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HomeMy WebLinkAboutCAG2019-090 - Insurance Certificate - Children's Therapy Center - Updated Liability Coverage - 07/25/2021P5260028002 AssuredPartners of Washington, LLC I 325 Fourth Avenue, Suite 2l 00 Seattle, WA 98101 202107101410 )66 cc: The data included in this notice and in the attached document is confidential to Ebix BPO and the party responsible for bringing you this information. I ffi Electronic Service Requested EBIX BPO IlIXED ADC lAI] 1,931 q .5eeE flB 1' 513 1l'l'11'r1r1r1l1['lrh'iltlllll'll11ll;1'rilllllllllllll'rlll'11 Citv of Kent 155Hou3ing & Human Services P?O '{TH AVE S KENT, TJA lABIE-5434 If you have queetlons regardlng bhe content of Lhis docunent or need any changes' pLeaBe - contact the Producsr/Agent llsted on ths certLfLcate of lnEurance.- If you Lrave recelved thie c€rtLflcale vLa rnall and would 1l-ke to receLve futsure certLfLcatses - electronlcal].y, Erlease contact ua wlth your enall addresa or fax nuniber.- fi !+ o.lq o'mo\ zI! Certilicate Delivery by C€rtltlcat€sNow - www.ConlirmNet.com' 877'669.8600 ENV 1939 I OF 24 B P5260028002 Irr CERTIFICATE OF LIABILITY INSURANCE 627796t3 H#It dN I& N o\ o\ zt! DATE 07/ (fitil/DD/YYYY) 29 1202t THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the an INSURED, the must have provisions or be endors6d. lf SUBROGATION lS WAIVED, Bubject to the tormo and condltlons of th6 pollcy, cortaln policlos may roquiro an ondorsoment. A statoment on does not confer to the certificate in lieu of such PRODUCER 0 ren€6 f6arg AsauredPaltnela of washlngton, IJI,C AssuredPartn€rs of Wash. IaE. Agency' LLC CA IJlc 0x51065 1325 Fourth Av6!ue, gulte 2100 NAIC # geattle, WA 98101 PHIIJADELPHTA I!|ID INg CO 18058 INSURED tihe Cblldlrenrs Tberapy Center 10811 SE K€nt fangley Rd Kert,, wA 98030 INSURER B : INSUREN C : INSURER D : INSTJRER E : lNSllnEP F ! THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSUMNCE AFFORDED BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONOITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LIMITgIN9RrtEWPEOFII{SURANCE lNcn M POLICY NUiIBER $ 1,000,000EACH OCCURRENCE $ 100,000 MED EXP (Anv one o€Mn)$ 5,000 PERSONAL & ADV INJURY $ 1,000,000 $ 3,000,000GENERALAGGREGATE I 3,000,000PRODUCTS. COMP/OP AGG o7 tzst2t 07 125122 $ x x pHPR2307045ACOTIIIERCIAL GENERAL LIABILITY SerEuaL Ahrse - $lu AGGREGATE LIMIT APPLIES PER: eornv fl !ffi [-l to. x Stop Cap - $1M x x x x CLAIMS"MADE OCCUR $ 1,000,000 $BODILY INJURY (Per porson) $BODILY INJURY (P€r s@ld€nl) c o7 12512L 07 125122 $ PHPR2307045AAUTO[IOEILE LIABILITY ANYAUTO OWNED AUTOS ONLY HIRED AUTOS ONIY SCHEDULED AUTOS NON.OWNED AUTOS ONLYxx EACH OCCURRENCE E ll7 000' 000xt( s 4,0oo,oooAGGREGATE UITIBRELLALIAB EXCESS LIAB OCCUR CLAIMS"MADE ( PHn8779355 07 /25/2!07 /25t22A DED x RETENTIoNs 10,OOO PhRSTATI ITF utH- FR E.L. EACH ACCIDENT $ E.L, DISEASE - EA EMPLOYEE $ $ N I A E.L. DISEASE - POLICY LIMIT WORKERS COMPENSATIOII AND EMPLOYER9' LIABILITY ANYPROPRIETORiPARTNEFUEXECUTIVE OFFICER/MEMBEREXCLUDED? lfy6s, de6crib6 undsr nFSCRlPTldN 6F OPFRATIONS h.lM (Mandatory ln NH) Y/NT DESCRTPTTON OF OPERATIONS / LOCATIONS t VEHICLES (ACORD t0t, Addltlonal R6marks Schldulo, may bo attschod lf mon 3pa6 13 roqulrGd) SHOULD AT{Y OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. &rrr^ * 'vWynoyt AUTHORIZED REPRESENTATIVE ugA c{!y of Kent Houging & Hunnn gervLces 220 6E}r Avenu€ gouth K€nt, wA 98032 @ 1988-2015 ACORD CORPORATION. All rights ressrvod' ACORD 25 (2016/03) r6n€ef,earg 627796L3 The ACORD name and logo are roglstered markt of AGORD PJ260028002I I I P|-GLD-HS (10/11) T.HIS ENDAR$F.MENT qHAN.q.FS THE .P,gJICJ. .PLF.AqE RHA.D II.9AREf.ULI,Y. GENERAL LIABILITY DELUXE ENDORSEMENT: HUMAN SERVICES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE It is understood and agreed that the following extensions only apply in the event that no other specific coverage for the indicated loss exposure is provided under this policy. lf such specific coverago applies, the terms, conditions and limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otheruvise noted on this endorsement. The following is a summary of the Limits of lnsurance and additional coverages provided by this endorsemont. For complete details on specific coverages, consult the policy contract wording. Fage 1 of 12 lncludes copyrighted material of lnsurance Services Office, lnc., with its pormission. CI 2011 Philadelphia lndemnity lnsurance Company o $GI c'I o\ o\ z E] Coverage Applicable Limil of lnsurance Page # Extended Property Damage lncluded 2 Limited Rental Lease Agreement Gontractual Liability $50,000limit 2 Non-Owned Watercraft Less than 58 feet 2 Damage to Property You Own, Rent, or Occupy $30,000limit 2 Damage to Premises Rented to You $1,000,000 3 HIPAA Clarilication 4 Medical Payments $20,000 5 Medical Payments - Extended Reporting Poriod 3 years 5 Athletic Activities Amended 5 Supplementary Payments - Bail Bonds $5,000 5 Supplementary Payment - Loss of Harnings $1,000 per day 5 Employee lndemnification Dsfense Coverage $25,000 5 Key and Lock Replacement - Janitorial Services Cliont Coverage $10,000limit o Additional lnsured - Newly Acquired Time Period Amended 6 Additional lnsured - Medical Directors and Administrators lncluded 7 Additional lnsured * Managers and Supervisors (with Fellow Employee Coverage) lncluded 7 Additional lnsured * Broadened Named lnsured lncluded 7 Additional lnsured - Funding $ource lncluded 7 Additiqnal lnsured - Hsme Care Providers lncluded 7 Additional lnsurod - Managers, Landlords, or Lessors of Premises lncluded 7 Additional lnsured - Lessor of Leased Equipment lncluded 7 Additional lnsured * Grantor of Permits lncluded I Additional lnsured - Vendor lncluded I Additional lnsurod - Franchisor lncluded I Additional lnsured -When Required by Contract lncluded I Additional lnsured - Owners, Lessees, or Contractors lncluded I Additional lnsured * State or Political Subdivisions lncluded 10 Duties in the Event of Occunence, Claim or Suit lncluded 10 Unintentional Failure to Disclose Hazards lncluded 10 Transfer of Rights of Recovery Against Others To Us Clarification 10 Liberalization lncluded 11 Bodily lnjury - includes Mental Anguish lncluded 11 Personal and Advertising lnjury - includes Abuse of Process, Discrimination lncluded 11 P52(,0028002 I P|-GLD-HS (10/11) A. Extended Property Damage SECTION I_ COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY D.AMAGE LIABILITY, $ubsection 2. Exclusionr, Paragraph a. is deleted in its entirety and replaced by the following: a. Expected or lntended lnjury "Bodily injuff' or property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. B. Limitod Rental Lease Agreement Gontractual Liabillty SECTION I- COVERAGE$, COVERAGE A. BODILY INJURY ANO PROPERW DAMAGE LIABILITY, $ubsection 2. Exclusions, Paragraph b" Gontractual Liability is amended to include the following: (3) Based on the named insured's request at the time of claim, we agree to indemnify the named insured for their liability assumed in a contract or agreement regarding the rental or lease of a premises on behalf of their client, up to $50,000. This coverage extension only applies io rental lease agreements. This coverage is excess over any renter's liability insurance of the client. C. Non.Owned Watercraft $ECTION I* COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph g. (2) is doleted in its entirety and replaced by the following; (2) A watercraft you do not own that is: (a) Less than 58 feet long; and (b) Not being used to carry persons or property for a charge; This provision applies to any person, who with your consent, either uses or is responsible for the use of a watercraft. This insurance is excoss over any othor valid and collectible insurance available to the insured whether primary, excess or contingent. D. Damage to Property You Own, Rent or Occupy SECTION I - COVERAGES, COVERAGE A BODILY INJURY ANO PROPERTY