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CAG2019-309 - Original - R. F. Duncan & Associates - Milwaukee II Levee - 05/14/2019
�O_T Records Management Document CONTRACT COVER SHEET This is to be completed by the, Contrz�ctl manager prior to submis_,i%,�,,, to the City Clerk's Office, AN portions are to the completed. .Li you have questions, please contact the City Clesii-"s Office at 253-8"- Vendor Name: R. F. Duncan & Associates Inc. Vendor Number ()DE): 1254392 Contract Number (City Clerk): 6H(-7 701 Category: Contract Agreement Sub-Category (if applicable): None Project Name: Milwaukee 11 Levee Contract Execution Date: 5/14/19 Termination Date: 11/1/19 Contract Manager: Dee Martindale Department: PVV: Engineering Contract Amount: $800 Budgeted: 1-y-il Grant? Part of NEW Budget: F] Local: F] State: F] Federal: Related to a New Position: Basis for Selection of Contractor? Other Approval Authority: 1__/1 Director F] Mayor City Council Other Details: Perform a review of the owner's of Skyway Towing and Recovery appraisal. KENT W A S N N G T O Y 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 perform a review of the owner's appraisal for the Milwaukee II Levee - Skyway Towing and Recovery, Inc. parcel. 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 November 1, 2019. III. COMPENSATION. The City shall pay Contractor a total amount not to exceed Eight Hundred Dollars ($800.00) 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 Required. Prior to commencing the tasks described in Section I, Contractor agrees to provide proof of a current city of Kent business license pursuant to Chapter 5.01 of the Kent City Code. PROFESSIONAL SERVICES AGREEMENT - 3 ($20,000 or Less) 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 KENT: t. By: ` By: (signature) (signature) Print Name: Richard F. Duncan Print Name: Michael Mactutis, P.E. Its: owner Its: Environmental Engineering Manager (title) DATE: 5-7-1 s DATE:4 .1 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) N/A (facsimile) (253) 856-6500 (facsimile) ATTE T: r ,4� U , Kent City Clerk 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 7th day of May , 2019 By: - For: Richard F. Duncan Title: Owner Date: 5-7-19 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 EXHIBIT A R . F . LUNCAN & 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 May 6, 2019 Ms. Cheryl Rolcik-Wilcox, Property and Acquisition Analyst Design Engineering I Public Works Department 220 Fourth Avenue South, Kent, WA 98032 RE: City of Kent; Milwaukee Levee II; Skyway Towing and Recovery, Inc.; Review of Owner Appraisal. Dear Ms. Rolcik-Wilcox: My proposal to perform a review of the owner's appraisal on the above referenced parcel is for a fee of$800.00, with a delivery of one week from the time I receive the appraisal. The fee proposal is at my rate of $150 per hour and includes all my costs for the performing the review appraisal services. My appraisal review reports will meet or exceed all City of Kent, state, federal, WSDOT, USPAP, RCO, and TIB requirements. Thank you for the opportunity to submit this proposal. Sincerely, Richard F. Duncan, MAI T E L E P H O N E ( 3 6 0 ) 9 5 1 - 8 2 5 8 P O B O X 1 2 3 0 0 • 0 L Y M P I A , W A S H I N G T 0 N 9 8 5 0 8 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. i ACC /? ! L� DaTE tMMIDD vvvvl CERTIFICATE OF LIABILITY INSURANCE 20 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS19 CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED j REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed I If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on I this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME Judy Land i Duncan&Associates Insurance Brokers PHONE -- B FAX- - P.O. Box 1458-2111 Harrison Ave NW MZ01°- +I 360 352-7568 ,A,c,,N.i 360-943-6304 Olympia,WA 98502 ADDRFOS JII(I a)du tic anu+ COm ,RDiNG COVERAGE NAIC 4 _ INSURED _.... _ I INSURER A Ohio SOCUrity ITISUrance C011l(JBtly ;531311 R F Duncan &Associates, Inc !INSURER© Ohio Security Insurance Company DBA The Granger Company INSURER P O Box 12300 INSi RFR p Olympia,WA 98508 wsq«;tR E ' r _ COVERAGES NSURER F _ CERTIFICATE NUMBER. 00000000.159778 REVISION NUMBER: 16 _ IIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO i"HE INSURED NAMED ABOVE FOR THE POLICY PERIOD rr IND GATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDI DON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH T I!5 4 RT P1t ATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT-I'D ALL THE TERMS, EXCLUSIONS AND CONDITIONS Of SUCH POL C ES LIMITS S HO"VN MAY HAVE BEEN REDUCED BY PAID CLAIMS 'POOL+&UBR TR,_a TYPE OF INSURANCE I t u ..... i POLICY EFP POLICY EXP - "` __. .IN34,W4D _-,•„_ _OLtCY NUMBER IMMA) YYYyt iLy�,DbSYY� LIMITS A �( COMMERCIAL GENERAL LIABIUTY Y N BLS 20 56696377 105108/2019 t05/08/2020 EACH OCCURRENCE- $ 1,0p01000 + vL.uN6-MADE ��OCCUR ! i iS�fw4A TOtiPiTLO fRRLi+ FS 'aowrrvn,�eL. 1,000,000 ( s _ PERSONAL&ACV INJURY ! WLAGGREGATEIIMIF APPLIES PER: , ,1,0 0000 0 X FCU Y ._.!SECT rA_�LOC { GLNERALAGGREGATE 2„OWOOO zT•I+ER € "Of1uCTs coMPIOPAGG S 2 000,000 _ . —._. B AUTOMOBILE LIABILITY °•----- `� { Y N SAS 20 56696377 105/23/2019 05/23/2020 1aaGINFD SINGLE uAa X.1 ANi AUTO ... {S L..Y IN URY(P r perb n)- _a i SCHEDULED no nno { i n4-O.,ONLY AUTOS ! s( X =iR NON-OWNED � P O i. INJURY AtnCv ONi,Y X AUTOS ONLY r'c at!*•enl� - DI,MAt'E . i i � � i '{f+er AtcetlFntl i I UMBRELLA LIAB I i t---^---f- $ OCCUR j EXCESS LIA6 CtAIMy.MADF _E.Csl c> l <REN.i: .._...i 5 _..._. I ixo, 1 RETENITON S i WORKERS COMPENSATION — q AND EMPLOYERS'LIABILITY {{ I "'--•�-------- j ANY PROF>RIETOR/PARTNER/EXECUTIVE Y f N€ ` TUTE ORI _... t 7PfICERIMEMBER EXCLUDED? `N 1 A I i E_EACH ACC!JEN+landaWry in NH) i ( _ 15 I-as-JeseriUe under DI EASE FA rldrLC YE Y<5 .. .. 0f,5CRIPT'ON OF OPERATIOr4tS nehr,, __T,• ` t •-- -. E L OISEASE,POL ICY i iA I i t$ I i I ) RE DESCRIPTIONOPERATIONS)LOCATIONS I VEHICLES (AGORO 101,Additional Rern.rks Schedule nay be attached if..re space is required) :All 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 per form CG 88 10 04 13, Additional Insured for the Commercial Auto Liability coverage above applies per form AC 85 01 06 18, I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Of Kent THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 400 West G owe ACCORDANCE WITH THE POLICY PROVISIONS. Kent, WA 98032 n AUTH RIZED REPRESENTATIVE '^--^w•--- su-.L.A• ©1988-2015 ACORD CORPORATION- All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Printed by JAL On May 07,2019 at 04.18PM I Liberty Mutual. INSURANCE Policy Number: BLS 56696377 Prior Policy: NOT AVAILABLE Coverage Is Provided In The Ohio Security Insurance Company Billing Type: Direct Bill Named Insured and Mailing Address: Agent: R F DUNCAN & ASSOCIATES, INC DUNCAN & ASSOCIATES INC PO BOX 12300 PO BOX 1458 OLYMPIA, WA 98508 OLYMPIA, WA 98507-1458 Agent Code: 466104 Agent Phone: (360) 352-7588 Policy Declarations, Forms and Endorsements LO N co N LO O O O N O O O O O V N O N O O O_ C7 y t This page intentionally left blank. 46 6104 BLS 56696377 DUNCAN & ASSOCIATES INC 05/08/2020 PO BOX 1458 OLYMPIA, WA 98507-1458 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. If there 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): Thank you for your assistance. Please Send to: Liberty Mutual Insurance ATTENTION: C.S.I. UNIT CAU: NONE i i i z i i i I i i i i j This page intentionally left blank. i I i Liberty Mutual INSURANCE Policyholder Information Named Insured&Mailing Address Agent Mailing Address&Phone No. R h DUNCAN & ASSOCIATES, INC (360) 352-7588 DBA THE GRANGER COMPANY DUNCAN & ASSOCIATES INC PO BOX 12300 PO BOX 1458 OLYMPIA, WA 98508 OLYMPIA, WA 98507-1458 Dear Policyholder: We know you work hard to build your business. We work together with your agent, Your DUNCAN & ASSOCIATES INC (360) 352-7588 ��ommercial to help protect the things you care about. Thank you for selecting us. ,ocumenls 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 ij - If you have any changes, please contact your Agent at (360) 352-7588 Reminders . In case of a claim, call your Agent or 1-800-362-0000 You Need To Know . CONTINUED ON NEXT PAGE To report a claim, call your Agent or 1-800-362-0000 DS 70 20 01 08 mm� You Need To Know - continued . NOTICE(S) TO POLICYHOLDERS) The Important Notice(s) to Policyholder(s) provide a general explanation of changes in coverage to your policy. The Important Notice(s) 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 CNI90 10 10 18 Important Notice To Policyholders Exclusion - Tobacco, Tobacco Products, Nicotine, Nicotine Products and Electronic Smoking Devices CNI90 11 07 18 Reporting A Commercial Claim 24 Hours A Day NP 72 42 01 15 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 01 07 Important Audit Information NP 89 71 09 10 Important Policyholder Information Concerning Billing Practices Liberty Northwest NP 96 00 10 14 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. CNI 90 10 10 18 IMPORTANT