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HomeMy WebLinkAboutCAG2019-486 - Amendment - #1 - A & M Consulting - West Hill Reservoir Utility Coordination - 12/01/2020ApprovalOriginator:Department: Date Sent:Date Required: Authorized to Sign: o Director or Designee o Mayor Date of Council Approval: Budget Account Number: Budget? o Yes o No Grant? o Yes o No Type:Review/Signatures/RoutingDate Received by City Attorney:Comments: Date Routed to the Mayor’s Office: Date Routed to the City Clerk’s Office:Agreement InformationVendor Name:Category: Vendor Number:Sub-Category: Project Name: Project Details: Agreement Amount: Start Date: Basis for Selection of Contractor: Termination Date: Local Business? o Yes o No* *If meets requirements per KCC 3.70.100, please complete “Vendor Purchase-Local Exceptions” form on Cityspace. Notice required prior to disclosure? o Yes o No Contract Number: Agreement Routing Form For Approvals, Signatures and Records Management This form combines & replaces the Request for Mayor’s Signature and Contract Cover Sheet forms. (Print on pink or cherry colored paper) Visit Documents.KentWA.gov to obtain copies of all agreementsadccW22373_1_20 AMENDMENT - 1 OF 2 AMENDMENT NO. 1 NAME OF CONSULTANT OR VENDOR: A & M Consulting CONTRACT NAME & PROJECT NUMBER: West Hill Reservoir ORIGINAL AGREEMENT DATE: December 10, 2019 This Amendment is made between the City and the above-referenced Consultant or Vendor and amends the original Agreement and all prior Amendments. All other provisions of the original Agreement or prior Amendments not inconsistent with this Amendment shall remain in full force and effect. For valuable consideration and by mutual consent of the parties, Consultant or Vendor’s work is modified as follows: 1. Section I of the Agreement, entitled “Description of Work,” is hereby modified to add additional work or revise existing work as follows: In addition to work required under the original Agreement and any prior Amendments, the Consultant or Vendor shall: No change to the scope of work, however an amendment is needed to extend the time of completion to December 31, 2021 due to the project is ongoing. 2. The contract amount and time for performance provisions of Section II “Time of Completion,” and Section III, “Compensation,” are modified as follows: Original Contract Sum, including applicable WSST $2,640 Net Change by Previous Amendments including applicable WSST $0 Current Contract Amount including all previous amendments $2,640 Current Amendment Sum $0 Applicable WSST Tax on this Amendment $0 Revised Contract Sum $2,640 Original Time for Completion (insert date) t2ttu20 Revised Time for Completion under prior Amendments (insert date) nlr' Addl Days Required (+) for this Amendment 365 calendar days Revised Time for Completion (insert date) t2t3u2t The Consultant or Vendor accepts all requirements of this Amendment by signing below, byits signature waives any protest or claim it may have regarding this Amendment, and acknowledges and accepts that this Amendment constitutes full payment and final setilement of all claims of any kind or nature arising from or connected with any work either covered or affectedby this Amendment, including, without limitation, claims related to contract time, contract acceleration, onsite or home office overhead, or lost profits. This Amendment, unless otherwise provided, does not relieve the Consultant or Vendor from strict compliance with the guarantee and waranty provisions of the original Agreement. All acts consistent with the authority of the Agreement, previous Amendments (if any), and this Amendment, prior to the effective date of this Amendment, are hereby ratified and affiimed, and the terms of the Agreement, previous Amendments (if any), and this Amendment shall be deemdd to have applied. ' The parties whose names appear below swear under penalty of perjury that they are authorized to enter into this Amendment, which is binding on the parties of this contract. IN WITNESS' the pafties below have executed this Amendment, which will become effective on the last date written below. coNSULTANT/VENDOR: By: Print Name n n / *fl'fuaDATE: CITY OF KENT: By: Print Name:Carla Mal . P.E. Its Desion Eno no Manaoer (titte) DATE:1?t 1202a ATTEST: {*l{*ffi Kent City Clerk APPROVED AS TO FORM: (applicable lf l4ayor's signature requlred) Kent Law Department A A il Conrultlng - West HIll Rerervolr Amd l/Holconb AMENDMENT. 2 OF 2 DATE {MM/DD¡YYYY} 020Tl{lS CERTIFICATE ls ISSUED AS A MATTER oF tt¡¡FoRffATtoN ONLY AND CONFERS NO RIGI{TS UPON THE CERTIFIC,ATE IIOLDER"TII¡S GERTIFICATE DOES NOT AFFIRMATIVELY OR NEG/TTVEI-Y AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY TIIE POLICIES BELOW- TII¡$ GERTIFIGATE OF ¡NSURANCE ÐOE$ NOT CONST¡TUTE A CONTRACÍ BETWEEN THE tsstjtl,lc tNsuRER(S), AUT!{OR,IZED REFRE5ENTATIVE OR PRODUCER, AND THE CERTIFICATE I{OLDER. IMPORTANT:tf the certificate holder ls an ADDITIONAL INSURED,the policy(ies)must be endorsed.tf SUBR,OGA TloNts WAIVËD, sub¡ect Éo the terms and condiúions of the policy,cerüair¡policies mãy reqr.lire an endorsement A statement on th!s cerÉificaúe does notconfer rights to the centificate holder in lieu of such endoreernent(s). PRODUCER AJ GALLAGHER & CO INS BRKRS CÄ/PHS 72255202 The Hartford Business Service Center 3600 Wiseman Blvcl San Antonio, TX78251 CONTACT NAMT- PHONE {BBB) e20-6259 (Á/C, Nc, Exi): FAx (888)443_6112 {,4/Ç, No): E-MAIL ADDRESS: INSURER{S) AFFORDING COVERAGE NAIC# INSURED ARNOLD TOMAC DBA A & ÍIJI CONSULTING 181 19 NE 3OTH ST REDMOND WA 98052-5902 INSURERA: Hartford CasualtylnsuranceCompany 29424 INSURER B INSURER C INSURER D INSURER E INSURER F COVERAGES CERTIFICATE OF LIABILITY INSURANGE CERTIFICATE Nt,!MBER:REVISIOIII NLIMBE${: GELLA @ 1988-2015 ACORI) CORPORAT'ION. At¡ rights reserved. ïhe ACORÐ name and logo are reg¡stered rnarks of ACORD IND ICATEÐ.NOTWITHSTAND ING MAY ISTHIS CERTIFYTO THETHAT OFPOLTCtES LISTEDiNSURANCE HAVEBELOW ENBE TOISSUED INSUREDTHE ABOVENAMED THEFOR POLICY PERIOD REQUANY TERMIREMENT OR CONDITION ANYOF CONTRACT OR DOCUMENTOTHER WITH RESPECT WHICHTÕ THiSCERTIFICATEBEDISSUEMAORTHEPERTAIN,INSURANCE BYAFFORDED THE POLICIES HEREINDESCRIBED SUBJECT ALLTO THETERMù,ANDEXCLUSIONS oCONDITIONS F SUCH LIMITSPOLtCtES.SHOWN MAY BEENHAVE BYREDUCED CLAIMS.PAID TYPE OF INSURANCE POLICY NUMBER LtMlfs EACH OCCURRENCE ,000,000 $300,000 X COMMERCIAL GENERAL LIABILITY OCCUR l\JlÉD EXP (Any one person)$10,000 & ADV GENERAL AGGREGATE PRODUCTS - COMP|AP AGG $4,000,000 A GEN'L AGGREGATE LIMITAPPLIES PER: OTHER: LOCPRO. JF.(j.-| X 72 SBM llK5025 11tO1t2020 1'1t0112021 $2,000,000 BODILY INJURY {P"r personJ BODILY INJURY (Per aæídanl) X X acc¡dent) ,AUTOHOBILË LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON..OWNED AUTOS 72 SBM UK5O25 11/O1t2020 1'l1o1t2021 EACHUMBRELLA LIAS EX6ESS LIAB CLAIMS- MADE AGGREGATE REIENTON $ E,L. EACH ACCIDENT $1,000,000 E,L. DISEASE,EA EMPLOYEE $1,000,000 A ÂND EIIPLOYERS' UÄBILITY ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandaiory in NH) lf yes, decribe under Y/ñt WORKERS N¡,4,72 SBM UK5O25 11tO1t202A 11|t1t2021 E,L. DISEASE - POLICY LIMIT $1,000,000 A EMPLOYMENT PRACTICES LIABILITY 72 SBM UK5025 11t01t2A20 111A1/2021 Each Claim Limit Aggregate Limif Those usual to the lnsured's Operations. Certificate Holder is an Additional Insured per the Business Liabilíty Çoverage Form SS000B attached to thispolícy. ÐE$CR,FTION OF OPERATIONS / LOCAT'ONS / WHICLES (ACORD 101, Add¡t¡onäl Rêmarl(s $chedule,máy bs atiached if mors spacê is rsquired) ABOVE DESCRIBED POLICIES BE CANCELLËD BEFORE THE EXPIRATION DATE THEREOF, NOTICE wlLL tsE DËLIVERED It'¡ ACCORDANCE W|TH THE POLICY PROVTSIONS. SHOULD ANY OF THEThe City of Kent Public Works Engineering 222 4TH AVE S KENT WA 98032 lft"a-attã /a¿ât-,¿^- AUTHORIZED REPRESENTIITIVE ACORÐ 25 (2016103) POLICYHOLDER NOTICE . WASHINGTON tlate:09/15/20 Policy Number: 72 sBM UK5025 Renewa! Date: 11/01/20 Your Hartford Agent: Ãdf GÀI¡.¡\(ffiR & CO ffS BRInS g,À/pES "Hr# o 0o (BB8) 920-6259 .ÊR¡ÚOIiD TOHAC DBA À E il goNsuf,ìFr¡[e 18i"19 ¡E"r- 30|118 SIIREET RTIËTGüID PÛã. 9805? Dear Valued Hartford lnsured, Your current policy provided by The Hartford will expire shortly. The purpose of this notice is to advise you of certain changes to your policy upon renewal" A. Folicv Fremium The new premium for your policy for the upcoming term is indicated below. This premium amount is based on current information known to us and may be subject to change based on any additional information we may receive from you or your Hartford agent or broker. More information on your premium determination can be obtained from your agent or broker, or from The Hartford- RenewalPremium - $ Amount of lncrease = $ 425.ÐA The reason(s) for the increase in premium is due to one or more of the following: 1. A change in rates or the method of calculating premium. 2. A change in your exposures, loss experience, or other risk characteristics. B- Goveraqe Ghanges (if applicable) Your policy for the upcoming term will include certain reductions or additional restrlctions in coverage, as indicated by an (x) below" lf your state requires a notice of nonrenewal as a result of the indicated change(s), this is our notice to you in compliance with the applicable law" ( ) lncrcase in Deductibleto: ( ) Reduction in Limits to ( ) Reductions in Coverage: ( ) Other Changes or Restrictions in Coverage: ïhe coverage change is due to the following indicated reason(s): ( ) Your exposures, loss experience, or other risk characteristics indicate a need for the change" ( ) A change in our rules, forms or underwriting guidelines for yourtype of policy, Fonn lH 70 501210 Page f Further information regarding the reason for the coverage change(s) is available from the company or your agent or broker. You may receive other notices of coverage changes for the upcoming policy term under separate cover. Those other changes will apply in addition to the changes described above. This is not a bill. You will receive a separate bill for all or part of the premium due for your renewal policy. lf you do not pay the amount shown by the due date as stated in the bill, your insurance coverage will expire or be cancelled for non-payment of premium. lf you have any questions about your policy or about your overall ilrsura¡ruç ¡reecis, piease corúaci your äarüorci ageni or broker. Fonn lH 7{150 t2 l0 Page2 25 50 UK SBM This Spectrum Policy consists of the Declarations, Coverage Forms, Common Policy Conditions and any other Forms and Endorsements issued to be a part of the Policy. This insurance is provided bythe stock insurance company of The Hartford lnsurance Group shown below. INSURER: HARTFORD CASUALTY ]NSURANCE COMPANY ONE HARTFORD PLAZA, HARTFORD, CT 061-55 COMPANYCODE: 3 Policy Number: 72 SBM UK5025 DX SPECTRUM POLICY DECLARATIONS @ ò Named lnsured and Mailing Address: (No., Street, Town, State, Zip Code) ORIGINAL ARNOLD TOMAC DBA A & M CONSULTTNG 181]-9 N.E. 3OTH STREET REDMOND üIA 98052 Poficy Period: From 1J/AI/20 To L1"/0L/2L 1 YEAR 12:01 a.m., Standard time at your mailing address shown above. Exception: 12 noon in New Hampshire Nameof Agent/Broker: AJ GALLAGHER & CO rNS BRKRS CA/PHS Code: 255202 Previous Policy Number: 72 SBM UK5025 Named Insured is: TNDTVTDUAL Audit Period: NON-AUDITABLE Type of Property Goverage: NONE lnsurance Provided: ln return for the payment of the premium and subject to all of the terms of this policy, we agree with you to provide insurance as stated in this policy. TOTAL ANNUAL PREMIUM lS: ç42s Mp rN RECOGNTTION OF THE MULTIPLE COVERAGES TNSURED II'TTH THE HARTFORD, YOUR POLTCY PREMIUM TNCLUDES AN ACCOU\]T CREDTT. Countersigned by L**-an-f /a¿â**-*r--- Authorized Representative 09 /1,5 /20 Date Page 001- (CoNTINUED ON NEXT PAGE) Policy Expiration Date: t1-/ 01-/2L Form SS 00 021206 Process Date: 09 /L5/2A TNSURED COPY SPECTRUM POLICY DECLARATIONS (Continued) POLICYNUMBER: 72 SBM UK5025 Location(s), Building(s), Business of Named lnsured and Schedule of Coverages for Premises as designated by Number below Location: 001 Building: 001 4 ôl I ^ ar ñ a^ñ1" ññññEñIO1IJ ¡T.!. JVI¡¡ 9¡IlgUI RF:DMC)ND ht¿, 98052 Description of Business: REÀL ESTATE APPRAISER Deductible: NO COVERAGE BUILDING AND BUSINESS PERSONAL PROPERTY LIMITS OF INSURANCE BUILDING NO CO\rERAGE BUSINESS PERSONAL PROPERTY REPLACEMENT COST PERSONAL PROPERTY OF OTHERS REPLACEMENT COST NO COVERAGE NO COVERAGE MONEY AIVD SECURITIES INSIDE THE PREMISES OUTSTDE THE PREMISES Form SS 00 02 12 06 Process Date: 09 /L5/2A NO COVERAGE NO COVER.A,GE Page 002 (CONTINUED ON NEXT PAGE) Policy Expiration Date: LI/0I/2L SPECTRUM POLICY DECLARATTONS (Continued) POLICYNUMBER: 72 SBM UK5O25 BUSINESS LIABILITY LIABILITY AND MEDICAL EXPENSES MEDICAL EXPENSES - ANY ONE PERSON PERSONAL AND ADVERTISING INJURY LIMITS OF INSURANCE $2, 000, 000 $ 10, 000 $2,000,000 DAMAGES TO PREMISES RENTED TO YOU ANY ONE PREMISES $ 300,000 AGGREGATE LIMITS PRODUCTS-COMPLETED OPERATIONS $4, 000, 000 $4, 000, 000GENERAL AGGREGATE EMPLOYMENT PRACTICES LIABILITY COVERAGE¡ FORM SS 09 0t- EACH CLAIM LIMIT $ S, OOO DEDUCTIBLE - EACH CLAIM LIMIT NOT APPLICABLE AGGREGATE LIMIT $ 5, OOO RETROACTIVE DATE: l_1_0L2 005 This Employment Practices Liability Coverage contains claims made coverage. Except as may be othenviseprovided herein, specified coverages of this insurance are limited generally to liability for injuries for w-hich claims arefirst made against the insured while the insurance is in force. Please read and review tlre insurance carefully and discuss the coverage with your Hartford Agent or Broker. The Limits of lnsurance stated in this Declarations will be reduced, and may be completely exhausted, by thepayment of "defense expense" and, in such event, The Company will not be obligated to pay any further"defense expense" or sums which the insured is or may become legally obligated to pay as "damages". BUSINESS LIABILTTY OPTIONAL COVERAGES HTRED/NON-OWNED AUTO LTABTLITY FORM: SS 01 70 $2,000,000 Form SS A0021206 Process Date: 09 /L5/2A Page OO3 (CONTINUED ON NEXT PAGE) Policy Expiration Date: L1" / 0L / 21, SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 72 SBM UK5025 BUSINESS LIABILITY OPTIONAL COVERAGES (Gontinued) lllPI¡CrYERg I¡IÀBII¡IT]I åND STOP CIAP BODII.Y IN'N'RT !T ASCIDE¡IT ETCE ÀCCIDE¡IT+NíGU ËÚ ñTd'IClEE\,lJItr¡ tll rñ¡ D¡ v¡9se5 EACE EOIPLOTEE BODIITT INit{tRÏ BY DIgEÀgE POLXCI I¡MIfl APPLICABLE |t!O LOCATIONS IN llEE FOLI¡OWI¡IG¡ SIÍÀEE(S) ¡ W.ASHITi¡G¡IION WAI\TER OF SUBROGTÀTION: FOnil flg 12 15 IOCÀTION: 001 BUILDXI{GI: 001 NA!G: If ã¡ÍI Form SS 00 02 12 06 process Date: 09 /L5/20 LIMITS OF INSURANCE sl, 000, 000 s1, 000, 000 $l-, 000, 000 PagE OO4 (CONTTNUED ON NEXT PAGE) PolicY ExPiration Ðalet IL/ 0L/2t SPECTRUM POLICY DECLARATTONS (Conrinued) POLICYNUMBER: 12 SBNI UK5025 ADDITIONAL INSUREDS: THE FOLLOWING ARE ADDITIONAL INsUREDs FoR BUsINEss LIABILITY COVERAGE IN THIS POLICY. @ oo LOCATION TCPE NÀME OO1 BUII.DIIIG¡ OO1 !