DAMAGE Page 2 of 12 lncludes copyrighted material of lnsurance Services Office, lnc., with its permission. @ 2011 Philadelphia lndemnity lnsurance Company ffi Iri a.l ,t o\ o\ zi! P52(nD28002 I P|-GLD-HS (10/11i LIABILITY, Subsection 2. Exclusions, Paragraph j. Damage to Property, ltem (1) is deleted in its entirety and replaced with the following: (1 ) Property you own, rent, or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancemont, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another's property, unless the damage to property is caused by your client, up to a $30,000 limit. A client is defined as a porson under your direct care and supervision. E. Damage to Premises Rented to You l. lf damage by fire to premises rented to you is not othenrvise excluded from this Coverage Part, the word "fire" i8 changed to "fire, lightning, explosion, $moke, or leakage from automatic fire protective systems" where it appears in: a. The last paragraph of $ECTI0N l- covERAGEs, covERAGE A BoDtLy tNJURy AND PROPERTY DAMAGE LIABILITY, $ubsection 2. Exclusione; is deleted in its entirety and replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke, or leakage from automatic fire proteetive systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in SEGTTON ttt* LtMtTS OF TNSURANCE. b. SECTION lll- LIMITS OF INSURANCE, Paragraph 6. is deleted in its entirety and replaced by the following: subject to Paragraph 5. above, the Damage To Premises Rented ro you Limit is the most we will pay under Coverage A for damages because of "prope*y damage', to any one premises, while rented to you, or in the case of damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems while rented to you or temporarily oecupied by you with permission of the owner. c. $ECTION V - DEFINITIONS, Paragraph 9.a., is deleted in its entirety and replaced by the following: A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract"; 2. SECTION lV - COMMERCIAL GENERAL LIABILITY CONDITIONS, $ubsection 4. Other lnsurance, Paragraph b. Excess Insurance, {f } (a} (ii} is deleted in its entirety and replaced by the following: That is insurance fsr fire, lightning, explosion, smoke, or leakage from automatic fire protective systems for premises rented to you or temporarily occupied by you with permission of the owner; 3" The Damage To Premises Rented To You Limit eection of the Declarations is amended to the greater of: Page 3 of 12 lncludes copyrighted material of lnsurance services office, lnc., with its permission. O 2011 Philadelphia lndemnity lnsurance Company msal IL o\ o\ z F.l P5260021t002 I P|-GLD-HS (10/11) a. $1,000,000;or b. The amount shown in the Declarations as the Damage to Premises Rented to You Limit. This is the most we will pay for all damage proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective systems or any combination thereof. F. HIPAA SEGTION I- COVERAGE$, COVERAGE B PER$ONAL AND ADVERTISING INJURY LIABILITY, is amended as follows: 1. Paragraph 1. lnsuring Agreement is amended to include the following: We will pay those sums that the insured becomes legally obligated to pay as damages because of a "violation(s)" of the Health lnsurance Portability and Accountability Act (HIPAA). We have the right and the duty to defend the insured against any "suit," "investigation," or "civil proceeding" seeking these damages. However, we will have no duty to defend the insured against any "suit" seeking damages, "investigation," or "civil proceeding" to which this insurance doas not apply. 2. Paragraph 2. Exclusions is amended to include the following additional exclusions: This insuranco does not apply to: a. lntentlonal, Willful, or Deliberate Violations Any willful, intentional, or deliberate "violation(s)" by any insured. b. CriminalActs Any "violation" which results in any criminal penalties under the HIPAA. c. Other Remedies Any remedy other than monetary damages for penalties a$sessed. d. Compliance Reviews or Audits Any compliance reviews by the Department of Health and Human $ervices' 3. SECTION V - DEFINITIONS is amended to include the following additional definitions: a. "Civil proceeding" means an action by the Department of Health and Human Services (HHS) arising out of "violations." b. "lnvestigation" means an examination of an actual or alleged "violation(s)" by HH$. However, "investigation" does not include a Compliance Review. c. "Violation" mean$ the actual or alleged failure to comply with the rogulations included in the HIPM. Page 4 of '12 lncludes copyrighted materialof lnsurance $ervices Office, lnc., with its permission O 2011 Philadelphia lndemnity lnsurance Company ffi lJ. vcl f&o \f, 01 ztll I n P5260028002 P|-GLD-HS (10/11) G. Medical Payments - Limit lncreased to $20,000, Extended Reporting period lf COVERAGE C MEDICAL PAYMENTS is not othenr'rise excluded from this Coverago Part: 1. The Medical Expense Limit is changod subject to all of the terms of SECTION lll - LtMtTS OF INSURANCE to the greater of: a. $20,000; or b. The Medical Expense Limit shqwn in the Oeclaralions of this Coverage part, 2. SECTION l- COVERAGE, COVERAGE C MEDICAL PAVMENTS, $ubsection {. lnsuring Agreement, a. (3) (b) is deleted in its entirety and reptaced by the following: (b) The expenses are incurred and reported to us within three years of the date of the accident. H. Athletic Activities SECTION I- COVERAGES, COVERAGE C MEDICAL PAYMENTS, $ubsection 2. Exctusions, Paragraph e. Athletic Activities is deleted in its entirety and replaced with the following: e. Athletlc Activitles To a person injured while taking par{ in athletics. l, $upplementaryPayments $ECTION l- COVERAGES, SUPPLEMENTARY PAYMENTS - COVER.AGE A AND B are amended as follows: 1. b, is deleted in its entirety and replaced by the following: I' b. Up to $5000 for cost of bail bonds required because of aecidents or traffic law violations arising out of the use of any vehicle to which the Bodily lnjury Liability Coverage applies. We do not have to furnish these. 1.d. is deleted in its entirety and replaced by the following: 1. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $1,000 a day because of time off from work. J. Employee lndemnification Dofense Goverage $HCTION I - COVERAGES, $UPPLEMENTARY PAYMENTS * COVERAGES A AND B thE following is added: We will pay, on your behalf, defense costs incurred by an "employee" in a criminal proceeding occurring in the course of omployment. The most we will pay for any "employee" who is alleged to be directly involved in a criminal proceeding is $25,000 regardless of the numbers of "employees," claims or "suit$" brought or persons or organizations making claims or bringing "suits. Page 5 of 12 lncludes copyrighted material of lnsurance services office, lnc., with its permission. O 2011 Philadelphia lndemnity lnsurance Company u c-'l IL(J {- o\ o\ z F.] P5260028002 I pr-GLD-HS (10i11) K. Key and Lock Replacement - Janitorial Services Glient Coverage SECTION I. COVERAGES, $UPPLEMENTARY PAYMENTS - COVERAGE$ A AND B iS amended to includo the following: We will pay for thc cost to replace keys and locks at the "clients" premises due to theft or other loss to koys enlrusted to you by your "client," up to a $10,000 limit per occurrence and $10,000 policy aggregate, We will not pay for loss or damage resulting from theft or any other dishonest or criminal act that you or any of your partners, members, officers, "employees", "managers", directors, trustees, authorized representatives or any one to whom you entrust the keys of a "client" for any purposs commit, whether acting alone or in collusion with other person$. The following, when used on this coverage, are defined as follows: a. "Client" means an individual, company or organization with whom you have a written contract or work order for your services for a described premises and have billed for your services. b. "Employee" mgans: (1) Any natural person: (a) While in your service or for 30 days