NOTICE TO POLICYHOLDERS EXCLUSION - TOBACCO, TOBACCO PRODUCTS, NICOTINE, NICOTINE PRODUCTS AND ELECTRONIC SMOKING DEVICES This Notice explains changes in your Commercial General Liability, Products/Completed Operations, Com- mercial Umbrella and/or Commercial Excess renewal policy. It contains a brief synopsis of the change and must be reviewed in conjunction with your expiring and renewal policies to reference the forms described herein. This Notice does not form a part of your insurance contract. The Notice is designed to alert you to changes in your Commercial General Liability Coverage Form, Products/Completed Operations Coverage Form, Commercial Umbrella Coverage Form and/or Commercial Excess Coverage Form. If there is any conflict between this Notice and the policy (including its endorsements), the provisions of the policy (including its endorsements)apply. Carefully read your renewal and expiring policies, including the endorsements attached to your renewal and expiring policies, If you have any questions, please contact your agent. SUMMARY OF POLICY CHANGES If your renewal policy contains endorsement CG 88 84 10 18 EXCLUSION - TOBACCO, TOBACCO PRODUCTS, NICOTINE, NICOTINE PRODUCTS OR ELECTRONIC SMOKING DEVICES and your expiring policy contained CG 88 8412 08 EXCLUSION - TOBACCO or did or did not contain a similar endorsement, the following change applies to your policy: RESTRICTIONS IN COVERAGE This exclusion removes coverage for bodily injury, property damage and personal and advertising injury arising or allegedly arising, in whole or in part, out of tobacco,tobacco products, nicotine, nicotine products and electronic smoking devices. EDITORIAL CHANGES New defined terms "electronic smoking device", "nicotine or nicotine products" and "tobacco or tobacco products" are added. If your renewal policy contains endorsement CG 93 18 10 18 ALASKA CHANGES - EXCLUSION - TOBACCO, TOBACCO PRODUCTS, NICOTINE, NICOTINE PRODUCTS OR ELECTRONIC SMOKING DEVICES and your expiring policy contained CG 88 8412 08 EXCLUSION -TOBACCO or did or did not contain a similar endorsement, the following change applies to your policy., RESTRICTIONS IN COVERAGE This exclusion removes coverage for bodily injury, property damage and personal and advertising injury arising or allegedly arising out of tobacco, tobacco products, nicotine, nicotine products and electronic smoking devices. EDITORIAL CHANGES New defined terms "electronic smoking device", "nicotine or nicotine products" and "tobacco or tobacco products" are added. CNI 90 10 10 18 © 2018 Liberty Mutual Insurance Page 1 of 6 If your renewal policy contains endorsement CG 90 20 10 18 NEW YORK CHANGES - EXCLUSION - TOBACCO, TOBACCO PRODUCTS, NICOTINE, NICOTINE PRODUCTS OR ELECTRONIC SMOKING DEVICES and your expiring policy contained CG 90 20 04 12 NEW YORK CHANGES-EXCLUSION -TOBACCO PRODUCTS or did or did not contain a similar endorsement, the following change applies to your policy: RESTRICTIONS IN COVERAGE This exclusion removes coverage for bodily injury, property damage and personal and advertising injury arising or allegedly arising out of nicotine, nicotine products and electronic smoking devices and the delete- rious health effects associated with the use of tobacco or tobacco products. EDITORIAL CHANGES New defined terms "electronic smoking device", "nicotine or nicotine products" and "tobacco or tobacco products" are added. If your renewal policy contains endorsement CG 88 85 10 18 EXCLUSION - TOBACCO, TOBACCO PRODUCTS, NICOTINE, NICOTINE PRODUCTS OR ELECTRONIC SMOKING DEVICES and your expiring policy contained CG 88 85 12 08 EXCLUSION - TOBACCO or did or did not contain a similar endorsement, the following change applies to your policy. RESTRICTIONS IN COVERAGE This exclusion removes coverage for bodily injury and property damage arising or allegedly arising, in whole or in part, out of tobacco, tobacco products, nicotine, nicotine products and electronic smoking devices, EDITORIAL CHANGES New defined terms "electronic smoking device", "nicotine or nicotine products" and "tobacco or tobacco products" are added. If your renewal policy contains endorsement CG 93 19 10 18 ALASKA CHANGES - EXCLUSION - TOBACCO, TOBACCO PRODUCTS, NICOTINE, NICOTINE PRODUCTS OR ELECTRONIC SMOKING DEVICES and your expiring policy contained CG 88 85 12 08 EXCLUSION - TOBACCO or did or did not contain a similar endorsement, the following change applies to your policy: RESTRICTIONS IN COVERAGE This exclusion removes coverage for bodily injury and property damage arising or allegedly arising out of tobacco,tobacco products, nicotine, nicotine products and electronic smoking devices. EDITORIAL CHANGES New defined terms "electronic smoking device", "nicotine or nicotine products" and "tobacco or tobacco products" are added. If your renewal policy contains endorsement CG 90 21 10 18 NEW YORK CHANGES - EXCLUSION - TOBACCO, TOBACCO PRODUCTS, NICOTINE, NICOTINE PRODUCTS OR ELECTRONIC SMOKING DEVICES and your expiring policy contained CG 90 2104 12 NEW YORK CHANGES- EXCLUSION-TOBACCO PRODUCTS or did or did not contain a similar endorsement, the following change applies to your policy. CNI 90 10 10 18 © 2018 Liberty Mutual Insurance Page 2 of 6 RESTRICTIONS IN COVERAGE This exclusion removes coverage for bodily injury and property damage arising or allegedly arising out of nicotine, nicotine products and electronic smoking devices and the deleterious health effects associated with the use of tobacco or tobacco products. EDITORIAL CHANGES New defined terms "electronic smoking device", "nicotine or nicotine products" and "tobacco or tobacco products" are added. If your renewal policy contains endorsement CG 93 20 10 18 GEORGIA CHANGES - EXCLUSION - TOBACCO, TOBACCO PRODUCTS, NICOTINE, NICOTINE PRODUCTS OR ELECTRONIC SMOKING DEVICES and your expiring policy contained CG 88 85 12 08 EXCLUSION - TOBACCO or did not contain a similar endorsement, the following change applies to your policy: RESTRICTIONS IN COVERAGE This exclusion removes coverage for bodily injury, property damage and personal and advertising injury arising or allegedly arising, in whole or in part, out of the possession, sale or distribution of tobacco, tobacco products, nicotine, nicotine products and electronic smoking devices. EDITORIAL CHANGES New defined terms "electronic smoking device", "nicotine or nicotine products" and "tobacco or tobacco products" are added. If your renewal policy contains endorsement CG 93 21 10 18 GEORGIA CHANGES - EXCLUSION - TOBACCO, TOBACCO PRODUCTS, NICOTINE, NICOTINE PRODUCTS OR ELECTRONIC SMOKING DEVICES and your expiring policy contained CG 88 84 12 08 EXCLUSION - TOBACCO or did not contain a similar endorsement, the following change applies to your policy: RESTRICTIONS IN COVERAGE This exclusion removes coverage for bodily injury, property damage and personal and advertising injury arising or allegedly arising, in whole or in part, out of the possession, sale or distribution of tobacco, tobacco products, nicotine, nicotine products and electronic smoking devices. EDITORIAL CHANGES New defined terms "electronic smoking device", "nicotine or nicotine products" and "tobacco or tobacco products" are added, If your renewal policy contains endorsement CU 88 90 10 18 TOBACCO, TOBACCO PRODUCTS, NICOTINE, NICOTINE PRODUCTS OR ELECTRONIC SMOKING DEVICES EXCLUSION and your expiring policy contained CU 88 90 07 16 TOBACCO EXCLUSION or did or did not contain a similar endorsement, the following change applies to your policy: RESTRICTIONS IN COVERAGE This exclusion removes coverage for bodily injury, property damage and personal and advertising injury arising or allegedly arising, in whole or in part, out of tobacco,tobacco products, nicotine, nicotine products and electronic smoking devices. CNI 90 10 10 18 © 2018 Liberty Mutual Insurance Page 3 of 6 EDITORIAL CHANGES New defined terms "electronic smoking device", "nicotine or nicotine products" and "tobacco or tobacco products" are added. If your renewal policy contains endorsement CU 88 94 10 18 ALASKA TOBACCO, TOBACCO PRODUCTS, NICOTINE, NICOTINE PRODUCTS OR ELECTRONIC SMOKING DEVICES EXCLUSION and your expiring policy contained CU 88 94 01 12 TOBACCO EXCLUSION - ALASKA or did or did not contain a similar endorsement, the following change applies to your policy. RESTRICTIONS IN COVERAGE This exclusion removes coverage for bodily injury, property damage and personal and advertising injury arising or allegedly arising out of tobacco, tobacco products, nicotine, nicotine products and electronic smoking devices. EDITORIAL CHANGES New defined terms "electronic smoking device", "nicotine or nicotine products" and "tobacco or tobacco products" are added. If your renewal policy contains endorsement CU 90 55 10 18 NEW YORK TOBACCO, TOBACCO PRODUCTS, NICOTINE, NICOTINE PRODUCTS OR ELECTRONIC SMOKING DEVICES EXCLUSION and your expiring policy contained CU 60 61 06 97 TOBACCO HEALTH HAZARD EXCLUSION or did or did not contain a similar endorsement, the