ÛÀ¡TAC¡ER LESSOR sEE roR![ XE 12 00 Form SS A0 021206 Process Date: 09/L5/20 Page 005 (CONTTNUED ON NEXT PAGE) Policy Expiration Datei TL/0L/2L ıı ^n AÊ, 1) nÁÚJ VV AJ LZ SS 89 93 07 L6ss 0s 03 03 00ss 09 aI 12 L4ss 09 ]L L2 L4 rH 99 4l- 04 09 05 09 l_ 1_ L7 L4 09 09 06 03 L2 04 ^ot/o 70 63 1_0 7A 40 SPECTRUM POLICY DECLARATIONS (Continued) POL¡CYNUMBER: 72 SBM UK5025 Form Numbers of Forms and Endorsements that apply: L2 85 ADD]TIONAI, INSURED - MANAGER/LESSOR Form SS 00 02 1 2 06 Process Date: 09 /L5 /20 00 01- 4L 5l_ 09 99 ÞÐ S5 SS ss ss IH UU L7 05 l_5t4 00 ^^ ^- l1vv v) L¿ 01 28 05 4L 02 04 50 l-9 01- 09 67 09 r_2 l_5 03 ùÞ ss SS ì)Þ ss ss I+t6 L5 1-5 L4 9B L5 1- l- 03 09 09 09!2 09 01_ 00 55 UU Ufss 00 64ss 00 60ss 05 47ss 09 2sss 1-0 04ss 83 76 IH Policy Expiration Date: TL/ 0L/2L Page 006 BUSINESS LIABILITY COVERAGE FORM EE E --EEGEtEt- - d rfl C\t r'1 oit orr{do rJ)c\oro M c\lr* oiloo r-{ (v1 l. ----g -E GG -*IEE -----------Gt -ryE -t -EE O 2005, The Hartford Form SS 00 0E 04 05 QUICK REFERENCE BUSINESS LIABILITY COVERAGE FORM READ YOUR POLICY CAREFULLY BUSINESS LIABILITY COVERAGE FORM A. COVERAGES Business Liability Medical Expenses Coverage Extension - Supplementary Payments B. EXCLUSIONS C. WHO IS AN INSURED LIABILITY AND MEDICAL EXPENSES LIMITS OF INSURANCE E. LIABILITY AND MEDICAL EXPENSES GENER.AL CONDITIONS 1. Bankruptcy 2. Duties ln The Event Of Occurrence, Offense, Claim Or Suit 3. Financial Responsibility Laws 4. LegalAction Against Us 5. Separation Of lnsureds 6. Representations 7. Other lnsurance 8. Transfer Of Rights Of Recovery Against Others To Us F. OPTIONAL ADDITIONAL INSURED COVERAGES Additional lnsureds G. LIABILITY AND MEDICAL EXPENSES DEFINITIONS Beginning on Page 14 15 15 15 16 16 16 16 16 17 18 18 20 ,l 1 2 2 3 10 D Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights, duties and what is and is not covered. Throughout this policy the words 'you" and "youl'' refer to the Named lnsured shown in the Declarations. The wordsnwe", "us" and "out" refer to the stock insurance company member of The Hartford providing this insurance. The word "insured" means any person or organization qualiffing as such under Section C. - \Mlo ls An lnsured. Other words and phrases that appear in quotation marks have special meaning. Refer to Section G. - Liability And Medical Expenses Defi nitions. c\ rr1c\ rr-)c\ Ol dt+o 1r)c\olft M!)ft F-c\oorl F1 J. A. COVERAGES 1. BUSTNESS LtABtLtTy COVERAGE (BODtLy INJURY, PROPERTY DAMAGE, PERSONAL AND ADVERTTSTNG TNJURY) lnsuring Agreement a. V\le will pay those sums that the insured becomes legally obligated to pay as damages because of 'bodily injury", "property damage' or 'personal and advertising in.iury' to which this insurance applies. \Ale will have the right and duty to defend the insured against any nsuit" seeking those damages. However, we will have no duty to defend the insured against any "suito seeking damages for "bodily injury", "property damage" or "personal and advertising injury" to which this insurance does not apply. We may, at our discretion, investigate any "occurrence" or offense and setile any claim or "suit" that may result. But: (1) The amount we will pay for damages is limited as described in Section D. - Liability And Medicat Expenses Limits Of lnsurance; and (21 otr right and duty to defend ends when we have used up the applicable limit of insurance in the payment of judgnrents, setlements or rnedlcal e;penses to wtrich this insur:ance applles. No other oHigation or liability to pay suns or perbrm ads or services is covered unless exfliciUy povided br under Coverage Extension - Supplennntary Paynents. b. This insurance applies: (1) To "bodily injury' and .property damage" only if: (a) The "bodily injury" or "property damage" is caused by an "occurrence" that takes place in the "coverage territory"; (b) The "bodily injury" or 'property darnage' occurs during the policy period; and (c) Prior to the policy period, no insured listed under Paragraph 1. of Section C. - \Mro ls An lnsured and no 'employee" authorized by you to give or receive notice of an "occunence" or claim, knew that the 'bodily injury" or'property damage" had occuned, in whole or in part. lf such a listed insured or authorized "employee" knew, prior to the policy period, that the "boclily iniury" or "property damage' occurred, then any continuation, change or resumption of such 'bodily injury' or 'property damage' during or after the policy period will be deemed to have been known prior to the policy period. l2l To "personal and advertising injury" caused by an offense arising out ofyour business, but only if the offense was committed in the ncoverage tenitory. during the policy period. c. .Bodily injury" or "property damage" will be deemed to have been known to have occuned at the earliest time when any insured listed under Paragraph 1. of Section C. - Who ls An lnsured or any *employee" authorized by you to give or receive notice of an "occurrence' or claim: (1) Reports all, or any part, of the "bodily injury' or "property damage' to us or any other insurer; ltttlt:& -G EIGI !!!Er -- @ -* - --: -ttE * G EtlG --G GG -E- --E* -tlErGE- - Form SS 00 08 04 05 @ 2005, The Hartford Page 1 of24 BUSINESS LIABILIry COVERAGE FORM l2l Receives a written or verlcal demand or claim for damages because of the "bodily injury" or "property damage"; or (3) Becomes aware by any other means that "bodily injury" or "property damage" has occuned or has begun to occur. d. Damages because of "bodily injury" include damages claimed by any person or organization for care, loss of services or death resulting at any time from the "bodily injury". e. lncidental Medical Malpractice (1) "Bodily injury" arising out of the rendering of or failure to render professional health care services as a physician, dentist, nurse, emergency medical technician or paramedic shall be deemed to be caused by an "occurrence", but only if: (a) The physician, dentist, nurse, emergency medical technician or paramedic is employed by you to provide such services; and (b) You are not engaged in the business or occupation of providing such services. (2) For the purpose of determining the limits of insurance for incidental medical malpractice, any act or omission together with all related acts or omissions in the furnishing of these services to any one person will be considered one "occurrence". 2. MEDICAL EXPENSES lnsuring Agreement a. We will pay medical expenses as described below for "bodily injury" caused by an accident: (1) On premises you own or rent; (2) On ways next to premises you own or rent; or (3) Because of your operations; provided that: (f) The accident takes place in the "coverage territory" and during the policy period; (21 The expenses are incuned and reported to us within three years of the date of the accident; and (3) The injured person submits to examination, at our expense, by physicians of our choice as often as we reasonably require. b. We will make these payments regardless of fault. These payments will not exceed the applicable limit of insurance. We will pay reasonable expenses for: (f ) First aid administered at the time of an accident; l2l Necessary medical, surgical, x-ray and dental services, including prosthetic devices; and (3) Necessary ambulance, hosPital, professional nursing and funeral services. 3. COVERAGE EXTENSION - SUPPLEMENTARY PAYMENTS a. We will pay, with respect to any claim or "suit" we investigate or settle, or any "suit" against an insured we defend: (1) Allexpenses we incur. l2l Up to $1,000 for the cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which Business Liability Coverage for "bodily injury" applies. We do not have to furnish these bonds. (3) The cost of appeal bonds or bonds to release attachments, but only for bond amounts within the applicable limit of insurance. We do not have to furnish these bonds. (4) 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. (5) All costs taxed against the insured in the "suit". (6) Prejudgment interest awarded against the insured on that part of the judgment we pay. lf we make an offer to PaY the applicable limit of insurance, we will not pay any prejudgment interest based on that period of time after the offer. (71 All interest on the full amount of any judgment that accrues after entry of the judgment and before we have Paid, offered to pay, or deposited in court the part of the judgment that is within the applicable limit of insurance. Any amounts paid under (1) through (7) above will not reduce the limits of insurance. Page 2 of 24 Form SS 00 08 04 05 B b. lf we defend an insured against a "suit" and an indemnitee of the insured is also named as a party to the "suit", we will defend that indemnitee if all of the following conditions are met: (1) The'suit" against the indemnitee .seeks damages for which the insured has assumed the liability of the indemnitee in a contract or agreement that is an "insured contract"; (21 This insurance applies to such liability assumed by the insured; (3) The obligation to defend, or the cost of the defense of, that indemnitee, has also been assumed by the insured in the same'insured contract"; (4) The allegations in the "suit" and the information we know about the 'occurrence" are such that no conflict appears to exist between the interests of the insured and the interest of the indemnitee; (5) The indemnitee and the insured ask us to conduct and control the defense of that indemnitee against such "suit" and agree that we can assign the same counsel to defend the insured and the indemnitee; and (6) The indemnitee: (a) Agrees in writing to: (i) Cooperate wilh us in the investigation, settlement or defense of the "suit"; (ii) lmmediately send us copies ofany demands, notices, summonses or legal papers received in connection with the'suit'; (iii) Notiff any other insurer whose coverage is available to the indemnitee;and (iv) Cooperate with us with respect to coordinating other' applicable insurance available to the indemnitee; and (b) Provides us with written authorization to: (0 Obtain records and other information related to the 'suit"; and (ii) Conduct and control the defense of the indemnitee in such nsuit". BUSINESS LIABILITY COVERAGE FORM So long as the above conditions are rnet, attomeys' fees incuned by us in the defense of that indemnitee, necessary litigation expenses incuned by us and necessary litpation elpenses incuned by the indemnitee at our request will be paid as Supplementary Payments. Notwithstanding the provisions of Paragraph l.b.(b) of Section B. - Exclusions, such payments will not be deemed to be damages for "bodily injury" and 'property damage" and will not reduce the Limits of lnsurance. Our obligation to defend an insured's indemnitee and to pay for aftorneys' fees and necessary litigation expenses as Supplementary Payments ends when: (1) We have used up the applicable limitof insurance in the payment of judgments or settlements; or (21 The conditions set forth above, or the terms of the agreement described in Paragraph (6) above, are no longer met. B. EXCLUSIONS 1. Applicable To Business Liability Goverage This insurance does not apply to: a. Expected Or lntended lnjury (1) "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 ftom the use of reasonable force to protecl persons or property; or (21 "Personal and advertising in!ry" arising out of an oftnse committed by, at the direction of or with the consent or aoquiescence of the insured with the expectation of infliding "personal and adrrertising inirry'. b. Contractual Liability (11 "Bodily inirry" or"property damage'; or (21 'Personal and advertising injury" for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages because of: (a) 'Bodily inln/, 'property damage" or "personal and adwrtising injury" that the insured rnrculd have in the absence of the contrad or agreennnt;or c?| cac{ c.l c\il o\dr-lo rnc\otrl M5 c\tr\Noo d ca* - ;G --- : G -iET it -=aEr G! G -- -E -n Form SS 00 08 04 05 Page 3 of 24 BUSINESS LIABILITY COVERAGE FORM (b) "Bodily injury" or "property damage" assumed in a contract or agreement that is an "insured contract", provi<led the "bodily injury" or 'property damage" occur':s subsequent to the execution of the contract or agreernent. Solely for the purpose of liability assumed in an "insured contract", reasonable attomeys' fees and ne@ssary litigation expenses incuned by or for a party other than an insured are deemed to be damages because of "bodily injury" or "property damage" provided: (i) Liability to such party for, or for the cost of, that party's defense has also been assumed in the same "insured contract", and (ii) Such attorneys' fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged. c. Liquor Liability "Bodily injury" or "property damage" for which any insured-may be held liable by reason of: (1) Causing or contributing to the intoxication of any person; l2'l The fumishing of alcoholic beverages to a person under the legal drinking age or underthe influence of alcohol;or (3) Any statute, ordinance or regulation relating to the sale, gift, distribution or use of alcoholic beverages. This exclusion applies only if you are in the business of manufacturing, distributing, selling, serving or fumishing alcoholic beverages. d. Workers' Compensation And Similar l-aws Any obligation of the insured under a workers' compensation, disability benefits or unemployment compensation law or any similar law. e. Employer's Liability "Bodily injury" to: (1) An "employee" of the insured arising out ofand in the course ot (a) Employment by the insured; or (b) Performing duties related to the conduct of the insured's business, or (21 The spouse, child, parent, brother or sister of that "employee" as a consequence of (1) above. This exclusion applies: (1) Wrether the insured may be liable as an employer or in any other capacity; and l2l To any obligation to share damages with or repay someone else who must pay damages because of the injury. This exclusion does not apply to liability assumed by the insured under an "insured contract". f. Pollution (1) "Bodily injury", "property damage" or "personal and advertising injury" arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of "pollutants": (a) At or from any premises, site or location which is or was at any time owned or occupied by, or rented or loaned to any insured. However, this subparagraph does not apply to: (i) "Bodily injury" if sustained within a building and caused by smoke, fumes, vapor or soot produced by or originating from equipment that is used to heat, cool or dehumldiff the building, or equipment that is used to heat water for personal use, by the building's occupants or their guests; (ii) "Bodily injury" or "property damage" for which you may be heb liable, if you are a contrador and the owner or lessee of such premises, site or location has been added to your policy as an additional insured with respect to your ongoing operations perfonred for that additional insured at that premises, site or location and such premises, site or location is not and never was owned or occupied by, or rented or loaned to, any insured, other than that additional insured; or Page 4 of 24 Form SS 00 08 04 05 <l l-.t C\f cac\ o\r{rlorn c|ilolr) MDc\r\c\oo f{('1 :} (iii) "Bodily injury" or "property damage' arising out of heat, smoke or fumes from a "hostile fire"; (b) At or from any premises, site or location which is or was at any time used by or for any insured or others for the handling, storage, disposal, processing or treatment of waste; (c) \Mtich are or were at any time transported, handled, stored, treated, disposed of, or processed as waste by or for: (i) Any insured; or (ii) Any person or organization for whom you may be legally responsible; (d) At or from any premises, site or location on which any insured or any contractors or subcontractors working directly or indirectly onany insured's behalf are performing operations if the 'pollutants' are brought on or to the premises, site or location in connection with such operations by such insured, contractor or subcontrac{or. However, this subparagraph does not apply to: (a) 'Bodily injury" or 'property damage' arising out of the escape of fuels, lubricants or other operating fluids which are needed to perform the normal el€ctrical, hydraulic ornechanical functions necessary for the operation of "rnobile equipment" or its parts, if sucfr