTFN BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING 1NSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate holderis an ADDITIONAL INSURE an endorsement t A statement polleon this certificate does of confer rights to the the terms and conditions of the policy,certain policies may require certificate:holder in IieU of such endorsement(s). ACT Ou Land PRODUCERpHDNE 360.332 758E FAX No 3ti0-9A3-G304 Duncan &Associates Insurance Brokers E—L Judy duncanins.com P.O.Box 1458-2111 Harrison Ave NW tNSU S1 AFFORDING COVERAGE NAICS Olympia,WA 98502 BOsuRERA: Ohia Securi Insurance COmDan 53131 wsuRER a- INSURED INSURER C: R.F.Duncan&Associates,Inc INSURERO• P O Box 12300 INSURERE: Olympia,WA 98508 INSURERF: REVISION NUMBER: 1 COVERAGES CERTIFICATE NUMBER: o0000000 0 NAMED INSURED HIINDSCATEDC OFFFY THAT THE TWI n ISTANDINGANY REOUIREMIMCTFJ2M OR CONDRION OF ANY CONTRACT REDTO EOTHE LIS I El ER DOC MU ENT ABOVE WBJ RESPECT TO E TERMCH S. IX LUS ONE CERTIFICATE AND CONDITIONS ONO OF SUCH PU POLICIES.U SURANCE AFFORDED BY THE POLICIES WA�BEEN RE UCED BY P DI DESCRIBED HEREIN IS SUBJECT TO ALL THE TER1,M15, MPoLJCY FFF POLICY EXP LIMITS ILISRR TYPE OF INSURANCE �N S POLICY NUMBER MM� A X cOMMERCIALGENERALLIAHILrIY Y N BLS 17 56696377 D510812016 05lDB12017 EAcOCCURRENCE : 1,000,000 pREMISF Ea Dmareruo S -- OOO CLAIMS-MADE F0 OCCUR IAED EXP one arson) S 15,000 PERSONAL BADVINJURY S 1 000 000 GENERAL AGGREGATE S 2 000 000 GEN'L AGGREGATE U41T APPLIES PM PRODUCTS-COMPIOPAGG S 2,000,000 I �( POLICY❑J RD• 0 LDC S OTHER: COMBINFD SINGLE LMR S aeede AUrOMOME LIABILITY BODILY INJURY(Per Person) S ANY AUTO BODILY tN IUNY(Pet eeodrr� S ALL ALrrODSM� A5 LED p DAMAGE S NON OYyN nr ED S HIRE AUTOS AUTOS FACH OCCURRENCE S UMBRELLALIAB OCCUR AGGREGATE S •M EXCESS LLAH CLAIMSADE S p� RETENTION S PEAT'TE OTH• WORKERS coMRENsA'noN EL EACH ACCIDENT S ' AND EMPLOYERS'LIABILITY YIN ID PROPRIETOR/PARTNER'MCUTNENfA EL DISEASE-EA EM S ICERNEIdBER EXCLUDED? ndatoryInNH) EL DISEASE-POLICY IJMIrs nbeunder C7777 pFSCRIPTION OF OPERATIONS f LOCATIONS'VEHICLES IACORD 5pr,Addilronal Remarks Sshedul..may be attached ifmom spate is mquiredl RE:AII projects under contract between insured and certificate holder City of Kent is named as an additioinal insured in regard to the General Liability coverages above perform CG 88 10 0413 CANCELLATION CERTIFICATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Kent ACCORDANCE WITH THE POLICY PROVISIONS. ` 400 West Goble AVINDRIZED REPRESENTATIVE I Kent,WA 98032 Q,-, -�.`'�1 0-"J �i (JAL) f ®1988-2014 ACORD CORPORATION. All rights reserved- ACORD 25(2014101} the ACORD name and toga are registered marks of ACORD rinted by JAL on March 25.2016 at 10.25AM • .� � _ - _ f _ � {{ _ + .. ,�_ t. ___ . � ._ _�; _ :: i • i r - � . . � .. � .. r i - t I t . 4 Liliez MAR Mutual. INSURANCE • Policy NeunUer: BLS 56696377 Prior Policy: NOT AVAILABLE Coverage Is provided In The Ohio Security Insurance Com any Billin T e: Direct Bill Named Insured and Mailing Address: Agent: 9 DUNCAN$i ASSOCIATES INC R F DUNCAN ASSOCIATES, INC po BOX 1458 ra PO BOX 12300 OLYMPIA,WA 98507-I458 CD LO OLYMPIA,WA 98509 Agent Code: 466104 r . Agent Phone: (360)352-7588 a Policy DeclarafiionS, Forms and Endorsements V -- i 4 t This gage intentionally left blank.. [ -j lr j i 46 6104 BLS 56696377 DTJNCAN & ASSOCIATES INC 05/08/2017 PO BOX 1458 OLYMPIA,WA 98507-1459 We strive to produce a quality product for our agents to deliver to the policyholder. In doing so, We ask that you assist us by taking time to review the enclosed policy accuracy.'IEthere are any modifications that need to be made, we request that you return this letter to the Business Center outlining what is in error. Named Insured: R F DUNCAN & ASSOCIATES, INC Corrections needed to be made on this policy (This form is not for routine change requests): l Thank you for your assistance. PIease,send to: Liberty Mutual Insurance ATTENTION: U.S.I. UNIT CAU: NONE l This page intentionally left blank. I I i :. Libe Policyholder MfOrmatien Named Insured&Mailing Address Agent Ma ling Address&lahone No. (360) 352-7588 R.R DUNCAN &ASSOCIATES, INC DUNCAN &.ASSOCIATES INC PO BOX 12300 PO BOX 1458 OLYMPIA, WA 98508 OLYMPI:A,WA 98507-1458 Dear Pvllcylioldet we know you work hard to build your business. We work together with your agent, DUNCAN & ASSOCIATES INC (360) 352-7588 � on care about. Thant:.you for selecting us. to help protect the things y Enclosed are your insurance documents consisting of: • General Liability To find your specific coverages, limits of liability, and premium, please refer to your Declarations page(s). if you have any questions or changes that may affect your insurance needs, please contact your Agent at(360)352-7588 Verify that all information is correct If you have any changes, please contact your Agent at(360) 352-7588 Reminders In casa of a claim, call your Agent or 1-800-362-0000 you Need To KnOw CONTINUED ON NEXT PAGE S To teport a claim, call your Agent of I-800-362-6000 n.q 7n 20 0103 You Need To Know - continued . NOTICE(S)TO POLICYHOLDER(S) The Important Notice(s)to PolicyhoIder(s)provide a general explanation of changes in coverage to your policy. The Important Notices) to Policyholder(s)is not a part of your insurance policy and it does not alter policy provisions or conditions. Only the provisions of your policy determine the scope of your insurance protection. It is important that you read your policy carefully to determine your rights, duties and what is and is not covered. FORM NUMBER TITLE NP 72 42 0115 Terrorism Insurance Premium Disclosure And Opportunity To Reject NP 74 44 09 06 U.S. Treasury Department's Office of Foreign Assets Control(OFAC)Advisory Notice to Policyholders NP 74 50 0107 Important Audit Information NP 89 710910 Important Policyholder Information Concerning Billing Practices Liberty Northwest NP 96 00 1014 General Liability Access Or Disclosure Of Confidential Or Personal Information Exclusions Advisory Notice To Policyholders . This policy will be direct billed. You may choose to combine any number of policies on one bill with your billing account. Please contact your agent for more information. i i s i i 3 f i 03/14/16 R F DUNCAN BLS (17) 56 69 63 77 ASSOCIATES, INC From 05/08/2016 To 05/08/2017 PO BOX WOO OLYMPIA, WA 98508 (360) 352-7588 DUNCAN 6 ASSOCIATES INC PO BOX 1458 OLYMPIA, WA 98507-145B TERRORISM INSURANCE PREMIUM DISCLOSURE AND OPPORTUNITY TO REJECT This notice contains important information about the Terrorism Risk Insurance Act and its effect on your policy.Please read it carefully. THE TERRORISM RISK INSURANCE ACT The Terrorism Risk Insurance Act, including all amendments ("TRIA" or the "Act"),establishes a program to spread the risk n catastrophic r'sses from losses fromtain acts of cetifi d actserrorism between of terrorism exceed Insurers spec'tied dedu federal ble � government. If an individual insurer aid in amount,the government will reimburse the insurer for a percentage of losses(the "Federal Share") p excess of the deductible, but its rdeductibleUs not liable fgregate indstry losses rom such acts exceeor any portion of loss es n1 excess ss of$100 Trig- ger".An insurer that has met its insure billion per year. Similarly,the federal government is no losses up to that mo nliabe for any losses covered tmay be the cproarated,at exceed this amount.If aggregate insured losses exceed$100 b determined by the Secretary of the Treasury. The Federal Share and Program Trigger by calendar year are: Calendar Year Federal Share Program Trigger 5 85% $100,000,000 201 84% $120,000,000 2016 83% $140,000,000 8 82% $160,000,000 201 201 81% $180,000,000 2020 80% $200,000,000 MANDATORY OFFER OF COVERAGE FOR CERTIFIED ACTS OF TERRORISM" AND DISCLOSURE OF PRE- MIUM ava " lable for any loss that occurs within the United States (or TRIA requires insurers to make coveraag sionsland certain it carries and vessels),results from 8 "certified outside of the U.S.in the case of U.S. r act of terrorism"AND that is otherwise covered under your policy. A"certifled act ofterrorism" means: (A]ny act that Is certified by the Secretary [of the Treasury] , in consultation with the Secretary of Homeland Security,and the Attorney General of the United States. (i) to be an act of terrorism; Page 1 of 2 rup 79 119 n1 15 O 2o15 Liberty Mutual Insurance (ii) to be a violent act or an act that is dangerous to- i (1) human life; (11) property,or (Ili) infrastructure, (iii) to have resulted In damage within the United States,or outside of the United States in the case of- (1) an air carrier(as defined in section 40102 of title 49, United States Code)or United States flag vessel (or a vessel based principally in the United States,on which United States income tax Is paid and whose Insurance coverage Is subject to regulation in the United States);or (i1) the premises of a United States mission; and' (iv) to have been committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. REJECTING TERRORISM INSURANCE COVERAGE-WHAT YOU MUST DO We have Included in your policy coverage for losses resulting from "certified acts of terrorism" as defined above. THE PREMIUM CHARGE FOR THIS COVERAGE APPEARS ON THE DECLARATIONS PAGE OF THE POLICY AND DOES NOT INCLUDE ANY CHARGES FOR THE PORTION OF LOSS COVERED BY THE FEDERAL GOV- ERNMENT UNDER THE ACT. If we are providing you with a quote,the premium charge will also appear on your quote as a separate line item charge. IF YOU CHOOSE TO REJECT THIS COVERAGE, PLEASE CHECK THE BOX BELOW, SIGN THE ACKNOWL- EDGMENT,AND RETURN THIS FORM TO THE ADDRESS BELOW: Please ensure any resection is received within thirty(30)days of the effective date of your aolicy. Before making a decision to reject terrorism Insurance, refer to the Disclaimer for Standard Fire Policy States located at the end of this Notice. ❑ I hereby reject this offer of coverage.I understand that by rejecting this offer,I will have no coverage for losses arising from "certified acts of terrorism"and my policy will be endorsed accordingly. Policyholder/Applicant's Signature Print Name Date Signed • I Named Insured Policy Number R F DUNCAN & ASSOCIATES, 1NG BLS (17) 56 69 63 77 Palley Effective/Expiration Date From 05/08/2016 To 05/o8/2o17 IF YOU REJECTED THIS COVERAGE,PLEASE RETURN THIS FORM TO: Attn: Commercial Lines Division-Terrorism PO Box 66400 London,KY 40742-6400 I Note: Certain states (currently CA, GA, [A, IL, ME, MO, NY, NC, NJ, OR, RI, WA, WI and WV) mandate coverage for toss caused by fire following a "certified act of terrorism"in certain types of insurance policies. If you reject TRIA coverage in these states on those policies, you will not be charged any additional premium for that state mandated coverage. The summary of the Act and the coverage under your policy contained in this notice is necessarily general in nature. Your policy contains specific terms, definitions, exclusions and conditions. in case of any I conflict,your policy language will control the resolution of all coverage questions.Please read your policy carefully. If you have any questions rega rding this notice,please contact your agent. NP 72 42 01 15 © 2015 Liberty Mutual Insurance Page 2 of 2 ! I NP 74 44 09 06 U.S. TREASURY DEPARTMENT'S OFFICE OF FOREIGN ASSETS CONTROL "OFAC ) ADVISORY NOTICE TO POLICYHOLDERS o coverage Is provided by this Policyholder Notice nor can it be construed to replace any provisions of N g our Declarations page for complete information on the your policy.You should read your policy and review y coverages you are provided. g possible impact on your insurance coverage due to directives This Notice provides Information concernin issued by OFAC.Please read this Notice carefully. Please refer any questionsyou may have to your insurance agent. The Office of Foreign Assets Control(OFAC) administers andand enforces sanctions n policy,based on Presiden- T OFAC has identified tial declarations of"national emergency . o Foreign agents; Front organizations; e Terrorists; a Terrorist organizations;and Narcotics traffickers; ns". This list can be located on the United States as "Specially Designated Nationals and Blocked Perso Treasury's web site-http//www.treas.gov/ofac. It is determined that You or any other insured, or any, person or In accordance with OFAC regulations, if entityclaiming the benefits of this insurance has violated insurancecwill be considered a blocked or frozen OFAC,t National and Blocked Person, as identified by be made contract and all provisions of this insurance are imamednoelly subjec to pAemiuhrrtrrefunds may policy s considered to be such a blocked or frozen contract, without authorization from OFAC.Other limitations on the premiums and payments also apply. O 2011 Liberty Mutual insurance.All rights reserved. Page 1 of 1 .._1_.,. -.1�f Insurance Services Office,Inc.,with its permission. i NP 74 50 0107 Important Notice Notice to Policyholders This explanation is not a part of your insurance policy, and it does not alter any of its provisions or conditions. Please refer any questions you may have to your insurance agent. We would like to thank you for being a policyholder.We appreciate your business. If your policy contains a condition stating it is subject to a premium audit we would like to take this opportunity to explain how the audit process works and answer the most common questions we receive from our policyholders.The information in this notice will make it easierfor you to prepare foryour audit. Insurance Premium Audit Facts Audits can benefit our policyholders by allowing us to collect the appropriate amount of premium for each policy. Most commercial policies are written.based on estimated or fluctuating exposure bases.At the end of the policy term an audit will determine the actual exposure bases and the premium will be adjusted accord- ingly.A company representative will conduct the audit. The premium auditor will examine and audit records that relate to your policy. The records necessary to complete the audit will vary,based on the coverages you have.Types of records that may be requested for your audit include,but are not limited to: • Payroll Records,including 941 forms • Sales Journals or income statements • General Ledger Cash Disbursements Journal • Subcontractor Certificates i Keeping accurate and complete records will allow the auditor to properly classify and allocate your expo- sures correctly.Often there are allowable credits available according to insurance manual classification and ' rating rules. The premium auditor will be able to give you the credits, tb which you are entitled, if your records provide the necessary details. Providing the records your auditor needs can save you time and money as well as expedite the audit process. Nova Audits are Conducted Audits are handled in different ways, depending on the types of coverages you may have. We conduct audits in the following ways: Physical Audit - An auditor will contact you and set up a convenient time to personally come to your business and review your records. Phone Audit-Forms will be mailed to you, explaining what is necessary to complete a phone audit. The phone auditor will contact you or your bookkeeper for this information. Voluntary Audit- Forms will be mailed to you for completion.We will provide you with contact information If you need assistance in completing the forms. �. i NP 74 50 01 07 j completing the auditand lled Many states have enacted legislation that governs oliciestas well as regular audithe time In which an s, in orderto cost be mply mp Y withable for audit when our st e paid. This applies to audits for cancelle regulations,it is important to mak he auditwithinecords l a reasonable time after the close of the policy period We will make every effort to complete stated in your policy. Frequently Asked Questions Q,What if 1 use subcontractors? r Subcontractors are factored in tlo the audit process. r actors who do not have Insurance are treated as though they are your empyeestthetime of the audit.if your subcontractor furnishes you with a certificate of liability or workers' compensation insurance, your insurance cost for that subcontractor could be less.See your policy for details on limits of insurance required for certificates. Q:I have no employees and writ alone.Does the insurance company still need to complete an audit? A: Yes. The auditor will need to verify you worked alone by examining business records that may include tax filings,disbursements,and check stubs. Q:Do 1 need an audit if l have cancelled my policy or am no longer insured with you. A: An audit may still be necessary even if you no longer have an active lmay d termine with us. elf an'auditlis cover the time period for which you were insured by us Other factors that necessary include the time the policy was In effect and the amount of premium involved. Q: if 1 use leased employees but the leasing company carries the liability, are the leased employees j excluded from my General Liability policy? A: No.The manual rules stipulate that all leased employees are covered on the insured's policy. Q:is it necessary to keep records on any casual labor I use? A:Yes.Casual labor payroll is examined during the audit. Q•What happens if I do not comply with the audit and fail to provide all necessary records and verifica- tion? ll to do so, A: It's important to provide the necessaeWdInformation umay also rrrece'ivve an estimated audder to complete the itst tement based on your policy may be cancelled or nonren increased policy exposure estimates due to non-compliance of audit. If you would like additional information about the policy audit process,your independent agent can assist you.The Premium Audit Department is also available to answer any questions you may have regarding this process. Please contact us at 1-888-224-9246 or via E-mail at premiumAud!tServices@libertymutual.com l NP 89 71 0910 IMPORTANT POLICYHOLDER INFORMATION CONCERNING BILLING PRACTICES Dear Valued Policyholder: This insert provides you with important information about our policy billing practices that may affect you. Please review it carefully and contact your agent if you have any questions. Premium Notice:We will mail you a policy Premium Notice separately.The Premium Notice will provide you with specifics regarding your agent,the account and policy billed,the billing company, payment plan, policy number,transaction dates,description of transactions,charges/credits,policy amount balance,mini- mum amount, and payment due date. This insert explains fees that may apply to and be shown on your Premium Notice. Available Premium Payment Plans: • Annual Payment Plan: When this plan applies, you have elected to pay the entire premium amount balance shown on your Premium Notice in full. No installment billing fee applies when the Annual Payment Plan applies. • Installment Payment Plan: When this plan applies, you have elected to pay your policy premium in installments (e.g.: quarterly or monthly installments - Installment Payment Plans vary by state). As noted below,an Installment fee may apply when the Installment Payment Plan applies. The Premium Payment Plan that applies to your policy is shown on the top of your Premium Notice. Please contact your agent if you want to change your Payment Plan election. installment Payment Plan Fee: if you elected to pay your premiums in installments using the Installment Premium Payment Plan, an installment billing fee applies to each