following change applies to your policy: RESTRICTIONS IN COVERAGE This exclusion removes coverage for bodily injury, property damage and personal and advertising injury arising or allegedly arising out of nicotine, nicotine products and electronic smoking devices and the delete- rious health effects associated with the use of tobacco or tobacco products. EDITORIAL CHANGES New defined terms "electronic smoking device", "nicotine or nicotine products" and "tobacco or tobacco products" are added, If your renewal policy contains endorsement CU 90 57 10 18 GEORGIA TOBACCO, TOBACCO PRODUCTS, NICOTINE, NICOTINE PRODUCTS OR ELECTRONIC SMOKING DEVICES EXCLUSION and your expiring policy contained CU 88 90 07 16 TOBACCO EXCLUSION or did not contain a similar endorsement, the following change applies to your policy., RESTRICTIONS IN COVERAGE This exclusion removes coverage for bodily injury, property damage and personal and advertising injury arising or allegedly arising, in whole or in part, out of the possession, sale or distribution of tobacco, tobacco products, nicotine, nicotine products and electronic smoking devices. EDITORIAL CHANGES New defined terms "electronic smoking device", "nicotine or nicotine products" and "tobacco or tobacco products" are added. CNI 90 10 10 18 © 2018 Liberty Mutual Insurance Page 4 of 6 If your renewal policy contains endorsement CE 88 75 10 18 TOBACCO, TOBACCO PRODUCTS, NICOTINE, NICOTINE PRODUCTS OR ELECTRONIC SMOKING DEVICES EXCLUSION and your expiring policy contained CE 88 75 07 16 TOBACCO EXCLUSION or did or did not contain a similar endorsement, the following change applies to your policy. RESTRICTIONS IN COVERAGE This exclusion removes coverage for bodily injury, property damage and personal and advertising injury arising or allegedly arising, in whole or in part, out of tobacco,tobacco products, nicotine, nicotine products I and electronic smoking devices. EDITORIAL CHANGES New defined terms "electronic smoking device", "nicotine or nicotine products" and "tobacco or tobacco products" are added. If your renewal policy contains endorsement CE 88 86 10 18 ALASKA TOBACCO, TOBACCO PRODUCTS, NICO- TINE, NICOTINE PRODUCTS OR ELECTRONIC SMOKING DEVICES EXCLUSION and your expiring policy contained CE 88 86 07 16 TOBACCO EXCLUSION or did or did not contain a similar endorsement, the following change applies to your policy: RESTRICTIONS IN COVERAGE This exclusion removes coverage for bodily injury, property damage and personal and advertising injury arising or allegedly arising out of tobacco, tobacco products, nicotine, nicotine products and electronic smoking devices. EDITORIAL CHANGES New defined terms "electronic smoking device", "nicotine or nicotine products" and "tobacco or tobacco products" are added. If your renewal policy contains endorsement CE 89 11 10 18 NEW YORK TOBACCO, TOBACCO PRODUCTS, NICOTINE, NICOTINE PRODUCTS OR ELECTRONIC SMOKING DEVICES EXCLUSION and your expiring policy contained CE 65 70 06 97 TOBACCO HEALTH HAZARD EXCLUSION or did or did not contain a similar endorse- ment, the following change applies to your policy., RESTRICTIONS IN COVERAGE This exclusion removes coverage for bodily injury, property damage and personal and advertising injury arising or allegedly arising out of nicotine, nicotine products and electronic smoking devices and the delete- rious health effects associated with the use of tobacco or tobacco products, EDITORIAL CHANGES New defined terms "electronic smoking device", "nicotine or nicotine products" and "tobacco or tobacco products" are added, If your renewal policy contains endorsement CE 89 14 10 18 GEORGIA TOBACCO, TOBACCO PRODUCTS, NICOTINE, NICOTINE PRODUCTS OR ELECTRONIC SMOKING DEVICES EXCLUSION and your expiring policy contained CE 88 75 07 16 TOBACCO EXCLUSION or did not contain a similar endorsement, the following change applies to your policy. CNI 90 10 10 18 © 2018 Liberty Mutual Insurance Page 5 of 6 RESTRICTIONS IN COVERAGE This exclusion removes coverage for bodily injury, property damage and personal and advertising injury arising or allegedly arising, in whole or in part, out of the possession, sale or distribution of tobacco, tobacco products, nicotine, nicotine products and electronic smoking devices. EDITORIAL CHANGES New defined terms "electronic smoking device", "nicotine or nicotine products" and "tobacco or tobacco products" are added. CNI 90 10 10 18 © 2018 Liberty Mutual Insurance Page 6 of 6 CNI 90 11 07 18 REPORTING A COMMERCIAL CLAIM 24 HOURS A DAY Liberty Mutual Insurance claims professionals across the United States are ready to resolve your claim quickly and fairly, so you and your team can focus on your business. Our claims teams are specialized, experienced and dedicated to a high standard of service. We're Just a Call Away - One Phone Number to Report All Commercial Insurance Claims Reporting a new claim has never been easier, A Liberty Mutual customer service representative is available to you 24/7 at 800-362-0000_ for reporting new property, auto, liability and workers' compensa- tion claims, With contact centers strategically located throughout the country for continuity and accessibility, we're there when we're needed! Additional Resource for Workers' Compensation Customers In many states, employers are required by law to use state-specific workers compensation claims forms and posting notices. This type of information can be found in the Policyholders Toolkit section of our website along with other helpful resources such as: • Direct links to state workers compensation websites where you can find state-specific claim forms • Assistance finding local medical providers • First Fill pharmacy forms - part of our managed care pharmacy program committed to helping injured workers recover and return to work Our Policyholder Toolkit can be accessed at www.libertymutuaigroup.com/toolkit. For all claims inquiries please call us at 800.362.0000. i I © 2018 Liberty Mutual Insurance CNI 90 11 07 18 Page 1 of 1 This page intentionally left blank. 03/18/19 R F DUNCAN & ASSOCIATES, INC BLS (20) 56 69 63 77 DBA THE GRANGER COMPANY From 05/08/2019 To 05/08/2020 PO BOX 12300 OLYMPIA, WA 98508 (360) 352-7588 DUNCAN S ASSOCIATES INC Po Box 1458 OLYMPIA, WA 98507-1458 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 of catastrophic losses from certain acts of terrorism between insurers and the federal government. If an individual insurer's losses from certified acts of terrorism exceed a specified deductible amount, the government will reimburse the insurer for a percentage of losses (the "Federal Share") paid in excess of the deductible, but only if aggregate industry losses from such acts exceed the "Program Trig- ger". An insurer that has met its insurer deductible is not liable for any portion of losses in excess of $100 billion per year. Similarly, the federal government is not liable for any losses covered by the Act that exceed this amount. If aggregate insured losses exceed $100 billion, losses up to that amount may be pro-rated, as determined by the Secretary of the Treasury. The Federal Share and Program Trigger by calendar year are; Calendar Year Federal Share Program Trigger 2015 85% $100,000,000 2016 84% $120,000,000 2017 83% $140,000,000 2018 82% $160,000,000 2019 81% $180,000,000 2020 80% $200,000,000 MANDATORY OFFER OF COVERAGE FOR "CERTIFIED ACTS OF TERRORISM" AND DISCLOSURE OF PRE- MIUM TRIA requires insurers to make coverage available for any loss that occurs within the United States (or outside of the U.S. in the case of U.S, missions and certain air carriers and vessels), results from a "certified act of terrorism" AND that is otherwise covered under your policy. A "certified act of terrorism" 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; NP 72 42 01 15 © 2016 Liberty Mutual Insurance Page 1 of 2 (ii) to be a violent act or an act that is dangerous to- (1) human life; (II) property; or (III) 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 (II) 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 policy. 