fuels, lubricants or other operating fluids escape ftom a whicle part designed to hold, store or receiw them. This exce$ion does not apply if the 'boclily injury" or 'property damage" arises out of the intentional discha rge, dispersalor release of the fuels, lubricants or other operating fluiCs, or if such fuels, luhicants or other operating flukJs are brought on or to the premises, site or location withthe intent that they be discharged, dispersed or BUSINESS LIABILITY COVERAGE FORM released as part of the operations being performed by such insured, contractor or subcontractor; (ii) "Bodily injury" or "property damage" sustained within a building and caused by the release of gases, funes or vapors from materials brought into that building in connedion wtth operations being perfornnd by you or on your behalf by a contrador or subcontractor; or (iii) "Bodily injury" or "property damage" arising out of heat, smoke or fumes from a "hostile fire"; or (e) At or fom any premises, site or location on which any insured or any contractors or subcontractors working diredly or indirectly on any insured's behalf are performing operations if the operations are to test fur, nnnitor, clean up, remove, contain, treat, detoiff or neutralize, or in any way respond to, or assess the efiects of, "pollutanls'. (21 Any loss, cost or expense arising out of any: (a) Request, dernand, order or statutory or regulatory requirement that any insured or others test ficr, monitor, clean up, remove, contain, treat, detoxiff or neutralize, or in any way respond to, orassess the efiects of, "pollutants";or (b) Claim or suit by or on behalf of a governnental authority for damages because of testing for, monitoring, cleaning up, rernoving, containing, treating, detoxiffing or neutralizing, or in any way responding to, or assessing the effects of, "pollutants". However, this paragraph does not apply to liability for damages because of .property damage" that the insured wouh have in the absence of such request, demand, order or statutory or regulatory requirement, or such claim or nsuitn by or on behalf of a govemmental authority. !E - !E -G -G Gt -=t @ -,- - -=: : -E G: - -G -GEG -- Form SS 00 08 04 05 Page 5 of 24 BUSINESS LIABILITY COVERAGE FORM g. Aircraft, Auto Or Watercraft "Bodily injury" or "property damage" arising out of the ownership, maintenance, use or entrustment to othes of any aircraft, "auto" or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and "loading or unloading". This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supeMsion, hiring, employrnent, training or monitoring of otherc by that insured, if the "occunence" which caused the "bodily injury" or "property darnage" involved the ownership, maintenance, use or entrustment to others of any aircraft, "auto" or watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to: (1) A watercraft while ashore on premises you own or rent; (21 A watercraft you do not own that is: (a) Less than 51 feet long; and (b) Not being used to carry persons for a charge; (3) Parking an "auto" on, or on the ways next to, premises you own or rent, provided the "auto" is not owned by or rented or loaned to you or the insured; (4) Liability assumed under any "insured contract" for the ownership, maintenance or use of aircraft or watercraft; (51 "Bodily injury" or "property damage" arising out of the operation of any of the equipment listed in Paragraph f.(2) or f.(3) of the definition of "mobile equipment"; or (61 An aircraft that is not owned by any insured and is hired, chartered or loaned with a pald crew. However, this exception does not apply if the insured has any other insurance for such "bodily injury" or "property damage", whether the other insurance is primary, excess, contingent or on any other basis. h. Mobile Equipment "Bodily injury" or "property damage" arising out of: (1) The transportation of "rnobile equipment" by an "auto" owned or operated by or rented or loaned to any insured; or (2) The use of "mobile equipment" in, or while in practice or preparation for, a preananged racing, speed or demolition contest or in any stunting activity. i. War "Bodily injury", "property damage" or "personal and advertising injury", however caused, arising, directly or indirectly, out of: (1) War, including undeclared or civil war; (21 Warlike action by a military force, including action in hindering or defending against an actual or expected attack, by any government, sovereign or other authority using military personnel or other agents; or (3) lnsurrection, rebellion, revolution, usurped power, or action taken by governmental authority in hindering or defending against any of these. j. ProfessionalServices "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or failure to render any professional service. This includes but is not limited to: (1) Legal, accounting or advertising seMces; l2l Preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, fieb oders, change ordem, designs or drawings and specifi cations; (3) Supervisory, inspection, architectural or engineering activities; (4) Medical, surgical, dental, x-ray or nursing services treatment, advice or instruction; (5) Any health or therapeutic service treatment, advice or instruction; (6) Any service, treatment, advice or instruction for the purpose of appearance or skin enhancement, hair removal or replacement or personal grooming; (71 Optical or hearing aid services including the prescribing, preparation, fitting, demonstration or distribution of ophthalmic lenses and similar products or hearing aid devices; Page 6 of 24 Form SS 00 08 04 05 LOrac\ r'1c! Or t-{rlo lf)c\orft D4Doilr\ C\iloo f{ra.t (8) Optometry or optometric services including but not limited to examinationof the eyes and the prescribing, preparation, ffting,demonstration or dbtribution of ophthalmic lenses and similar products; (e) Any: (a) Body piercing (not including ear piercing); (b) Tattooing, including but not limited to the insertion of pigments into or under the skin; and (c) Similar services; (10) Services in the practice of pharmacy; and (11) Computer consulting, design or programming seMces, including web site design. Paragraphs (4) and (5) of this exclusion do not apply to the lncidental Medical Malpractice coverage afforded under Paragraph 1.e. in Section A. - Coverages. k. Damage To Property "Property damage" to: (1) Property you own, rent or occupy, including any costs or expenses incuned by you, or any other person, organization or entity, for repair,replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to anothefs property; (21 Prenilses you sell, give away or abandon, if the "property damage" arises out of any part of those premises; (3) Property loaned to you; (4) Personal property in the care, custody or control of the insured; (5) That particular part of real property on which you or any contradors or subcnntractors workiry diredly or indiredly on your behalf are performing operations, if the "property damage" arises out of those operations; or (6) That particular part of any property that must be restored, repaired or replaced because 'your work" was inconectly performed on it. BUSINESS LIABILITY COVERAGE FORM Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire) to premises, including the contents of such premises, rented to you for a period of 7 or fewer consecutive days. A separate Limitof lnsurance applies to Damage To Premises Rented To You as described in Section D. - Limits Of lnsurance. Paragraph (2) of this exclusion does not apply if the premises are 'your work" and were never occupied, rented or held for rental by you. Paragraphs (3) and (41of this exclusion do not apply to the use of elevators. Paragraphs (3), (4), (5) and (6) of this exclusion do not appty to liability assumed under a sidetrack agreement. Paragraphs (3) and (4) of this exclusion do not apply to "property damage" to bonowed equipment while not being used to perform operations at a job site. Paragraph (6) of this exclusion does not apply to "property damage" included in the 'products-completed operations hazard". l. Damage To Your Product 'Property damage" to "your product" arising out of it or any part of it. m. Damage To Your Work "Property damage' to 'your work" arising out of it or any part of it and included in the "products-completed operations hazard". This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor. n. Damage To knpaired Property Or Property Not Physically lnjured "Property damage' to 'impaired property" or property that has not been physically injured, arising out of: (1) A defect, deficiency, inadequacy or dangerous condition in 'your product" or "your work"; or (21 A delay or failure by you or anyone ac*ing on your behalf to perform a contract or agreement in accordance with its terms. This exclusion does not apply to the loss of use of other property arising out of sudden and accidental physical in!ry to 'your product' or 'your work" afier it has been put to its intended use. : @ GT* -i !!t G -E -ry GG -a -s @ E 4G! -G -=Eg -!G Form SS 00 08 04 05 PageT oI 24 BUSINESS LIABILITY COVERAGE FORM o. Recall Of Products, Work Or lmpaired Property Damages claimed for any loss, cost or expense incurred by you or others for the loss of use, withdrawal, recall, inspection, repair, replacement, adjustment, removal or disposal of: (1) "Your product"; (21 "Your work"; or (3) "lmpaired property"; if such product, work or property is withdrawn or recalled from the market or fom use by any person or organization because of a known or suspected defect, deficiency, inadequacy or dangerous condition in it. p. PersonalAnd Advertising lnjury "Personal and advertising injury": (1) Arising out of oral, written or electronic publication of material, if done by or at the direction of the insured with knowledge of its falsity; (21 Arising out of oral, wriften or electronic publication of material whose first publication took place before the beginning of the policy period; (3) Arising out of a criminal act commilted by or at the direction of the insured; (4) Arising out of any breach of contract, except an implied contract to use another's "advertising idea" in your "advertisement"; (5) Arising out of the failure of goods, products or services to conform withany statement of quality or performance made in your "advertisement"; (6) Arising out of the wrong description of the price of goods, products orservices; (7) Arising out of any violation of any intellectual property rights such as copyright, patent, trademark, trade name, trade secret, service mark or other designation of origin or authenticity. However, this exclusion does not apply to infringement, in your "advertisement", of (a) Copyright; (b) Slogan, unless the slogan is also a trademark, trade name, service mark or other designation of origin or authenticity; or (c) Title of any literary or artistic work; (8) Arising out of an offense committed by an insured whose business is: (a) Advertising, broadcasting, publishing or telecasting ; (b) Designing or determining content of web sites for others; or (c) An lnternet search, access, content or service provider. However, this exclusion does not apply to Paragraphs a., b. and c. under the definition of "personal and advertising injury" in Section G. Liability And Medical Expenses Definitions. For the purposes of this exclusion, placing an "advertisement" for or linking to others on your web site, by itself, is not considered the business of advertising, broadcasting, publishing or telecasting ; tg) Arising out of an electronic chat room or bulletin board the insured hosts, owns, or over which the insured exercises control; (10) Arising out of the unauthorjzed use of anothefs name or product in your e-mail address, domain name or metatags, or any other similar tactics to mislead anothe/s potential customers ; (11) Arising out of the violation of a person's right of privacy created by any state or federal act. However, this exclusion does not apply to liability for damages that the insured would have in the absence of such state orfederal act; (12) Arising out of: (a) An "advertisement" for others on your web site; (b) Placing a link to a web site of others on your web site; (c) Content from a web site of others displayed within a frame or border on your web site. Content includes information, code, sounds, text, graphics or images; or (d) Computer code, software or programming used to enable: (i) Your web site; or (ii) The presentation or tunctionalily of an "advertisement' or other content on your web site; Page I of 24 Form SS 00 08 04 05 \ofnc\ aac\ orr{riort) GIo trat M5c\r\ C!oo f{ fr-).I (13) Arising out of a violation of any anti- trust law; (14) Arising out of the fluctuation in price or value of any stocks, bonds or other securities; or (15) Arising out of discrimination or humiliation committed by or at the direction of any "executive officef', director, stockholder, partner or member of the insured. q. Electronic Data Damages arising out of the loss of, loss of use of, damage to, corruption of, inabilityto access, or inabilily to manipulate "electronic data". r. Employment-Related Practices 'Bodily injury" or "personal and advertising injury" to: (1) A person arising out of any: (a) Refusalto employ that person; (b) Termination of that person's employment;or (c) Employnrent-related practices, policies, ads or omissions, such as coercion, demotion, evaluation,reassi;nment, discipline, def;amation, harassnrent, humiliation or discrimination directed at that person; or (21 The spouse, child, parent, brother orsister of that person as a consequence of 'bodily injury" or "personal and advertising injury" to the person at whom any of the employment-related practices described in Paragraphs (a), (b), or (c) above is directed. This exclusion applies: (1) \Mrether the insured may be liable as . an employer or in any other capacity; and (21 To any obligation to share damages with or repay someone else who must pay damages because of the injury. s. Asbestos (1) "Bodily injury', 'property damage' or 'personal and advertising injury" arising out of the "asbestos hazard". l2l Any damages, irdgments, settlernents, bss, costs or expenses that: BUSINESS LIABILITY COVERAGE FORM (a) May be awarded or incuned by reason of any claim or suit alleging actual or threatened injury or damage of any nature or kind to persons or property which would not have occuned in whole or in part but for the "asbestos hazard"; (b) Arise out of any request, demand, order or statutory or regulatory requirement that any insured or others test for, monitor, clean up, remove, encapsulate, contain, treat, detoxiff or neutralize or in any way respond to or assess the effects of an "asbestos hazard"; or (c) Arise out of any daim or suit for damages because of testing for, mnitoring, cleaning up, removing, encapsulating, containing, treating, detoxifring or neutralizing or in any way responding to or assessing the efieds ofan "asbestos hazard". t. Violation Of Statutes That Govern E- Mails, Fax, Phone Galls Or Other Methods Of Sending Material Or lnformation "Bodily injury', "property damage", or 'personal and advertising injury" arising directly or indirectly out of any action or omission that violates or is alleged to violate: (1) The Telephone Consumer Protection Act CICPA), including any amendment of or addition to such law; (2) The CAN-SPAM Act of 2003, including any amendment of or addition to such law; or (3) Any statute, ordinance or regulation, other than the TCPA or CAN-SPAM Ad of 2003, that prohibits or limits the sending, transmitting, communicating or distribution of rnaterial or information. Damage To Premises Rented To