after termination of service; (b) Who you compensate directly by salary, wages or commissions; and (c) Who you have the right to direct and control while performing services for you; or (2) Any natural person who is furnished temporarily to you: (a) To substitute for a permanent "employee" as defined in Paragraph ({) above, who is on leave; or (b) To meet seasonal or short-term workload conditions; while that person is subject to your direction and conlrol and performing services for you (3) "Employee" does not mean: (a) Any agent, broker, person leased to you by a labor leasing firm, factor, commission merchant, consignee, independent contractor or representative of the same general character; or (b) Any "manager," director or trustee except while performing acts coming within the scopo of the usual duties of an "employee." c. "Manager" means a person serving in a directorial capacity for a limited liability company L. Additionallneureds SECTION ll- VIIHO lS AN INSURED is amended as follows: 1. lf eoverage for newly acquired or formed organizations is not otherwise excluded from this Page 6 of '12 lncludes copyrighted material of lnsurance Services Office, lnc., with its permission @ 2A11 Philadelphia Indemnity lnsurance Company ffi E. $N f! o\ zt! I P|-GLD-HS (10111) Coverage Part, Paragraph 3.a. is deleted in its entirely and replaced by the following: a. Coverage under this provision is afforded until the end of the poticy period. 2. Each of the following is also an insured: Medical Directors and Administrators - Your medical directors and administrators, but only while acting within the scope of and during the course of their duties as such. $uch duties do not include the furnishing or failure to furnish professional services of any physician or psyehiatrist in the trsatment of a patient. b. Managerc and $upervisors - Your managers and supervisors are also insureds, but only with respect to their duties as your managers and supervisors. Managers and supervisors who are your "employees" are also insureds for "bodily injury" to a co- "employee" while in the course of his or her employment by you or performing duties related to the conduct of your business. This provision does not change ltem 2.a.(1){a) as ii applies to managers of a limited liability company. c. Broadened Named lnsured - Any organizalion and subsidiary thereof which you control and actively manage on the effective date of this Coverage Part. However, coverage does not apply to any organization or subsidiary not named in the Declarations as Named lnsured, if they are also insured under another similar policy, but for its termination or the exhaustion of its limits of insurance. d. Funding $ource * Any person or organization with respect to their liability arising out of: {1} Their financial control of you; or (e) Premises they own, maintain or control while you lease or occupy these premises. This insuranco does not apply to structural alterations, new construction and domolition operations performed by or for that person or organization" e. Home Carc Providers * At the first Named lnsured's option, any person or organization under your direct supervision and control while providing for you private home respite or foster home care for the developmentally disabled. f" Managers, Landlords, or Lessors of Premises * Any person or organization with respect to their liability arising out of the cwnership, maintenance or u$e of that part of the premises leased or rented to you subject to the following additional exclusions: This insurance does not apply to: (1) Any "occurrence" which takes place after you cease to be a tenant in that premises; or (2) $tructural alterations, new construction or demolition operations performed by or on behalf of that person or organization. g. Lessor of Leased Equipment * Automatic $tatus When Required in Lease Agreement With You - Any person or organization from whom you lease equipment when you and such person or organization have agreed in writing in a eontract or agreement that such person or organization is to be added as an addiiional insured on your policy. such person or Page 7 of 12 lncludes copyrighted material of lnsurance $ervices Office, lnc., with its permission. @ 2011 Philadelphia lndemnity lnsurance Company N t!o o\ o\ ZrI] P52(il028002 tr I- PI-GLD-HS (10/11) organization is an insured only with respect to liability for "bodily injury," "property damage" or "personal and advertising inju$' caused, in whole or in part, by your maintenance, operation or use of equipmeni leased to you by such person or organization. A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires, h. Grantors of Permits * Any state or political subdivision graniing you a permit in connection with your premises subject to the following additional provision: (1) This insurance applies only with respect to the following hazards for which the state or political subdivision has issued a permit in connection with the premises you own, rent or control and to which this insurance applies: {a) Tho existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures; (b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elovators covered by this insurance' i. Vendors - Only with respect to "bodily injury'' or "property damage" arising oul of "your products" which are distributed or sold in the regular course of the vendor's business, subject to ihe following additional exclusions: ({} The insurance afforded the vendor 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 contract or agreement; (b) Any expres$ warranty unauthorized by you; (c) Any physical or chemical change in the product made intentionally by the vendor; (d) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, 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 vendor's premises in connection with the sale of the product; Page I of 12 lncludes copyrighted materialof lnsurance Services Office, lnc., with its permission CI 2011 Philadelphia lndemnity lnsurance Company ffi tlrvN ll \o ( o, z ll.1 P5260028002 I - P|-GLD-HS (10111) {g} Products which, afler dishibution or sale by you, have been labeled or 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 sr those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: {i} The exceptions contained in $ub-paragraphs (d) or (f); or (ii) $uch inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. (2) This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, pard or container, entering into, aecompanying or containing. j. Franchisor - Any person or organization with respect to their liability as the grantor of a franchise to you. k. As Required by Contract - Any person or organization where required by a written contract executed prior to the occurrence of a loss. Such person or organization is an additional insured for "bodily injury," "property damage" or "personal and advertising injury" but only for liability arising out of the negligence of the named insured. The limits of insurance applicable to these additional insureds are the lesser of the policy limits or those limits specified in a contract or agreement. These limits are included within and not in addition to the limits of insurance shown in the Declarations l. Owners, Lessees or Gontractors - Any per$on or organization, but only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury" caused, in whole or in part, by: (1) Your acts or omissions; or {2) The acts or omissions of those acting on your behalf; in the performance of your ongoing operations fsr the additional insured when required by a contract. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: (a) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed;or (b) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in peforming operations for a principal as a part of ihe same projsct. Page I of 12 lncludes copyrighted materialof lnsurance Services Office, lnc., with its permission O 2011 Philadelphia lndemnity lnsurance Company o .