installment bill. The installment billing charge will not apply, however, if you pay the entire balance due when you receive the bill for the first installment. Because the amount of the Installment charge varies from state to state, please consult your Premium Notice for the actual fee that applies. Dishonored Payment Fee:Your financial institution may refuse to honor the premium payment withdrawal request you submit to us due to insufficient funds in your account or for some other reason. If that is the case, and your premium payment withdrawal request is returned to us dishonored, a payment return fee will apply. Because the amount of the return fee varies from state to state, please consult your Premium Notice for the actual fee that applies. Late Payment Fee:If we do not receive the minimum amount due on or before the date or time the payment Is due, as indicated on your Premium Notice, you wilt recelve a policy cancellation notice effective at a future date that will also reflect a late payment fee charge. Issuance of the cancellation notice due to non-payment of a scheduled Instaliment(s) may result in the billing and collection of all or part of any outstanding premiums due for the policy period. Late Payment Fees vary from'state to state and are not applicable in some states. Special Note: Please note that some states do not permit the charging of certain fees. Therefore, if your state does not allow the charging of an Installment Payment Plan, Dishonored Payment or Late Payment Fee,the disallowed fee will not be charged and will not be included on your Premium Notice. i EFE'-Automatic Withdrawals Payment Option: When you select this option,you will not be sent Premium Notices and, In most cases, will not be charged installment fees. For more information on our EFT Auto- matic Withdrawals payment option,refer to the attached policyholder plan notice and enrollment sheet. Once again, lease contact your agent ent if you have an g • p Y 9 Y y questions about the above billing practice informa- tion. i i Thank you for selecting us to service your insurance needs. ! i s i NP 89 7109 10 0 2010 Liberty Mutual insurance Company.All rights reserved. Page 1 of 1 NP 96 0010 14 GENERAL LIABILITY ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION EXCLUSIONS ADVISORY NOTICE TO POLICYHOLDERS Dear Valued Policyholder, merclal Thank you for selecting us as your carrier for y°ur c sonal information,There isomo a than ur l one version cy of the exclusion regarding access or disclosure of performi or charities noted may apply exclusion and each is described below. Plea bed fn this notice that not lrof the a comparable able state to specific forms in your specific policy.Any of the forms de lieu of the forms mentioned below. In those situations, oned in the thistntotice.the state forms on your policy will generally be very similar to one or more titles mend The changes d otherwise. In described below would also apply to those state specific forms, un made to the endorsements for coveess n ge forms,only addition,this notice does not reference every change material(or significant)changes. Please read your policy and review your declarations page for complete coverage infooumpto{ic n. No coverage(f there are is provided by this notice, nor can it be construed to replace any provisions of y y our policy and this notice, the provisions of the policy shall prevail. Should you discrepancies between y p lease contact your broker or agent.Thank you have questions after reviewing the changes outlined below,p for your business. With respect to bodily injury and property damage of coverage out of s inteor nt. Damagesclosure *related confidential to data personal information, these changes are a reinforcement n breaches, and certain data-related Ilabili ore appropriately not e covered under certain stain coverage elndo semeity ns parts. These types of damages may be m providing data compromise,attack and extortion and network security liability. Use With The Commercial General Liability Coverage CG 2106 05 14-Exclusion-Access Or Disclosure 0 Confidential Or Personal Information And Data-relate Liability-With Limited Bodily injury Exception (ForPart) When this endorsement is attached to your policy: Under Coverage A-Bodily Injury And Property Damage Liability,coverage is excluded for damages arising out of any access to or disclosure of confidential or personal information.This is a reinforce- ment of coverage. o Under Coverage B-Personal And Advertising Injury Liability,coverage is excluded for personal and advertising Injury arising out of any access to or disclosure of confidential or personal iforation nformation. In a oral To the extent that any access or disclosure of confidential privacy, than n result in a reduction In or written publication that violates a personright coverage. CG 2107 05 14-Exclusion-Access Or Disclosure Of Confidential i F rtiUse Or Personal The Commercial General Information Arid aLiabi Liability Liability = Limited Bodily injury Exception Not Included Coverage Part) When this endorsement is attached to your policy: es � Under Coverage A-Bodily Injury And Property confidential dential or peamage lrsonal informatioe is n Thisd for ls a relnfoc e- 1 arising out of any access to or disclosure result in a rent of coverage. However, when exception x eendorsement o t h respect to damages becauseof bodily reduction injury coverage due to the deletion of an exc p arising out of loss of, loss of use of, damage to, corruption of, inability to access, or Inability to manipulate electronic data. 0 2014 Liberty Mutual Insurance page 1 of 2 ,__,..� ..,—rinhred material of insurance Services office,Inc.,with its permission. • Under Coverage B-Personal And Advertising Injury Liability,coverage Is excluded for personal and advertising injury arising out of any access to or disclosure of confidential or personal information. ' To the extent that any access or disclosure of confidential or personal information results in an oral or written publication that violates a person's right of privacy, this may result in a reduction in coverage. CG 21 08 05 14 - Exclusion -Access Or Disclosure Of Confidential Or Personal Information (Coverage B Only) (For Use With The Commercial General Liability Coverage Part) When this endorsement is attached to your policy,coverage is excluded for personal and advertising injury arising out of any access*to or disclosure of confidential or personal information. To the extent that any access or disclosure of confidential or personal information results in an oral or written publication that violates a person's right of privacy,this may result in a reduction in coverage. CG 04 37 05 14-Electronic Data Liability(For Use With The Commercial General Liability Coverage Part) With respect to damages arising out of access or disclosure of confidential or personal information,when this endorsement is attached to your policy: a Under Coverage A-Bodily Injury And Property Damage Liability,coverage is excluded for damages arising out of any access to or disclosure of confidential or personal information.This Is a reinforce- ment of coverage. • Under Coverage B-Personal And Advertising injury Liability,coverage is excluded for personal and advertising injury arising out of any access to or disclosure of confidential or personal information. To the extent that any access or disclosure of confidential or personal information results in an oral or written publication that violates a person's right of privacy, this may result in a reduction in coverage. CG 33 53 05 14-Exclusion-Access Or Disclosure Of Confidential Or Personal Information And Data-related Liability - With Limited Bodily Injury Exception (For Use With The Owners And Contractors Protective Liability Coverage Part and Products/Completed Operations Coverage Part) When this endorsement is attached to your policy, coverage is excluded for damages arising out of any access to or disclosure of confidential or personal Information.This is a reinforcement of coverage. CG 33 59 05 14-Exclusion-Access Or Disclosure Of Confidential Or Personal Information And Data-related Liability-Limited Bodily Injury Exception Not included(For Use With The Owners And Contractors Protec- tive Liability and Products/Completed Operations Liability Coverage Parts) When this endorsement is attached to your policy, coverage Is excluded for damages arising out of any access to or disclosure of confidential or personal information.This is a reinforcement of coverage. ' I However, when this endorsement is attached,it will result in a reduction of coverage due to the deletion of ? an exception with respect to damages because of bodily injury arising out of loss of,loss of use of,damage to,corruption of,inability to access,or inability to manipulate electronic data. CG 33 63 05 14-Exclusion-Access,Disclosure Or Unauthorized Use Of Electronic Data(For Use With The Electronic Data Liability Coverage Part) With respect to damages arising out of access or disclosure of confidential or personal information, when this endorsement is attached to your policy coverage is excluded for damages arising out of any access to or disclosure of confidential or personal Information.This is a reinforcement of coverage. However,to the extent that damages arising out of theft or unauthorized viewing,copying,use,corruption, manipulation or deletion, of electronic data by any Named Insured, past or present employee, temporary worker or volunteer worker of the Named insured may extend beyond loss of electronic data arising out of such theft or the other listed items,this revision may be considered a reduction in coverage. a r i i 2014 Liberty Mutual Insurance NP 96 00 10 14 Includes co © pyrighted material of Insurance Services office,Inc.,with its P ermitslon. Page 2 of 2 j coverage is provided In: Policy Number. Liberty O BLS (17) 56 69 68 77 Ohio Security Insurance Company policy Period: mutual. From 05108/2015 To 05108120i7 INSURANCE 12.01 am Standard Time Common Polley Declarations at insured Mailing Location Named insured&Mailing Address Agent Mailing Address&Phons No. (360)352-7588 R F DUNCAN& ASSOCIATES, INC DUNCAN &ASSOCIATES INC PO BOX 12300 p0 BOX 1458 OLYMPIA,WA 98508 OLYMPIA,WA 98507-1458 Named Insured Is:CORPORATION Named Insured Business Is: REAL ESTATE APPRAISER Ira retrrna for tlae payntent of the premium, and subject to all the terms of this policy, the agree with yore to proride the insa ance as stated in this policy. SUMMARY OF COVERAGE PARTS AND CHARGES on Policy Declarations page, Common Policy Conditions, Coverage Parts This policy consists of this Comm (which consist of coverage forms and otter applicable forms and endorsements, if any, issued to form a part of them) and any otter forms and endorsements issued to be part of this policy. COVERAGE PART CHARGES Commercial General Liability $250.00 Total Charges for all of the above coverage parts: $250.00 Included) Certified Acts of Terrorism Coverage: $1.00 Note: This is not a bill IMPORTANT MESSAGES This policy is auditable. Please refer to the conditions of the policy for details or contact your agent. Servicing Offiee Western Washington Authorized Representative and Issue Date 03/14/16 NEW To report a claim, calf your Agent or 1-600-362-0000 %.f m no sc nr 1R Coverage Is Provided It Policy Number. u � Ohio Security insurance Company BLS (17) 56 69 63 77 Policy Period• INSURANCE Policy 05/08/2016 To 115/08/2017 Common Policy Declarations 12.01 am Standard Time at Insured Mailing Location Named Insured Agent R F DUNCAN& ASSOCIATES, INC (360) 352-7588 DUNCAN& ASSOCIATES INC POLICY FORMS AND ENDORSEMENTS This section lists the Forms and Endorsements for your policy. Refer to these documents as needed for detailed information concerning your coverage. FORM NUMBER TITLE CG 00 Ol 04 13 Commercial General Liability Coverage Form-Occurrence CG 018105 09 Washington Changes CG 0197 12 07 Washington Changes-Employment-Related Practices Exclusion CG 2106 05 14 Exclusion- Access Or Disclosure Of Confidential Or-Personal Information And Data-Related Liability-With Limited Bodily Injury Exception CG 2170 01 15 Cap on Losses from Certified Acts of Terrorism CG 2176 0115 Exclusion of Punitive Damages Related to a Certified Act of Terrorism. CG 22 24 04 13 Exclusion-Inspection, Appraisal and Survey Companies CG 24 26 04 13 Amendment of Insured Contract Definition CG 26 77 12 04 Washington- Fungi or Bacteria Exclusion CG 84 99 08 09 Non-Cumulation Liability Limits Same Occurrence CG 88 10 04 13 Commercial General Liability Extension CG 88 77 12 08 Medical Expense At Your Request Endorsement CG 89 27 10 09 Washington Exclusion-Asbestos 1L 0123 11 13 Washington Changes-Defense Costs IL 0146 08 10 Washington Common Policy Conditions IL.0198 09 08 Nuclear Energy Liability Exclusion Endorsement(Broad Form) i i In witness whereof, we have caused this policy to be signed by our authorized officers. i DIA f r ' Dexter Legg Paul Condrin Secretary President ' To report a claim,call your Agent or 1-8067-362-0909 DS 70 21 01 09 4116 56696377 N0280220 235 NCAOPPNO AGENTCOPY 000827 PAGE ie OF 18 Coverage Is Frovlded In: Policy Number: ty Ohio Security Insurance Company BLS (17) 5(i 69 ti3 TT Liber Policy Period: 10�mutuR From 05J0812016'fo 0510812017 INSURANCE commercial General Liab'llity 12,01 am standard rme DeeiarationS at Insured Marling Location Basis:occurrence Named Insured Agent R F DUNCAN &AS50CIATFS, INC (360) 352-7588DUNCAN&ASSOCIATES INC SUMMARY OF LIMITS AID CHARGES LIMIT Commercial DESCRIPTION 1,000,000 General Each Occurrence Limit 1,000,000 Liability Damage To Premises Rented To You Limit(Any One Premises) 15,000 Limits of Medical Expense Limit(Any One Person) Insurance 1,000,000 Personal and Advertising injury Limit 2,000,000 General.Aggregate Limit(Other than Products-Completed Operations) p p 2,000,000 Products-Completed operations Aggregate Limit PREMIUM Explanation of DESCRIPTION 169.00 Charges General Liability Schedule Totals 80.00-.. Policy Writingll'Iinimun-rPreiniunr Adjustment- -- - �- -- 1.00 Certified Acts of Terrorism Coverage Total Aduarace Charges: $250.00 Note: This is not a bill i To report a clalm,call yourAgent or 1-809-362.0000 nC 7n 22 01 08 AnrW rnRy OOOB27 PAGE 17 OF 19 Coverage Is Provided In: policy Number: Liberty► Ohio Security Insurance Company BLS (17}Number fig 63 77 Mutual. Policy Period: INSURANCE Commercial General Liability From 05/0812016 To 05/08/2017 Declarations Schedule 12:01'am Standard Time at Insured Mailing Location Named Insured Agent R P DUNCAN& ASSOCIATES, INC (360) 352-7588 DUNCAN&ASSOCIATES INC SUMMARY OF CLASSIFICATIONS - BY LOCATION 0001 909 Wes say 0r NW, OLYMPIA, WA 98502 Insured: R F DUNCAN&ASSOCIATES, INC CLASSIFICATION- 96317 - Inspection And Appraisal Companies-Inspecting For Insurance Or Valuation Purposes Products-Completed Operations Are Subject To The General Aggregate Limit. RATED J PER COVERAGE DESCRIPTION PREMIUM BASED ON- Executive Officers 1,000 PREMIUM Premise/Operations 17,800 Dollars Of Payroll 8.646 $154.00 Minimum Premium Adjustment $15.00 Total Included CLASSIFICATION- 96317 Inspection And Appraisal Companies- Inspecting For Insurance Or Valuation Purposes Products-Completed Operations Are Subject To The General j Aggregate Limit. RATED J PER COVERAGE DESCRIPTION PREMIUM BASED ON- Employees Payroll 1,000 PREMIUM Premise/Operations Dollars Of Payroll- if any 8.646 Total: Commercial General Liability Schedule Total $169.00 } i i To report a claim,caA your Agent or 1-800 362-0000 i DS 70 23 0108 116 56696377 N0280220 235 NCAOPPNO AGENTGOPY 000827 PAGE 18 OF 18 COMMERCIAL GENERAL LIABILITY CG oo 01 04 13 COMMERCIAL GENERAL LIABILITY COVERAGE FORM 1 b. This insurance applies to "bodily injury" Various provisions in this policy restrict coverage. and "property damage" only ifi: Read the entire policy carefully to determine Injury" oI "properly rights, duties and what is and is not covered. (1) The "bodily j Throughout this policy the words "you" and damage" is caused by an "occur- rence" that takes place in the "cov- "your° refer to the Named Insured shown in the erage territory"; Declarations, and any other person or organiza- y j " or "pro e lion qualifying as a Named Insured under this (2) The "bodil in ury P Hy policy. The words "we", "us" and "our" refer to damage" occurs during the policy the company providing this insurance. period; and —~ The word "insured" means any person or organl- (3) Prior to the policy period, no Insured zation qualifying as such under Section 11 -Who Is listed under Paragraph 1. of Section An Insured. li - Who Is An Insured and no "em- ployee" authorized by you to give or Other words and phrases that appear in quotation receive notice of an "occurrence" or I marks have special meaning. Refer to Section V - claim, knew that the "bodily injury" Definitions. or property damage" had occurred, in whole or in part. If such a listed ---- SECTION I -COVERAGES insured or authorized "employee" COVERAGE A - BODILY INJURY AND PROPERTY knew, prior to the policy period, that DAMAGE LIABILITY the "bodily injury" or"property dam- 1, insuring Agreement age" occurred, then any continu- a. We will pay those sums that the insured ation, change or resumption of such becomes legally obligated to pay as dam- "bodily injury" or "property dam- ages because of "bodily injury" or"prop- age" during or after the policy period erty damage to which this insurance ap- will be deemed to have been known plies. We will have the right and duty to prior to the policy period. defend the insured against any "suit" c. "Bodily injury" or "property damage" seeking those damages. However, we which occurs during the policy period will have no duty to defend the insured and was not, prior to the policy period, against any "suit" seeking damages for known to have occurred by any insured "bodily injury or property damage" to listed under Paragraph 1. of Section II - which this insurance does not apply. We Who Is An Insured or any "employee" au- may, at our discretion, investigate any thorized by you to give or receive notice "occurrence" and settle any claim or- of an occurrence or claim, includes any "suit" that may result. But: continuation, change or resumption of (1) The amount we will pay for damages that "bodily injury" or "property dam- is limited as described in Section III - age after the end of the policy period. Limits Of Insurance; and d. "Bodily injury" or "property damage" (2) Our right and duty to defend ends will be deemed to have been known to when we have used up the applica- have occurred at the earliest time when ble limit of insurance in the payment any insured listed under Paragraph 1. of of judgments or settlements under Section 11 - Who Is An Insured or any Coverages A or B or medical ex "employee" authorized by you to give or penses under Coverage C. receive notice of an "occurrence" or No other obligation or liability to pay claim: sums or perform acts or services is cov- (1) Reports all, or any part, of the "bod- ered unless explicitly provided for under ily injury" or "property damage" to 1 Supplementary Payments - Coverages A us or any other insurer; and B. (2) Receives a written or verbal demand or claim for damages because of the "bodily injury" or "property dam- age"; or other means c. Liquor Liability an (3) Becomes aware by Y "Bodily injury" or "property damage' for any ' that 'bodily injury' or 'property insured may