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 arisirig 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, INC BLS (20) 56 69 63 77 i DBA THE GRANGER COMPANY Policy Effective/Expiration Date From 05/08/2019 To 05/08/2020 IF YOU REJECTED THIS COVERAGE, PLEASE RETURN THIS FORM TO: Attn: Commercial Lines Division -Terrorism PO Box 66400 London, KY 40742-6400 Note: Certain states (currently CA, GA, IA, IL, ME, MO, NY, NC, NJ, OR, RI, WA, WI and WV) mandate coverage for loss 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 conflict, your policy language will control the resolution of all coverage questions. Please read your policy carefully. If you have any questions regarding this notice, please contact your agent, NP 72 42 01 15 © 2016 Liberty Mutual Insurance Page 2 of 2 NP 74 44 09 06 U.S. TREASURY DEPARTMENT'S OFFICE OF FOREIGN ASSETS CONTROL ("OFAC") ADVISORY NOTICE TO POLICYHOLDERS No coverage is provided by this Policyholder Notice nor can it be construed to replace any provisions of your policy. You should read your policy and review your Declarations page for complete information on the coverages you are provided. This Notice provides information concerning possible impact on your insurance coverage due to directives issued by OFAC. Please read this Notice carefully. Please refer any questions you may have to your insurance agent. The Office of Foreign Assets Control (OFAC) administers and enforces sanctions policy, based on Presiden- tial declarations of "national emergency". OFAC has identified and listed numerous: • Foreign agents; • Front organizations; • Terrorists; • Terrorist organizations; and • Narcotics traffickers; as "Specially Designated Nationals and Blocked Persons". This list can be located on the United States Treasury's web site- http//www.treas.gov/ofac. In accordance with OFAC regulations, if it is determined that you or any other insured, or any person or entity claiming the benefits of this insurance has violated U,S, sanctions law or is a Specially Designated National and Blocked Person, as identified by OFAC, this insurance will be considered a blocked or frozen contract and all provisions of this insurance are immediately subject to OFAC. When an insurance policy is considered to be such a blocked or frozen contract, no payments nor premium refunds may be made without authorization from OFAC. Other limitations on the premiums and payments also apply, © 2011 Liberty Mutual Insurance.All rights reserved. NP 74 44 09 06 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 1 of 1 NP 74 50 01 07 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 easier for you to prepare for your 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 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, to 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. How 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. NIP 74 50 01 07 Completing the audit Many states have enacted legislation that governs the time in which an audit must be completed, billed and paid. This applies to audits for cancelled policies as well as regular audits. In order to comply with state regulations, it is important to make your records available for audit when our representative contacts you. We will make every effort to complete the audit within a reasonable time after the close of the policy period stated in your policy. Frequently Asked Questions Q:What if I use subcontractors? A: Subcontractors are factored in to the audit process. Subcontractors who do not have insurance are treated as though they are your employees at the time 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: 1 have no employees and work 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 I need an audit if I 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 policy with us, The audit would cover the time period for which you were insured by us, Other factors that may determine if an audit is necessary include the time the policy was in effect and the amount of premium involved. Q: If I use leased employees but the leasing company carries the liability, are the leased employees 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? A: It's important to provide the necessary information in order to complete the audit. If you fail to do so, your policy may be cancelled or nonrenewed. You may also receive an estimated audit statement based on 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 PremiumAuditServices@libertymutuaI.com NP 74 50 01 07 NP 89 71 09 10 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 will receive 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 installment(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. EFT-Automatic Withdrawals Payment Option: When you select this option, you will not be sent Premium Notices and, inmost 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, please contact your agent if you have any questions about the above billing practice informa- tion, Thank you for selecting us to service your insurance needs. NP 89 71 09 10 © 2010 Liberty Mutual Insurance Company.All rights reserved. Page 1 of 1 NP96001014 GENERAL LIABILITY ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION EXCLUSIONS ADVISORY NOTICE TO POLICYHOLDERS Dear Valued Policyholder, Thank you for selecting us as your carrier for your commercial insurance. Your renewal policy contains an exclusion regarding access or disclosure of personal information. There is more than one version of the exclusion and each is described below. Please note that not all of the forms or changes noted may apply to Your specific policy. Any of the forms described in this notice may have comparable state specific forms in lieu of the forms mentioned below. In those situations, the title of the state forms on your policy will generally be very similar to one or more titles mentioned in this notice. The changes described below would also apply to those state specific forms, unless noted otherwise, In addition, this notice does not reference every change made to the endorsements or coverage forms, only material (or significant) changes. Please read your policy and review your declarations page for complete coverage information, No coverage is provided by this notice, nor can it be construed to replace any provisions of your policy. If there are discrepancies between your policy and this notice, the provisions of the policy shall prevail. Should you have questions after reviewing the changes outlined below, please contact your broker or agent. Thank you for your business. With respect to bodily injury and property damage arising out of access or disclosure of confidential or personal information, these changes are a reinforcement of coverage intent. Damages related to data breaches, and certain data-related liability, are not intended to be covered by various liability coverage parts. These types of damages may be more appropriately covered under certain coverage endorsements providing data compromise, attack and extortion and network security liability. CG 2106 05 14-Exclusion-Access Or Disclosure Of Confidential Or Personal Information And Data-related Liability - With Limited Bodily Injury Exception (For Use With The Commercial General Liability Coverage Part) 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. • 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 07 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 Commercial General Liability Coverage Part) 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. 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. © 2014 Liberty Mutual Insurance NP 96 00 10 14 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 1 of 2 I • 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; • 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. 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, © 2014 Liberty Mutual Insurance NP 96 00 10 14 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 2 of 2 Coverage Is Provided In: Poll Number: Liberty Ohio Security Insurance Company BLS(y20) 56 69 63 77 Mutual. c Policy Period: INSURANCE From 05/08/2019 To 05/08/2020 12:01 am Standard Time Common Policy Declarations at Insured Mailing Location Named Insured &Mailing Address Agent Mailing Address&Phone No. R F DUNCAN & ASSOCIATES, INC (360) 352-7588 DI3A THE GRANGER COMPANY DUNCAN & ASSOCIATES INC PO BOX 12300 PO BOX 1458 OLYMPIA, WA 98508 OLYMPIA, WA 98507-1458 Named Insured Is:CORPORATION Named Insured Business Is: REAL ESTATE APPRAISER In return for the payment of the prencium, and subject to all the tenns of this policy, we agree with you to provide the insurance as stated in this policy. SUMMARY OF COVERAGE PARTS AND CHARGES This policy consists of this Common Policy Declarations page, Common Policy Conditions, Coverage Parts (which consist of coverage forms and other applicable forms and endorsements, if any, issued to form a part of them) and any other 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 Certified Acts of Terrorism Coverage: $1.00 (Included) 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. Issue Date 03/18/19 Authorized Representative To report a claim, call your Agent or 1-800-366-6446 DS 70 21 11 16 fill 1AHa c9909177 Pni CVCQ )u Airnnoonin Ar.GniT enov M1001 onr_r oa nG 00 Coverage Is Provided In: Policy Number: Liberty Ohio Security Insurance Company BLS (20) 56 69 63 77 Mutual PolicyPeriod: INSURANCE From 05/08/2019'IO 05/08/2620 12:01 am Standard Time at Insured Mailing Location Common Policy Declarations Named Insured Agent R F DUNCAN & ASSOCIATES, INC (360) 352-7588 DBA THE GRANGER COMPANY DUNCAN & ASSOCIATES INC PO BOX 12300 PO BOX 1458 OLYMPIA, WA 98508 OLYMPIA, WA 98507-1458 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 01 04 13 Commercial General Liability Coverage Form- Occurrence CG 01 81 05 08 Washington Changes CG 01 97 12 07 Washington Changes - Employment-Related Practices Exclusion CG 21 06 05 14 Exclusion - Access Or Disclosure Of Confidential Or Personal Information And Data-Related Liability - With Limited Bodily Injury Exception CG 21 70 01 15 Cap on Losses from Certified Acts of Terrorism CG 21 7601 15 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 IL 01 23 11 13 Washington Changes - Defense Costs IL Of 46 08 10 Washington Common Policy Conditions IL 01 98 09 08 Nuclear Energy Liability Exclusion Endorsement (Broad Form) In witness whereof, we have caused this policy to be signed by our authorized officers. /�—� *1C__ Mark Touhey Paul Condrin Secretary President To report a claim, call your Agent or 1-800-362-000o DS 70 21 11 16 nwiafia sgaaF177 Pnicurc 91r; Nf'.anPPAIn arPhlrrnnv nni9Qi PArF 9a nF 9A 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 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 Rented To You as described in Section III-Limits Of Insurance. 