+ N qi o\ o\ zFI P5260028002 I Pr-GLD-HS (101111 m. State or Polltical Subdivlslons - Any state or political subdivision as required, subject to the following provisions: (1) This insurance applies only with respect to oporations performed by you or on your behalf for which the state or political subdivision has issued a permit, and is required by contract. (2) 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 injury" or "property damage" ineluded within the "products-completed operations hazard." M. Duties in the Event of Occurrence, Glaim or $uit $ECTION lV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 2. is amended as follows: a. is amended lo include: This condition applies only when the "occurrence" or offense is known to: (l) You, if you are an individual; (2) A partner, if you are a partnership; or (3) An executive officer or insurance manager, if you are a corporation. b. is amended to include: This condition will not be considered breached unless the breach occurs after such claim or "suit" is known to: {l) You, if you are an individual; (2) A partner, if you are a partnership; or {3} An executive officer or insurance manager, if you are a corporation. N. Unintentional Failure To Disclose Hazards $ECTION lV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 6. Representations is amended to include the following: It is agreed that, based on our reliance on your representations as to existing hazards, if you should unintentionally fail to disclose all such hazards prior to the beginning of the policy period of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure. O. Transfer of Rights of Recovery Against Others To Us SECTION lV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 8. Transfer of Rights of Page 10 of 12 lncludes copyrighted materialof lnsurance $ervices Office, lnc., with its permission @ 2011 Philadelphia lndemnity lnsurance Company ffi r& :j'N t! r o\ o\ zt! P5260028002 ! PI-GLD-HS (10/11) Recovery Against Others To Us is deleted in its entirety and replaced by the following: lf the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. Therefore, the insured can waive the insurer's rights of recovery prior to the occurrence of a loss, provided the waiver is made in a written contract. P, Liberalization SECTION lV - COMMERCIAL GENERAL LIABILITY CONDITIONS' is amended to include the following: lf we revise this endorsement to provide more coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state. Q. Bodily lnjury - Mental Anguish SECTION V * DEFINITION$, Paragraph 3. ls deleted in its entirety and replaced by the following "Bodily injury" means: a. Bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of these; and b. Except for menial anguish, includes death resulting from the foregoing (ltem a. above) at any time. R. Personal and Advertising lnjury - Abuse of Proeess, Discrimination lf COVERAGE B PERSONAL AND ADVERTI$ING INJURY LIABILITY GOVERAGE is not otherwise excluded from this Coverage Part, the definilion of "personal and advertising injurf is amended as follows: I' SECTION V - DEFINITION$, Paragraph 14.b. is deleted in its entirety and replaced by the following: b. Malicious prosecution or abuse of process; 2, SECTION V - DEFINITION$, Paragraph 14. is amended by adding the following: Discrimination based on race, color, religion, sex, age or national origin, except when: a. Done intentionally by or at the direction of, or with the knowledge or consent of: {l} Any insured; or (2) Any executive officer, director, stockholder, partner or memher of the insured; b. Directly or indirectly related to the employment, former or prospective employment, termination of employment, or application for employment of any person or persons by an insured; Page11ai12 lncludes copyrighted material of lnsurance services office, lnc., with its permission. O 2011 Philadelphia lndemnity lnsuranco Company o <.(\ t*(J t'- o\ o\ zE] I+! It+N ao o\c4 zr! P5260028002 P|-GLD-HS (10/11) c. Directly or indirectly related to the sale, rental, lease or sublease or prospective sales, rental, lease or sub-lease of any room, dwelling or premises by or at the dhection of any insured; or d. lnsurance for such discrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative ruling. The above does not apply to fines or penalties imposed because of discrimination, Page 12o112 lncludes copyrighted material of lnsurance Services Office, lnc., with its permission. O 2011 Philadelphia lndemnity lnsurance Company ffi It T P5260028002 I AssuredPartners of Washington, LLC I 325 Fourth Avenue, Suite 2l 00 Seattle, wA 98101 Electronic Service Requested IlIXED ADC 9AI] l,i39 r.t.5ea0 l'lB 1.51,3 1l,lr1l,l1l1 hll'llh'ltlllllrlllllll;urlllllllllsllrlllrll )56 H# EBIX BPO f& !i N o\ z e If you have queFtions regarding the content of thl6 document or need any changegr pLeaee - conUact the Producer/Agen! llsted on ttr€ certl-fLcate of l"ngurance'- If you have recel-ved thLe certLflcale vj.a mal"l and would J.Ike t'o recelve futsure o€rtlficates - €lecUronleallyr plaase contact u8 wlth your €naLl addrees or fax ngmber. cc: The data included in this notice and in the attached document is confidential to Ebix BPO and the party responsible for bringing you this information. l1 K & A Citv ofHoulinqee0 '{THKENT ' tdA nt Hunan ServicesES 1AO3E.5A3A 155 Certlllcate Delivery by CertiflcatesNow - www.ConlirmNet.com - 877.669.8600 202t01 301111\IENV 1939 9 0F 24 B DATE 07/ (rtfti,DD/YYYY) 29l20ZL THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORIUATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. TH|S CERTTFICATE OF TNSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. the is an ADDITIONAL INSURED, the INSURED provisions or be lf SUBROGATION lS WAIVED, subject to the lorms and conditions of the policy, certain pollcies may requlre an endorsement, A statemont on this certiflcate doos not confer to tho holdor ln lleu of euch PRODUCER renee fearE AgauredPaltner6 of vlashLngton, LI,c AgsuredPartn€rs of wash. Ins. Agenoy' LI,c CA Llo 0K61066 1325 Fourth Av€uue, gulte 2100 geatrle, wA 98101 PHIIADELPHIA IND INS CO 18058 INSURED tihe Childlenrg Therapy CeDter 10811 SE Kent Rangley Rd K€ab, wA 98030 INSURER B : INSURER C : INSURER D INSURER E : INSURSn F r q P5260028002 COVERAGES Ir_ CERTIFICATE OF LIABILITY INSURANCE TE NUMBER: 62779126 ffi tJi .f, N 9a o\ o\ zt! FICA ACORD 25 (2016/03) !€!oefeaf,s 62779L26 NUMBER: @ 1988-2015 ACORD CORPORATION. All rlghts reserved' THIS IS TO CERTIFY THAT THE POLICIES OF INSUMNCE LISTED BELOW HAVE INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. PdI ICY trUMBER LIMITSWPE OF IN8URANCE luqn s 1,000r000EACH OCCURRENCE $ 100,000 MED EXP (Anv one mHnl $ s,000 s 1,000,000PERSONAL & ADV INJURY s 3,000r000GENERAL AGGREGATE $ 3,000,000PRODUCTS - COMP/OP AGG 07 lzs/2t 07 125122 $ x PHPK23070,C5ACOTiTERCIAL GENERAL LIABILIW senreL Abqge - $1lt x fttop Oap - SUil x LOCf--.l pno.I IJECT | | x x x POLICY LIMIT APPLIES PER: CIAIMS.MADE OCCUR $ 1,000,000 $BODILY INJURY (Psr psrson) $BODILY INJURY (P€r a@ident) $ 07 125/2L 07 t25t22 $ AUTOMOBILE LIABILIW ANYAUTO OWNEO AUTOS ONLY HIRED AUTOS ONLY AUTOS ONLY SCHEDULED AUTOS NON.OWNEOxx PHPK23070,tt5A EACH OCCURRENCE 3 41000;000xx $ 4,00o,oooAGGREGATE UIIIBRELLA LIAB EXCEss LIAB OCCUR CLAIMS.MADE 07 125122PHI'8779356 07 t2stztA DED x RETENTIoNs 10, OOO PEKSTATI ITF ut H- FN E.L. EACH ACCIDENT ! E.L, DISEASE - EA EMPLOYEE F I DISEASE - POLICY LIMIT N I A WORKERS COMPEN3ATION AND EiTPLOYERS' LIABILIW ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICEFUMEMBER EXCLUDED? (Mandstory ln NH) lfv6s. doscribs undsr nFsiRrPTtoN oF oPFRAT|oNS b.tM 1, 00o, oooo7 l25l2L 07 /25122 P6r Occu].r€nceAProfesglonal Ltabtuty PHPR23070d5 DESCntpTtOt{OFOPERA?