be held liable by damage has occurred or has begun which reason of to occur. Causing or contributing to the intoxl- e. Damages because of 'bodily injury" in- {1) clude damages claimed by any person or cation of any person; (2} The famishing of alcoholic bever- organization for care, loss of services the ages ages to a person under the legal death resulting at any 9 drinking age or under the influence "bodily injury". of alcohol; or 2.. Exclusions (3) Any statute, ordinance or regulation This insurance does not apply to: relating to the sale, gift, distribution a. Expected Or Intended Injury or use of alcoholic beverages. "Bodily injury" or "property damage" ex This exclusion applies even if the claims pected or intended from the standpoint of against any insured allege negligence or the insured. This exclusion does not ap- other wrongdoing. in: ply to "bodily injury° resulting from the employ- use a The supervision, hiring, of reasonable force to protect per ( } ment, training or monitoring of sons or property. others by that insured; or b. Contractual Liability (b) Providing or failing to provide "Bodily injury" or "property damage" for transportation with respect to which the insured is obligated to pay any person that may be under damages by reason of the assumption of ,the influence of alcohol; liability in a contract or agreement. This ion does not apply to liability for if the 'occurrence" which a e ", t exclus bodily injury*' or"Property dama 9 h ; damages: volved that which is described in Para- (1) That the insured would have in the graph (1), (2) or(3) above. absence of the contract or agree- However, this exclusion applies only if meet; or you are in the business of manufacturing, (2) Assumed in a contract or agreement distributing, selling, serving or furnishing that is an "insured contract', pro- alcoholic beverages. For the purposes of vided the "bodily injury or proper- this exclusion, permitting a person to ty damage11 occurs subsequent to the bring alcoholic beverages on your prem- execution of the contract or agree- u ises, for consumption on your premises, ment. Solely for the purposes of li- whether or not a fee is charged or a li- ability assumed in an "'insured con- tense is required for such activity, is not tract", , reasonable attorneys' fees expenses in- by itself consdefumishng alcoholic business sell- and necessary litigation ing, serving o curred by or for a party other than an erages. insured are deemed to be damages d Workers' Compensation And similar s because of "bodily 'injury" or "prop- Laws erty damage", provided: a for, or for Any obligation of the insured under a (a) Liability to such party defense workers' compensation, disability bene- the cost of, that party fits or unemployment compensation law has also been assumed in the or any similar law. same "insured contract"; and (b) Such attorneys' fees and litiga- e. Employer's L;abillity Von expenses are for defense of Bodily injury against a civil or alter- (1) An "employee of the insured ads- An party • native dispute resolution pro- ing out of and in the course of: ` ceeding in which damages to (a) Employment by the insured; or which this insurance applies are (b) Performing duties related to the alleged. conduct of the insured's busi- ness-, or rrr oo 01 04 13 (2) The spouse, child, parent, brother or (ifi) "Bodily injury" or "property sister•of that "employee" as a con- damage" arising out of heal, sequence of Paragraph (1) above. smoke or fumes from a This exclusion applies whether the in- "hastile fire"; sured may be liable as an employer or in (b) At or from any premises, site or any other capacity and to any obligation location which is or was at any td share damages with or repay someone time used by or for any insured else who must•pay damages because of or others for the handling, stor- i the injury, age, disposal, processing or This exclusion does not apply to liability treatment of waste; assumed by the insured under an "in- (c) Which are or were at any time = sured contract". transported, handled, stored, f. Pollution treated, disposed of, or pro- (1) "Bodily injury" or "property dam- cessed as waste by or for age" arising out of the actual, (i) Any insured; or f al- leged or threatened discharge, (ii) Any person or organization dispersal, seepage, migration, re- for whom you may be legal- i lease or escape of "pollutants": ly responsible; or (a) At or from any premises, site or (d) At or from any premises, site or location which is or was at any location on which any insured or time owned or occupied by, or any contractors or subcontrac- rented or loaned to, any insured. fors working directly or indirect- However, this subparagraph ly on any insured's behalf are does not apply to: Iperforming operations if the (i) "Bodily injury" if sustained "pollutants" are brought on or to Within a building and caused the premises, site or location in by smoke, fumes, vapor or connection with such operations soot,produced by or origi- by such insured, contractor or nating from equipment that subcontractor. However, this is used to heat, cool or de- subparagraph does not apply to: humidify the building, or (i) "Bodily injury" or "property equipment that is used to damage" arising out of the heat water for personal use, escape of fuels, lubricants or by the building's occupants other operating fluids which or their guests; are needed to perform the • (ii) "Bodily injury" or "property normal electrical, hydraulic ' damage" for which you may or mechanical functions be held liable, if you are a necessary for the operation contractor and the owner or of "mobile equipment" or lessee of such premises, site its parts, if such fuels, or location has been added lubricants or other operating to your policy as an addi- fluids escape from a vehicle i tional insured with respect part designed to hold, store to your ongoing operations or receive them. This excep- performed for that addition- tion does not apply if the I ! al insured at that premises, "bodily injury" or "property I site or location and such damage" arises out of the premises, site or location is intentional discharge, not and never wAs owned or dispersal or release of the occupied by, or rented or fuels, lubricants or other op- loaned to, any insured, other erating fluids, or if such fu- i than that additional insured;. els, lubricants or other oper- or ating fluids are brought on r I or to the premises, site or lo- cation with the intent that they be discharged, dis- persed or released as part of GG 00 01 04 13 m ! Insurance Services Office, Inc., 2012 Page 3 of 17 r the operations being per- g. Aircraft, Auto Or Watercraft damage" formed by such insured, "Bodily injury" or "property contractor or subcontractor, arising out of the ownership, mainten- " (ti) Bodily injury" or "property ante, use or entrustment to others of any damage" sustained within a aircraft, "auto" or watercraft owned or building and caused by the operated by or rented or loaned to any release of gases, fumes or insured. Use includes operation and vapors from materials "loading or unloading". brought into that building in This exclusion applies even if the claims connection with operations against any insured allege negligence or being performed by you or other wrongdoing in the supervision, hir- on your behalf by a contrac- ing, employment, training or monitoring for or subcontractor, or of others by that insured, if the "occur rrr "Bodily injury" or "property rence' which caused the "bodily injury ( ) damage arising out of heat, or "property damage" involved the own- smoke or fumes from a ership, maintenance, use or entrustment "hostile fire". to others of any aircraft, "auto" or water- remises, site or craft that is owned or operated by or (e) At or from any p rented or loaned to any insured. location on which any insured or p to: any contractors or subcontrac- This exclusion does not a ply tors working directly or indirect (1) A watercraft while ashore on prem- ly on any insured's behalf are ises you own or rent; performing operations if the op- (2) A watercraft you do not own that is: erations are to test for, monitor, (a) Less than 26 feet long; and clean up, remove, contain, treat, detoxify or neutralize, or in any ( ) persons / b Not being used to carry p way respond to, or assess the ef- or property for a charge; fects of, "pollutants". (3) Parking an "auto" on, or on the ways (2) Any foss, cost or expense arising out next to, premises you own or rent, of any: provided the "auto" is not owned by nest, demand, order or state- or rented or loaned to you or the in- Request, sured; tory or regulatory requirement In- that any insured or others test (4) Liability u b�ty�assumedor lithe rownership, for, monitor, clean up, remove, contain, treat, detoxify or neu- maintenance or use of aircraft or tralize, or in any way respond to, watercraft; or or assess the effects of, "pollu- (5) "Bodily injury" or "property dam- tants"; or age" arising out of: (b) Claim or suit by or on behalf of a (a) The operation of machinery or governmental authority for dam- equipment that is attached to, or ages because of testing for, part of, a land vehicle that would monitoring, cleaning up, remov- qualify under the definition of ing, containing, treating, detox- "mobile equipment" if it were ifying or neutralizing, or in any not subject to a compulsory or way responding to, or assessing financial responsibility law or the effects of, "pollutants". other motor vehicle insurance However, this paragraph does not law where it is licensed or princi- apply to liability for damages be- pally garaged; or cause of "property damage" that the (b) The operation of any of the ma- insured would have in the absence of chinery or equipment listed in such request, demand, order or stat Paragraph f.(2) or f.(3) of the f utory or regulatory requirement, or definition of "mobile equip- such claim or "suit" by or on behalf ment". of a governmental authority. h. Mobile Equipment (6) That particular part of any property "Bodily injury" or "property damage" that must be restored, repaired or re- arising out of: placed because "your work" was in- t (1) The transportation of"mobile equip- correctly performed on it. ment' by an "auto" owned or oper- Paragraphs (1), (3) and (4) of this exclu- ated by or rented or loaned to any sion do not apply to "property damage" insured; or (other than damage by fire) to premises, including the contents of such premises, {2) The use of"mobile equipment" in, or reefed to you for a period of seven or while in practice for, or while being fewer consecutive days. A separate limit prepared for, any prearranged vac- of insurance applies to Damage To Prem- ing, speed, demolition, or stunting ises Rented To You as described in Sec- ; activity. Lion III-Limits Of Insurance. I. War Paragraph (2) of this exclusion does not "Bodily injury" or "property damage", apply if the premises are 'your work" however caused, arising, directly or Ind!- and were never occupied, rented or held rectly, out of for rental by you. (1) War, including undeclared or civil Paragraphs (3), (4), (5) and (6) of this ex- war, elusion do not apply to liability assumed (2) Warlike action by a military force, in- under a sidetrack agreement. = eluding action in hindering or de- Paragraph (6) of this exclusion does not fending against an actual or expect- apply to "property damage" included in ad attack, by any government, the "products-completed operations haz- sovereign or other authority using ard• military personnel or other agents; k. Damage To Your Product or "Property damage" to "your product" (3) Insurrection, rebellion, revolution, arising out of it or any pan` of it. usurped' power, or action taken by governmental authority in hindering 1. Damage To Your Work or defending against any of these. "Property damage" to "your work" aris- j. Damage To Property ing out of it or any part of it and included "Property damage" to: in the "products-completed operations hazard". (1) Property you own, rent, or occupy, This exclusion does 'eat apply if the Including any costs or expenses in- damaged ,work or the work out of which ' curved by you, or any other person; the damage arises was performed on organization or entity, for repair, re- your behalf by a subcontractor. placement, enhancement, restora- tion or maintenance of such property m. Damage To Impaired Property Or Prop- for any reason, including prevention arty Not Physically Injured of injury to a person or damage to "Property damage" to "impaired proper- another's property; ty" or property that has not been phys- (2) Premises you sell, give away or ically injured, arising out of: , abandon, if the "property damage" (1) A defect, deficiency, inadequacy or arises out of any part of those prem- dangerous condition in "your prod- ises; uct' or"your work"; or (3) Property loaned to you; (2) A delay or failure by you or anyone (4) Personal property in the care, custo- acting on your behalf to perform a contract or agreement in accordance , dy or control of the insured; 5 That articular property with its terms. . ( ) p part of realI on which you or any contractors or This exclusion does not apply to the loss subcontractors working directly or of use-of other property arising out of Indirectly on. your behalf are per- sudden and accidental physical injury to forming operations, if the "property "your product" or "your work" after it i damage" arises out of those oper- has been put to its intended use. I ations; or GG 00 01 04 13 O Insurance Services Office, Inc., 2012 Page 5 of 17 ` t i (4) Any federal, state or local statute, or- n. Recall Of Products, Work Or Impaired dinance or regulation, other than the Property TCPA, CAN-SPAM Act of 2003 or Damages claimed for any loss, cost or ex d ad- FCRA and their amendments an you or others for the ditions, that addresses, prohibits, or loss se incurred by Y limits the printing, dissemination, loss of use, withdrawal, recall, Inspec- send- tlon, repair, replacement, adjustment, re- disposal, collecting, recording, ing, transmitting, communicating or mova{ or disposal of of material or informa- (1) "Your product";. distribution (2) "Your work`; or ton. to dam- Exclusions c.through n. do not apply (3) "Impaired property"; age by fire to premises while rented to you or if such product, work, or property is with- temporarily occupied by you with permission drawn or recalled from the market or of the owner. A separate limit of insurance from use by any person or organization applies to this coverage as described in Sec- because of a known or susopecteed defect, us tion III -Limits Of Insurance. deficiency, inadequacy condition in it. COVERAGE B - PERSONAL AND ADVERTISING o, Personal And Advertising Injury INJURY LIABILITY "Bodily injury" arising out of "personal 1. Insuring Agreement and advertising injury". a. We will pay those sums that the insured becomes legally obligated to pay as dam- p. Electronic Data t of the loss of, loss ages because of "personal and advert�s- Damages arising ou of use of, damage to, corruption of, in- ing injury" to which this 'insurance ap- We will have the right and du to ability to access, or inability to manipu- plies. u against any V late electronic data. defend the insured seeking those damages. However, we However, this exclusion does not apply will have no duty to defend the insured to liability for damages because of "bod- against any "suit~' seeking damages for ily injury". "personal and advertising injury" to As used in this exclusion, electronic data which this insurance does not apply- We means information, facts or programs may, at our discretion, investigate any of stored as or on, created or u uter o softr fense and settle any claim or "suit" that transmitted to or from computer may result. But: ware, including systems and app The amount we will pay for damages software, hard or floppy disks, CD-ROMs, - is limited as described in Section ll! - tapes, drives, cells, data processing de Limits Of Insurance; and vices or any other media which are used ipment. (2) Our right and duty to defend end with electronically controlled equ when we have used up the applica q, Recording And Distribution Of Material ble limit of insurance in the payment Or Information In Violation of Law of judgments or settlements under "Bodily injury" or "property damage" Coverages A or B or medical ex- arising directly or indirectly outpenses under Coverage C. tion or omission that violates or is al- No other obligation or liability to pay leged to violate: sums or perform acts or services is cov- (1) The Telephone Consumer Protection ered unless explicitly provided for under Act (TCPA), including any amend- Supplementary Payments - Coverages A ment of or addition to such law; and B. b. This insurance pplies to "persona{ and a (2) The CAN-SPAM Act of 2003, includ- caused b an offense ing any amendment of or addition to advertising injury" Y such law; arising out of your business but only if { (3) The Fair Credit Reporting Act (FCRA), the offense was committed in the "cov- and any erage territory" during the policy period. amendment of or addition to such law, including the Fair and Ac- curate Credit Transactions Act (FACTA); or 2. Exclusions i. Infringement Of Copyright, Patent, This insurance does not apply to: Trademark Or Trade Secret ' a. Knowing Violation Of Rights Of Another "Personal and advertising injury" arising "Personal and advertising injury" caused out of the infringement of copyright, pat- by or at the direction of the insured with ent, trademark, trade secret or other in- the knowledge that the act would violate tellectual property rights. Linder this ex- the rights of another and would inflict elusion, such other intellectual property " rights do not include the use of another's personal and advertising injury". advertising idea in your "advertisement". b. Material Published With Knowledge Of However, this exclusion does not apply Falsify to infringement, in your "advertisement", --' "Personal and advertising injury" arising of copyright, trade dress or slogan. out of oral or written publication, in any manner, of material, if done by or at the !