You - Exception For Damage By Fire, Lightning or Explosion Exclusions c. through h. and k. through o. do not apply to damage by fire, lightning or explosion to premises rented to you or temporarily occupied by you with permission of the owner. A separate Limit of lnsurance applies to this coverage as described in Section D. - Liability And Medical Expenses Limits Of lnsurance. : -E G - G -G -G =3G !E E G @ !G! --!E -E== Form SS 00 08 04 05 Page 9 of 24 BUSINESS LIABILIry COVERAGE FORM 2. Applicable To Medical Expenses Coverage We will not pay expenses for "bodily injury": a. Any lnsured To any insured, except "volunteer workers". b. Hired Person To a person hired to do work for or on behalf of any insured or a tenant of any insured. c. lnjury On Normally Occupied Premises To a person injured on that part of premises you own or rent that the person normally occupies. d. Workers' Compensation And Similar [aws To a person, whether or not an "employee" of any insured, if benefits for the "bodily injury" are payable or must be provided under a workers' compensation or disability benefits law or a similar law. e. AthleticsActivities To a person injured while practicing, instructing or participating in any physical exercises or games, sports or athletic contests. f. Products-Completed Operations Hazard lncluded with the "products-completed operations hazard". g. Business Liability Exclusions Excluded under Business Liability Coverage. C. WHO IS AN INSURED 1. lf you are designated in the Declarations as: a. An individual, you and your spouse are insureds, but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or pint venture, you are an insured. Your nrembers, your partners, and their spouses are also insureds, but only with respecf to the condud ofyour business. c. A limited liability company, you are an insured. Your members are also insureds, but only with respect to the conduct of your business. Your managers are insureds, but only with resped to their duties as your rn€rnagers. d. An organization other than a partnership, irint venture or limited liability company, you are an insured. Your "executirre officers" and direc{ors are insureds, but only with respect to their duties as your officers or diredors. Your stockholders are also insureds, but only with respect to their liability as stockholders. e. A trust, you are an insured. Your trustees are also insureds, but only with respect to their duties as trustees. 2. Each of the following is also an insured: a. Employees And Volunteer Workers Your "volunteer workers" only while performing duties related to the conduct of your business, or your "employees", other than either your "executive officers" (if you are an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company), but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However, none of these "employees" or "volunteer workers" are insureds for: (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), or to a co-"emPloyee" while in the course of his or her employment 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 that "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 seryices. lf you are not in the business of providing professional health care seMces, Paragraph (d) does not apply to any nurse, emergency medical technician or paramedic employed by you to provide such services. (21 "Property damage" to property: (a) Owned, occupied or used by, Page 10 of 24 Form SS 00 08 04 05 r\ afic!rn C\ cnr{rtolftc\o LO M5c\r\c\oo r-tr.l.* (b) Rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by you, any of your "employees", "volunteer workers", any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability company). b. Real Estate Manager Any person (other than your "employee" or "volunteer workef'), or any organization while acting as your real estate manager. c. Temporary Gustodians Of Your Property Any person or organization having proper temporary custody of your property if you die, but only: (1) \Mth resped to liability arising out of the maintenance or use of that property; and (21 Until your legal representative has been appointed. d. Legal Representative lf You Die Your legal representative if you die, but only with respect to duties as such. That representative will have all your rights and duties under this insurance. e. Unnamed Subsidiary Any subsidiary and subsidiary thereof, of yours which is a legally incorporated entity of which you own a financial interest of more than 50olo of the voting stock on the effective date of this Coverage Part. The insurance afforded herein for any subsidiary not shown in the Declarations as a named insured does not apply to injury or damage with respect to which an insured under this insurance is also an insured under another policy or would be an insured under such policy but for its termination or upon the exhaustion of its limits of insurance. 3. Newly Acquired Or Formed Organization Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain financial interest of more than 50o/o of the voting stock, will qualiff as a Nanred lnsured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the 180th day after you acquire or form the oryanization or the end of the policy period, whichever is earlier; and BUSINESS LIABILITY COVERAGE FORM b. Coverage under this provision does not apply to: (1) "Bodily injury" or "property damage" that occuned; or (21 .Personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. 4. Operator Of Mobile Equipment lr1/lth respect to 'npbile equipment' registered in your name under any motor vehicle registration law, any person 's an insured while driving such equipment along a public hQhway with your permission. Any other person or organization responsible for the condud of such person is also an insured, but only with respect to liability arising out of the operation of the equipment, and only if no other insurance of any kind is available to that person or organization for this liability. However, no person or organization is an insured with respedto: a. "Bodily injury' to a co-'employee" of the person driving the equipment; or b. "Property damage' to property owned by, rented to, in the charge of or occupied by you or the employer of any person who is an insured underthis provision. 5. Operator of Nonowned Watercraft \Mth respect to watercraft you do not own that is less than 51 feet long and is not being used to carry persons for a charge, any person is an insured while operating such watercraft with your permission. Any other person or organization responsible for the conduct of such person is also an insured, but only with respect to liability arising out of the operation of the watercraft, and only if no other insurance of any kind is available to that peron or organization for this liability. However, no person or organization is an insured with respect to: a. "Bodily injury' to a co-"employee" of the person operating the watercraft; or b. "Property damagel to property owned by, rented to, in the charge of or occupied by you or the employer of any person who is an insured under this provision. 6. Additional lnsureds When Required By Written Contract, Written Agreement Or Permit The person(s) or organization(s) identified in Paragraphs a. through f. below are additional insureds when you have agreed, in a wriften -=_!=!= !@ i* G i- -E -@EE IE re G !G --: -@ -!t!!!E Form SS 00 08 04 05 Page 11 ot 24 BUSINESS LIABILITY COVERAGE FORM contract, written agreement or because of a permit issued by a state or political suMivision, that such person or organization be added as an additional insured on your policy, provided the injury or damage occurs subsequent to the execution of the contract or agreement, orthe issuance of the permit. A person or organization is an additional insured under this provision only for that period of time required by the contract, agreement or permit. However, no such person or organization is an additional insured under this provision if such person or organization is included as an additional insured by an endorsement issued by us and made a part of this Coverage Part, including all persons or organizations added as additional insureds under the specific additional insured coverage grants in Section F. - OptionalAdditional lnsured Coverages. a. Vendors Any person(s) or organization(s) (efened to below as vendor), but only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendofs business and only if this Coverage Part provides coverage for "bodily injury" or "property damage" included within the "produd.s-completed operations hazard". (1) The insurance afforded to the vendor is subject to the following additional exclusions: This insurance does not apply to: (a) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contracl or agreement; (b) Any express warranty unauthorized by you; (c) Any physical or chemical change in the product made intentionally by the vendor; (d) Repackaging, except when unpacked solely ficr the purpose of inspection, demonstration, testing, or the substitution of parts under instructions f'om the manufadurer, and then repackaged in the original container; (e) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; (f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendods premises in connection with the sale of the product; (g) Products which, after distribution or sale by you, have been labeledor relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or (h) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (i) The exceptions contained in Subparagraphs (d) or (f); or (ai) Such inspections, ad.lustments, tests or seMcing as the vendor has agreed to make or normally undertakes to rnake in the usual course of business, in connection with the distribution or sale of the products. l2l This insurance does not apply to any insured person or organization from whom you have acquired such producls, or any ingredient, part or container, entering into, accompanying or containing such products. b. Lessors Of Equipment (1) Any person or organization from whom you lease equipment; but only with respect to their liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization. Page 12 ol 24 Form SS 00 08 04 05 6 cf)c\rrl c\l ol t{r{o rrrtc\oro !dD(\tr\c\oorJfa.} (21 \Mth respect to the insurance affordedto these additional insureds, this insurance does not apply to any "occurrence' which takes place after you cease to lease that equipment. c. Lessors Of Land Or Premises (1) Any person or organization from whom you lease land or premises, but only with respect to liability arising out of the ownership, maintenance or use of that part of the land or premises leased to you. l2l V\rlth respect to the insurance affordedto these additional insureds, this insurance does not apply to: (a) Any "occurrence' which takes place after you cease to lease that land or be a tenant in that premises; or (b) Structural alterations, new construction or demolition operations performed by or on behalf of such person or organization. d. Architects, Engineers Or Surveyors (1) Any architec{, engineer, or surveyor, but only with respecd to liability for "bodily in.iury", "property dannge' or "personal and advertbing injury" caused, in whole or in part, by your ads or omissions or the ads or omissions of those acting on your behalf (a) ln connection with your premises; or (b) ln the performance of your ongoing operations performed by you or on your behatf. (21 Wth respect to the insurance affordedto these additional insureds, the following additional exclusion applies: This insurance does not apply to 'bodily injury", "property damage" or 'personal and advertising injury" arising out of the rendering of or the failure to render any professional services by or for you, including: (a) The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, deslgns or drawings and specifications; or (b) SupeMsory, inspection, architectural or engineering activities. BUSINESS LIABILITY COVERAGE FORM e. Permits lssued By State Or Political Subdivisions (1) Any state or political subdivision, but only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit. (21 \Mth respect to the insurance afforded to these additional insureds, this insurance does not apply to: (a) "Bodily injury", "property damage"or 'personal and advertising injury" arising out of operations performed for the state or municipality; or (b) "Bodily in.fury" or "property damage" included within the 'products- cornpleted operations hazard". f. Any Other Party (1) Any other person or organization who is not an insured under Paragraphs a. through e. above, but only with respect to liability for "bodily injury", "property damage" or "porsonal and advertising injury" caused, in whole or in part, by your acts or omissions or the acis or omissions of those acting on your behalf: (a) ln the performance of your ongoing operations; (b) ln connection with your premises owned by or rented to you; or (c) ln connection with "your work" and included within the 'products- completed operations hazard', but only if (i) The written contract or written agreement requires you to provide such coverage to such additional insured; and (ii) This Coverage Part provides coverage for "bodily injury" or "property damage" includedwithin the "products- completed operations hazard". (21 \A/lth respect to the insurance affordedto these additional insureds, this insurance does not apply to: "Bodily injury", 'property damage' or "personal end advertising inirry" arising out of the rendering ol or the failure to render, any professional architectural, engineering or surveying services, including: =!!!! --ta ;G; i---. -El&. t -G E: -t -:e G G ---4 G --!!tG Form SS 00 08 04 05 Page 13 of 24 BUSINESS LIABILITY COVERAGE FORM (a) The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawings and specifications; or (b) Supervisory, inspection, architectural or engineering activities. The limits of insurance that apply to additional insureds are described in Section D. - Limits Of lnsurance. How this insurance applies when other insurance is available to an additional insured is described in the Other lnsurance Condition in Section E. - Liability And Medical Expenses General Conditions. 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 lnsured in the Declarations. D. LIABILITY AND MEDICAL EXPENSES LIMITS OF INSURANCE 1. The Most We Will Pay The Limits of lnsurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of: a. lnsureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 2. Aggregate Limits The most we will pay for: a. Damages because of "bodily injury" and "property damage" included in the 'products-completed operations hazard" isthe Products-Completed Operations Aggregate Limit shown in the Declarations. b. Damages because of all other "bodily injury", "property damage" or "personal and advertising injury", including medical expenses, is the General Aggregate Limit shown in the Declarations. This General Aggregate Limit applies separately to each of your "locations" owned by or rented to you. "Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway or right-of-way of a railroad. This General Aggregate limit does not apply to "property damage" to premises while rented to you or temporarily occupied by you with permission of the owner, arising out of fire, lightning or explosion. 3. Each Occurrence Limit Subject to 2.a. or 2.b above, whichever applies, the most we will pay for the sum of all damages because of all "bodily injury", "property damage" and medical expenses arising out of any one "occurrence" is the Liability and Medical Expenses Limit shown in the Declarations. The most we will pay for all medical expenses because of "bodily injury" sustained by any one person is the Medical Expenses Limit shown in the Declarations. 