2. Paragraph 6. under Section III-Limits Of Insurance is replaced by the following: 6. 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. 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 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 It - 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: 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 written agreement provided that the "bodily injury" or "property damage" occurs, or the "per- sonal and advertising injury" is committed, subsequent to the signing of such written contract or written agreement; or © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services office,Inc.,with its permission. Page 3 of 8 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 bylaw; 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. 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. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office.Inc..with its permission. page it of 8 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. d. "Bodily injury" or"property damage" occurring after: (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. 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 following is added to Section III -Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement,the most we will pay on behalf of the additional insured is the amount of insurance: 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 Declarations. 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 the additional insured's policy for damages we cover. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 5 of 8 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, an 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 Ill - 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 II-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 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 © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services office,Inc.,with its permission. Page 6 of 8 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 11-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. 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 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 11 -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. 0. 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 result"§from such physical injury, sick- ness or disease. © 2013 Liberty Mutual Insurance CC.,88 10 04 13 - Includes copyrighted material of Insurance Services office,Inc.,with Its permission. Page 7 of 8 P. EXTENDED PROPERTY DAMAGE _ Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU Under Section IV- Commercial General Liability Conditions,the following is added to Condition 8.Trans- fer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against a person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard" provided: 1. You and that person or organization have agreed in writing in a contract or agreement that you waive such rights against that person or organization; and 2. The injury or damage occurs subsequent to the execution of the written contract or written agree- ment. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 13 of 8 Coverage Is Provided In: Policy Number; Liberty Ohio Security Insurance Company BLS (20) 56 69 63 77 Mutua Policy Period: INSURANCEE From 05/08/2019 To 05/08/2020 Commercial General Liability 12:01 am Standard Time Declarations at Insured Mailing Location Basis:Occurrence Named Insured Agent R F DUNCAN & ASSOCIATES, INC (360) 352-7588 DBA THE GRANGER COMPANY DUNCAN & ASSOCIATES INC SUMMARY OF LIMITS AND CHARGES Commercial DESCRIPTION LIMIT General Each Occurrence Limit 1,000,000 Liability Damage To Premises Rented To You Limit (Any One Premises) 1,000,000 Limits of Insurance Medical Expense Limit (Any One Person) 15,000 Personal and Advertising Injury Limit 1,000,000 General Aggregate Limit (Other than Products - Completed Operations) 2,000,000 Products - Completed Operations Aggregate Limit 2,000,000 Explanation of DESCRIPTION PREMIUM Charges General Liability Schedule Totals 175.00 Policy Writing Minimum Premium Adjustment 74.00 Certified Acts of Terrorism Coverage 1.00 Total Advance Charges: $250.00 Note, This is not a bill To report a claim, call your Agent or 1-800-362-0000 DS 70 22 01 08 m/ip/1R SRR9077 POISUOS 935 NGAOPPNO AGFNTOOPy OWN PAGF 27 OF 28 Coverage Is Provided In. Policy Number: o L ibel Ohio Security Insurance Company BLS (20) 56 69 63 77 INSURANCE Policy Period: From 05/08/2019 To 05/081ZJ20 Commercial General Liability 12:01 am Standard Time Declarations Schedule at Insured Mailing Locatior, Named Insured Agent R F DUNCAN & ASSOCIATES, INC (360) 352-7588 DBA THE GRANGER COMPANY DUNCAN & ASSOCIATES INC SUMMARY OF CLASSIFICATIONS - BY LOCATION 0001 999 West Bay Dr NW, OL YMP/A, 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/PER COVERAGE DESCRIPTION PREMIUM BASED ON- Executive Officers 1,000 PREMIUM Premise/Operations 17,800 Dollars Of Payroll 9.134 $163.00 Minimum Premium Adjustment $12.00 Total: Included CLASSIFICATION- 96317 Inspection And Appraisal Companies - Inspecting For Insurance Or Valuation Purposes Products-Completed Operations Are Subject To The General Aggregate Limit. RATED/PER COVERAGE DESCRIPTION PREMIUM BASED ON- Employees Payroll 1,000 PREMIUM Premise/Operations Dollars Of Payroll - if any 9.134 Total: Commercial General Liability Schedule Total $175.00 To report a claim, call your Agent or 1-800-362-0000 DS 70 23 10 16 03/18/19 56696377 POLSVCS 235 NCAOPPNO AGENT COPY 001291 PAGE 28 OF 28 46 6104 BAS 56696377 DUNCAN & ASSOCIATES INC 05/23/2020 PO BOX 1458 OLYMPIA, WA 98507-1458 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. If there 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): Thank you for your assistance. Please send to: Liberty Mutual Insurance ATTENTION: C.S.I. UNIT CAU: NONE Liberty Mutual. INSURANCE Policyholder Information Named Insured &Mailing Address Agent Mailing Address & Phone No. 1 R F DUNCAN & ASSOCIATES, INC (360) 352-7588 I DBA THE GRANGER COMPANY DUNCAN & ASSOCIATES INC PO BOX 12300 PO BOX 1458 OLYMPIA, WA 98508 OLYMPIA, WA 98507-1458 I f 1 Dear Policyholder: We know you work hard to build your business. We work together with your agent, Your DUNCAN & ASSOCIATES INC (360) 352-7588 { Commercial to help protect the things you care about. Thank you for selecting us. Documents Enclosed are your insurance documents consisting of: i } • Business Auto " 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 Detach the ID Card located at the back of the policy Verify that all information is correct If you have any changes, please contact your f Agent at (360) 352-7588 Reminders In case of a claim, call your Agent or 1-800-362-0000 I • I " I You Need To Know . AUTO I.D. CARDS ARE INCLUDED AT THE BACK OF THE POLICY and can be used as evidence of insurance and provide you with information on what to do in case of an accident. i . CONTINUED ON NEXT PAGE A To report a claim, call your Agent or 1-800-362-0000 mwmm� DS 70 20 01 08 You Need To Know - continued NOTICE(S) TO POLICYHOLDERS) The Important Notice(s) to Policyholder(s) provide a general explanation of changes in coverage to your policy. The Important Notice(s) 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 CNA90 19 06 18 Important Notice To Policyholders CN190 11 07 18 Reporting A Commercial Claim 24 Hours A Day NP 74 44 09 06 U.S. Treasury Department's Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders NP 88 01 09 08 Important Information About Driving Outside of the United States and Proof of Auto Insurance NP 89 71 09 10 Important Policyholder Information Concerning Billing Practices Liberty Northwest SNA46 02 09 17 Important Notice To Policyholders Revisions To The Transfer Of Rights Of Recovery Against Others To Us Provision 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. Coverage Is Provided In: Liberty, Policy Number: Mutual Ohio Security Insurance Company BAS (20) 56 69 63 77 INSURANCE Policy Period: From 05/23/2019 To 05/23/2020 12:01 am Standard Time I at Insured Mailing Location Common Policy Declarations Named Insured &Mailing Address Agent Mailing