• Insureds In Media And Internet Type direction of the insured with knowledge Businesses of its falsity. "Personal and advertising injury" com- c. Material Published Prior To Policy Period miffed by an insured whose business is: "Personal and advertising injury" arising (1) Advertising, broadcasting, publish- out of oral or written publication, in any ing or Telecasting; manner, of material whose first publica- (2) Designing or determining content of tion took place before the beginning of web sites for others; or the policy period. (3) An Internet search, access, content d. Criminal Acts or service provider, i "Personal and advertising injury" arising However, this exclusion does not apply out of a criminal act committed by or at to Paragraphs 14.a., b. and c. of "person- the direction of the insured. al and advertising injury" under the Defi- e. Contractual Liability nitions section. "Personal and advertising injury" for For the purposes of this exclusion, the placing of frames, borders or links, or ad- which the insured has asstirned liability in a con-tract or agreement This exciu- veriising, for you or others anywhere on the Internet, sion does not apply to liability for dam- ages that the insured would have in the the business of advertising, broadcast- absence of the contract or agreement ing, publishing or telecasting. f, Breach Of Contract k. Electronic Chatrooms Or Bulletin Boards "Personal and advertising injury" arising "Personal and advertising injury" arising out of a breach of contract, except an im- out of an electronic chafroom or bulletin plied contract to use another's adverbs- board the insured hosts, owns, or over ; ing idea in your "advertisement". which the insured exercises control. Unauthorized Use Of Another's Name Or g. Quality Or Performance Of Goods - Fail- i. Product ure To Conform To Statements "Personal and advertising injury arising "Personal and advertising injury" arising ! out of the failure of goods, products or out of the unauthorized use of another's services to conform with any statement name or product in your e-mail address, of quality or performance made in your domain name or metatag, or any other "advertisement". similar tactics to mislead another's po- tential customers. h. Wrong Description Of Prices � m. Pollution "Personal and advertising injury arising out of the wrong description of the price "Personal and advertising injury" arising of goods, products or services stated in out of the actual, alleged or threatened your "advertisement". discharge, dispersal, seepage, migration, release or escape of "pollutants" at any time. f i i I CG 00 01 04 13 o Insurance Services Office, Inc., 2012 Page T of 17 R, PoI[utlon-reEated (4) Any federal, state or local statute, or- dinance or regulation, other than the Any loss, cost or expense arising out of TCPA, CAN-SPAM Act of 2D03 or any: FCRA and their amendments and ad- (1) Request, demand, order or statutory ditions, that addresses, prohibits, or or regulatory requirement that any limits the printing, dissemination, insured or others test for, monitor, disposal, collecting, recording, send- clean up, remove, contain, treat, de- ing, transmitting, communicating or to)* or neutralize, or in any way re- distribution of material or informa- spond to, or assess the effects of, tion. "pollutants"; or COVERAGE C-MEDICAL PAYMENTS (2) Claim or suit by or on behalf of a 1 Insuring Agreement governmental authority for damages .because of testing for, monitoring, a. We will pay medical expenses as de- scribed below for "bodily injury" caused cleaning up, removing, containing, id treating, detoxifying or neutralizing, by an accent or in any way responding to, or as- (1) On premises you own or rent; sessing the effects of, "pollutants". (2) On ways next to premises you own o. War or rent; or "Personal and advertising injury", how- (3) Because of your operations; ever caused, arising, directly or indirect provided that: ly, out of: (a) The accident takes place in the (1) War, including undeclared or civil "coverage territory' and during war, the policy period; (2) Warlike action by a military force, in- (b) The expenses are incurred and (' cluding action in hindering or de- reported to us within one year of fending against an actual or expect the date of the accident; and ed attack, by any government, (c) The injured person submits to sovereign or other authority using examination, at our expense, by military personnel or other agents; physicians of our choice as often or as we reasonably require. (3) Insurrection, rebellion, revolution, b. We will make these payments regardless usurped power, or action taken by of fault. These payments will not exceed governmental authority in hindering the applicable limit of insurance. We will or defending against any of these. pay reasonable expenses for: p. Recording And Distribution Of Material (1) First aid administered at the time of Or information In Violation Of Law an accident; "Personal and advertising injury" arising (2) Necessary medical, surgical, X-ray directly or indirectly out of any action or and dental services, including pros- omission that violates or is alleged to vio- thetic devices; and late: (3) Necessary ambulance, hospital, pro- (1) The Telephone Consumer Protection fessional nursing and funeral ser- Act (TCPA), including any amend- vices. ment of or addition to such law; 2 Exclusions (2) The CAN-SPAM Act of 2003, includ- We will not pay expenses for "bodily injury": ing any amendment of or addition to a. Any insured such law; (3) The Fair Credit Reporting Act (FCRA), To any insured, except "volunteer and any amendment of or addition to workers". such law, including the Fair and Ac- b. Hired Person ( curate Credit Transactions Act To a person hired to do work for or on (FACTA); or behalf of any insured or a tenant of any i insured. . I C. Injury On Normally Occupied Premises g• All interest on the full amount of any To a person injured on that part of prem- judgment that accrues after entry of the ises you own or rent that the person nor- judgment and before we have paid, of- i mally occupies. fered to pay, or deposited in court the part of the judgment that is within the ap- d. Workers' Compensation And Similar plicable limit of insurance. Laws These payments will not reduce the limits of I To a person, whether or not an "employ- insurance. 11 - ee" of any insured, if benefits for the " j _ 2. If we defend an insured against a suit" and "bodily injury" are payable or must be an indemnitee of the insured is also named as provided under a workers' compensation " or disability benefits law or a similar law. a party to the suiY', we will defend that indemnitee if all of the following conditions ' e. Athletics Activities are met: I To a person injured while practicing, in- a. The "suit" against the indemnitee seeks structing or participating in any physical. damages for which the insured has as- exercises or games, sports, or athletics sumed the liability of the indemnitee in a contests. contract or agreement that is an "insured ' f. Products-Completed Operations Hazard contract"; Included within the "products-completed b. This insurance applies to such liability operations hazard". assumed by the insured; I g. Coverage A Exclusions c. The obligation to defend, or the cost of Excluded under Coverage A. the defense of, that indemnitee, has also SUPPLEMENTARY PAYMENTS - COVERAGES A been assumed by the insured in the same 'insured contract'; AND B 1. We will pay, with respect to any claim we in- d. The allegations in the "suit' and"the in- vestigate or settle, or any "suit" against an formation we know about the occur- insured we defend: rence are such that no conflict appears to exist between the interests of the in- a. All expenses we incur. sured and the interests of the b. Up to $250 for cost of bail bonds required indemnitee; because'of accidents or traffic law viola- e. The indemnitee and the insured ask us to Lions arising out of the use of any vehicle conduct and control the_ defense of that to which the Bodily Injury' Liability Cov- indemnitee against such "suit" and agree erage applies. We do not have to furnish that we can assign the same counsel to these bonds. defend the insured and the indemnitee; c. The cost of bonds to release attachments, and I but only for bond amounts within the ap- f. The indemnitee: j plicable limit of insurance. We do not (1) Agrees in writing to: have to furnish these bonds. d. All reasonable expenses incurred by the (a) Cooperate with us in the inves- I Ligation, settlement or defense r insured at our request to assist us in the of the "suit"; investigation or defense of the claim or ' "suit", including actual loss of earnings (b) Immediately send us copies of up to $250 a day because of time'off from any demands, notices, sum- work. monses or legal papers received in connection with the "suit"; e. All court costs taxed against the insured in the "suit". However, these payments (c} Notify any other insurer whose 1 do not include attorneys' fees or attor- coverage is available to the neys' expenses taxed against the in- indemnitee; and sured. (d). Cooperate with us with respect f. Prejudgment interest awarded against to coordinating other applicable the insured on that part of the judgment insurance available to the we pay. If we make an offer to pay the indemnitee; and applicable limit of insurance, we will not pay any prejudgment interest based on that period of time after the offer. CG 00 01 04 13 m Insurance Services Office, Inc., 2012 Page 9 of 17 e. A trust, you are an insured. Your trustees (2) Provides us with written authoriza- are also insureds, but only with respect lion to: to their duties as trustees. (a) Obtain records and other infor- mation related to the "suit"; and 2. Each of the following is also an insured: (b) Conduct and control the defense a. Your "volunteer workers" only while per- of the indemnitee in such "suit". forming duties related to the conduct of your business, or your "employees", oth- So long as the above conditions are met, at- er than either your "executive pfficers" (if tomeys' fees incurred by us in the defense of you are an organization other than a part- that indemnitee, necessary litigation ex- nership, joint venture or limited liability penses incurred by us and necessary libga- company) or your managers (9 you are a tion expenses incurred by the indemnitee at limited liability company), but only for ovr request will be paid as Supplementary acts within the scope of their.employ- Payments. Notwithstanding the provisions of ment by you or while performing duties Paragraph 2.b.(2) of Section I - Coverage A - related to the conduct of your business. Bodily Injury And Property Damage Lability, However, none of these "employees" or such payments will not be deemed to be °volunteer workers" are insureds for: damages for "bodily injury" and "property " or "personal and ad- 1 damage" and will not reduce the limits of in- ( ) "Bodily injury p vertising injury": surance. (a) To you, to your partners or Our obligation to defend an insured's members (if you area partner- indemnitee and to pay for attorneys fees and ship or joint venture), to your necessary litigation expenses as Supplemen- members (if you are a limited fl- tary Payments ends when we have used up ability company), to a co applicable limit of insurance in the pay- ployee" while ) the course of ment of judgments or settlements or the con- his or her employment or per- t ditions set forth above, or the terms of the forming duties related to the agreement described in Paragraph f. above, conduct of your business, or to are no longer met. your other volunteer workers" SECTION 11-WHO 15 AN INSURED while performing duties related 1. If you are designated in the Declarations as: to the conduct of yqur business; a. An individual, You and your spouse are (b) To the spouse, child, parent, insureds, but only with respect to the brother or sister of that co- "em- conduct of a business of which you are ployee" or "volunteer worker" the sole owner. as a consequence of Paragraph b. A partnership or joint venture, you are an (1)(a) above;( insured. Your members, your partners, c) For which there is any obligation and their spouses are also insureds, but to share damages with or repay only with respect to the conduct of your someone else who -must pay business. damages because of the injury you are an described in.Paragraph (1)(a) or c. A limited liability company, Y b above; or i insured. Your members are also in- (d) Arising out of his or her provid- sureds, but only with respect to the con- duct of your business. Your managers are ing or failing to provide profes- insureds, but only with respect to their sional health care services. duties as your managers. (2) "Property damage" to property: d. An organization other than a partnership, (a) Owned, occupied or used by; joint venture or limited liability company, (b) Ranted to, in the care, custody or you are an insured. Your "executive of- control of, or over which phys- ficers" and directors are insureds, but ical control is being exercised for only with respect to their duties as your any purpose by; officers or directors. Your stockholders are also insureds, but only with respect uonteernyworkers",of your "e any Ye partner or to their liability as stockholders. member (if you are a partnership or joint venture), or any member (if you are a limited liability company). nt .fI b. Any person (other than your "employee" b. Damages under Coverage A, except dam- or "volunteer worker"), or any organiza- ages because of"bodily injury" or "prop- bon while acting as your real estate man- arty damage" included in the 'products- ager. completed operations hazard"; and c. Any person or organization having prop- c. Damages under Coverage B. er temporary custody of your property if 3. The Products-Completed Operations Aggre- you die, but only. gate Limit is the most we will pay under (1) With respect to [lability arising out of Coverage A for damages because of "bodily the maintenance or use of that prop- injury" and "property damage" . included in erty; and the "products-completed operations hazard". _ (2) Until your legal representative has 4. Subject to Paragraph 2. above, the Personal been appointed. And Advertising Injury Limit is the most we d. Your legal representative if you die, but will pay under Coverage B for the sum of all _ only with respect to duties as such. That damages because of all "personal and adver- representative will have all your rights using injury" sustained by any one person or and duties under this Coverage Part. organization. 3. Any organization you newly acquire or form, �- Subject to Paragraph 2. or 3. above, which- = other than a partnership, joint venture or ever applies, the Each Occurrence Limit is the limited liability company, and over which you most we will pay for the sum of: _— maintain ownership or majority interest, will a. Damages under Coverage A;and qualify as a Named Insured if there is no oth- b. Medical expenses under Coverage C er similar insurance available to that organi- zation. However. because of all "bodily injury" and "properly damage" arising out of any one "occur- I a. Coverage under this provision is afforded rence". only until the 90th day after you acquire 6. Subject to Paragraph 5. above, the Damage or form the organization or the end of the To Premises Rented To You Limit is the most Policy period, whichever is earlier, we will pay under Coverage A for damages b. Coverage A.does not apply to "bodily in- because of "property damage" to any one jury" or"property damage" that occurred premises, while rented to you, or in the case before you acquired or formed the orga- of damage by fire, while rented to you or tem- nization; and porarily occupied by you with permission of c. Coverage B does not apply to "personal the owner. and advertising injury" arising out of an 7. Subject to Paragraph 5. above, the Medical offense committed before you acquired Expense Limit is the most we will pay under or formed the organization. ' Coverage C for all medical expenses because No person or organization is an insured with re- of "bodily injury" sustained by any one per- spect to the conduct of any current or past part son. nership, joint venture or limited liability company The Limits of Insurance of this Coverage Part ap- that is not shown as a Named Insured in the Dec- ply separately to each consecutive annual period larations. and to any remaining period of less than 12 SECTION III -LIMITS OF INSURANCE months, starting with the beginning of the policy 1. The Limits of Insurance shown in the Declara- period shown in the Declarations, unless the pol!- tions and the rules below fix the most we will cy period is extended after issuance for an add!- pay regardless of the number of: tional period of less than 12 months. In that case, the additional period will be deemed part of the a, insureds; last preceding period for purposes of determining b. Claims made or "suits" brought; or the Limits of Insurance. c. Persons or organizations making claims SECTION 1V - COMMERCIAL GENERAL or bringing "suits". LIABILITY CONDITIONS 2. The General Aggregate Limit is the most we 1. Bankruptcy will pay for the sum of: Bankruptcy or insolvency of the insured or of a. Medical expenses under Coverage C; the insured's estate will not relieve us of our I ! obligations under this Coverage ParL i i I CG 00 01 04 13 m Insurance Services Office, Inc., 2012 Page 11 of 17 i ` 2. Duties in The Event Of Occurrence, Offense, q person or organization may sue us to re- cover on an agreed settlement or on a final Claim Or Suit judgment against an insured; but we will not a. You must see to it that we are notified as be liable for damages that are not payable un- soon as practicable of an "occurrence" or der the terms of this Coverage Part or that are an offense which may result in a claim. in excess of the applicable limit of insurance. To the extent. possible, notice should in- An agreed settlement means a settlement clude: and release of liability signed by us, the in- (t) How, when and where the "occur- sured and the claimant or the claimant's legal rence" or offense took place; representative. (2) The names and addresses of any in- 4. Other Insurance jured persons and witnesses; and if other valid and collectible insurance is (3) The nature and location of any injury available to the insured for a loss we cover or damage arising out of the "occur- under Coverages A or B of this Coverage Part, rence" or offense. our obligations are limited as follows: b. If a claim is made*or "suit' is brought a. Primary Insurance against-any insured, you must This insurance is primary except when (t) immediately record the specifics of Paragraph b. below applies. If this insur- the claim or "suit" and the date re- ance is primary, our obligations are not ceived; and affected unless any of the other insur- (2) Notify us as soon as practicable. ance is also primary. Then, we will share You must see to it that we receive written with all that other insurance by the meth- od described in Paragraph c. below. notice of the claim or "suit" as soon as b Excess Insurance practicable. c. You and any other involved insured (1) This insurance is excess over. (. must: (a) Any of the other insurance, whether primary, excess, contin- gent or on an (t) Immediately send us copies of any other basis: demands, notices, summonses or le- y gal papers received in connection (i) That is Fire, Extended Cov- with the claim or"suit"; erage, Builder's Risk, Instal- lation Risk or similar (2) Authorize us to obtain records and coverage for "your work"; other information; That is Fire insurance for (3) Cooperate with us in the investiga- premises rented to you or tion or settlement of the claim or de- temporarily occupied by you fense against the "suit"; and request, in the with permission of the own- (4) Assist us, upon our g er, enforcement of any right against any person or organization which may be (iii) That is insurance purchased by you to cover your liability liable to the insured because of in- as a tenant for "properly jury or damage to which this insur- damage" to premises rented ance may also apply, to you or temporarily occu- d. No insured will, except at that insured's pied by you with permission own cost, voluntarily make a payment, of the owner, or s assume any obligation, or incur any ex- (iv) If the loss arises out of the pense, other than for first aid, without our maintenance or use of air- consent. craft, "autos" or watercraft 3. Legal Action Against Us to the extent not subject to No person or organization has a right under