4. PersonalAnd Advertising lnjury Limit Subject to 2.b. above, the most we will pay for the sum of all damages because of all "personal and advertising injury" sustained by any one person or organization is the Personal and Advertising lnjury Limit shown in the Declarations. 5. Damage To Premises Rented To You Limit The Damage To Premises Rented To You Limit is the most we will pay under Business Liability Coverage for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, lightning or explosion, while rented to you or temporarily occupied by you with permission of the owner. ln the case of damage by fire, lightning or explosion, the Damage to Premises Rented To You Limit applies to all damage proximately caused by the same event, whether such damage results from fire, lightning or explosion or any combination of these. 6. How Limits Apply To Additional lnsureds The most we will pay on behalf of a person or organization who is an additional insured under this Coverage Part is the lesser of: a. The limits of insurance specified in a written contract, written agreement or permit issued by a state or political suMivision; or b. The Limits of lnsurance shown in the Declarations. Such amount shall be a part of and not in addition to the Limits of lnsurance shown in the Declarations and described in this Section. Page 14 of 24 Form SS 00 08 04 05 Orr.l N ca cril c t-Jrtolrt oitoro M!)c\ F\ oitoor{ c.llr lf more than one limit of insurance under this policy and any endorsements aftached thereto applies to any claim or "suit", the most we will pay- under this policy and the endorsements is the single highest limit of tiability of ail coverages applicable to such claim or "suit". However, this paragraph does not apply to the Medical Expenses limit set forth in Paragraph 3. above. The Limits of lnsurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the policy peri,od is extended afier issuance for an additional period of less than 12 months. ln that case, the additional period will be deerned part of the last preceding period for purposes of determining the Limits of lnsurance. E. LIABILITY AND MEDICAL EXPENSES GENERAL GONDITIONS 1. Bankruptcy Bankruptcy or insolvency of the insured or of the insured's estate will not relieve us of our obligations under this Coverage part. 2. Duties ln The Event Of Occurrence, Offense, Claim Or Suit a. Notice Of Occurrence Or Offense You or any additional insured must see toit that we are notified as soon as practicable of an "occurrenceo or an offense which may result in a claim. To the eXent possible, notice should include: (1) How, when and where the "occurrence" or offense took place; (21 The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injuryor damage arising out of the*occurronce" or offense. b. Notice Of Claim lf a claim is made or "suit' is brought against any insured, you or any additional insured must: (1) lmmediately record the specifics of the claim or "suit" and the date received; and (21 Notiff us as soon as practicabte. You or any additional insured must see to it that we receive a wriften notice of the claim or nsuit' as soon as practicable. c. Assistance And Gooperation Of The lnsured You and any other involved insured must: BUSINESS LIABILITY COVERAGE FORM (1) lmmediately send us copies of any demands, notices, summonses or legal papers received in connection with the claim or'suit"; (21 Authorize us to obtain records and other information; (3) Cooperate with us in the investigation, settlement of the claim or defense against the 'suit"; and (4) Assist us, upon our request, in the enforcement of any right against any percon or organization that may be liable to the insured because of injury or damage to which this insurance may also apply. d. Obligations At The lnsured's Own Gost No insured will, except at that insured's own cost, voluntarily nnke a payment, assurre any oblpation, or incur any expense, other than ficr first aid, without our consent. e. Additional lnsured's Other lnsurance lf we cover a claim or nsuit" under this Coverage Part that may also be coveredby other insurance available to an additional insured, such additional insured must submit such claim or 'suit" to the other insurer for defense and indemnity. However, this provision does not apply to the extent that you have agreed in a written contract, written agreement or permit that this insurance is primary and non-contributory with the additional insured's own insurance. f. Knowledge Of An Occurrence, Offense, Claim Or Suit Paragraphs a. and b. apply to you or to any additional insured only when such "occurrence', offense, claim or 'suit" is known to: (1) You or any additional insured that is an individual; (21 Any partner, if you or an additional insured is a partnership; (3) Any manager, if you or an additional insured is a limited liability company; (4) Any nexecutive officel,' or insurance manager, if you or an additional insured is a corporation; (5) Any trustee, if you or an additional insured is a trust; or (S) Any elecled or appointed official, if you or an additional insured is a political suMivision or public entity. !EE! =* G !E -- G 4 E tlE -FG - -GiE E -G G -!EE ----'G - -rllilll Form SS 00 08 04 05 Pago 15 of 24 BUSINESS LIABILITY COVERAGE FORM This Paragraph f. applies separately to you and any additional insured. 3. Financial Responsibility Laws a. When this policy is certified as proof of financial responsibility for the future under the provisions of any motor vehicle financial responsibility law, the insurance provided by the policy for "bodily injury" liability and "property damage" liability will comply with the provisions of the law to the extent of the coverage and limits of insurance required by that law. b. Wth respect to "mobile equipment" to which this insurance applies, we will provide any liability, uninsured motorists, underinsured motorists, no-fault or other coverage required by any motor vehicle law. We will provide the required limits for those coverages. 4. LegalAction Against Us No person or organization has a right under this Coverage Form: a. To join us as a party or otherwise bring us into a "suit" asking for damages from an insured; or b. To sue us on this Coverage Form unless all of its terms have been fully complied with. A person or opanization may sue us to recover on an agreed settlement or on a final fudgment against an insured; but we will not be liable for damages that are not payable under the terms of this insurance or that are in excess of the applicable limit of insurance. An agreed settlement means a settlement and release of liability sQned by us, the insured and the cla i mant or the cla i ma nt's lega I representative. 5. Separation Of lnsureds Except with respect to the Limits of lnsurance, and any rights or duties specifically assigned in this policy to the first Named lnsured, this insurance applies: a. As if each Named lnsured were the only Named lnsured; and b. Separately to each insured against whom a claim is made or "suit" is brought. 6. Representations a. When You Accept This Policy By accepting this policy, you agree: (1) The statements in the Declarations are accurate and complete; (21 Those statements are based upon representations you made to us; and (3) We have issued this policy in reliance upon your representations. b. Unintentional Failure To Disclose Hazards lf unintentionally you should fail to disclose all hazards relating to the conduct of your business at the inception date of this Coverage Part, we shall not deny any coverage under this Coverage Part because of such failure. 7. Other lnsurance lf other valid and collectible insurance is available for a loss we cover under this Coverage Part, our obligations are limited as follows: a. Primary lnsurance This insurance is primary except when b. below applies. lf other insurance is also primary, we will share with all that other insurance by the method described in c. below. b. Excess lnsurance This insurance is excess over any of the other insurance, whether primary, excess, contingent or on any other basis: (1) YourWork That is Fire, Extended Coverage, Builder's Risk, lnstallation Risk or similar coverage for *your work"; l2l Premises Rented To You That is fire, lightning or explosion insurance for premises rented to you or temporarily occupied by you with permission of the owner; (3) Tenant Liability That is insurance purchased by you to cover your liability as a tenant for "property damage" to premises rented to you or temporarily occupied by you with permission of the owner; (4) Aircraft, Auto Or Watercraft lf the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of Section A. - Coverages. (5) Property Damage To Borrowed Equipment Or Use Of Elevators lf the loss arises out of "property damage" to borrowed equipment or the use of elevators to the extent not subject to Exclusion k. of Section A. - Coverages. Page l6 of 24 Fomr SS 00 08 04 05 oslc\r.lc\ Orrlr{o Lrtc\orrt !4 C\t\c\oo t{(.t .L (6) When You Additional lnsurance Are Added As An lnsured To Other That is other insurance available to you covering liability for damages arising out of the premises or operations, or products and completed operations, for which you have been added as an additional insured by that insurance; or (71 When You Add Others As AnAdditional lnsured To This lnsurance That is other insurance available to an additional insured. However, the following provisions apply to other insurance available to any person or organization who is an additional insured under this Coverage Part: (a) Primary lnsurance When Required By Contract This insurance is primary if you have agreed in a written contract, written agreement or permit that this insurance be primary. lf other insurance is also primary, we will share with all that other insurance by the method described in c. below. (b) Primary And Non€ontributoryTo Other lnsurance When Required By Contract lf you have agreed in a written contraci, written agreement or permit that this insurance is primary and non-contributory withthe additional insured's own insurance, this insurance is primary and we will not seek contribution fom that other insurance. Paragraphs (a) and (b) do not apply to other insurance to which the additional insured has been added as an additional insured. When this insurance is excess, we will have no duty under this Coverage Part to defend the insured against any 'suit" if any other insurer has a duty to defend the insured against that 'suit". lf no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. BUSINESS LIABILITY COVERAGE FORM \Mren this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (1) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (21 The total of all deductible and self- insured amounts under all that other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this Excess lnsuranec provision and was not bought specifically to apply in excess of the Limits of lnsurance shown in the Declarations of this Coverage Part. c. Method of sharing lf all the other insurance permits contribution by equal shares, we will follow this method also. Under this approach, each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. lf any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Underthis method, each insurefs share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. 8. Transfer Of Rights Of Recovery Against Others To Us a. Transfer Of Rights Of Recovery lf the insured has r(lhts to recover all orpart of any payment, including Supplementary Payments, we have made under this Coverage Part, those rphts are transfened to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. This condition does not apply to Medical Expenses Coverage. b. Waiver Of Rights:Of Recovery (Waiver Of Subrogation| lf the insured has waived any rights of recovery against any peron or organization for all or part of any payment, including Supplementary Payments, we have made under this Coverage Part, we also waive that right, provided the insured waived their rights of recovery against such person or organization in a contract, agreement or permit that was executed prior to the injury or damage. G -*E -t -- -# * !!ltE: G G : -E -tEE= Form SS 00 08 04 05 Page 17 ot 24 BUSINESS LIABILITY COVERAGE FORM F. OPTIONAL ADDITIONAL INSURED COVERAGES lf listed or shown as applicable in the Declarations, one or more of the following Optional Additional lnsured Coverages also apply. \Men any of these Optional Additional lnsured Coverages apply, Paragraph 6. (Additional lnsureds When Required by Written Contract, Written Agreement or Permit) of Section G., \y'Vho ls An lnsured, does not apply to the person or organization shown in the Declarations. These coverages are subject to the terms and conditions applicable to Business Liability Coverage in this policy, except as provided below: 1. Additional lnsured - Designated Person Or Organization \A/tlO lS AN INSURED under Section C. is amended to include as an additional insured the person(s) or organization(s) shown in the Declarations, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: a. ln the performance of your ongoing operations; or b. ln connection with your premises owned by or rented to you. 2. Additional lnsured - Managers Or Lessors Of Premises a. \ tslO lS AN INSURED under Section C. is amended to include as an additional insured the person(s) or organization(s) shown in the Declarations as an Additional lnsured - Designated Person Or Organization; but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Declarations. b. Vvith respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: (1) Any "occurrence" which takes place after you cease to be a tenant in that premises; or (21 Structural afterations, new construction or demolition operations performed by or on behalf of such person or organization. 3. Additional lnsured - Grantor Of Franchise \ IiO lS AN INSURED under Section G. is amended to include as an additional insured the person(s) or organization(s) shown in the Declarations as an Additional lnsured Grantor Of Franchise, but only with respect to their liability as grantor of franchise to you. 4. Additional lnsured - Lessor Of Leased Equipment a. \ /FlO lS AN INSURED under Section C. is amended to include as an additional insured the person(s) or organization(s) shown in the Declarations as an Additional lnsured - Lessor of Leased Equipment, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s). b. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after you cease to lease that equipment. 5. Additional lnsured - Owners Or Other lnterests From Whom Land Has Been Leased a. \ /FlO lS AN INSURED under Section G. is amended to include as an additional insured the person(s) or organization(s) shown in the Declarations as an Additional lnsured - Owners Or Other lnterests From Whom Land Has Been Leased, but only with respect to liability arising out of the ownership, maintenance or use of that part of the land leased to you and shown in the Declarations. b. With respect to the insurance afforded to these additional insureds, the following additional exclusions aPPly: This insurance does not apply to: (1) Any "occurrence" that takes place after you cease to lease that land; or (2) Structural alterations, new construction or demolition operations performed by or on behalf of such person or organization. 