Address &Phone No. R F DUNCAN & ASSOCIATES, INC (360) 352-7588 DBA THE GRANGER COMPANY DUNCAN & ASSOCIATES INC PO BOX 12300 PO BOX 1458 OLYMP[A, WA 98508 OLYMPIA, WA 98507-1458 i i Named Insured Is:CORPORATION Named Insured Business Is: REAL ESTATE APPRAILSALS I i In return for the payment of the premium, and subject to all the terms of this policy, we agree with you to I provide the insurance as stated in this policy. o SUMMARY OF COVERAGE PARTS AND CHARGES i i This policy consists of this Common Policy Declarations page, Common Policy Conditions, Coverage Parts (which consist of coverage forms and other applicable forms and endorsements, if any, issued to form a part of them) and any other forms and endorsements issued to be part of this policy. COVERAGE PART CHARGES Business Auto $1,917.00 Total Charges for all of the above coverage parts: $1,917.00 Coverage for Terrorism resulting from Nuclear, Biological or Chemical Acts is Excluded Note: This is not a bill IMPORTANT MESSAGES Issue Date 04/01/19 Authorized Representative To report a claim, call your Agent or 1-800-362-0000 DS 70 21 11 16 04/01/19 56696377 POLSVCS 235 NCAOPPNO AGENT COPY 009639 PAGE 5 OF 20 Coverage Is Provided In: Policy Number: Liberty Ohio Security Insurance Company BAS (20) 56 69 63 77 Mutual. Policy Period: INSURANCE From 05/23/2019 To 05/23/2020 12:01 am Standard Time at Insured Mailing Location Common Policy Declarations Named Insured Agent R F DUNCAN & ASSOCIATES, INC (360) 352-7588 DBA THE GRANGER COMPANY DUNCAN & ASSOCIATES INC PO BOX 12300 PO BOX 1458 OLYMPIA, WA 98508 OLYMPIA, WA 98507-1458 POLICY FORMS AND ENDORSEMENTS This section lists all the Forms and Endorsements for your policy. Refer to these documents as needed for detailed information concerning your coverage. FORAM NUMBER TITLE STATE(S)Applicable AC 00 31 01 14 Changes In Your Policy WA AC 01 15 08 17 Washington Changes WA AC 84 59 06 14 State Application Of Terrorism Exclusion Endorsements Involving Nuclear, WA Biological Or Chemical Terrorism AC 85 01 06 18 Business Auto Coverage Enhancement Endorsement WA CA 00 01 03 06 Business Auto Coverage Form WA CA 21 34 01 08 Washington Underinsured Motorists Coverage WA CA 23 45 11 16 Public or Livery Passenger Conveyance and On - Demand Delivery Services WA Exclusion CA 23 85 01 06 Exclusion of Terrorism Involving Nuclear, Biological or Chemical Terrorism WA CA 23 87 01 06 Exclusion of Terrorism Involving Nuclear, Biological or Chemical Terrorism Above WA Minimum Statutory Limits CA 2.3 89 01 06 Alaska Exclusion of Terrorism Involving Nuclear, Biological or Chemical WA Terrorism Above Minimum Statutory Limits CA 23 93 01 06 Washington Exclusion of Terrorism Involving Nuclear, Biological or Chemical WA Terrorism In witness whereof, we have caused this policy to be signed by our authorized officers. Mark Touhey Paul Condrin Secretary President To report a claim, call your Agent or 1-800-362-0000 DS 70 21 11 16 04/01/19 56696377 POLSVCS 235 NCAOPPNO AGENT COPY 009639 PAGE 6 OF 20 Coverage Is Provided In: Policy Number: Mutual Liberty.. Ohio Security Insurance Company BAS(20) 56 69 63 77 INSURANCE Policy Period: From 05/23/2019 To 05/23/2020 12:01 am Standard Time at Insured Mailing Location Common Policy Declarations Named Insured Agent R F DUNCAN & ASSOCIATES, INC (360) 352-7588 DBA THE GRANGER COMPANY DUNCAN & ASSOCIATES INC PO BOX 12300 PO BOX 1458 OLYMPIA, WA 98508 OLYMPIA, WA 98507-1458 POLICY FORMS AND ENDORSEMENTS - CONTINUED 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 STATE(S)Applicable CA 85 47 12 93 Temporary Substitute Auto - Physical Damage Insurance WA CA 85 53 12 93 Recreational Trailers and Boat Trailers WA CA 99 03 03 06 Auto Medical Payments Coverage WA CA 99 89 05 01 Washington Loss Payable Form Reg-335 WA IL 01 23 11 13 Washington Changes - Defense Costs WA IL 01 46 08 10 Washington Common Policy Conditions WA IL 01 98 09 08 Nuclear Energy Liability Exclusion Endorsement (Broad Form) WA To report a claim, call your Agent or 1-800-362-0000 DS 70 21 11 16 04/01/19 56696377 POLSVCS 235 NCAOPPNO AGENT COPY 009639 PAGE 7 OF 20 SECTION II -LIABILITY COVERAGE is amended as follows: 2. NEWLY FORMED OR ACQUIRED SUBSIDIARIES SECTION II - LIABILITY COVERAGE, Paragraph A.1. - Who Is An Insured is amended to include the following as an "insured": d. Any legally incorporated subsidiary of which you own more than 50 percent interest during the policy period. Coverage is afforded only for 90 days from the date of acquisition or formation. However, "insured" does not include any organization that: (1) Is a partnership or joint venture; or (2) Is an "insured" under any other automobile policy except a policy written specificall y to apply in excess of this policy; or (3) Has exhausted its Limit of Insurance or had its policy terminated under any other automobile policy. Coverage under this provision d. does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization. 3. EMPLOYEES AS INSUREDS SECTION II - LIABILITY COVERAGE, Paragraph A.1. Who Is An Insured is amended to include the following as an "insured": e. Any "employee" of yours while using a covered "auto" you do not own, hire or borrow but only for acts within the scope of their employment by you. Insurance provided by this endorsement is excess over any other insurance available to any "employee". f. Any "employee" of yours while operating an "auto" hired or borrowed under a written contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business and within the scope of their employment. Insurance provided by-this endorsement is excess over any other insurance available to the "employee". 4. ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT SECTION II - LIABILITY COVERAGE, Paragraph A.1. Who Is An Insured is amended to include the following as an "insured": g. Any person or organization with respect to the operation, maintenance or use of a covered "auto", provided that you and such person or organization have agreed in a written contract, written agreement, or permit issued to you by governmental or public authority, to add such person, or organization, or governmental or public authority to this policy as an "insured". However, such person or organization is an "insured": (1) Only with respect to the operation, maintenance or use of a covered "auto"; (2) Only for "bodily injury" or "property damage" caused by an "accident" which takes place after you executed the written contract or written agreement, or the permit has been issued to you; and (3) Only for the duration of that contract, agreement or permit. The "insured" is required to submit a claim to any other insurer to which coverage could apply for defense and indemnity. Unless the "insured" has agreed in writing to primary noncontributory wording per enhancement number 24, this policy is excess over any other collectible insurance. 5. SUPPLEMENTARY PAYMENTS SECTION II - LIABILITY COVERAGE, Coverage Extensions, 2.a. Supplementary Payments, Paragraphs (2) and (4) are replaced by the following: (2) Up to $3,000 for cost of bail bonds (including bonds for related traffic violations ) required because of an "accident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. © 2017 Liberty Mutual Insurance A(: 85 01 06 18 Includes copyrighted material of Insurance Services Office Inc.,with its Permission. Page 2 of 7 21. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT, OR LOSS SECTION IV - BUSINESS AUTO CONDITIONS, Paragraph A.2.a. is replaced in its entirety by the follow- ing: a. In the event of"accident", claim, "suit" or "loss", you must promptly notify us when it is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) Member, if you are a limited liability company; (4) An executive officer or the "employee" designated by the Named Insured to give such notice, if you are a corporation. To the extent possible, notice to us should include: m (a) How, when and where the "accident" or"loss" took place; (b) The "insureds" name and address; and (c) The names and addresses of any injured persons and witnesses. " 22. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US SECTION IV - BUSINESS AUTO CONDITIONS, Paragraph A.5. Transfer Of Rights Of Recovery Against Others To Us, is amended by the addition of the following: If the person or organization has in a written agreement waived those rights before an "accident" or "loss", our rights are waived also. 23. HIRED AUTO COVERAGE TERRITORY SECTION IV - BUSINESS AUTO CONDITIONS, Paragraph B.7. Policy Period, Coverage Territory, is amended by the addition of the following: f. For"autos" hired 30 days or less, the coverage territory is anywhere in the world, provided that the "insured's" responsibility to pay for damages is determined in a"suit", on the merits, in the United " States, the territories and possessions of the United States of America, Puerto Rico or Canada or in a settlement we agree to. This extension of coverage does not apply to an "auto" hired, leased, rented or borrowed with a driver. 