|ONS/LOCATTONS/VEHICLES (ACORDl0l,AddltlonrlR.markssch.dule,nayboattachsdlfmorospaasltr.quirsd} p€r ths attached eldorssrent tbe followlng are lncluded as addttlonal insuredl: City of Rent Clty of K€nt Houslng & Hullan gervic€E 220 4th Avenuo gouth K€nt, wA 98032 I usA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI'I DATE THEREOF, NOTICE WLL BE DELIVERED lN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZEO REPRESENTATIVE 0**^ * 'vWnu,t The ACORD name and logo are reglstered marks of ACORD P5260028002 P|-GLD-HS (10t11) TH|S ENq,QRsEr',lFlyLgHANGFs IHE F-grlcy., pLEAgE gEAp.tL caREFUt ty". GENERAL LIABILITY DELUXE ENDORSEMENT: I HUMAN SHRVICES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE It is understood and agreed that the following extensions only apply in the event that no other specific coverage for the indicatod loss exposure is provided under this policy. lf such specific coverago applies, the terms, conditions and limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted on this endorsement, The following is a summary of the Limits of lnsurance and additional coverages provided by this endorsement. For complete details on specific covsrages, consult the policy contract wording, . Page 1 of 12 lneludes copyrighted materialof lnsurance Services Office, lnc., with its permission. @ 2011 Philadelphia lndemnity lnsurance Company c0 c.l l!o o\ ztJl Goverage Appllcable Llmit of lnsurance Page # Extended Property Damago lncluded 2 Limited Rental Lease Agreement Contractual Liability $50,000limit 2 Non-Owned Watercraft Less than 58 feet 2 Damage to Property You Own, Rent, or Occupy $30,000limit 2 Damage to Premises Rented to You $1,000,000 3 HIPAA Clarification 4 Medical Payments $20,000 5 Medical Payments - Extonded Reporting Period 3 years 5 Athletic Activities Amended 5 Supplementary Payments - Bail Bonds $$,000 5 Supplementary Payment * Loss of Earnings $1,000 per day 5 Employee lndemnification Defense Coverage $25,000 5 Key and Lock Replacement * Janitoriai Services Client Coverage $10,000limit o Additional lnsured * Newly Acquired Time Period Amended 6 Additional lnsured * Medical Directors and Administrators lncluded 7 Additional lnsured - Managers and $upervisors (with Fellow f,mployee Coverage) lncluded 7 Addifional lnsured - Broadened Named lnsured lncluded 7 Additional lnsured * Funding $ource lncluded 7 Additional lnsured - Home Care Providers lncluded 7 Additional lnsured - Managers, Landlords, or Lessors of Premises lncluded 7 Additional lnsured - Lessor of Leased Equipment lncluded 7 Additional lnsured - Grantor of Permits lncluded B Additional lnsured - Vendor lncluded I Additional lnsured -. Franchisor lncludod I Additional lnsured -When Required by Contract lncluded I Additional lnsured - Owners, Lessees, or Contractors lncluded I Additional lnsured * State or Political Subdivisions lncluded 10 Duties in the Event of Occurrence, Claim or Suit lncluded 10 Unintentional Failure to Disclose Hazards lncluded 10 Transfer of Rights of Recovery Against Others To Us Clarification 10 Liberalization lncluded 11 Bodily lnjury - includes Mental Anguish lncluded 11 Personal and Advertising lnjury - includes Abuse of Process, Discrimination lncluded 11 P52r)00280o2 I PI-GLD-HS l1ol11) A, Extended Properly Damage SEGTION I* COVERAGES, COVERAGE A BOOILY INJURY AND PROPERTY DAMAGE LIABILITY, $ubsection 2. Exclusions, Paragraph a. is deloted in its entirety and roplaced by the following: a. Expected orlntended lnjury "Bodily injury'' or property damag6" expected or intended from the standpoint of the insured, This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect per$ons or property. B. Limited Rental Lease Agreomant eonfiactual Liability SECTION I. COVERAGES, COVERAGE A. BODILY INJURY ANP PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph b" Gontractual Liability is amended to include the following: (3) Based on the named insured's request at the time of claim, we agree to indemnify the named insured for their liability assumed in a contract or agreement regarding the rental or lease of a premises on behalf of their client, up to $50,000. This eoverage extension only applies to rental lease agreements. This coverage is excess over any renter's liability insurance of the client. C. Non-0wned Watercraft $ECTION I. COVERAGES, COVERAGE A BODILY INJURY AND PROPERTV DAMAGE LIABILITY, Subsection 2. Excluslons, Paragraph g. (2) is deleted in its entirety and replaced by the following: (2) A watercraft you do not own that is (a) Less than 58 feet long; and (b) Not being used lo carry persons or property for a charge; This provision applies to any person, who with your consent, either uses or is responsible for the use of a watorcraft. This insurance is excess over any olhor valid and colloctible insurance available to the insured whether primary, excess or contingent. D. Damage to Property You Own, Rent or Occupy SECTION I- COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE Page 2 of 12 lncludes copyrighted material of lnsurance Services Office, lnc., with its permission. @ 2011 Philadelphia lndemnity lnsurance Company ffi F. c.l IL Or Oi zr]t b R Pr-GLD-HS (10/11) LlABlLlTY, Subsection 2. Exclusions, Paragraph j. Damage to Property, ltem ({) is doleted in its entirety and replaced with the following: (1) Property you own, rent, or occupy, including any costs or expenses incurred 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 another's property, unless the damage to property is caused by your client, up to a $30,000 limit. A client is defined as a person under your direct care and supervision. E. Damage to Premises Rented to You t" lf damage by fire to premises rented to you is not otherwise excluded from this Coverage Part, the word "fire" is changed to "fire, lightning, explosion, smoke, or leakage from automatic fire protective system$" where it appears in: a. The last paragraph of sEcrloN I - covERAGES, covERAGE A BoDtLY tNJURy AND PROpERTY OAMAGE LIABILITY, Subsection 2. Excluslons; is delotod in its entirety and replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, $moke, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in $EGT|ON ttl- LIM|TS OF TNSURANCE. b. SECTION lll- LIMITS OF INSURANCE, Paragraph 6. is deleted in its entirety and replaced by the following: Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, lighining, explosion, smoke, or leakage from automatic fire protective systems while rented to you or temporarily occupied by you with permission of the owner. c' SECTION V - DEFINITION$, Paragraph 9.a., is deleted in its entirety and replaced by the following: A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract"; 2. SECTION lV - COMMERCIAL GENERAL LIABILITY CONDITIONS, $ubsection 4. Other lneurance, Paragraph b. Excess lnsurance, (1) (a) tii) is deleted in its entirety and replaced by the following: That is insurance for fire, lightning, explosion, smoke, or leakage from automatic fire protective systems for premises rented to you or temporarily occupied by you with permission of the owner; 3. The Damage To Premises Rented To You Limit section of the Declarations is amended to the greater of: Page 3 of 12 lncludes copyrighted material of lnsurance Services Office, lnc., with its permission. O 2011 Philadelphia lndemnity lnsurance Company o+N l!o Oia z tr.l P52(ilo211002 -l P|-GLD-Hs (10/11) a. $1,000,000;or b, The amount shown in the Declarations as the Damage to Premises Rented to You Limit. This is the most we will pay for all damage proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective systems or any combination thereof. F, HIPAA SECTION I- COVERAGES, COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY, is amended as follows: 1. Paragraph 1. lnsurlng Agreement is amended to include the following: We will pay those sums that the insured becomes legally obligated to pay as damages because of a "violation(s)" of the Health lnsurance Portability and Accountability Act (HIPAA). We have the right and the duty to defend the insured against any "suit," "investigation," or "civil proceeding" seeking these damages. However, we will have no duty to defend the insured against any "suit" seeking damages, "investigation," or "civil proceeding" to which this insurance does not apply. 