6. Additional lnsured - State Or Political Subdivision - Permits a. \ /l-lo lS AN INSURED under Section G. is amended to include as an additional insured the state or political suMivision shown in the Declaralions as an Additional Page 18 of 24 Form SS 00 08 04 05 r{stlc\ rr)c\ orrlrlo!o c\|o LO !4bc\c\ oitoor{fa.x lnsured - State Or Political Subdivision - Permits, but only with respect to operations performed by you or on your behalf for which the state or political suMivision has issued a permit. b. M/ith respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: (1) "Bodily injury", 'property damage" or "personal and advertising injury" arising out of operations performed for the state or municipality; or (21 "Bodily injury" or 'property damage" included in the "product-completed operations" hazard. 7. Additional lnsured - Vendors a. \ /FlO lS AN INSURED under Section G. is amended to include as an additional insured the person(s) or organization(s) (refered to below as vendor) shown in the Declarations as an Additional lnsured - Vendor, but only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendo/s business and only if this Coverage Part provides co\€rage for 'bodily injury" or "property damage" included within the "products-completed operations hazard". b. The insurance afforded to the nendor is subjec;t to the following additional exclusions: (1) This insurance does not apply to: (a) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability tor damages that the vendor would have in the absence of the contract or agreement; (b) Any express warranty unauthorized by you; (c) Any physical or chemical change in the product made intentionally by the vendor; (d) Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions fom the manufadurer, and then repackaged in the original containeI BUSINESS LIABILITY COVERAGE FORM (e) Any failure to nrake such inspections, adjustments, tests or seMcing as the rendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution orsale of the products; (0 Demonstration, installation, servicing or repair operations, except such operations performed at the vendods premises in connection with the sale of the product; (g) Products which, after distribution or sale by you, have been labeledor relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or (h) 'Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (i) The exceptions contained in Subparagraphs {d) or (f); or (ii) Such inspections, adpstments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the. distribution or sale of the products. (21 This insurance does not apply to any insured person or organization from whom you have acquired such products, or any ingredient, part orcontainer, entering into, accompanying or containing such products. E. Additional lnsured - Controlling lnterest \A/l-lO lS AN INSURED under Section C. is amended to include as an additional insured the person(s) or organization(s) shown in the Declarations as an Additional lnsured Controlling lnterest, but only with respect to their liability arising out of: a. Their financial control of you; or b. Premises they own, maintain or control while you lease or occupy these premises. -GG! G * -!!!!t!! -t G ---GT = ---EE G = -- ---TEE Form SS 00 08 04 05 Page 19 of 24 BUSINESS LIABILITY COVERAGE FORM This insurance does not apply to structural afterations, new construction and demolition operations performed by or for that person or organization. 9. Additional lnsured - Owners, Lessees Or Contractors Scheduled Person Or Organization a. \A/l-lO lS AN INSURED under Section G. is amended to include as an additional insured the person(s) or organization(s) shown in the Declarations as an Additional lnsured - Owner, Lessees Or Contractors, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (1) ln the performance of your ongoing operations for the additional insured(s); or (21 ln connection with "your work" performed for that additional insured and included within the "products- completed operations hazard'f , but only if this Coverage Part provides coverage for "bodily injury" or "property damage" included within the "products-completed operations hazafd". b. \Mth respect to the insurance afforded to these additional insureds, this insurance does not apply to "bodily injury", "property damage" or "personal an advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawings and specifications; or l2l Supervisory, inspection, architectural or engineering activities. 10. Additional lnsured - Co-Owner Of lnsured Premises \ lFlO lS AN INSURED under Section G. is amended to include as an additional insured the person(s) or Organization(s) shown in the Declarations as an Additional lnsured - Co- Owner Of lnsured Premises, but only with respect to their liability as co-owner of the premises shown in the Declarations. The limits of insurance that apply to additional insureds are described in Section D. - Limits Of lnsurance. How this insurance applies when other insurance is available to an additional insured is described in the Other lnsurance Condition in Section E. - Liability And Medical Expenses General Conditions. G. LIABILITY AND MEDICAL EXPENSES DEFINITIONS 1. "Advertisement" means the widespread public dissemination of information or images that has the purpose of inducing the sale of goods, products or services through: a.(1) Radio; (21 Television; (3) Billboard; (4) Magazine; (5) Newspaper; b. The lnternet, but only that part of a web site that is about goods, products or services for the purposes of inducing the sale of goods, products orservices; or c. Any other publication that is given widespread public distribution. However, "advertisement" does not include: a. The design, printed material, information or images contained in, on or upon the packaging or labeling of any goods or products; or b. An interactive conversation between or arnong persons through a computer network. 2. "Advertising idea" means any idea for an "advertisement". 3. "Asbestos hazard" means an exposure or threat of exposure to the actual or alleged properties of asbestos and includes the mere presence of asbestos in any form. 4. "Auto" means a land motor vehicle, trailer or semi-trailer designed for travel on public roads, including any attached machinery or equipment. But "auto" does not include "mobile equipment". 5. "Bodily injury" means physical: a. lnjury; b. Sickness; or c. Disease sustained by a person and, if arising out of the above, mental anguish or death at any time. 6. "Coverage territory" means: Page 20 of 24 Form SS 00 08 04 05 c\<l oilfa o(l orr{-{olrtc\oro Mb c.{ F\Nooilfat a. The United States of America (including its territories and possessions), Puerto Rico and Canada; b. lnternational waters or airspace, but only if the injury or damage occurs in the course of travel or transportation between any places included in a. above; c. All other parts of the world if the injury or damage arises out of: (1) Goods or produds made or sold by you in the tenitory described in a. above; (21 The activities of a person whose home is in the territory described in a. above, but is away for a short time on your business; or (3) "Personal and advertising injury" offenses that take place through the lnternet or similar electronic means of communication provided the insured's responsibility to pay damages is determined in the United States of America (including its territories and possessions), Puerto Rico or Canada, in a "suit" on the merits according lo the substantive law in such tenitory, or in a settlement we agree to. 7. "Electronic data" means information, facts or prograrns: a. Stored as or on; b. Created or used on; or c. Transmifted to or from computer software, including systems and applications software, hard or floppy disks, CD-ROMS, tapes, drives, cells, data processing devices or any other media whichare used with electronically controlled equipment. 8. "Employee' includes a 'leased workef . "Employee' does not include a "temporary workef. 9. "Executive ofiicef' means a person holding any of the officer positions created by your charter, constitution, byJaws or any other similar governing document. 10. "Hostile fire" means one which becomes uncontrollable or breaks out from where it was intended to be. 11. 'lmpaired property" means tangible property, other than "your product" or "your wort', that cannot be used or is less useful because: a. ft incorporates "your produd' or "your work" that is known or thought to be defectiw, deficient, inadequate or dargerous; or BUSINESS LIABILITY GOVERAGE FORM b. You have failed to tulfill the terms of a contract or agreement; if such property can be restored to use by: a. The repair, replacement, adjustment or removal of "your product" or "your work"; or b. Your fulfilling the terms of the contract or agreement. 12. "lnsured contract" means: 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 or explosion to premises while rented to you or temporarily occupied by you with permission of the owner is subpct to the Damage To Premises Rented To You limit described in Section D. - Liability and Medical Expenses Limits of lnsurance b. A sidetrack agreement; c. Any easement or license agreement, including an easement or license agreement in connection with construction or demolition operations on or within 50 feet of a railroad; d. Any obligation, as required by ordinance,to indemniff a municipality, except in connection with work for a municipality; €. An elevator maintenance agreement; or f. That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury" or "property damage'to a third person or organization, provftled the "bodily infury' or 'property damage" is caused, in whole or in part, by you or by those acting on your behalf. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. includes that part of any contract or agreement that indemnifies a railroad for "bodily injury" or *property damage" arising out of construction or demolition operations within 50 feet of any railroad property and affecting any railroad bridge or trestle, tracks, road-beds, tunnel, underpass or crossing. However, Paragraph f. does not include that part of any contract or agreement: _G G !G r GE - & --iE @ --s -G !l'!tt @!G tr -G -IE - Form SS 00 08 04 05 Page 21 ot 24 BUSINESS LIABILITY COVERAGE FORM (1) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a) Preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; or l2l Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, including those listed in (1) above and supervisory, inspection, architectural or engineering activities. 13. "Leased worker" means a person leased to you by a labor leasing firm under an agreement between you and the labor leasing firm, to perform duties related to the conduct of your business. "Leased worker" does not include a "temporary worke/'. 14. "Loading or unloading" means the handling of property: a. After it is moved from the place where it is accepted for movement into or onto an aircraft, watercraft or "auto"; b. \Mrile it is in or on an aircraft, watercraft or "auto"; or c. \Mrile it is being moved from an aircraft, watercraft or "auto" to the place where it is finally delivered; but "loading or unloading" does not include the movement of property by means of a mechanical device, other than a hand truck, that is not attached to the aircraft, watercraft or "auto". 15. "Mobile equipment" means any of the following types of land vehicles, including any attached machinery or equipment: a. Bulldozers, farm machinery, forklifts and other vehicles designed for use principally ofi public roads; b. Vehicles maintained for use solely on or next to premises you own or rent; c. Vehicles that travel on crawler treads; d. Vehicles, whether self-propelled or not, on which are permanently mounted: (1) Power cranes, shovels, loaders, diggers or drills; or (21 Road construction or resurfacing equipment such as graders, scrapers or rollers; e. Vehicles not described in a., b., c., or d. above that are not self-propelled and are maintained primarily to provide mobility to permanently attached equipment of the following types: (1) Air compressors, pumps and generators, including sPraying, welding, building cleaning, geophysical exploration, lighting and well servicing equipment; or (21 Gherry pickers and similar devices used to raise or lower workers; f. Vehicles not described in a., b., c., or d. above maintained primarily for purposes other than the transportation of persons or cargo. However, self-propelled vehicles with the following types of permanently attached equipment are not "mobile equipment" but will be considered "autos": (1) Equipment, of at least 1,000 pounds gross vehicle weight, designed primarily for: (a) Snow removal; (b) Road maintenance, but not construction or resurfacing; or (c) Street cleaning; (21 Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers; and (3) Air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting and well servicing equipment. {6. "Occurrence" rneans an accident, including continuous or repeated exposure to substantially the same general harmful conditions. 17. "Personal and advertising injury" means injury, including consequential "bodily injury", arising out of one or more of the following offenses: a. False arrest, detention or imprisonment; b. Malicious prosecution; Page 22 ol 24 Form SS 00 08 04 05 cn<lc! rrl C\t o'l d t{orof\to lr) M5c\lr\c!oor{ ca* c. The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room, dwelling or premises that the person occupies, committed by or on behalf of ils owner, landlord or lessor; d. Oral, written or electronic publication of material that slanders or libels a person or organization or disparages a p€rson's or organization's goods, products or services ; e. Oral, written or electronic publication of material that violates a person's right of privacy; f. Copying, in your "advertisement", a person's or organization's'advertising idea" or style of "advertisement"; g. lnfringement of copyright, slogan, ortiile of any literary or artistic work, in your "advertisement"; or h. Discrimination or humiliation that resutts in injury to the feelings or reputation of a natural person. 18. "Pollutants" rneans any solirJ, lQuid, gaseous or thermal initant or contaminant, including smoke, vapor, soot, ftrrnes, acids, alkalis, chemicals and waste. \Ahste includes materials to be recycled, reconditioned or redaimed. 1 9. "Products-completed operations hazard"; a. lncludes all .bodily injury" and .property damage" occuning away from premises you own or rent and arising out of "your product" or "your worft" except: (1) Products that are still in your physical possession;or l2l Work that has not yet been completed or abandoned. However, "your work" will be deemed to be compteted at the earliest of the following times: (a) \Men all of the work called for in your contract has been completed. (b) \Mren all of the work to be done at the job site has been completed if your contract calls for work at npre than one job site. (c) \Mren that part of the work done at a |rb site has been put to its intended use by any person or oganization other than another contractor or subcontractor worting on the same prolect. BUSINESS LIABILITY COVERAGE FORM Work that may need service, maintenance, correction, repair or replacement, but which is otherwise complete, will be treated as completed. The "bodily injury" or "property damage" must occur away from premises you own or rent, unless your business includes the selling, handling or distribution of "your product" for consumption on premises you own or rent. b. Does not include 'bodily injury" or.property damage" arising out of: (1) The transportation of property, unless the injury or damage arises out of a condition in or on a vehicle not owned or operated by you, and that condition was created by the "loading or unloading" of that vehicle by any insured; or (21 The existence of tools, uninstalled equipment or abandoned or unused materials. 