24. PRIMARY AND NON-CONTRIBUTING IF REQUIRED BY WRITTEN CONTRACT OR WRITTEN AGREE- MENT The following is added to SECTION IV -BUSINESS AUTO CONDITIONS, General Conditions, B.5. Other Insurance and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1. Such "insured" is a Named Insured under such other insurance; and 2. You have agreed in a written contract or written agreement that this insurance would be primary and would not seek contribution from any other insurance available to such "insured". SECTION V-DEFINITIONS is amended as follows: 25. BODILY INJURY REDEFINED Under SECTION V -DEFINITIONS, Definition C. is replaced by the following: "Bodily injury" means physical injury, sickness or disease sustained by a person, including mental anguish, mental injury, shock, fright or death resulting from any of these at any time. © 20171-iberty Mutual Insurance AC 86 01 06 18 Includes copyrighted material of Insurance Services Office Inc.,with its Permission. Page 7 of 7 L Coverage /s Provided In: LlUeI'ty Policy Number: `.1 Mutual Ohio Security Insurance Company BAS (20) 56 69 63 77 INSURANCE Policy Period: Business Automobile From 05/23/2019 To 05/23/2020 12:01 am Standard Time Policy Declarations at Insured Mailing Location ITEM ONE: Named Insured Agent R F DUNCAN & ASSOCIATES, INC (360) 352-7588 DBA THE GRANGER COMPANY DUNCAN & ASSOCIATES INC ITEM TWO: SCHEDULE OF COVERAGES AND COVERED AUTOS This policy provides only those coverages where a charge is shown in the premium column below. Each of these coverages will apply only to those "autos" shown as covered "autos". "Autos" are shown as covered "autos" for a particular coverage by the entry of one or more of the symbols from the COVERED AUTO Section of the Business Auto Coverage Form next to the name of the coverage. *See Business Auto Coverage Form CA 00 01 for Covered Auto Symbol Descriptions COVERAGES LIMIT PREMIUM Liability Insurance $1,000,000 each accident $1,076.00 Covered Auto Symbol(s) 01* Medical Payments $35,000 per person $81.00 Covered Auto Symbol(s) 02* Underinsured Motorist Coverage Limit $164.00 Washington Underinsured Motorists Bodily Injury and Property Damag$1,000,000 each accident - Covered Auto Symbol(s) 02* Physical Damage Refer to Item Three Comprehensive $144.00 Covered Auto Symbol(s) 07* Collision $302.00 Covered Auto Symbol(s) 07* To report a claim, call your Agent or 1-800-362-0000 DS 70 43 01 08 04/01/19 56696377 POLSVCS 235 NCAOPPNO AGENT COPY 009639 PAGE 9 OF 20 Coverage Is Provided In: Liberty Policy Number: utual Ohio Security Insurance Company BAS (20) 56 69 63 77 M ., INSURANCE Policy Period: From 05/23/2019 To 05/23/2020 Business Automobile 12:01 am Standard Time Policy Declarations at Insured Mailing Location Named Insured Agent R F DUNCAN & ASSOCIATES, INC (360) 352-7588 DBA THE GRANGER COMPANY DUNCAN & ASSOCIATES INC ITEM TWO: SCHEDULE OF COVERAGES AND COVERED AUTOS - continued COVERAGES LIMIT PREMIUM Miscellaneous Coverages Business Auto Enhancement Endorsement $150.00 Total Provisional Charges: $1,917.00 ,Note: This is not a bill SUMMARY OF COVERED VEHICLES UNIT YEAR MAKE/MODEL VIN TERR ST CLASS ZIP SYNI/COST 001 2011 DODGE 1500 1 D7RV 1 GTOBS545210 035 46 01 199 98502 $30,385 To report a claim, call your Agent or 1-800-362-0000 DS 70 43 01 08 04/01/19 56696377 POLSVCS 235 NCAOPPNO AGENT COPY 009639 PAGE 10 OF 20 Coverage Is Provided In: Policy Number: Liberty Ohio Security Insurance Company BAS (20) 56 69 63 77 Mutual. Policy Period: INSURANCE From 05/23/2019 To 05/23/2020 Business Automobile 12:01 am Standard Time Policy Declarations at Insured Mailing Location Named Insured Agent R F DUNCAN & ASSOCIATES, INC (360) 352-7588 DBA THE GRANGER COMPANY DUNCAN & ASSOCIATES INC ITEM THREE: COVERED VEHICLES AND PREMIUM DETAIL UNIT 001 2011 DODGE 1500 VIN: 1 D7RV1 GT0BS545210 Rating CLASS SYM/COST TERRITORY RISK STATE RATING ZIP TOWN CODE Factors O11gg $30,385 035 WA 98502 0217 Loss Payee Alaska USA Federal Credit Union PO Box 691608 SAN ANTONIO, TX 78269 DESCRIPTION PREMIUM Liability Insurance $822.00 Medical Payments $81.00 Underinsured Motorist Bodily Injury and Property Damage $164.00 Physical Damage Comprehensive - Actual Cash Value Less $500 Deductible $144.00 Collision - Actual Cash Value Less $500 Deductible $302.00 Total Premium $1,513.00 ITEM FOUR: HIRED AUTO COVERAGE Estimated Annual Rate Per Each Cost of Hire $100 Annual Cost of Hire Liability $100.00 1.721 $85.00 Cost of Hire means the total amount you incur for the hire of"autos"you don't own(not including "autos"you borrow or rent from your partners or employees or their family or their family members). Cost of hire does not include charges for services performed by motor carriers of property or passengers. To report a claim, call your Agent or 1-800-362-0000 DS 70 43 01 08 04/01/19 56696377 POLSVCS 235 NCAOPPNO AGENT COPY 009639 PAGE 11 OF 20 Coverage Is Provided In: _ Llberty Policy Number: Mutual, Ohio Security Insurance Company BAS (20) 56 69 63 77 INSURANCE Policy Period: From 05/23/2019 To 05/23/2020 Business Automobile 12:01 am Standard Time Policy Declarations at Insured Mailing Location Named Insured Agent R F DUNCAN & ASSOCIATES, INC (360) 352-7588 DBA THE GRANGER COMPANY DUNCAN & ASSOCIATES INC ITEM FIVE: NON-OWNERSHIP LIABILITY COVERAGE Named IncnrP t'c RncinPcc Rating Racic Mimher Prom iuln Other than Garage Service Number of Employees 1 $169.00 Operations and Other Than Social Service Agencies To report a claim, call your Agent or 1-800-362-0000 DS 70 43 01 08 04/01/19 56696377 POLSVCS 235 NCAOPPNO AGENT COPY 009639 PAGE 12 OF 20 CNA 90 19 06 18 IMPORTANT NOTICE TO POLICYHOLDERS Dear Valued Policyholder, Thank you for selecting us as your carrier for your commercial insurance. This notice contains a brief summary of coverage changes being made to the Business Auto Coverage Enhancement Endorsement, AC 85 01, on your policy. This Notice does not form a part of your policy nor is any coverage provided by this Notice. It should not be construed as replacing any provision of your policy. You should read your policy and review your Declara- tions page for complete information on the coverages you are provided. If there is any conflict between the Policy and this Notice, THE PROVISIONS OF THE POLICY SHALL PREVAIL. This Notice provides information concerning the following forms and endorsements which apply to your renewal policy being issued by us. The forms and endorsements may reduce or broaden coverage. Should you have questions after reviewing the changes outlined below, please contact your independent agent. Thank you for your business. COVERAGE CHANGES BROADENINGS AND NEW COVERAGE -- Primary and Non-Contributing if Required by Written Contract or Written Agreement If an insured agrees to be primary and non- contributing in a written contract we will be primary and without right of contribution. Trailers -Increased Load Capacity " Increases trailers automatically covered for liability to 3,000 lbs. Physical Damage Deductible -Vehicle Tracking System Any comprehensive deductible will be reduced by 50% for a theft loss in which a vehicle tracking device was used as the method to recover the vehicle. Towing and Labor Coverage for private passenger vehicles and light trucks is now $75 per tow. Two or More Deductibles For the state of California, the Two or More Deductible Provision was already included in Business Auto Coverage Enhancement Endorsement, CA 88 10 01 13 and does not represent a change in coverage. Under Physical Damage Coverages, if two or more company policies or coverage forms apply to the same accident, the applicable deductible will be reduced by the amount of the smallest deductible (And, if the applicable deductible is the smaller deductible, then that deductible will be waived). " CLARIFICATIONS AND REDUCTIONS Audio, Visual and Data Electronic Equipment Coverage Changes in format to make the coverage easier to read. Waiver of Transfer of Rights of Recovery Against Others to Us This coverage now requires the insured to have waived the right to subrogation in a written contract or written agreement. Rental Reimbursement Coverage now requires rental of a comparable or lesser vehicle. The $500 in tools coverage and rental reimbursement is excess over other collectible insurance. Additionally, if you elect to schedule higher limits in your policy - the coverage in this endorsement is in addition to the coverage you have pur- chased. Hired Auto Physical Damage The coverage extension does not include autos rented or borrowed from an insured's employee or any member of the employee's household. Additionally, the coverage is excess over other collectible insur- ance. © 2017 Liberty Mutual Insurance CNA 90 19 06 18 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 1 of 2 Amended Fellow Employee Exclusion This coverage now requires you have workers compensation in force for all your employees in order for coverage to apply. Additionally, the coverage is now excess over any other collectible insurance (i.e. the employee's personal auto