2. Paragraph 2. Exclusions is amended to include the following additional exclusions: This insurance does not apply to: a. Intentional, Willful, or Deliberate Violatione Any willful, intentional, or deliberate "violation(s)" by any insured. b. CriminalActs Any "violation" which results in any criminal ponalties under the HIPAA. c. Other Remedies Any remedy other than monetary damages for penalties assessed. d. Compliance Reviews or Audits Any compliance reviews by the Department of Health and Human $ervices. 3. $ECTION V - DEFINITIONS is amended to include the following additional definitions a. "Civil proceeding" means an action by the Department of Health and Human Services (HHS) arising out of "violations," b. "lnvestigation" means an examination of an actual or alleged "violation(s)' by HH$. However, "investigation" does not include a Compliance Review. c. "Violation" means the actual or alleged failure to comply with the regulations included in the HIPAA^ Page 4 of 12 lncludes copyrighted material of lnsurance Services Office, lnc., with its permission O 2011 Philadelphia lndemnity lnsurance Company ffi tlr .f, N al ol z P5260028002 Pr-GLD-HS (10111) G. Medical Payments - Limit lncreased to $20,000, Extended Reporting Period lf COVERAGE C MEOICAL PAYMENTS is not otherwise excluded from this Coverage Part: 1. The Medical Expense Limit is changed subject to all of the terms of SECTION lll " LIMITS OF INSURANCE to the greater of: a. $20,000; or b. The Medical Expense Limit shown in the Declarations of this Coverage Part. 2. SECTION l- COVERAGE, COVERAGE C MEDICAL PAYMENTS, Subsection 1. lnsuring Agreement, a, (3) (b) is deleted in its entirety and replaced by the following: (b) The expense$ are incurred and reported to us within three years of the date of the accident. H. Athletic Activities SECTION l- COVERAGES, COVERAGE C MEDICAL PAYMENTS, $ubsection 2. Excluslons, Paragraph e. Athletic Activitiee is dsleted in its entirety and replaced with the following: e. Athletic Activities To a person injured while taking part in athletics. l, $upplemontaryPayments SECTION I - COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGE A AND B are amended as follows: {. b, ie deleted in its entirety and replaeed by the following: {. b. Up to $5000 for cost of bail bonds required because of accidents or haffic law violations arising out of the use of any vehicle to which the Bodily lnjury Liability Coverage applies. We do not havc to furnish these. 1.d. is deleted in its entirety and replaced by the following: 1. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "$uit", including actual loss of earnings up to $1,000 a day because of time off from work. J. Employee lndemnification Defense Coverage SECTION I * COVERAGES, $UPPLEMENTARY PAYMENTS * COVERAGES A AND B thg following is added: We will pay, on your behalf, defense costs incurred by an "employee" in a criminal proceeding occurring in the course of omployment. The most we will pay for any "employee" who is alleged to be diroctly involved in a criminal proceeding is $25,000 regardless of the numbers of "employees," claims or "suits" brought or person$ or organizations making claims or bringing "suits. Page 5 of 12 lncludes copyrighted materialof lnsurance Services Office, lnc., with its permission. CI 2011 Philadelphia lndemnity lnsurance Company o.+att! ct o\ aztJl P5260028002 I I P|-GLD-HS (10111) K. Key and Lock Replacement - Janitorial Services Client Goverage SECTION I. COVERAGES, SUPPLEMENTARY PAYMENTS. COVERAGE$ A AND B iS amended to include the following: We will pay for the cost to replace keys and locks at the "clients" premises due to theft or other loss to keys entrusted to you by your "client," up to a $10,000 limit per occurrence and $10,000 policy aggregate. We will not pay for loss or damage resulting from theft or any other dishonest or criminal act that you or any of your partners, members, officers, "gmployeos", "managers", directors, trustees, authorized representatives or any one to whom you enlrust the keys of a "client" for any purpo$e commit, whether acting alone or in collusion with olher persons. The following, when used on this coverage, are defined as follows: a" "Client" means an individual, company or organization with whom you have a written contract or work order for your services for a described premises and have billed for your senrices. b. "Employee" means: {f) Any natural person: (a) While in your service or for 30 days after termination of service; (b) Who you compensate directly by salary, wages or commissions; and (c) Who you have the right to direct and control while performing services for you; or (2) Any natural person who is furnished temporarily to you: {a) To substitute for a permanent "employee" as defined in Paragraph (1) above, who is on leave; or (b) To meet seasonal or short-term workload conditions; while that person is subject to your direction and control and performing services for you. (3) "Employee" does not mean: (a) Any agent, broker, persoR leased to you by a labor leasing firm, factor, commission merchant, consignee, independent contractor or representative of the same general character; or (b) Any "manager," director or trustee except while performing acts coming within the scope of the usual duties of an "employee." c. "Manager" means a porson serving in a directorial capacity for a limited liability company. L. Additionallnsureds SECTION ll- I,VHO lS AN INSURED is amended as follows: 1. lf coverage for newly acquired or formed organizalions is not otherwise excluded from this Page 6 of 12 lncludes copyrighted material of lnsurance Services Office, lnc., with its permission @ 2011 Philadolphia lndomnity lnsurance Company ffi t! a.tq o\ o\ z P5260028002 t R I P|-GLD-HS (10/11) Coverage Part, Paragraph 3.a. is deleted in its entirely and replaced by the following: a. Coverage under this provision is afforded until the end of the policy period. 2" Each of the following is also an insured: a. Medical Directors and Administrators - Your medical directors and administrators, but only while acting wilhin the scope of and during the course of their duties as such. $uch duties do not include the furnishing or failure to furnish professional services of any physician or psychiatrist in the treatmont of a patient. b. Managers and $upervisors - Your managers and supervisors are also ineureds, but only with re$pect to their duties as your managers and supervisors. Managers and superuisors who are your "employees" are aiso insureds for "bodily injury', to a co- "employee" while in the course of his or her employment by you or performing duties related to the conduct of your business. This provision does not change ltem 2.a.(1)(a) as it applies to managers of a limited liability company. c. Broadened Named lnsured - Any organization and subsidiary thereof which you control and actively manage on the effective date of this Coverage Part. However, coverage does not apply to any organization or subsidiary not named in the Declarations as Named lnsured, if they are also insured under another aimilar policy, but for iis termination or the exhaustion of its limits of insurance" d. Funding $ource - Any person or organization with respect to their liability arising out of: (1) Their financial control of you; or {2) Premises they own, maintain or eontrol while you lease or oceupy these premises. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. e. Home Care Providers - At the first Named lnsured's option, any person or organization under your direct supervision and control whiie providing for you private home respite or foster home care for the developmentally disabled. f. Managers, Landlords, or Lessors of Premises * Any person or organization with respect to their liability arising out of the ownership, maintenance or use of that part of the premises leased or rented to you subject to the following additional exclusions: This insurance does not apply to: (1) Any "occurrence" which takes place after you cease to be a tenant in that premises; or (2) Shuctural alterations, new construction or demolition operations performod by or on behalf of that person or organization. g. Lessor of Leased Equipment * Automatic $tatus When Required in Lease Agreement With You - Any person or organization from whom you lease equipment when you and such per$on or organization have agreed in writing in a contract or agreement that such person or organization is to bo added as an additional insured on your policy. such person or Page 7 of 12 lncludes copyrighted materialof lnsurance services office, lnc., with its permission" A 24fi Philadelphia lndemnity lnsurance Company o c'l rL o\ zEI P52(il028002 rr P|-GLD-HS (10/11) organization is an insured only with respect to liability for "bodily injury," "property damage" or "personal and advertising injut'' caused, in whole or in pad, by your maintenance, operation or use of equipment leased to you by such person or organization. A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires, h. Grantors of Permlts * Any state or political subdivision granting you a permit in connection with your premises subject to the following additional provision: (l) This insurance applies only with respect to the following hazards for which the state or political subdivision has issued a permit in connection with the premises you own, rent or control and to which this insurance applies: (a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures; (b) The construction, erection, or removal of elevators; or (c) The ownorship, maintenance, or use of any elevators covered by this insurance Vendors * 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 vendor's business, subject to the following additional exclusions: (1) The insurance afforded the vendor 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 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, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original conlainer; {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 vendor's premises in connection with tho sale of the product; Page I of 12 lncludes copyrighted material of lnsurance Services Office, lnc., with its permission @ 2A11 Philadelphia lndemnity lnsurance Company ffitr F4 N l!(, .+ O, z ll.1 P5260028002I I P|-GLD-HS (10/11) {g} Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, paft 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: (l) The exceptions contained in Sub-paragraphs (d) or (f); or {ii) $uch inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. {2) This insurance does not apply to any insured per$on or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing. J. Franchisor - Any person or organization with respect to their liability as the grantor of a franchise to you. k. As Required by Contract - Any person or organization where required by a written contract executed prior to the occurrenee of a loss. Such person or organization is an additional insured for "bodily injury," "property damage" or "personal and advertising injury" but only for liability arising out of the negligence of the named insured. The limits of insurance applicable to these additional insureds are the lesser of the policy limits or those limits specified in a contract or agreement. These limits are included within and not in addition to the limits of insurance shown in the Declarations l. Owners, Lessees or Contractors - Any per$on or organization, but only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury" caused, in whole or in part, by: (1) Your acts or omissions; or {2} The acls or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured when required by a contract. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occuning after: {a) All work, including materials, paris or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs)to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed;or (b) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. Page 0 of 12 lncludes copyrighted material of lnsurance Services Office, lnc., with its permission @ 2011 Philadelphia lndemnity lnsurance Company .+al l!(J <. o\ o\ zt! P52(,0028002 I P|-GLD-HS (10111',) m. $tate or Polltical Subdivlslons - Any state or political subdivision as required, subject to the following provisions: (f ) This insurance applies only with respoct to operations performed by you or on your behalf for which the state or political subdivision has issued a permit, and is required by contract. (2) 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 injury" or "property damage" included within the "products-completed operations hazard." M. Duties in the Event of Occurrence, Glairn or Suit $ECTION lV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 2. is amended as follows: a. is amended to include: This condition applies only when the "occurrence" or offense is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; or (3) An executive officer or insurance manager, if you are a corporation. b. is amended to include: This condition will not be considered breached unless the breach occurs after such claim or "suit" is known to: (l) You, if you are an individual; (2) A partner, if you are a partnership; or (3) An executive officer or insurance manager, if you are a corporation. N. Unintentional Failure To Disclose Hazards SECTTON lV - COMMERCIAL GENERAL LIABILITY CONDITION$, 6. Representations is amended to include the following: It is agreed that, based on our reliance on your representations as to existing hazards, if you should unintentionally fail to disclose all such hazards prior to the beginning of the policy period of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure. O. Transfer of Rights of Recovery Against Others To Us SECTTON tV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 8. Transfer of Rights of Page 10 of 12 lncludes copyrighted material of lnsurance Services Offiee, lnc., with its permission' @ 2011 Philadelphia lndemnity lnsurance Company ffi :f, NE zn I PI-GLD-HS {10111} Recovery Against Others To Us is deleted in its entirety and replaced by the following: lf the insured has rights to recover all cr part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "$uit" or transfer those rights to us and help us enforce them. Therefore, the insured can waive the insurer's rights of recovery prior to the occurrence of a loss, provided the waiver is made in a written contract, P. Liboralization SECTICIN lV - COMMERCIAL GENERAL LIABILITY CONDITION$, is amended to include the following: lf we revise this endorsement to provide more coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state. Q. Bodily Injury * Mental Anguish SECTION V - DEFINITION$, Paragraph 3. ls deleted in its entirety and replaced by the following "Bodily injury" means: a. Bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of these; and b. Hxcept for mental anguish, includes death resulting from the foregoing (ltem a. above) at any time. R. Perssnal and Advertising lnjury - Abuse of Process, Discrimination lf COVERAGE B PERSONAL AND ADVERTI$ING INJURY LIABILITY GOVERAGE is not otherwise excluded from this Coverage Part, the definition of "personal and advertising injury" is amended as follows: 1. SECTION V * DEFINITION$, Paragraph 14.b. is deleted in its entirety and replaced by the following: b. Malicious prosecution or abuse of process; 2. SECTION V * DEFINITIONS, Paragraph 14. is amended by adding the foilowing: Discrimination based on race, color, religion, sex, age or national origin, except when: a. Done intentionally by or at the direction of, or with the knowledge or consent of: (l) Any insured; or (2) Any executive officer, director, stockholder, partner or member of the insured; b, Directly or indirectly related to the employment, former or prospective employment, termination of employment, or application for employment of any person or persons by an insured; Page 11 of 12 lncludes copyrighted material of lnsurance Servicos Office, lnc., with its permission. @ 2011 Philadelphia lndemnity lnsurance Company o <fcl F(J zEl PJ260028002 +! ffi P|-GLD-HS (10/11) c. Directly or indirectly related to the sale, rental, Iease or sublease or prospec'tive sales, rental, lease or sub-lease of any room, dwelling or premises by or at the direction of any insured; or d. lnsurance for such diecrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative ruling. The abovs does not apply to fines or penalties impooed because of discrimination. Page 12 ol 12 lncludes copyrighted material of lnsurance Services Offico, lnc., with its permission. O 2011 Philadelphia lndemnity lnsurance Company TL!