20. "Property damage" means: a. Physical injury to tangibte property, including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it; or b. Loss of use of tangible property that is not physically in.lured. All such loss of use shall be deemed to occur at the time of "occurrence" that caused it. As used in this definition, "electronic data" is not tangible property. 21.'Suit" means a civil proceeding in which damages because of "bodily injury', "property damage' or "personal and advertising injury' to which this insurance applies are alleged. "Suit'includes: a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent; or b. Any other altemative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. 22. "Temporary workef means a person who is fumished to you to substitute for a permanent "employee" on leave or to meet seasonal or short-term workload conditions. 23. "Volunteer worke/' means a person who: a. ls not your "employee'; --t!-!= 4 G Erlt !!GG TE -EG -i- --G lMt -- -E G G -: 4 -*r GG --r -r Form SS 00 08 04 05 Page 23 of 24 BUSINESS LIABILITY COVERAGE FORM b. Donates his or her work; c. Acts at the direction of and within the scope of duties determined by you; and d. ls not paid a fee, salary or other compensation by you or anyone else for their work performed for you. 24. "Your product": a. Means: (1) Any goods or products, other than real property, manufactured, sold, handled, distributed or disposed of by: (a) You; (b) Others trading under your name; or (c) A person or organization whose business or assets you have acquired; and (21 Containers (other than vehicles), materials, parts or equipment furnished in connection with such goods or products. b. lncludes: (1) Wananties or representations made at any time with respect to the fitness, quality, durability, performance or use of"your product"; and (21 The providing of or failure to provide warnings or instructions. c. Does not include vending machines or other property rented to or located for the use of others but not sold. 25. "Your work": a. Means: (1) Work or operations performed by you or on your behalf; and (2) Materials, parts or equipment furnished in connection with such work or operations. b. lncludes: (1) Warranties or representations made at any time with respect to the fitness, quality, durability, performance or use of "your work"; and l2l The providing of or failure to provide wamings or instructions. Page 24 ol 24 Form SS 00 08 04 05 SPECTRUM POLICY DECLARATIONS (Continued) POLICYNUMBER: 72 sBM UK5025 SUPPLEMENTAL DECLARATIONS: A service fee of $ 6.00 ¡s charged for each installment when your premium is paid in installments. The service fee is $ 6. o0 per withdrawal when you select an electronic fund transfer payment plan. The service fee will be added to the premium amount shown on your premium billing statement. Form SS 00 45 12 06 Process Date= 09/L5/20 @ Policy Expiration Ðate: Lt/0L/2L o @ COMMON POLICY CONDITIONS Form SS 00 05 12 06 @ 2006, The Hartford QUICK REFERENCE . SPECTRUM POL¡CY DECLARATIONS and COMMON POLICY CONDITIONS !. DECLARATIONS Named lnsurecj anci Maiiing Address Policy Period Description and Business Location Coverages and Limits of lnsurance II. COMMON POLICY CONDIT¡ONS á. B. Changes G. Concealment, Misrepresentation Or Fraud D. Examination Of Your Books And Records E. lnspections And Surveys F. lnsurance Under Two Or More Coverages G. !-ibe¡^alization H. Other lnsurance - Property Coverage l. Premiums J. Transfer Of Rights Of Recovery Against Others To Us K. Transfer Of Your Rights And Duties Under This Policy L. Premium Audit Beginning on Page 1_ 1 z 2 2 2 z 2 2 2 3 .t Form SS 00 05 12 06 tr COMMON POLICY CONDIT¡ONS All coverages of this policy are subject to the following conditions A. Cancellation 1. The first Named lnsured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. 2. We may cancel this policy by mailing or delivering to the first Named lnsured written notice of cancellation at least: a. 5 days before the effective date of cancellation if any one of the following conditions exists at any building that is Covered Property in this policy: (1) The building has been vacant or unoccupied 60 or more consecutive days. This does not apply to: (a) Seasonal unoccupancy; or (b) Buildings in the course of construction, renovation or addition. Buildings with 65% or more of the rental units or floor area vacant or unoccupied are considered unoccupied under this provision. (2) After damage by a Covered Cause of Loss, permanent repairs to the building: (a) Have not started; and (b) Have not been contracted for, within 30 days of initial payment of loss. (3) The building has: (a) An outstanding order to vacate; (b) An outstanding demolition order; or (c) Been declared unsafe by govern mental authority. (4) Fixed and salvageable items have been or are being removed from the building and are not being replaced. This does not apply to such removal that is necessary or incidental to any renovation or remodeling. (5) Failure to: (a) Furnish necessary heat, water, sewer service or electricity for 30 consecutive days or more, except during a period of seasonal unoccupancy; or (b) Pay property taxes that are owing and have been outstanding for more than one year following the date due, except that this provision will not apply where you are in a bona fide dispute with the taxing authority regarding payment of such taxes. b. 10 days before the effective date of cancellation if we cancel for nonpayment of premium. c. 30 days before the effective date of cancellation if we cancel for any other reason. 3. We will mail or deliver our notice to the first Named lnsured's last mailing address known to us. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. lf this policy is canceled, we will send the first Named lnsured any premium refund due. Such refund will be pro rata. The cancellation will be effective even if we have not made or offered a refund. 6. lf notice is mailed, proof of mailing will be sufficient proof of notice. 7. lf the first Named lnsured cancels this policy, we will retain no less than $100 of the premium. B. Changes This policy contains allthe agreements between you and us concerning the insurance afforded. The first Named lnsured shown in the Declarations is authorized to make changes in the terms of this policy with our consent. This policy's terms can be amended or waived only by endorsement issued by us and made a part of this policy. @ Form SS 00 05 12 06 @ 2006, The Hartford Page I of 3 COMMON POLICY CONDITIONS C. Concealment, Misrepresentation Or Fraud This policy is void in any case of fraud by you as Ít relates to this policy at any time. lt is also void if you or any other insured, at any time, intentionally conceal or misrepresent a materialfact conceming: 1. This policy; 2. Tne uovereci Propeny; 3. Your interest ¡n the Covereci Properiy; or Á A nlqim nnderlhic, nolimrr-"-t' D. Examination Of Your Books And Records We may examine and audit your books and records as they relate to the policy at any t¡me during the policy period and up to three years afterward. E. lnspections And SurveYs We have the right but are not obligated to: I Make insnecfions anci sttrvevs at anv time: 2. Give you reports on the conditions we find; and 3. Recommend changes. Any inspections, surveys, reports or recommendations relate only to insurability and the premiums to be charged. We do not make safety inspections. We do not undertake to perform the duty of any person or organization to pror4do for the healr.h or safety of any person. And we do not represent or warrant that conditions: 1. Are safe or healthful; or 2. Comply with laws, regulations, codes or standards. This condition applies not only to us, but also to any rating, advisory, rate service or similar organization which makes insurance inspections, surveys, reports or recommendations. F. lnsurance Under Two Or More Goverages lf two or more of this policy's coverages apply to the same loss or damage, we will not pay more than the actual amount of the loss or damage. G. Liberalization lf we adopt any revision that would broaden the coverage under this policy without additional premium within 45 days prior to or during the policy period, the broadened coverage will immediately apply to this policy. H. Other lnsurance - Property Coverage lf there is other insurance covering the same loss or damage, we will pay only for the amount of covered loss or damage in excess of the amount due from that other insurance, whether you can collect on it or not. But we will not pay more than the applicable Limit of lnsurance. l. Premiums 1. The first Named lnsured shown in the Declarations: a. ls responsible for the payment of all premiums; and b. Will be the payee for any return premiums we pay. 2. The premium shown in ihe Deciarations was computed based on rates in effect at the time the policy was issued. lf applicable, on each renewal, continuation or anniversary of the effective date of this policy, we will compute the premium in accordance with our rates and rules then in effect. -1. t¡Vith our consent, you ma!, continue this polic;t in force by paying a continuation premium for each successive one-year period. The premium must be: a. Pald to us pnorto tne annversary oate; ano b. Determined in accordance with Paragraph 2. above. Our forms then in effect will appl.v. lf you do not pay the continuation premium, this policy will expire on the first anniversary date that we have not received the Premium. ¡ ^L^--^- :- ^- ^!-^-"4. Unanges in exposui^es Ûi cnanges in yoüí business operation, acquisition or use of locations that are not shown in the Declarations may occur during the policy period. lf so, we may require an additionalpremium. That premium will be determined in accordance with our rates and rules then in effect. J. Transfer Of Rights Of Recovery Against Others To Us Applicable to Property Coverage: lf any person or organization to or for whom we make payment under this policy has rights to recover damages from another, those rights are transferred to us to the extent of our payment. That person or organization must do everything necessary to secure our rights and must do nothing after loss to impair them. But you may waive your rights against another party in writing: 1. Prior to a loss to your Covered Property. 2. Afrer a loss to your Covered Property only if, at time of loss, that party is one of the following: a. Someone insured by this insurance; b. A business firm: (1) Owned or controlled bY You; or (2) That owns or controls You; or Page 2 of 3 Form SS 00 05 12 06 c. Your tenant. You may also accept the usual bills of lading or shipping receipts limiting the liability of carriers. This will not restrict your insurance. K. Transfer Of Your Rights And Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual Named lnsured. lf you die, your rights and duties will be transferred to your legal representative but only while acting within the scope of duties as your legal representative. Until your legal representative is appointed, anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. *?'- Lisa Levin, Secretary COMMON POLICY CONDITIONS L. Premium Audit a. We will compute all premiums for this policy in accordance with our rules and rates. b. The premium amount shown in the Declarations is a deposit premium only. At the close of each audit period we will compute the earned premium for that period. Any additional premium found to be due as a result of the audit are due and payable on notice to the first Named lnsured. lf the deposit premium paid for the policy term is greater than the earned premium, we will return the excess to the first Named lnsured. c. The first Named lnsured must maintain all records related to the coverage provided by this policy and necessary to finalize the premium audit, and send us copies of the same upon our request. @ì o Our President and Secretary have signed this policy. Where required by law, the Declarations page has also been countersigned by our duly authorized representative. qt^{r'UArÃb Douglas Elliot, President Form SS 00 05 12 06 Page 3 of 3 POLICY NUMBER: 72 SB.M UK5025 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ADDTTIONAL TNSURED - MANAGER/LESSOR THE CITY OF KENT PUBLIC WORKS EATGINEERING 222 FOVP'IH AVE. SO. KE}üT WA 98032 ffi @ ooo Form lH 12 ü, 1l 85 T SEQ. NO. 002 Process Date: 09 /75 /20 Printed in U.S.A. Page 001- Expiration Ðalez It / 0t / 2t INSURED COPY @ @ ôo Named lnsured: Policy Number: Effective Date: Company Name ÀR¡IOI.D TO!ûAC DBA À & M 72 SBM UK5O25 1,L/0L/20 Expiration Date HARTFORD CASUALTY INSURANCE COMPAXIY LL / OT/2I THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY TRADE OR ECONOMIC SANCTIONS ENDORSEMENT This insurance does not apply to the extent that trade or economic sanctions or other laws or regulations prohibit us from providing insurance, including, but not limited to, the payment of claims. All other terms and conditions remain unchanged Form lH 99 41 04 09 Page I of I THE THE HARTFORD BUSINESS SERVICE CENTER 36TÛ WISEMAN BLVD HARTFORD SAN ANTONIO TX 78251 HB 01 000517 88792 H 3 A ,tll,t,u,til¡tl,,l,ltttt¡ll¡,tll,ll!t,,!ilt,ilt¡1,,¡t,,otlt¡,olo ARNOLDTOMACDBAA&MCO 181 19 N-E, 3OTH STREET REDMOND WA SBO52_5902 Policy lnformation: Policy N¡.