Exclusion g. of ,Section I - this Coverage Part: Coverage A - Bodily Injury a. To join us as a party or otherwise bring And Property Damage Li- us into a "suit" asking for damages from ability. an insured; or b'. To sue us on this Coverage Part unless all of its terms have been fully complied with. (b) Any other primary insurance b. Premium shown in this Coverage Part as available to you covering liabil- advance premium is a deposit premium ity for damages arising out of the only. At the close of each audit period we premises or operations, or the will compute the earned premium for products and completed oper- that period and send notice to the first ations, for which you have been Named Insured. The due date for audit added as an additional insured. and retrospective premiums is the date (2) When this insurance is excess, we shown as the due date on the bill. If the will have no duty under Coverages A sum of the advance and audit premiums f or B to defend the insured against paid for the policy period is greater than any "suit" if any other insurer has a the earned premium, we will return the duty to defend the insured against excess to the first Named Insured. that *suit'. If no other insurer de- c. The first Named Insured must keep i fends, we will undertake to do so, but records of the information we need for 4 we will be entitled to the insured's premium computation, and send us rights against all those other insur- copies at such times as we may request. I ern. 6. Representations (3) When this insurance is excess over By accepting this policy, you agree: other insurance, we will pay only our a.' The statements in the Declarations are share of the amount of the loss, if accurate and complete; any, that exceeds the sum of. (a) The total amount that all such b. Those statements are based upon repre- other insurance would pay for sentations you made to us; and the loss in the absence of this in- c. We have issued this policy in reliance surance; and upon your representations. (b) The total of all deductible and 7. Separation Of Insureds self-insured amounts under all Except with respect to the Limits of Insur- that other insurance. ancb, and any rights or duties specifically as- (4) We will share the remaining loss, if signed in this Coverage Part to the first any, with any other insurance that is Named Insured, this insurance applies: not described in this Excess Insur- a. As if each Named Insured were the only ante provision and was not bought Named Insured; and specifically to apply in excess of the b. Separately to each insured against whom Limits of Insurance shown in the claim is made or"suit" is brought. Declarations of this Coverage Part. g_ Transfer Of Rights Of Recovery Against Oth- c. Method Of Sharing ers To Us If all of the other insurance permits con- If the insured has rights to recover all or part tribution by equal shares, we will follow of any payment we have made under this this method also. Under this approach Coverage Part, those rights are transferred to each insurer contributes equal amounts us. The insured must do nothing after loss to until it has paid its applicable limit of in- impair them. At our request, the insured will surance or none of the loss remains, bring "suit" or transfer those rights to us and whichever comes first help us enforce them. If any of the other insurance does not per- g_ When We Do Not Renew mit contribution by equal shares, we will If-we decide not to renew this Coverage Part, contribute by limits. Under this method, In- each insurer's share is based on the ratio we will mail or deliver to the first Named In- , sured shown in the Declarations written no- of its applicable limit of insurance to the total applicable limits of insurance of all tice of the nonrenewal not less than 3t) days before the expiration date. insurers. If notice is mailed, proof of mailing will be S. Premium Audit sufficient proof of notice. a. We will compute all premiums for this Coverage Part in accordance with our i rules and rates. ' f E CG 00 Of 04 13 © Insurance Services Office, Inc., 2012 Page 13 of 17 (3) "Personal and advertising injury" SECTION V-DEFINITIONS offenses that flake place through the 1. "Advertisement' means a notice that is Internet or similar Electronic means broadcast or published to the general public of communication; or specific market segments about Your provided the insured's responsibility to pay goods, products or services for the purpose of dams es is determined in a 'suit' on the attracting customers or supporters. For the merits, in the territory described in Paragraph purposes of this definition: a.above or in a settlement we agree to. a. Notices that are published .include mate- rial placed on the Internet or on similar 5. "Employee" includes a "{eased worked'. electronic means of communication; and "Employee" does not include a "temporary worker. b. Regarding web sites, only that part of a " web site that is about your goods, pro- 6. "Executive offices" means a person holding ducts or services for the purposes of at any of the officer positions created by your tracting customers or supporters is con- charter, constitution, bylaws or any other sidered an advertisement. similar governing document. T. "Hostile fire" means one which becomes un- 2. "Auto" means: controllable or breaks out from where it was a. A land motor vehicle, trailer or intended to be. semitrailer designed for travel on public 8 impaired property" means tangible proper- roads, including any attached machinery ty, other than "your product" or "your work", or equipment; or that cannot be used or is less useful because: b. Any other land vehicle that is subject to a compulsory or financial responsibility a. It incorporates "your product" or "your law or other motor vehicle insurance law work" that is known or thought to be de- fective, deficient, inadequate or danger- where it is licensed or principally ga- ous; or raged. b. You have failed to fulfill the terms of a However "auto" does not include "mobile contracf or agreement; equipment'. if such property can be restored to use by the 3. "Bodily injury means bodily injury, sickness or disease sustained by a person, including Pair, replacement, adjustment or removal re d of "your product" or "your work" or your ful- eath resulting from any of these at any time. filling the terms of the contract or agreement. 4. "Coverage territory" means: 9. Insured contract" means: a. The United States of America (including a A contract for a lease of premises. How- its territories and possessions), Puerto ever, that portion of the contract for a Rico and Canada; lease of premises that indemnifies any b. Intemational waters -or airspace, but only person or organization for damage by fire if the injury or damage occurs in the to premises while rented to you or tem- course of travel or transportation be porarily occupied by you with permission tween any places included in Paragraph of the owner is not an "insured contract"; a. above; or b. A sidetrack agreement; c. All other parts of the world if the injury or c. Any easement or license agreement, ex- damage arises out of: cept in connection with construction or (1) Goods or products made or sold by demolition operations on or within 50 you in the territory described in Para- feet of a railroad; graph a.above; d. An obligation, as required by ordinance, (2) The. activities of home is in the territory described in connection with work for a municipality-, --Paragraph a. above, but is away for a e. An elevator maintenance agreement; short time on your business; or I f. That part of any other contract or agree- b. While it is in or on an aircraft, watercraft ment pertaining to your business (Includ- or "auto"; or ing an indemnification of a municipality c. While it is being moved from an aircraft, in connection with work performed for a watercraft or "auto" to the place where it r municipality) under which you assume is finally delivered; the tort liability of another party to pay but "loading or unloading" does not include for "bodily injury" or "property damage" the movement of property by means of a me- to a third person or organization. Tort li- chanical device, other than a hand truck, that ability means a liability that would be im- is not attached to the aircraft, watercraft or posed by law in the absence of any con- "auto" , tract or agreement. Paragraph f. does not include that part of 12. "Mobile equipment" means any of the fol- lowing types of land vehicles, including any any contract or agreement attached machinery or equipment: (1) That indemnifies a railroad for "bad- a. Bulldozers, farm machinery, forklifts and l ily injury" or. "property damage" other vehicles designed for use principal- fI arising out of construction or ly off public roads; demolition operations, within 50 feet of any railroad property and affecting b. Vehicles maintained for use solelj+ on or i any railroad bridge or trestle, tracks, next to premises you own or rent; road-beds, tunnel, underpass or c. Vehicles that travel on crawler treads; crossing; d. Vehicles, whether self-propelled or not, (2) That indemnifies an architect, engi- maintained primarily to provide mobility neer or surveyor for injury or dam- to permanently mounted: age arising out of: (1) Power cranes, shovels, loaders, dig- (a) Preparing, approving, or failing gers or drills; or to prepare or approve, maps, (2) Road construction or resurfacing shop drawings, opinions, re- equipment such as graders, scrapers ports, surveys, field orders, or rollers; change orders or drawings and e. Vehicles not described in Paragraph a., specifications; or b., c. or d. above that are not self- (b) Giving directions or instructions, propelled and are maintained primarily to or failing to give them, if that is provide mobility to permanently attached the primary cause of the injury equipment of the following types: or damage; or (1) Air compressors, pumps and gener- (3) Under which the insured, if an archi- ators, including spraying, welding, sect, engineer or surveyor, assumes building cleaning, geophysical ex- liability for an injury or damage aris- ploration, lighting and well servicing ing out of the insured's rendering or equipment; or failure to render professionai ser- (2) Cherry pickers and similar devices vices, including those its#ed in (2) used to raise or lower workers; above and supervisory, inspection, architectural or engineering activi- f. Vehicles not described in Paragraph a., ties. b., c. or d. above maintained primarily for 10. "Leased worker" means a person leased to purposes ocher than the transportation of you by a labor leasing firm under an agree- persons or cargo. , ment between you and the labor leasing firm, However, self-propelled vehicles with the to perform duties related to the conduct of following types of permanently attached i your business. "Leased worker" does not in- equipment are not "mobile equipment" j elude a"temporary worker". but will be considered "autos": 11. "Loading. or unloading" means the handling (1) Equipment designed primarily for: of property: (a) Snow removal; a. 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Means: use shall be deemed to occur at the time , of the "occurrence" that caused it (1) Any goods or products, other than real property, manufactured, sold, For the purposes of this Insurance, electronic handled, distributed or disposed of data is not tangible property. by: As used in this definition, electronic data (a) You; means information, facts or programs stored (b) Others trading under your name; as or on, created or•used on, or transmitted to or or from computer software, including sys- tems and applications software, hard or flop- (c) A person or organization whose —' py disks, CD-ROMs, tapes, drives, cells, data business or assets you have ac- processing devices or any other media which quired; and are used with electronically controlled equip- (2) Containers (other than vehicles), ma- ment. 1 I terials, parts or equipment furnished i 18. "Suit" means a civil proceeding In which in connection 'with such goods or damages because of "bodily injury", "prop- products. _ erty damage", or "personal and advertising b. Includes: injury" to which this insurance applies are al- (1) Warranties or representations made leged. "suit" includes: at any time with respect to the fit- _ a. An arbitration proceeding in which such ness, quality, durability, perfor- damages are claimed and to which the mance or use of"your product"; and insured must submit or does submit with (2) The providing of or failure to provide our consent; or warnings or instructions. b. Any other alternative dispute resolution c. Does not include vending machines or proceeding In which such damages are other property rented to or located for the claimed and to which the insured sub- use of others but not sold. mits with our consent. 22. "Your work": 19. 'Temporary worker" means a person who is a. Means: furnished to you to substitute for a permanent "employee" on leave or to meet seasonal or (1) Work or operations performed by short-term workload conditions. you or on your behalf; and 20. "Volunteer worker" means a person who is (2) Materials, parts or equipment fur- not your "employee", and who donates his or nished in connection with such work her worts and acts at the direction of and with- or operations. _ in the scope of duties determined by you, and b. Includes: is not paid a fee, salary or other compensa- (1) Warranties or representations made tion by you or anyone else for their work per- at any time with respect to the fit- formed for you. ness, quality, durability, perfor- ' mance or use of"your work'; and (2) The providing of or failure to provide i warnings or instructions. i i i i i i CG 00 01 04 13 0 Insurance Services Office, Inc., 2012 Page 17 of 17 I I r COMMERCIAL GENERAL LIABILITY CG 01 81 05 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WASHINGTON CHANGES This endorsement modife's insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART With respect to "employees" of the insured of Coverage A-Bodily Injury And whose employment is subject to the Indus- A. Exclusion e.mage Liability (Section I -Cover- trial Insurance Act of Washington, the refer- Property Da ily injury" to any ence to "volunteer workers" is removed from ages) applies only to "bod "employee" of the insured whose employ- Paragraph 2.(a) of Section II -Who Is An In- ment is not subject to the Industrial Insurance sured and Paragraph 2.a.(1) of Section II is Act of Washington (Washington ton Revised replaced with the following: Code Title 51). 2. Each of the following is also an insured: With respect to "bodily injury" to "employ- a. Your "employees", other than either p your "executive officers" (if you are ees" of the insured whose employment is organization other than a parfner- subject to e Industrial Insurance Act of oint venture or limited liability th an org Washington, Exclusion e. is replaced with the ship, j following: company) or your managers (if you are a limited liability company), but This insurance does not apply to: only for acts within the scope of their 1, "Bodily injury" to an "employee" of the employment by you or while per- insured arising out of and in the course forming duties related to the conduct of of your business. However, none of a. Employment by the insured; or these "employees" is an'ensured for. b. Performing duties related to the con- (1) "Bodily injury" or "personal and duct of the insured's business; or advertising injury": 2. Any obligation to share damages with or (a) To you, to your partners or repay someone else who must pay dam- members (if you are a part- ages because of the injury, nership or joint venture), to I to liability as- your members (if you are a This exclusion does not apply limited liability company), sumed by the insured under an "insured con- or to a co-"employee" while tract". that co-"employee" is either B. Paragraphs 2.a.(1)(a), (b) and (c) of Section 11- in the course of his or her Who Is An Insured apply only to "employees" employment or performing of the insured whose employment is not sub- duties related to the conduct ject to the Industrial Insurance Act of Wash- of your business; ington (Washington Revised Code Title 51). (b) For which there is any obli- gation to share damages with or repay someone else who must pay damages be- cause of the injury described in Paragraph (1)(a) above; or (c) Arising out of his or her pro- viding or failing to provide professional health care ser- vices. awne 1 of 1 COMMERCIAL GENERAL LIABIUTY CG 01 97 12 07 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WASHINGTON CHANGES - EMPLOYMENT- RELATED PRACTICES EXCLUSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following exclusion is added to Para- B. The following exclusion is added to Para- graph 2., Exclusions of Coverage k- Bodily graph 2., Exclusions of Coverage B Personal Injury And Property Damage Liability (Sec- Injury And Advertising Injury Liability (Sec- tion I Coverages): tion t-Coverages): This insurance does not apply to: This insurance does not apply to: "Bodily injury" to: "Personal and advertising injury" to: 1. A person arising out of any: 1. A person arising out of any: _ a. Refusal to employ that person; a. Refusal to employ that person; b. Termination of that person's employ- b. Termination of that person's employ- ment; or ment; or c. Employment-related practices, pol- c. Employment-related practices, poli- icies, acts or omissions, such as cies, acts or omissions, such as coercion, demotion, evaluation, rea- coercion, demotion, evaluation, ssignment, discipline, defamation, reassignment, discipline, defama- harassment, humiliation, discrimina- lion, harassment, humiliation, dis- don or malicious prosecution direct- crimination or malicious prosecution ed at that person; or directed at that person; or 2. The spouse, child, parent, brother or sis- 2. The spouse, child, parent, brother or sis- ter of that person as a consequence of ter of that person as a consequence of "bodily injury" to that person at whom "personal and advertising injury" to that any of the employment- related practices person at whom any of the employment- described in Paragraphs a., b. and c. related practices described in Paragraphs above is directed. a., b. and c.above is directed. I This exclusion applies: This exclusion applies: 1. Whether the injury-causing event de- 1. Whether the injury-causing event de- scribed in Paragraphs a., b. or c. above scribed in Paragraphs a., b. or c. above occurs before employment, during em- occurs before employment, during em- ployment or after employment of that ployment or after employment of that person; person; 2. Whether the insured may be liable as an 2. Whether the insured may be liable as an employer or in any other capacity; and employer or in any other capacity; and ! 3. To any obligation to share damages with 3. To any obligation to share damages with or repay someone else who must pay or repay someone else who must pay - damages because of the injury. damages because of the injury. j However, Paragraphs 1.a. and 2. of this exclu- However, Paragraphs 1.a. and 2. of this exclu- sion do not apply.if such "bodily injury" is sion do not apply if such "personal and ad- sustained by any "employee" of the insured vertising injury" is sustained by any "employ- whose employment is subject to the Indus- ee" of the insured whose employment is trial Insurance Act of Washington (Washing- subject to the Industrial Insurance Act of I ton Revised Code Title 51). Washington (Washington Revised Code Title CG 01 97 12 07 0 ISO Properties, Inc., 2006. Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG 21 o6 o5 14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION AND DATA-RELATED LIABILITY -WITH LIMITED BODILY INJURY EXCEPTION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART As used in this exclusion, electronic A. Exclusion 2.p. of Section I-Coverage A l Bod- data means information, facts or pro- ily Injury And Property Damage Liability is grams stored as or on, created or replaced by the following: used on, or transmitted to or from 2. Exclusions computer software, including sys- This insurance does not apply to: tems and applications software, hard P Access Or Disclosure Of Confiden- or floppy disks, CD-ROMs, tapes, tial Or Personal Information And drives, cells, data processing devices Data-related Liability or any other media which are used Damages arising out of: with electronically controlled equip- ment. (1)'Any access to or disclosure of any person's or organization's B. The following is added to Paragraph 2. Exclu- sions of Section I-Coverage B-Personal And confidential or personal informa- Advertising Injury Liability: lion, including patents, trade se- crets, processing methods, cus- 2. Exclusions Comer lists, financial This insurance does not apply to: information, credit card informa- Access Or Disclosure Of Confidential Or tion, health information or any Personal Information other type of nonpublic informa- afisin "Personal and advertising injury" 9 tion; or out of any access to or disclosure of any (2) The loss of, loss of use of, dam- person's or organization's confidential or age to, corruption of, inability to personal information, including patents, access, or inability to manipulate trade secrets, processing methods, cus- electronic data. tomer lists, financial information, credit This exclusion applies even if dam- card information, health information or ages are claimed for notification any other type of nonpublic information. costs, credit monitoring expenses, This exclusion applies even if damages forensic expenses, public relations are claimed for notification costs, credit expenses or any other loss, cost or monitoring expenses, forensic expenses, expense incurred by you or others public relations expenses or any other arising out of that which is described loss, cost or expense incurred by you or in Paragraph (1) or(2) above. others arising out of any access to or dis- However, unless Paragraph (1) above closure of any person's or organization's applies, this exclusion does not ap- confidential or personal information. ply to damages because of "bodily injury". .,,,, Paae 1 of 1 . I• COMMERCIAL GENERAL LIABILITY CG 21 70 01 08 THIS ENDORSEMENT CH4NGES THE POLICY. PLEASE READ IT CAREFULLY. CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM This endorsement modifies insurance provided under the following: f COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY - i If aggregate insured losses attributable to terrorist "Certified act of terrorism" means an act that is acts certified under the federal Terrorism Risk In- certified by the Secretary of the Treasury, in con- -_ surance Act exceed $100 billion in a Program Year currence with the Secretary of State and the Aftor- _ (January 1 through December 31) and we have ney General of the United States, to be an act of met our insurer deductible under the Terrorism terrorism pursuant to the federal Terrorism Risk Risk Insurance Act, We shall not be liable for the Insurance Act. The criteria contained in the Ter- payment of any portion of the amount of such rorism Risk Insurance Act for a "certified act of losses that exceeds $100 billion, and in such case terrorism" include the following: insured losses up to that amount are subject to 1. The act resulted in insured losses in excess of pro rata allocation in accordance with procedures $5 million established by the Secretary of the Treasury. ,in the aggregate, attributable to all types of insurance subject to the Terrorism Risk Insurance Act; and 2. The act is a violent act or an act that is dan- gerous to human life, property or infrastruc- ture and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. I r I i CG 21 70 01 08 ISO Properties, Inc., 2007 Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG 2176 01 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION OF PUNITIVE DAMAGES RELATED TO A CERTIFIED ACT OF TERRORISM![ This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY A. The following exclusion is added: 2. The act is a violent act or an act that is dangerous to human life, property or in- This insurance does not apply to: frastructure and is committed by an in- TERRORISM PUNITIVE DAMAGES dlAdual or individuals as part of an effort to coerce the civilian population of the Damages arising, directly or indirectly, out of United States or to influence the policy or a"certified act of terrorism" that are awarded affect the conduct of the United States as punitive damages. Government by coercion. t B. The following definition is added: "Certified act of terrorism" means an act that is certified by the Secretary of the Treasury, in concurrence with' the Secretary of State . and the Attorney General of the United States, to be an act of terrorism pursuant to the federal Terrorism Risk Insurance Act. The criteria contained in the Terrorism Risk Insur- ance Act for a "certified act of terrorism" in- clude the following: 1_ The act resulted in insured losses in ex- cess of $5 million in the aggregate, attributable to all types of insurance sub- ject to the Terrorism Risk Insurance Act; and COMMERCIAL GENERAL LIABILITY CG 22 24 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - INSPECTION, APPRAISAL AND SURVEY COMPANIES I This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following exclusion is added to Paragraph 2. This exclusion applies even if the claims against Exclusions of Section I - Coverage A - Bodily In- any insured allege negligence or other wrongdo- jury And Property Damage Liability and Para- ing in the supervision, hiring, employment, train- graph 2. Exclusions of Section I - Coverage B - ing or monitoring of others by that insured, if the Personal And Advertising Injury Liability: "occurrence" which caused the "bodily injury" or This insurance does not apply to "bodily injury", "property damage", or the offense which caused "property damage" or "personal and advertising the "personal and advertising injury", involved injury" for which the insured may be held liable the rendering of or failure to render professional because of the rendering of or failure to render services in the performance of any claim, inves- professional services in the performance of any Ligation, adjustment, engineering, inspection, ap- claim, investigation, adjustment, engineering, in- praisal, survey or audit services. spection, appraisal, survey or audit services. i i CG 22 24 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 1 4 10 I a6ed l� }uaweei5e 10 13e1}uoo AUE 10 aouasge ay; ul mel 4q pasodwi aq pinom ;eyl A!I!geg a suEOLU f]!llaell el Aq oo uogdwns pa}}!wlad s! 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'palnsul ay; y3lgm �apu(1 (£) a 1o1 p !� 10 :a6ewep 10 fged!olunw a 10 uogeog!uwapul ue 6u! o asneo I.06ew ay} -pnloul) ssaulsnq !nor( o} 6ulule}1ad }uaw tinful ay; 1 -aa16e 10 }oei;uoo aay}o Aue 10 }red }eye 'way} 8nl6 0; 6u11!e1 10 'suogonl;sul 10 suol;oa11P 6u!ni0 (q) :}uawaal6e ueua;ulew 1o}ena{8 uy a ;IC;lIediolunw a 101 N1om tl}!m uol}oauuoo 10 :suogeog!oads iuwa u! o} pue s6u!melp 10 slaplo a6uey3 u! }deoxe jq!IEdloiunw e P a 's�Sanlns `shod 'aoueulplo Aq pallnbal se 'uoge6!{qo W P 'slap�o p{ � -a1 'suotuldo 'sBulmejp dogs :peolpel a }o }aa1 `sdew `anoldde io a1Edald of 05 uly;tm 10 uo suoplado uoq!lowap Bulpel 10 'bulAoidde 6upedaid (e) 10 u043n1}suoo y;!m uol;oauuoo u! ;dao :10;na 6uts!1e a6e xa '}uawaal6e asusog 10•}uawasee l�uy 0 -wep 10 tinful 1ol loAamns 10 laau quawaal6e �IoE1;aP!s t/ 'q -16ua `}oellyole uE sag!uwepul Wt4i (Z) ,upel;uoo palnsul. ue ;ou sl 1aUM0 ay}10 :6ulss013 uolsslwlad La!m noA Aq paldnoao Aluelod 10 ssediepun 'jauunj 'spaq-pool -wa} 10 noA, o} palual al!ym saslwald o; 'sNoe1} 'apsal} 10 a6puq peo11!e1 Aue aig Aq a6ewep 101 uol}ezlue6lo 10 uoslad 6ul;page pue �ladad peolllel AM 10 ICue sagluwapul }ey} saslwald 10 aseal ;aa1 O9 u!ym `suogelado uol}!lowap o uoglod }ey; liana a 101 }oe guoo ay; 1 10 uo.gOn4suoo 10 ;no 6ulslle -MOH •seslwald 10 aseal a 101 ;oe1}uoo y 'e „a6ewep A1adold, 10 „Alnful AR :sueew „;oe quoo palnsul„ _poq„ 1ol peol{le1 a sagluwapul ;ey1 (4) :6ulmo{lo1 ay}Aq paoeldal sl uo!}oas suol; queu1aa16e 10 }0e1}u03 Aus _lullap ay} w ,�oe1}uoo pelnsulu 10 uoglugap eq-L 10 }red }ey; apnloul ;au saop •1 yde16e1ed 18dd 3JyZ13A0O 31E)�3AO o{.LI�118dd101 a�3N3 Ootsioncioud ld 0�3WW00 121`d :6ulmopol ay; lapun pep!nold eouelnsul saglpow }uawaslopua sly! NOWN1330 131MINOO a323nSNI :JO 1N3WC1NEIW)f w-nzMd IVO 11 QH313S`o'31d 'J.3f1Od 3H1 S3JNVH3 1N3W3S'dOON3 SIHl E4 to 9Z IfZ JO ? 1,1111Sb1I1783N30 W10213WWOO COMMERCIAL GENERAL LIABILITY CG 26 77 12 04 i THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WASHINGTON - FUNGI OR BACTERIA EXCLUSION s This endorsement modifies insurance provided under the following: Ea COMMERCIAL GENERAL LIABILITY COVERAGE PART I A. The following exclusion is added to Para- B. The following exclusion is added to Para- graph 2., Exclusions of Section I - Coverage graph 2., Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Li- B - Personal And Advertising Injury Liabil- ability: ity: 2. Exclusions 2. Exclusions This insurance does not apply to: This insurance does not apply to: Fungi Or Bacteria Fungi Or Bacteria a. "Bodily injury" or "property dam- a. "Personal and advertising injury" age" which would not have oc- which would not have taken place, curred, in whole or in part, .but for in whole or in part, but for the ac- the actual, alleged or threatened in- tual, alleged or threatened inhala- halation of, ingestion of, contact lion of, ingestion of, contact with with, exposure to, existence of, or exposure to, existence of, or pres- presence of, any "fungi" or bacteria ence of any "fungi" or bacteria on on or within a building or structure, or within a building or structure, including its contents. including its contents. b. Any loss, cost or expenses arising b. Any loss, cost or expense arising obt of the abating, testing for, mon- out of the abating, testing for, mon- itoring, cleaning up, removing, con- itoring, cleaning up, removing, con- taining, treating, ' detoxifying, neu- taining, treating, detoxifying, neu- tralizing, remediating or disposing tralizing, remediating or disposing , of, or in any way responding to, or of, or in any way responding to, or assessing the effects of, "fungi' or assessing the effects of, "fungi" or bacteria, by any insured or by any bacteria, by any insured or by any other person or entity. other person or entity. This exclusion does not apply to any C. The following definition is added to the "fungi" or bacteria that are, are on, or Definitions Section: are contained in, a good or product in- I tended for bodily consumption. "Fungi" means any type or form of fungus, including mold or mildew and any mycotoxins, spores, scents or byproducts produced or released by fungi. i I CG 26 77 12 04 o ISO Properties, Inc., 2003 Page 1 of 1 i . � i COMMERCIAL GENERAL LIABILITY GG 32 21 01 07 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WASHINGTON CONDITIONAL EXCLUSION OF TERRORISM INVOLVING NUCLEAR, BIOLOGICAL OR CHEMICAL TERRORISM (RELATING TO DISPOSITION OF FEDERAL TERRORISM RISK INSURANCE ACT) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY (2) Decrease the federal govern- A. Applicability Of The Provisions Of This En- ment's statutory percentage dorsement share in potential terrorism 1. The provisions of this endorsement be- losses above such deductible; come applicable commericing on the or date when any one or more of the fol- (3) Redefine terrorism or make in- lowing first occurs. But if your policy surance coverage for terrorism (meaning the policy period in which subject to provisions or re- this endorsement applies) begins after quirements that differ from such date, then the provisions of this those that apply to other types endorsement become applicable on the of events or occurrences under date your policy begins. this policy. a. The federal Terrorism Risk Insur- 2. If the provisions of this endorsement ance Program ("Program"), estab- become applicable, such provisions: lished by the Terrorism Risk Insur- ance Act, has Terminated with a. Supersede any terrorism endorse- ment already endorsed to this po respect to the type of insurance li- provided under this Coverage Part cy that addresses "certified acfs'of or Policy; or terrorism"' andfor 'other acts of terrorism`, but only with respect b. A renewal, extension or replace- to an incident(s) of terrorism (how- . ment of the Program has became ever defined) which results in in- effective without a requirement to jury or damage that occurs on or make terrorism coverage available after the date when the provisions to you and with revisions that: of this endorsement become appli- (1) Increase our statutory percent- cable (for claims made policies, age deductible under the Pro- such an endorsement is supersed- gram for terrorism losses. ed only with respect to an incident I (That deductible determines of terrorism (however defined) that the amount of all certified ter- results in a claim for injury or dam- rorism losses we must pay in a age-first being made on or after calendar year, before the fed- the date when the provisions of era) government shares in sub- this endorsement become applica- sequent payment of certified ble); and terrorism lasses.); or !SO Properties, Inc., 2005 Page 1 of 2 CG 32 21 01 07 b. Remain applicable unless we notify C. The following exclusion is added: you of changes in these provisions, EXCLUSION OF TERRORISM in response to federal law. We will not pay for "any injury or damage" 3. If the provisions of this endorsement caused directly or indirectly by "terrorism", do NOT become applicable, any terror- including action in hindering or defending ism endorsement already endorsed to against an actual or expected incident of this policy, that addresses "certified certified "terrorism'. But this exclusion applies only when oRe or more of the following are acts of terrorism" and/or "other acts of terrorism", will continue in effect un- attributed to an incident of "terrorism": less we notify you of changes to that 1. The "terrorism" is carried out by means endorsement in response to federal of the dispersal or application of radio- - law. active material, or through the use of a B. The following definitions are added and ap- nuclear weapon or device that involves ply under this endorsement wherever the or produces a nuclear reaction, nuclear term terrorism, or the phrase any injury or radiation or radioactive contamination; damage, are enclosed in quotation marks: or 1. 'Terrorism" means activities against 2. Radioactive material is released, and it I or property of appears that one purpose of the "terror- persons, organizations any nature: ism" was to release such material; or a. That involve the following or prep- 3. The "terrorism" is carried out by means aration for the following: of the dispersal or application of patho- (1) Use or threat of force or vio- materials; or genic or poisonous biological or chemi- callence; or (2) Commission or threat of a clan- 4. Pathogenic or poisonous biological or gerous act; or chemical materials are released, and it appears that one purpose of the "terror- (3) Commission or threat of an act ism" was to release such materials. _that interferes with or disrupts an electronic, communication, In the event of any incident of "terrorism" information, or mechanical sys- that is not subject to this Exclusion, cow tern; and erage does not apply to "any injury or dam- age" that is otherwise excluded under this b. When one or both of the following Coverage Part or Policy. applies: (1) The effect is to intimidate or coerce a government or the ci- vilian population or any seg- ment thereof, or to disrupt any segment of the economy; or (2) It appears that the intent is to intimidate or coerce a govern- ment, or to further political, ideological, religious, social or economic objectives or to ex- press (or express opposition to) a philosophy or ideology. 2. "Any injury or damage" means any in- jury or damage covered under any Cov- erage Part or Policy to. which this en- cfasement its applicable, and includes but is not limited to "bodily injury", "property damage", "personal and ad- vertising injury", "injury" or "environ- mental damage" as may be defined in any applicable Coverage Part or Policy. 1 CG 32 21 01 07 o ISO Properties, Inc., 2005 Page 2 of 2 � i i COMMERCIAL GENERAL LIABILITY CG 84 99 OB 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASEREAD IT CAREFULLY. NoN-CUMULATION of LIABILITY LIMITS (SAME OCCURRENCE) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to Paragraph 5. under Section III -Limits Of Insurance: Non-Cumulation of Liability - Same Occurrence - if one "occurrence" causes "bodily injury" or "property the policy eriod and during the poiiay period of one or more prior, or future, general damage" during y P liability policies issued to you by us, then this policy's Each Occurrence Limit will be reduced by the amount of each payment made by us under the other policies because of such "occurrence." For purposes of this endorsement, the inclues all Grouppolicies issued by any company within the Liberty Mutual Agency Markets division of Liberty l i @2010 Liberty Mutual Insurance Company.All rights reserved. 9e a P T of 1 CG 84 99 08 09 Includes copyrighted material of Insurance Services Office,Inc.,vAh its permission . COMMERCIAL GENERAL LIABILITY CG 88 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ' COMMERCIAL GENERAL LIABILITY EXTENSION I This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX SUBJECT PAGE NON-OWNED AIRCRAFT 2 NON-OWNED WATERCRAFT 2 PROPERTY DAMAGE LIABILITY-ELEVATORS 2 EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) 2 MEDICAL PAYMENTS EXTENSION 3 EXTENSION OF SUPPLEMENTARY PAYMENTS -COVERAGES A AND B 3 ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT 3 t PRIMARY AND NON-CONTRIBUTORY- ADDITIONAL INSURED EXTENSION 5 ADDITIONAL INSUREDS -EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" 6 WHO'IS AN INSURED -INCIDENTAL MEDICAL ERRORS/MALPRACTICE AND WHO IS AN INSURED -FELLOW EMPLOYEE EXTENSION -MANAGEMENT EMPLOYEES 6 NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES 7 FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES 7 i KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT 7 - t i LIBERALIZATION CLAUSE 7 1 BODILY INJURY REDEFINED 7 EXTENDED PROPERTY DAMAGE 8 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - 8 WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU f 4 . I I I 0 2013 Liberty Mutual Insurance i C G 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 1 of 8 I •` i r policy apply unless modified by With respect to.coverage afforded by this endorsement, the provisions of the p cy PP Y the endorsement A. NON-OWNED AIRCRAFT Damage Liability, Under Paragraph 2• ExclusionsSection Or O craft does not apply to aBd ily Injury And Properly aircraft provided: exclusion g. Aircraft, A 1. it is not owned by any insured; 2. It is hired, chartered or loaned with a trained paid crew; • 3 The pilot in command holds a currently desigve nating her him a romyme cal the I or airfineted pilot;authority � of the United States of America or Canada 4. 