policy). If there is no coverage available, this coverage will be primary. Additional Insured by Contract, Agreement or permit The coverage now specifies that a written contract or written agreement must be in place for additional insured status to be granted. It also requires the insured submit a claim to the additional insured's insurer if the insured has not agreed in writing to be primary and noncontributing. Newly Formed or Acquired Subsidiaries This coverage now includes LLC's which represents a broadening in language. However, coverage is now limited to only newly acquired or formed subsidiaries for a period of 90 days after formation. When the insured purchases or forms a new entity we ask that that entity be disclosed to Liberty within 90 days. Extended Cancellation Condition The extended cancellation condition is being removed. This provision can be scheduled separately at no charge if requested. © 2017 Liberty Mutual Insurance CNA 90 19 06 18 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 2 of 2 CNI 90 11 07 18 REPORTING A COMMERCIAL CLAIM 24 HOURS A DAY Liberty Mutual Insurance claims professionals across the United States are ready to resolve your claim quickly and fairly, so you and your team can focus on your business. Our claims teams are specialized, experienced and dedicated to a high standard of service. We're Just a Call Away - One Phone Number to Report All Commercial Insurance Claims Reporting a new claim has never been easier. A Liberty Mutual customer service representative is available to you 24/7 at 800-362-0000 for reporting new property, auto, liability and workers' compensa- tion claims. With contact centers strategically located throughout the country for continuity and accessibility, we're there when we're needed! Additional Resource for Workers' Compensation Customers In many states, employers are required by law to use state-specific workers compensation claims forms and posting notices. This type of information can be found in the Policyholders Toolkit section of our website along with other helpful resources such as: Direct links to state workers compensation websites where you can find state-specific claim forms • Assistance finding local medical providers • First Fill pharmacy forms - part of our managed care pharmacy program committed to helping injured workers recover and return to work Our Policyholder Toolkit can be accessed at www.libertymutualgroup.com/toolkit. For all claims inquiries please call us at 800-362-0000. © 2018 Liberty Mutual Insurance CNI 90 11 07 18 Page 1 of 1 i - i 'i NP 74 44 09 06 i U.S. TREASURY DEPARTMENT'S OFFICE OF FOREIGN ASSETS CONTROL ("OFAC") ADVISORY NOTICE TO POLICYHOLDERS No coverage is provided by this Policyholder Notice nor can it be construed to replace any provisions of )! your policy. You should read your policy and review your Declarations page for complete information on the coverages you are provided. i This Notice provides information concerning possible impact on your insurance coverage due to directives issued by OFAC. Please read this Notice carefully. Please refer any questions you may have to your insurance agent. The Office of Foreign Assets Control (OFAC) administers and enforces sanctions policy, based on Presiden- tial declarations of "national emergency". OFAC has identified and listed numerous: • Foreign agents; • Front organizations; • Terrorists; • Terrorist organizations; and • Narcotics traffickers; as "Specially Designated Nationals and Blocked Persons". This list can be located on the United States Treasury's web site - http//www.treas.gov/ofac. 1 In accordance with OFAC regulations, if it is determined that you or any other insured, or any person or entity claiming the benefits of this insurance has violated U.S. sanctions law or is a Specially Designated National and Blocked Person, as identified by OFAC, this insurance will be considered a blocked or frozen contract and all provisions of this insurance are immediately subject to OFAC. When an insurance policy is considered to be such a blocked or frozen contract, no payments nor premium refunds may be made without authorization from OFAC. Other limitations on the premiums and payments also apply. © 2011 Liberty Mutual Insurance.All rights reserved. NP 74 44 09 06 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 1 of 1 NP 88 01 09 08 IMPORTANT INFORMATION ABOUT DRIVING OUTSIDE OF THE UNITED STATES AND PROOF OF AUTO INSURANCE THIS NOTICE DOES NOT PROVIDE ANY COVERAGE, NOR CAN IT BE CONSTRUED TO REPLACE ANY PROVISIONS OF YOUR POLICY. YOU SHOULD READ YOUR POLICY AND REVIEW YOUR POLICY DECLARATIONS FOR COMPLETE INFORMATION ABOUT THE " COVERAGE THAT APPLIES. IF THERE IS ANY CONFLICT BETWEEN THE POLICY AND THIS NOTICE, THE PROVISIONS OF THE POLICY PREVAIL. This notice provides you with information about territory provisions included in your policy. Your policy provides coverage for accidents or losses that occur within the policy period shown on the Declarations and within the policy territory. The policy territory is defined as the United States of America, its possessions (such as American Samoa, Guam and the U.S. Virgin Islands), Puerto Rico or Canada. While that is the case, in locations outside of the United States, authorities may not accept the Auto Identification Card we pro- vided to you with your policy as proof that you have insurance. For example, Canada requires non-resident operators to carry a special identification Card. For this reason, before you drive outside of the United States, be sure that you: e Familiarize yourself with the motor vehicle laws in the countries or territories you plan to drive in; and 0 Obtain a "Canada Non-Resident Inter-Province Motor Vehicle Liability Insurance Card" from your independent insurance agent when driving in Canada. In addition, because your policy's territory definition does not include Mexico, if you plan to drive in Mexico, contact your independent insurance agent to purchase Mexican Auto Insurance. Under Mexican laws, auto accidents are not just civil offenses. They are considered criminal offenses and, therefore, the consequences of driving uninsured can be severe. If you have any questions about this notice or the territory provisions of your policy, please contact your independent insurance agent. Your agent can answer your questions and, to the extent possible, ensure your coverage meets your insurance needs. NP 88 01 09 08 Page 1 of 1 NP 89 71 09 10 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 will receive 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 installment(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. EFT-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, please contact your agent if you have any questions about the above billing practice informa- tion. Thank you for selecting us to service your insurance needs. NP 89 71 09 10 © 2010 Liberty Mutual Insurance Company.All rights reserved. Page 1 of 1 SNA 46 02 09 17 IMPORTANT NOTICE TO POLICYHOLDERS REVISIONS TO THE TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US PROVISION Dear Valued Policyholder, Thank you for selecting us as your carrier for your commercial insurance. This Notice contains a brief summary of a coverage change being made to your policy. This Notice does not form a part of your policy nor is any coverage provided by this Notice. It should not be construed as replacing any provision of your policy. You should read your policy and review your Declara- tions page for complete information on the coverages you are provided. If there is any conflict between the — Policy and this Notice, THE PROVISIONS OF THE POLICY SHALL PREVAIL. This Notice provides information concerning the following forms and endorsements which apply to your renewal policy being issued by us. The forms and endorsements may reduce or broaden coverage. Should you have questions after reviewing the changes outlined below, please contact your independent agent. Thank you for your business. CLARIFICATION OF COVERAGE Washington Changes Endorsement -AC 01 15 08 17 We have updated the Transfer Of Rights Of Recovery Against Others To Us condition found in E.2.b. to more closely follow the language found in Washington Administrative Code 284-30-393. SNA 46 02 09 17 © 2017 Liberty Mutual Insurance Page 1 of 1 CERTIFICATE OF INSURANCE Producer: Issue Date:07/30/2018 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 P.O. Box 1 �^ 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 which this Certificate may be 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 claims. DISCLAIMER:This certificate of insurance does not affirmatively or negatively amend,extend,or alter the coverage afforded by the insurance policy. TYPE OF INSURANCE POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE LIMITS Professional Liability AA1002412-04 07/21/2018 07,121/2019 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 Kent,WA 98032 THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. LIA0001 (11/97)