¡mber:72 SBM UK5O25 October 3,202t tP Contact Us Business Service Center Business Hours: Monday - Fríday gAf\Í - 7PM CentralStandard Tíme) Phone: (888) 920-6259 Fax: (888) 443-6112 Ernail: agency.services@thehartford.oom Website: https://business.thehartford.com Enclosed please find information pertaining to your policy. Please c,ontact us if you have any questions or æncerns. Thank you for selecting The l-lartford for your business insurance needs. Sincerely, Your Hartford Service Tearn WLTRI}OI POLICYNUMBER: 72 SBM UK5O25 THIS ENDORSEMENT IS I\TTACHED TO ANÐ MADE PART OF YOUR POLICY IN RESPONSE TO THE DISGLOSURE REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT. DISGLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT SGHEDULE Terrorism Premi¡¡m: $ $s. oo o I A. Disclosure Of Premir¡m ln accordance with the federal Terrorism Risk lnsurance Act, as amended [fRA), we are required to provide you with a notice disclosing the portion of your premium, if any, attributable to coverage for "certified acts of terrorism" under TRIA. The portion of your premium attributable to such coverage is shown in the Schedule of this endorsement. B. The following definition is added with respect to the provisions of this endorsement: 1. A "certified act of terrorism" means an act that is certified by the Secretary of the Treasury, in accordance with the provisions of TRIA, to be an act of terorism under TRIA. The criteria contained in TRIA for a "certified act of terorism" include the following: a. ïhe act results in insured losses in excess of $5 million in the aggregate, attributabte to all types of insurance subject to TRIA; and b. The act results in damage within the United States, or outside the United States in the case of certain air caniers or vessels or the premises of an United States mission; and c. The act is a violent act or an act that is dangerous to human life, property or infrastructure and is committed by an individual or individuals as part of an effortto coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion G. Disclosure Of Federal Share Of Terrorism Losses The United States Department of the Treasury wíll reimburse insurers for a portion of insured losses, as indicated in the table below, attributable to "certÍfied acts of tenorism" under TRIA that exceeds the applicable insurer deductíble: Galendar Year Federal Share of Terrorism Losses 2015 85o/o 2016 844/o 2017 83o/o 2018 82o/o 2019 811/o 2020 or later 809/o However, if aggregate industry insured losses under TRIA exceed $100 biltion in a calendar year, the Treasury shall not make any payment for any port¡on of the amount of such losses that exceeds $100 billion. The United States government has not charged any premium for their participation in covering terrorism losses" Form SS 83 80 0l 15 Page 1 ot 2 @ 2015 , The Hartford (lncludes copyrighted material of the lnsurance Services Office, lnc., with Íts permission.) Process Datê: 09/15/20 policy Expiration Ðater 7L/OL/2L * D. Gap On lnsurer Liability for Tenorism Losses lf aggregate industry insured losses attributable to "certified acts of tenorism" under TRIA exceed $100 billion in a calendar year and we havè met, or will meet, our insurer deductible under TRIA, we shall not be liable for the payment of any portion of the amount of such losses that exceçd $100 billion- ln *--^L ^--^ ^^ Í^- t¡;a¡¡ir* l¡¡¡¡r øar¡JUUII WJgr yVUr WVEIqVV lvr Lvrlv¡¡J¡lr rvJrvr rrruJ be reduced on a pro-rata basis in accordance with procedures established by the Treasury, based on its estimates of aggregate industry losses and our estimate that we will exceed our insuror deductible. ln accondance with the Treasury's procedures, amounts paid for losses may be subjêct to further adjustments based on differences between actual iosses and estimates" E- Application of Other Exclusions The terms and limitations of any tenorism exclusion, the inapplicability or omission of a terrorism er¡nllrcinn. nr fhcr incluçion of telrrorism coveraoe, rlo not serve to create coverage for any loss which would otherwise be exclucied under this Goverage Form, Coverage Part or PolicY. F. All other terms and conclitions nemain the sarne" FormSS 83 80 0l 15 Fage 2ot 2 åR¡IOI¡D TC'![AC DBA À & M 18119 N.E. 3OTH STREET REDMOND lYA 98052 ***-#" @ Policy Number: 72 SBM UK5025 Renewal Date: 1_L / 01_ / 20 Thank you for being a loyal customer of The Hartford. # 1: Your Hartford Policy Enclosed are renewal documents for your policy, which is scheduled to renew on tL/OL/20 . Along with a new Declarations Page, which details the coverages provided by your policy, we are enclosing important policy documents. Please be aware that you will receive an invoice separately for this new policy term approximately 30 days prior to the renewal date; no action is required now. To ensure the premium you paid for this past policy term was accurate, we may contact you by letter, phone or email to conduct a premium audit. lf contacted, we will advise what information is needed to complete the audit. # 2: Your Business lnsurance Goverage Checkup Now is a great time to complete a business insurance coverage checkup with a Hartford lnsurance Professional. Because you wear so many hats each day, you may not be thinking about how changes to your business can impact the type and amount of insurance coverage needed to protect ¡t. Together we will evaluate how your needs may have changed over the past year. Examples include:- Has your mailing address and/or the physical location of your business changed?- Has there been any increase/decrease in the amount of business property/equipment you own?- Has there been any increase/decrease in your company's payroll or sales?- Have you added or eliminated any vehicles used in your business operations?- Are the bill plan and deductible on your policy right for your business? During the review we may make coverage recommendations, provide peace of mind solutions, and possibly reduce your costs. Here is all you need to do:- Call toll free (866) 467-8739, and select our renewal review service option any weekday from 7 A.M. to 7 P.M. CST and request your business insurance check-up.- To best serve you, please have your Policy Number or Account Number and a Copy of your current Renewal Policy in hand when you calt. # 3: Servicing Your Needs To login or register for our Online Business Service Center, go where any time, day or night you can:- Pay your bill, view payment history and enroll in Auto Pay- Request Auto lD Cards and Certificates of lnsurance- View electronic copies of billing and policy documents and sign up for paperless delivery # 4z ll You've Had A Loss or Accident... Report lt lmmediately We want to help! Contact us as quickly as possible at 1-800-327-3636.- Representatives are available 24-7 to assist in helping you recover from your loss. On behalf of A.r eÀr¡r¡AGEER & co xNs BRKRS ca/pus and The Hartford, we appreciate the opportunity to have been of service to you this past year and look forward to serving your business insurance needs forthe upcoming year. Sincerely, Your Hartford Team to www.theh artford.com/servicecenter tr IMPORTANT NOTICE TO POLICYHOLDERS THE HARTFORD CYBER CENTER WEBSITE ACCESS Thank you for choosing The Hartford for your business insurance needs. You are receiving this Notice because you purchased a business owner's policy from The Hartford, (your Policy was issued by The Hartford writing company identified on your policy Declarations page) which includes access to The Hartford Cyber Center. This portal was created because we recognize that businesses face a variety of cyber-related exposures and need help managing the related risks. These exposures include data breaches, computer virus attacks and cyber extortion threats. Through The Hartford Cyber Center, you have access to: o A panel of third party incident response service providers o Third party cybersecurity pre-incident service providers and a list of approved services to help protect your business before a cyber-threat occurs o Risk management tools, including self-assessments, best practice guides, templates, sample incident response plans, and data breach cost calculators o White papers, blogs and webinars from leading privacy and security practitioners o Up-to-date cyber-related news and events, including examples of privacy and security related events Accessing The Hartford Cyber Center is easy 1. Visit www.thehartford.com/cybercenter 2. Enter policyholder information 3. Access code:952689 4. Login to The Hartford Cyber Center This Notice does not amend or otherwise affect the provisions of your business owner's policy. Coverage Options: The Hartford offers a variety of endorsements to your busíness owner's policy that can help protect your business from a broad range of cyber-related threats. Please review your coverage with your insurance agent or broker to determine the most appropriate cyber coverages and limits for your business. Claims Reporting: lf you have a claim, you can report it by calling The Hartford's toll-free claims line at 1-800-327-3636. Should you have any questions, please contact your insurance agent, broker or you may contact us directly. We appreciate your business and look fon¡rard to being of continued service to you. Please be aware that: o The Hartford Cyber Center is a proprietary web portal exclusively provided to customers of The Hartford. Please do not share the access code with anyone outside your organization. o Registration is required to access the Cyber Center. You may register as many users as necessary. o Contacting a service provider about any issue does not constitute providing The Hartford notice of a claim as required under your insurance policy. Read your insurance policy and discuss any questions with your agent or broker. The Hartford Cyber Center provides third party service provider references and materials for educational purposes only. The Hartford does not specifically endorse any such service provider within The Hartford Cyber Center and hereby disclaims all liability with respect to use of or reliance on such service providers. All service providers are independent contractors and not agents of The Hartford. The Hartford does not warrant the performance of the service providers, even if such services are covered under your Business Owners Policy. We strongly encourage you to conduct your own assessments of the service providers' services and the fitness or adequacy of such services for your particular needs. o è Form SS 89 93 07 16 @ 2016, The Hartford Page I of I lnsurance Policy Billing lnformation Thank you for selecting The Hartford for your business insurance needs, Shortly, you will receive your first bill from us. You are receiving this Notice so you know what to expect as a valued customer of The Hartford. Should you have any questions after reviewing this information, please contact us at 866-467-8730, and we will be happy to assist you. o Your total policy premium will appear on your policy's Declarations Page. You will be billed based on the payment plan you selected. o You may pay the "minimum due" as it appears on your insurance bill or pay the policy balance in full. o An installment service fee is added to each installment. A late fee will also be applied if the "minimum due" is not received by the due date shown on your bíll. Service and late payment fees do not apply in all states. o lf you selected installment billing, any credit or additional premium due as the result of a change made to your policy, wlll be spread over the remaining billing installments. Additional premium due as a result of an audit will be billed in fullon your next billdate following the completion of the audit. o lf you elected Electronic Funds Transfer (EFT), policy changes may result in changes to the amount automatically withdrawn from your bank account. The invoice you receive following a policy change will include future withdrawal amounts. lf you need to adjust or stop your next scheduled EFT withdrawal, please contact us at least 3 days prior to the scheduled withdrawal date at the telephone number shown below. lf you selected installment billing and pay the premiums for your first policy term on time, at renewal, your account may qualify for our "Equal lnstallment" feature. This means that the percentage due for each installment, including the initial renewal installment, will be the same throughout the policy term - helping you better manage cash flow. Equal installments will continue as long as you pay your premiums on time and no cancellation notices are issued for any policy on your account. lf you no longer qualify for Equal lnstallments, future renewals will be billed based on the payment plan you selected, which includes a higher initial installment amount. o o o o lf your policy is eligible for renewal, your bill for the upcoming policy term will be sent to you approximately 30 days prior to your policy's renewal date. lf your insurance needs change, please contact us at least 60 days prior to your renewal date so we can properly address any adjustments needed. o One bill convenience -- you have the option of combining all eligible Hartford policies on one single bill allowing you to make one payment for all policies on your account as payments are due. You're ln Control ln addition to selecting a bill plan option that best meets your budget, you have the flexibility to decide how your payments are made ... o Repetitive EFT: Sign up for Repetitive EFT payments and have payments automatically withdrawn from your bank account. This option saves you money by reducing the amount of the installment service fee. o Pay Online: Register at www.thehartford.com/servicecenter. Online Bill Pay is Quick, Easy and Secure! o Pay by Check: Send a check with your remittance stub in the envelope provided with your bill. o Pay by Phone: Calltoll-free l-S66467-8730. Should you have any questions about your bill, please call Customer Service toll-free number: 1-866-467-8730 - 7AM - 7PM CST. We look forward to being of service to you. Fo¡m 10072211th Rev. Printed in U.S.A. POLICYNUMBER: 72 sBI,Il UK5O25 THIS ENDORSEMENT IS ATTACHED TO AND MADE PART OF YOUR POLICY IN RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT. DISCLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT SCHEDULE Terrorism Premium: $ $s. oo o @ @ A. Disclosure Of Premium ln accordance with the federal Terrorism Risk lnsurance Act, as amended (TRIA), we are required to provide you with a notice disclosing the portion of your premium, if any, attributable to coverage for "certified acts of terrorism" under TRIA. The portion of your premium attributable to such coverage is shown in the Schedule of this endorsement. B. The following definition is added with respect to the provisions of this endorsement: 1, A "certified act of terrorism" means an act that is certified by the Secretary of the Treasury, in accordance with the provisions of TRIA, to be an act of terrorism under TRIA. The criteria contained in TRIA for a "ceftifïed act of terrorism" include the following: a. The act results in insured losses in excess of $5 million in the aggregate, attributable to all types of insurance subject to TRIA; and b. The act results in damage within the United States, or outside the United States in the case of certain air carriers or vessels or the premises of an United States mission; and c. The act is a violent act or an act that is dangerous to human life, property or infrastructure and is committed by an individual or individuals as part of an effortto coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion C. Disclosure Of Federal Share Of Terrorism Losses The United States Department of the Treasury will reimburse insurers for a portion of insured losses, as indicated in the table below, attributable to "certified acts of terrorism" under TRIA that exceeds the applicable insurer deductible: Calendar Year Federal Share of Terrorism Losses 2015 85% 2016 84% 2017 83% 2018 82o/o 2019 81% 2020 or later 80% However, if aggregate industry insured losses under TRIA exceed $100 billion in a calendar year, the Treasury shall not make any payment for any portion of the amount of such losses that exceeds $100 billion. The United States government has not charged any premium for their participation in coveri ng terrorism losses. Form SS 83 76 01 15 @ 2015 , The Hartford (lncludes copyrighted material of the lnsurance Services Office, lnc., with its permission.) Page 1 of 2 D. Cap On lnst¡rer Liability for Terrorism Losses lf aggregate industry insured losses attributable to "certified acts of terrorism" under TRIA exceecl $100 billion in a calendar year and we have met, or will meet, our insurer deductible under TRIA, we shall not be liable for the payment of any portion of the amount of such losses that exceed $100 billion. ln such case. vour cove[aqe for terrorism losses may be reduced on a pro-rata basis in accordance with procedures established by the Treasury, based on its estimates of aggregate industry losses and our estimate that we will exceed our insurer deductible. ln accordance with the Treasury's procedures, amounts paid for losses may be subject to further adjustments based on differences between actual losses and estimates. E. Application uf Olltcr Exclusions The terms and limitations of any terrorism exclusion, the inapplicability or omission of a terrorism exclusion, or the inclusion of terrorism coverage, do not serve to create coverage for any loss wnlcn would otherwise be excluded under this Coverage Form, Coverage Part or PolicY. F. All other terms and conditions rernain the same. Form SS 83 76 01 15 Page 2 ol 2 tr @ N oIMPORTANT NOTICE TO POLICYHOLDERS To help your insurance keep pace with increasing costs, we have increased your amount of insurance . better protection in case of either a partial, or total loss to your property. lf you feel the new amount is not the proper one, please contact your agent or broker. . giving you Form PC€7¡t-0 Printed in U.S.A,