1t is not being used to carry persons or property for a charge. However, the insurance afforded by this'provision does not apply if there is available to the insured other valid and collectible insurance, whether primary, excess (other than insurance written to apply specifically in excess of this policy), contingent or on any other basis, that would also apply to the loss covered under this provision. B. NON-OWNED WATERCRAFT Under Paragraph 2.Exclusions of Section I-Coverage A-Bodily Injury And Property Damage Liability, Subparagraph (2) of exclusion g.Aircraft, Auto Or Watercraft is replaced by the following: This exclusion does not apply to: (2) A watercraft you do not own that is: ( (a) Less than 52 feet long; and a for a charge. (b) Not being used to carry persons or property C. PROPERTY DAMAGE LIABILITY -ELEVATORS rage A_ ury Damage Liabil- 1. Under Paragraph 2. Exclusions 6 section exclusion ove f Damage To Piropely lrfy do not apply�f such "property ity, Subparagraphs (3}, (4) and ( } damage" results from the use ofioe{�voas srsusedr the in automobile urpose of this provision, elevators or repair operations do not include vehicle lifts. Vehicle lifts are lifts 2. The following is added to Section IV - Commercial General Liability Conditions, Condition 4. Other insurance, Paragraph b. Excess Insurance: insurance, The insurance afforded by this provision of this endorsement is excess over any property whether primary, excess, contingent or on any other basis. D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) If Damage To Premises Rented To You is not otherwise excluded from this Coverage rage Property 1. Under Paragraph 2. Exclusions of Section l-coverage A-Bodily Injury P rtY Damage Liability: a. The fourth from the last paragraph of exclusion j. Damage To Property is replaced by the follow- ing: other than damage 4 of this exclusion do not apply to "property damage" Paragraphs (1), (3) and ( } by fire, lightning, explosion, smoke, or leakage from an automatic fire protection system} to: (i) Premises rented to you for a period art o raeWconsrent I ocutive r lease agreement for aperiod of ays; r (ii) Contents that you rent or lease asp premises more than 7 days. 3 of this exclusion do not apply to "property damage" to contents of Paragraphs (1}, ( } and (4) t premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described in Section Ili - Limits o Insurance. b. The last paragraph of subsection 2.Exclusions is replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or leakage i from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to Damage To Premises i Rented TD You as described in Section III- Limits Of Insurance. 2. Paragraph S.under Section II[-Limits Of Insurance is replaced by the following: S. Subject to Paragraph 5. above, the Damage To'Premises Rented To You Limit is the most we will pay under Coverage A for damages because of"property damage" to: a. Any one premise: (1) While rented to you; or (2) While rented to you or temporarily occupied by you with permission of the owner for damage by fire, lightning, explosion, smoke or leakage from automatic protection sys- tems; or b. Contents that you rent or lease as part of a premises rental or lease agreement. = i 3. As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) -Paragraph'9.a. of Definitions is replaced with the following: 9.a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or a leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such premises that are included in your premises rental or lease agreement, is not an "Insured contract". E. MEDICAL PAYMENTS EXTENSION If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this policy are amended as follows: Under Paragraph 1. Insuring Agreement of Section I -Coverage C-Medical Payments, Subparagraph (b) of Paragraph a. is replaced by the following: (b) The expenses are incurred and reported within three years of the date of the accident; and F. EXTENSION OF SUPPLEMENTARY PAYMENTS -COVERAGES A AND B 1. Under Supplementary Payments -Coverages A and B,Paragraph 1.b. is replaced by the following: b. Up to $3,000 for cost of bail bonds required because of accidents or traffic law violations arising ! out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2. Paragraph 1.d. is replaced by the following: d. All reasonable expenses incurred by the Insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. G. ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT 1. Paragraph 2. under Section II -Who is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract, written agreement or permit. Such person or organization is an additional insured but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused In whole or in part by: j = I a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your on going operations for the additional insured that are the subject of the written contract or I written agreement provided that the "bodily injury" or "property damage" occurs, or the "per- I sonal and advertising injury" is committed, subsequent to the signing of such written contract or written agreement; or ' m 2013 Liberty Mutual Insurance C G 88 10 04 13 Includes copyrighted malerial of Insurance Services Office,Inc.,with its permission. Page 3 of 8 i b. Premises or facilities rented by you or used by you; or c. The maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or d. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit subject to the following additional provisions: (1) This insurance does not apply to "bodily injury", "property damage", or "personal and ad- vertising injury" arising out of the operations performed for the state or political subdivision; (2) This insurance does not apply to "bodily injury" or "property damage" included within the "completed operations hazard". (3) Insurance applies to premises you own, rent, or control but only with respect to the following hazards: (a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar expo- sures; or (b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elevators covered by this insurance. However. 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. if coverage provided to the additional insured is required by a contract or agreement, the insur- ance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. t With respect to Paragraph 1.a. above, a person's or organization's status as an additional insured under this endorsement ends when: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a-principal as a part of the same project. With respect to Paragraph 1.b. above, a person's or organization's status as an additional insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends. With respects to Paragraph 1.c. above, this insurance does not apply to any "occurrence" which takes place after the equipment rental.or lease agreement has expired or you have returned such equipment to the lessor. The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or"property damage". We have no duty to defend an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured as required in Paragraph b. of Condition 2. Duties in the Event Of Occurrence, Offense, Claim Or Suit under Section IV -Commercial General Liability Condi- tions. ( o gn13Libertv Mutual Insurance _ r„ 2. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section I-Coverage A-Bodily Injury And Property Damage Liability: This insurance does not apply to: a. "Bodily injury" or"property damage" arising from the sole negligence of the additional insured. b. "Bodily injury" or "property damage" that occurs prior to you commencing operations at the location where such "bodily injury" or "property damage" occurs. c. "Bodily Injury", "property damage" or "personal and advertising injury" arising out of the render- ing of, or the failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occur- - rence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. I = d. "Bodily injury", or"property damage". occurring after. , (1) All work, including materials; parts or equipment furnished in connection with such work, on I the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as apart of the.same project. e. Any person or organization specifically designated as an additional insured for ongoing operations by a separate ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS endorsement is- sued by us and made a part of this policy. 3. With respect to the insurance afforded to these additional insureds, the fallowing is added to Section III -Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: a. Required by the contract or agreement; or b. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarauo ns. H. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. Condition 4. Other Insurance of SECTION IV -COMMERCIAL GENERAL LIABILITY CONDITIONS is amend- ed as follows: a. The following is added to Paragraph a. Primary Insurance: If an additional insured's policy has an Other Insurance provision making its policy excess, and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from l the additional insured's policy for damages we cover. , 0 2013 Liberty Mutual Insurance CC 88 10 04 13 Includes copyrighted material or Insurance Services Office,Inc.,with its permission. Page 5 of 8 i b. The following is added to Paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, en equipment rental or lease contract or agreement, or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non-contributory, this insurance is excess over any other insurance for which the addi- tional insured is designated as a Named insured. Regardless of the written agreement between you and an additional insured, this insurance is excess, over any other insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies. I. ADDITIONAL INSUREDS -EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. 1. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim or Suit: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence" or an offense that may result in a claim or "suit" under this insurance to us; b. Tender the defense and indemnity of any claim or "suit" to all insurers whom also have insurance available to the additional insured; and c. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. ( d. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a"suit" by the additional insured. 2. The limits of insurance applicable to the additional insured are those specified in a written contract or written agreement or the limits of insurance as stated in the Declarations of this policy and defined in Section lit - Limits of Insurance of this policy, whichever are less. These limits are inclusive of and not in addition to the limits of insurance available under this policy. J. WHO IS AN INSURED -INCIDENTAL MEDICAL ERRORS/MALPRACTICE WHO IS AN INSURED -FELLOW EMPLOYEE EXTENSION -MANAGEMENT EMPLOYEES Paragraph 2.a.(1) of Section 11 -Who Is An insured is replaced with the following: (1) "Bodily injury" or"personal and advertising injury": (a) To you, to your partners or members (if you are a partnership- or joint venture), to your members (if you are a limited liability company), to a co"employee" while in the course of his or her employ- ment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the Spouse, child, parent, brother or sister of that co-"employee" or "volunteer worker" as a consequence of Paragraph (1) (a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1) (a) or(b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. However, if you are not in the business of.providing professional health care services or providing profes- sional health care personnel to others, or if coverage for providing professional health care ser- vices is not otherwise excluded by separate endorsement, this provision (Paragraph (d))does not I� apply. . Paragraphs (a) and (b) above do not apply to "bodily injury" or"personal and advertising injury" caused by an "employee" who is acting in a supervisory capacity for you. Supervisory capacity as used herein means the`'employee's" job responsibilities assigned by you, includes the direct supervision of other 'employ- ees of yours. However, none of these "employees" are insureds for "bodily injury" or "personal and t_> —..,-.. —_ . AA..4....I 1ncl.f�nrP advertising injury" arising out of their willful conduct, which is defined as the purposeful or willful intent to cause "bodily injury' or "personal and advertising injury", or caused in whole or in part by their intoxica- tion by liquor or controlled substances. , The coverage provided by provision J. is excess over any other valid and collectable insurance available to your "employee". K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES Paragraph 3,of Section Il -Who Is An Insured is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However. a. Coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. I d. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations or qualifies as an insured under this provision. L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES r Under Section IV-Commercial General Liability Conditions, the following is added to Condition 6.Repre- sentations: Your failure to disclose all hazards or prior "occurrences" existing as of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior "occurrences" is not intentional. M. KNOWLEDGE OF OCCURRENCE, OFFENSE,CLAIM OR SUIT Under Section IV-Commercial General Liability Conditions, the following is added to Condition 2. Duties In The Event of Occurrence, Offense, Claim Or Suit: Knowledge of an "occurrence", offense, claim or "suit" by an agent, servant or "employee" of any Insured shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph 1. of Section li -Who Is An Insured or a person who has been designated by them to receive reports of "occurrences", offenses, claims or "suits" shall have received such notice from the agent, servant or "employee". N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the day the revision is effective in your state. O. BODILY INJURY REDEFINED Under Section V -Definitions, Definition 3. is replaced by the following: 3. "Bodily Injury" means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physical_ injury, sick- ness or disease. I O 2U13 Liberty Mutual Insurance GG B$ 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 7 of 0 ' I I EXTENDED PROPERTY DAMAGE Exclusion a. of COVERAGE A- BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following: a. Expected Or Intended Injury • " " damage" expected or intended from the standpoint of the insured. "Bodily injury or property " or "property damage" resulting from the use of This exclusion does not apply to bodily injury reasonable force to protect persons or property. Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED !N A CONTRACT DR AGREEMENT WITH YOU is added to Condition B. Trans- Under Section IV -Commercial General Liability Conditions, the following far Of Rights Of Recovery Against others To Us: we We waive any right of recovery we may have against a person izortoyourecwork ofdonemunder a make for injury or damage arising out of your ongoing operations contract with that person or organization and included in the "products-completed operations hazard" provided: erbson have areed an orotganization;n and in a contract or agreement thatyou 1. You and that person or organiz waive such rights against that p 2. The injury or damage occurs subsequent to the execution of the written contract or written agree- m ent. d anti,4I iherty Mutual Insurance p-np P. of R COMMERCIAL GENERAL LIABILITY CG 88 T7 12 08 t THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. MEDICAL EXPENSE AT YOUR REQUEST ENDORSEMENT 1 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to Section I-Coverage C-Medical Payments: If Medical Payments or Medical Expenses are not otherwise excluded from the policy, medical expenses will be paid only if an insured has requested that we pay such expenses. — I I l� I r ; CG 88 77 12 08 Includes Copyrighted Material of ISO Properties,fnc.,with its permission. Page 4 of I 1 COMMERCIAL GENERAL LIABILITY CG 89 27 10 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WASHINGTON EXCLUSION - ASBESTOS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS AND.COMPLETED OPERATIONS COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of alleged or actual ingestion or inhalation of asbestos or asbestos -containing materials. We shall not have the duty to defend any such claim or "suit". t I © 20101-iberty Mutual insurance.Al rights reserved. CG 89 27 10 09 Includes copyrighted material of insurance Services Office,with its permission. Page 1 of 1 IL 01 23 11 13 THIS.ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WASHINGTON CHANGES - DEFENSE COSTS This endorsement modifies insurance provided under the following: COMMERCIAL AUTOMOBILE COVERAGEPART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL LIABILITY UMBRELLA COVERAGE PART COMMERCIAL PROPERTYCOVERAGE PART-LEGAL LIABILITY COVERAGE FORM COMMERCIAL PROPERTY COVERAGE PART-MORTGAGEHOLDER'S ERRORSAND OMISSIONS COVERAGE FORM ELECTRONIC DATA LIABILITY COVERAGE PART FARM COVERAGE PART FARM UMBRELLA LIABILITY POLICY LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGEPART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGEPART PRODUCT WITHDRAWAL COVERAGE PART PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGEPART RAILROAD PROTECTIVE LIABILITY COVERAGEPART UNDERGROUND STORAGE TANK COVERAGE PART A. The provisions of Paragraph B. are added to 5. Coverage C - Mortgageholder's Liability all Insuring Agreements that set forth a duty under the Mortgageholdets Errors And to defend under. Omissions Coverage Form. 1. Section I of the Commercial General Li- Paragraph B. also applies to any other provl- ability, Commercial Liability Umbrella, sion in the policy that sets forth a duty to de- Electronic Data Liability, Farm, Liquor Li- fend. ability, Owners And Contractors Protec- B. if we initially defend an insured ("insured") or tive Liability, Pollution Liability, Pro- pay for an insured's ("insured's") defense but ducts/Completed Operations Liability, later determine that none of the claims Product Withdrawal, Medical Profession- ("claims"), for which we provided a defense al Liability, Railroad Protective Liability or defense costs, are covered under this in- and Underground Storage Tank Cover- surance, we have the right to reimbursement age Parts, Auto Dealers Coverage Form for the defense costs we have incurred. and the Fans Umbrella Liability Policy; The right to reimbursement under this provi- 2. Section 11 under the Auto Dealers, Busi- sion will only apply to the costs we have in- ness Auto and. Motor Carrier Coverage curred after we notify you in writing that Forms; there may not be coverage and that we are 3. Section III under the Auto Dealers and reserving our rights to terminate the defense Motor Carrier Coverage Forms; or the payment of defense costs and to seek 4. Section A. Coverage under the Legal Li- reimbursement for defense costs. ability Coverage Form; and I IL 01 23 11 13 m Insurance Services Office, Inc., 2013 Page i of 1 • I IL 01 46 08 10 i WASHINGTON COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions. The conditions in this endorsement replace any 3. We may cancel the Commercial Property similar conditions in the policy that are less favor- Coverage Part and the Capital Assets Pro- able to the insured. gram (Output Policy) Coverage Part, if A. Cancellation made a part of this policy, by mailing or delivering to the first Named Insured and 1. The first Named Insured shown in the the first Named Insured's agent or broker Declarations may cancel this policy by written notice of cancellation at least five notifying us or the insurance producer•in days before the effective date of cancella- one of the following ways: tion for any structure where two or more a. Written notice by mail, fax or e-mail; of the following conditions exist: b. Surrender of the policy or binder; or a. Without reasonable explanation, the c. Verbal notice. structure is unoccupied for more than 60 consecutive days, or at least Upon receipt of such notice, we will can- 65% of the rental units are unoccu- eel this policy or any binder issued as evi- pied for more than 120 consecutive dence of coverage, effective on the later days, unless the structure is main- of the following: tained for seasonal occupancy or Is a. The date on which notice is received under construction or repair; or the policy or binder is surren- b Without reasonable explanation, I dered; or progress toward completion of per- b. The date of cancellation requested manent repairs to the structure has by the first Named Insured. not occurred within 60 days after re- 2. We may cancel this policy by mailing or ceipt of funds following satisfactory delivering to the first Named Insured and adjustment or adjudication of loss re- the first Named Insured's agent or broker suiting from afire; written notice of cancellation, including c. Because of its physical condition, the the actual reason for the cancellation, to structure is in danger of collapse; the last mailing address known to us, at d. Because of its physical condition, a least: vacation or demolition order has a. 10 days before the effective date of been issued for the structure, or it cancellation if.we cancel for nonpay- has been declared unsafe in accor- ment of premium; or dance with applicable law; b. 45 days before the effective date of e. Fixed and salvageable items have cancellation if we cancel for any oth- been removed from the structure, fin- er reason; dicating an intent to vacate the struc- except as provided in Paragraphs 3. and ture; 4.below. f. Without reasonable explanation, heat, water, sewer and electricity are not furnished for the structure for 60 consecutive days; or g. The structure is not maintained in substantial compliance with fire, safety and building codes. 4. If: 7. If this policy is cancelled, we will send a. You are an individual; the first Named Insured any premium re- fund due. If we cancel, the refund will be 1 b. A covered auto you own is of the pro rata. If the first Named Insured can- "private passenger type"; and cels, the refund will be at least 9D%of the c. The policy does not cover garage, pro rats refund unless the following ap- automobile sales agency, repair plies: shop, service station or public park- a, For Division Two - Equipment Break- ing place operations hazards; down, if the first Named Insured can- we may cancel the Commercial Auto- cels, the refund will be at least 75% mobile Coverage Part by mailing or of the pro rata refund. delivering to the first Named Insured and b If — the first Named Insured's agent or broker (1) you are an individual; written notice of cancellation, including the actual reason for cancellation, to the (2) A covered auto you own is of the last mailing address known to us: "private passenger type"; a. At least 10 days before the effective (3) The policy does not cover ga- date of cancellation if we cancel for rage, automobile sales agency, nonpayment of premium; or repair shop, service station or b. At least 10 days before the effective public parking place operations date of cancellation for any other rea- hazards; and son if the policy is in effect less than (4) The first Named Insured cancels; ! 30 days; or the refund will be not less than 90% c. At least 20 days before the effective of any unearned portion not exceed- date of cancellation for other than ing $100, plus 95% of any unearned nonpayment if the policy is in effect portion over $100 but not exceeding 30 days or more; or $500, and not less than 97% of any d. At least 20 days before the effective unearned portion in excess of$500. { date of cancellation if the policy is in The cancellation will be effective even if effect for 6D days or more or is a re- we have not made or offered a refund. newal or continuation policy, and the a, If notice is mailed, proof of mailing will reason for cancellation is that your be sufficient proof of notice. driver's license or that of any driver B. Changes who customarily uses a covered "auto" has been suspended or The policy contains all the agreements be- revoked during policy period. tween you and us concerning the insurance afforded. The first Named Insured shown in 5. We will also mail or deliver to any mort the Declarations is authorized to make gage holder, pledgee or other person changes in the terms of this policy with our shown in this policy to have an interest in consent. This policy's terms can be amended any loss which may occur under this poli- or waived only by endorsement issued by us cy, at their last mailing address known to and made a part of this policy. us, written notice of cancellation, prior to the effective date of cancellation. If can- C. Examination Of Your Books And Records cellation is for reasons other than those We may examine and audit your books and contained in Paragraph A.3. above, this records as they relate to this policy at any notice will be the same as that mailed or time during the policy period'and up to three delivered to the first Named Insured. If years afterward. cancellation is for a reason contained in D. Inspection And Surveys. Paragraph A.3. above, we will mail or de- 1. We have the right to: liver this notice at least 20 days prior to a. Make inspections and surveys at any the effective date of cancellation. I time; 6_ Notice of cancellation will slate the effec- b. Give you reports on the conditions tive date of cancellation. The policy pe- riod will end on that date. we find; and i c. Recommend changes. i Page 2 of 4 o Insurance Services Office, Inc., 2010 IL 01 46 08 10 I 2. We are not obligated to make any inspec- G. Nonrenewal bons, surveys, reports or recommenda- 1. We may elect not to renew this policy by tions, and any such actions via do under- mailing or delivering written notice of take relate only to insurability and the• nonrenewal, stating the reasons for premiums to be charged. We do not nonrenewal, to the first Named Insured make safety inspections. We do not un- and the first Named Insured's agent or dertake to perform the duty of any person broker, at their last mailing addresses or organization to provide for the health known to us. We will also mail to any or safety of workers or the public. And we mortgage holder, pledgee or other per- do not warrant that conditions: son shown in this policy to have an inter- a. Are safe or healthful; or est in any loss which may occur under this policy, at their last mailing address b. Comply with laws, regulations, known to us, written notice of codes or standards. nonrenewal. We will mail or deliver these 3. Paragraphs 1. and 2. of this condition ap- notices at least 45 days.before the: ply not only to us, but also to any rating, a. Expiration of the policy; or advisory, rate service or similar organiza- b. Anniversary date of this policy if this tion which makes insurance inspections, policy has been written for a term of surreys, reports or recommendations. more than one year. 4. Paragraph 2. of this condition does not otherwise, we will renew this policy un- apply to any inspections, surveys, reports less: or recommendations we may make rela- tive to certification, under state or mu- a. The first Named Insured fails to pay nicipal statutes, ordinances or regula- the renewal premium after we have tons, of boilers, pressure vessels or expressed our willingness to renew, elevators. including a statement of the renewal premium, to the first Named Insured E. Premiums and the first Named Insured's insur- ance agent or broker, at feast 20 days The first Named Insured shown in the Dec- larations: before the expiration date; 1. is responsible for the payment of all pre- b. other coverage acceptable to the in- miums; and sured has been procured prior to the 2. Will be the payee for any return premi- expiration date of the policy; or ums we pay. c. The policy clearly states that it is not F. 'transfer Of Your Rights And Duties Under renewable and is for a specific line, This Policy subclassification, or type of coverage Your rights and duties under this policy may that is not offered on a renewable ba- not be transferred without our written con- sis. sent except in the case of death of an individ- 2. if: ual Named Insured. a. You are an individual; if you die, your rights and duties will be trans- b. A covered auto you own is of the ferred to your legal representative but only .1private passenger type'; and while acting within the scope of duties as C. The policy does not cover garage, your legal representative. Until your legal re- automobile sales 'agency, repair presentative is appointed, anyone having custody of our property shop, service station or public park- proper temporary Y Y ing place operations hazards; will have your rights and duties but only with respect to that property. 1 )n•in Page 3 of 4 the foil owing applies to nonrenewal of b. We will not refuse to renew Liability the Commercial Automobile Coverage Coverage or Collision Coverage sole- Part in place of G.1.• ly because an "insured" has submit- a. We may elect .not to renew or con- ted claims under Comprehensive f Coverage or Towing And Labor Cov- tinue this policy by mailing or ! delivering to you and your agent or erage. broker written notice at least 20 days c. If we fail to mail or deliver proper no- before the and of the policy period, lice of nonrenewal and you obtain including the actual reason for other insurance, this policy will and nonrenewal. If the policy period is on the effective date of that Insur- more than one year, we will have the ance. right not to renew or continue it only at an anniversary of its original effec- tive date. If we offer to renew or con- tinue and you do not accept, this policy will terminate at the end of the current policy period. Failure to pay the required renewal or continuation premium when due shall mean that you have not accepted our offer. f i Page 4 of 4 o Insurance Services Office, Inc., 2010 fL 01 46 08 10 IL 01 98 09 08 I THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT (Broad Form) This endorsement modifies Insurance provided under the following: COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL LIABILITY UMBRELLA COVERAGE PART FARM COVERAGE PART FARM UMBRELLA LIABILITY POLICY LIQUOR LIABILITY COVERAGE PART' MEDICAL PROFESSIONAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY 1. -The Insurance does not apply: B. Under any Medical Payments Coverage, to expenses incurred with respect to A. Under any Liability Coverage, to "bodily "bodily injury" resulting from the injury" or "property damage": "haz- ardous properties" of "nuclear mated-, ( (1) With respect to which an "insured" al" and arising out of the operation of a under the policy is also an insured "nuclear facility" by any person or or- under a nuclear energy liability poll-' ganization. cy issued by Nuclear Energy Liabil- C. Under any Liability Coverage, to "bodily ity Insurance Association, Mutual injury" or "property damage" resulting Atomic ' Energy Liability Underwrit- from "hazardous properties" ' of "nuclear ers, Nuclear Insurance Association material', if: of Canada or any of their succes- sors, or would be an insured under (1) The "nuclear material" (a) is at any any such policy but for its termina- "nuclear facility" owned by, or op- tion upon exhaustion of its' limit of erated by or on behalf of, an "in- liability; or sured" or (b) has been discharged (2) Resulting from the "hazardous or dispersed therefrom; 2 The "nuclear material" is contained properties" of "nuclear material" ( ) and with respect to which (a) any in "spent fuel" or "waste" at any person or organization is required time possessed, handled, used, pro- to maintain financial protection pur- cessed, stored, transported or suant to the Atomic Energy Act of disposed of, by or on behalf of an 1954, or any law amendatory there- "Insured"; or of, or (b) 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 agree- ment entered into by the United States of America, or any agency r thereof, with any person or organi- c zation. r (o71cn o,,,, rfT=e inn 7nn7 Pade 1 of 2 (3) The "bodily injury" or "property "Nuclear facility" means: j damage" arises out of the furnish- (a) Any "nuclear reactor; ing by an "insured" of services, (b) Any equipment or device designed materials, parts or equipment in connection with the planning, cun- or used for (1) separating the iso- topes of uranium or plutonium, (2) struction, maintenance, operation or processing or utilizing "spent fuel", use of any "nuclear facility", but if or (3) handling, processing or pack- such facility is located within the United States of America, its ter- aging "waste"; ritories or possessions or Canada, (c) Any 'equipment or device used for this Exclusion (3) applies only to the processing, fabricating or " damage" to such "nucle- ar alloying of "special nuclear mate- propertyar facility" and any property vial" if at any time the total amount = thereat. of such material in the custody of 2. As used in this endorsement: the "insured" at the premises where such equipment or device is "Hazardous properties" include radioactive, located consists of or contains toxic or explosive properties; more than 25 grams of plutonium "Nuclear material" means "source mated- or uranium 233 or any combination i _ al", "Special nuclear material" or "by-prod- thereof, or more than 250 grams of _ uct material"; uranium 235; "Source material", "special nuclear mate- (d) Any structure, basin, excavation, ! nal", , and "by-product material" have the premises or place prepared or used meanings given them in the Atomic Energy for the storage or disposal of ; Act of 1954 or in any law amendatory there- "waste"; of; and includes the site on which any of the , "Spent fuel" means any fuel element I or fuel foregoing is located, all operations conduct- component, solid or liquid, which has been ad on such site and all premises used for used or exposed to radiation in a "nuclear such operations; I reactor'; "Nuclear reactor' means any apparatus de- "Waste" means any waste material (a) contain- signed or used to sustain nuclear fission in ing "by-product material" other than the tailings a self-supporting chain reaction.. or to con- or wastes produced by the extraction or con- tain a critical mass of fissionable material; centration of uranium or thorium from any ore "Property damage" includes all forms of ra- I processed primarily for its "source material" dioactive contamination of property. content, and (b) resulting from the operation by any person or organization of any "nuclear fa- cility" included under the first two paragraphs of the definition of "nuclear facility". f I .I IL 01 99 09 08 @ISO Properties, Inc.,.200y Page 2 of 2 Policy Summary Page 1 of 2 t ��:��.�£f-�iic;r fnftrrm�iscsss RF DUNCAN AND Policy Status; �•: :1FE Name and Address., ASSOCIATES INC Agency Code: 1466556 PO BOX 12300 Total Term Premium(Including Policy OLYMPIA WA 98508 g 4417.00 E.evel Fees&Taxes) VICTORIA FIRE&CASUALTY Transaction Amount Company: COMPANY Premium 4392.00 Policy Number: 1910777 SR22 Fee 25.00 Term : 1D/0312016 to 10/03/2017 Veit Year Description Vin Lien 1D7RV1GTOBS545210 Yes El 1 2011 DODGE RAM 1500 QUAD Usage: Business& Personal Garaging LienholderUNIVERSALLOTT ALASKA USA CITY OF CITY OF Address: (s) FIELD CLEANWATERHDR,INC FEDERAL KENT, AUBURN, Details: SVCS INC ALLIANCE 1001 SW 5TH CREDIT UNION WASHINGTONWASHINGTON 909 WEST 6737 S 5D0 ADAMS AVE.#1 B00 2300 ABBOTT 25 WEST BAY DR NW ST NE PORTLAND,ORROAD KENT WA 85TH E 400 W GOWE MAIN ST OLYMPIA WA AVE OLYMPIA,WA 97204 ANCHORAGE,AK98032 AUBURN,WA 98502 TULSA,OK 98501 99507 98001 74133 Div Type Name Age Sex Marital Pts Filing 1 Driver RICHARD,DUNCAN 55 M S 1 SR-22 2 Non-Driver ZACHARY,DUNCAN 24 M S 2 N �.c„ �g�i:rr�:Ftatl•:ft o Vehicle#: 1 2011 DODGE RAM 1500 QUAD Total Premium: 4392.00 Gross Net Coverage Limit]Deduc Symbol Territory Premium Premium Bodily lnjurylProperty 10001C 0 0 3228.00 0,00 ;Damage 16001- 0 0 655.00 0.00 1 Collision 200001000 ;Comprehensive 16001- 0 0 192.00 0.00 200001000 ;Underinsured Motorist 1000/S 0 0 275.00 0.00 Underinsured Motorists 1000000 0 0 42.00 0.00 iPD i'2$�:=ii::ti'!��tii:::13::1±jis�S I�CrS�:C1i:Ci:•S No Discount/Surcharges Data Available P71:R C4'tti£:fiRa3r:i:�t�:??'�kr�T':C��i Prior Company: Titan Prior Limits: 25/50110 Prior Expiration: 1211012014 Same Agent?: Yes spinoff/Parent Co?: No Parent Co.Fallout?: No httr)s://WWW.VictoliainSurance.com/inqui y/PrintPoboySummary.do 10/19/2016 Policy Summary Page 2 of 2 No Premium Tax Data Available i i - rtt„-�-/hwwr_vir,toriain era-nc&comhneuirv/PzinfiPolicySummary.do 10/19/2016 t CERTIFICATE OF INSURANCE Producer: Issue Date:08/18/2016 This Certificate is issued as a matter of information only and LIA ADMINISTRATORS&INSURANCE SERVICES confers no rights upon the Certificate Holder.This Certificate P.O.Box 1319 does not amend,extend or alter the coverage afforded by the Santa Barbara,CA 93102-1319 policy below. Insured: 148215 COMPANY AFFORDING COVERAGE DUNCAN,RF AND ASSOCIATES INC. The Granger Company Aspen American Insurance Company Richard F.Duncan Box I Olympia,WAA 98508 Fax Number:360-867-1059 Authorized Representative This is to certify that the policy of insurance listed below has been issued to the Insured named above for the policy period indicated. Notwithstanding any requirement,term of condition of any contract or other document with respect to vIhich this Certificate maybe issued or may pertain,the insurance afforded by the policy described herein is subject to all the terms,exclusions and conditions of such policy.Limits shown may have been reduced by paid claim's. DISCLAIMER:This certificate of insurance does not affirmatively or negatively amend,extend,or alter the coverage afforded / by the insurance policy. (l TYPE OF INSURANCE POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE LIMITS Professional Liability AA1002412-02 07/21/2016 07/21/2017 Each Claim $ 1,000,000 General Aggregate $ 2,000,000 Description of Operations/Locations/Special Items: REAL ESTATE APPRAISERS PROFESSIONAL LIABILITY INSURANCE Certificate Holder: Cancellation: City of Kent,WA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 220 Fourth Avenue South BE CANCELLED BEFORE THE EXPIRATION DATE )Cent,WA 98032 THEREOF,NOTICE WILL BE DELIVERED IN I ACCORDANCE WITH THE POLICY PROVISIONS. t LIA0001 (11/97)