+N ll O\o o\ (t\ z 9.1 III I AssuredPartners of Washington, LLC I 325 Fourth Avenue, Suite 2l 00 Seattle, WA 98101 Electronic Service Requested MIXED ADC 9SO 1'133 r'l ,5ee0 1'lB 1,.5L3 hll,llh,llllllllrlllsllls,,,,lsllllllllls,rlll,ll e nt Human ServicesES9803e-5438 155 V )66 ffiEBIX BPO lji $N f! r o\t! zt! gl,lrll,lllllg Citv of KHouiing & AEO {TH A KENT, tlIA If you have quegtione regardlng the cont€nt of, thlg docr.urent or need any change5, pLease - contact th€ Produc€r/Agents llsted on the c€rtiflcate of Lnsurance.- If you have received thlg cerlLfloate vLa maL]. and would lik€ !o receLve fueur€ certifLcatea - electronlcally, plsaFe contacts us wlth your €naLl addreEs or fax nunber.- The data included in this notice and in the attached document is confidential to Ebix BPO and the party responsible for bringing you this information. C€rtificate Dollvory by C€rtitlcatesNow - www.ConfirmNet.com - 877.669.8600 202t0?3014 r0IENV 1939 t7 0F 248 DATE (rrilirDD/YYYY) 07 12912021" THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(s), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. -IMPORTANT'. lf the certiftiaie holder is an ADDITIONAL INSURED, the policy(ies) must have AODITIONAL INSURED provisions or be endorsed. lf SUBROGATION lS WAIVED, subJect to the terms and conditionE ol the policy, certain policlos may roquire an endorsement. A statoment on this cortificate does not confer rights to the certlficate holder ln lieu of such endorsemenl(s). PRODUCER !{A#877030 t-206-343-2323 Assur€dlPartaar6 of wasblagton, tl,c Assur€alpartaer6 of wa6h. rns. Agency, LIrc cA Llc 0K51056 1325 Pourth Avenue, Sulte 2100 geattle, WA 98101 renee fearg INSURER(S} AFFORDING COVERAGE NAIC f tNsr1RERA: PIIIIJI.DEIJPHIA rliD INg CO 18058 INSURED the Chlldlreni6 Thef,aDy c€nter 108U SE Nont Kangl€y Rd K€ag, lvA 98030 INTIIREP R: INSURER C : II{SURER D : INSURER E INSIINFP F , p52(iln28002 4- CERTIFICATE OF LIABILITY INSURANCE 627797!8 @ 1988-2015 ACORD CORPORATION. All rights resented. The ACORD name and logo are r€glsterod marks of ACORD ffi .+ c.lt\o€ o, ztjl TE ACORD 25 (2016/03) reneef,earE 627797tA OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. tEsTHIS IS TO CERTIFY THAT THE POLIC INDICATED. NOTWITHSTANDING ANY REQUIREMENT, HEREIN IS SUBJECT TO ALL THE TERMS, LIMITSINgRt?p TYPE OF INSURANCE tNqn lM POLICY NUIIBER s 1,000,000EACH OCCURRENCE $ 100,000 MED EXP (Anv on6 o€6on)s 5,000 PERSONAL &ADV INJURY S 1'000'000 GENERAL AGGREGATE g 3,000,000 s 3,000,000PRODUCTS - COMP/OP AGG 07 /25/22 $ x x PHPRz307045 07 l2sl2LACOMMERCIAL GENERAL LIABILITY Sexual Abuse - $lU x stop cap - $1M x x POLICY PRO- NJECT I I x x LIMITAPPLIES PER: LOC CLAIMS.MADE OCCUR $ 1,000,000 BODILY INJURY (P6r peBon)$ $BODILY INJURY (Per accldGnt) $ 07 /25122 $ PHPfi2307045 07 l25l2rAAUTOMOBILE LIAEILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY SCHEOULED AUTOS NON.OWNED AUTOS ONLYxx EACH OCCURRENCE g 41000,000xx AGGREGATE $ 4,000,000 UMBRELLALIAB EXCESS LIAB occuR CLAIMS.MADE $ PtruB779356 07 t25t2L 07 125122A DFT)x RETENTTONS 10' 000 PER STATUTE (JtH- FE E.L. EACH ACCIDENT $ E.L. DISEASE . EA EMPLOYET $ sE.L. DISEASE - POLICY LIMIT WORKERS COMPENSAIIOiI ANO EMPLOYERS' LIAEILIW ANYPROPRIETOFVPARTNERiEXECUTIVE OFFICER/MEMBER EXCLUDED? lf yas, dsscribs undsr nFSCRIPTInN OF .)PFFIATIONS helN (Mandatory ln NH) Y/NT N AI DESCR|PTIONOFOPERAT|ONS/LOCAI|ONS/VEHICLES (ACORDl0t,AddltlonalRomarksSchrdulc,maybeattachedlfmorespacolsroqulred) Clty of x6nt Eoueing & tlwlan gervlc€s 22O At}: Av6nu€ South Kent, WA 98032 I UgA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CAITICELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WLL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESEI'ITATIVE 0*^^ I tobvnoyn P526()028002I I r Pr-GLD-HS (10111) rtil,s ENDOBSEMFNT qHANqEs THF.poltcy. pL,FAgE BFAD tr SAREFULLY. GENERAL LIABILITY DELUXE ENDORSEMENT: HUMAN SERVICES This endorsemont modifies insurance provided under the following: COMMERCIAL GENERAL TIABILITY COVERAGE It is understood and agreed that the following extensions only apply in the event that no other specific coverage for the indicated loss exposure is provided under this policy. lf such specific coverage applies, the terms, conditions and limits of that coverage are the sole and exclusive cov€rage applicable under this policy, unless otherwise noted on this endorsement. The following is a summary of the Limits of lnsurance and additional coverages provided by this endorsement. For complete details on specific coverages, consult the policy contract wording. Page 1 of 12 lncludes copyrighted material of lnsurance Services Office, lnc., with its permission. @ 2011 Philadelphia lndemnity lnsurance Company c0.+N l! ao o\ o\ zEI Coverage Applicable Limit of lnsurance Page # Extended Property Damage lncluded 2 Limited Rental Lease Agreement Gontractual Liability $50,000limit 2 Non-Owned Watercraft Less than 58 feet 2 Damage to Property You Own, Rent, or Occupy $30,000limit 2 Damage to Premises Rented to You $1,000,000 3 HIPAA Clarification 4 Medical Payments $20,000 5 Medical Payments - Extended Reporting Period 3 years 5 Athletic Activities Amended Supplementary Payments - Bail Bonds $5,000 5 Supplementary Payment * Loss of Earnings $1,000 per day 5 Employee lndemnification Defense Coverage $25,000 5 Key and Lock Replacement - Janitorial Services Client Coverage $10,000limit tt Additional lnsured - Newly Acquired Time Period Amended 6 Additional lnsured - Medical Directors and Administrators lncluded 7 Additional lnsured - Managers and Supervisors {with Fellow Emplovee Coveraqe) lncluded 7 Additional lnsured - Broadened Named lnsured lncluded 7 Additional lnsured - Funding Source lncluded 7 Additional lnsured - Home Care Providers lncluded 7 Additional lnsured * Managers, Landlords, or Lossors of Premises lncluded 7 Additional lnsured - Lessor of Leased Equipment lncluded 7 Additional lnsured - Grantor of Permits lncluded o Additional lnsured * Vendor lncluded B Additional lnsured * Franchisor lncluded I Additional lnsured * When Required by Contract lncluded I Additional lnsured - Owners, Lessees, or Contractors lncluded I Additional lnsured * State or Political Subdivisions lncluded 10 Duties in the Event of Occurrence, Claim or $uit lncluded 10 Unintentional Failure to Disclose Hazards lncluded {n Transfer of Rights of Recovery Against Others To Us Clarification 10 Liberalization lncluded 11 Bodily lnjury - includes Mental Anguish lncluded 11 Personal and Advertising lnjury * includes Abuse of Process, Discrimination lncluded 11 P5260028002 I P|-GLD'HS (10/11) A, Extended Property Damage SECTION I* COVERAGES, COVERAGE A BODII.Y INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph a. is delsted in its entirety and roplaced by the following: a. Expected orlntended lnjury "Bodily injurf' or property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or propedy. B, Limited Rantal Lease Agreement Contractual Liabillty $ECTION I- COVERAGE$, COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph b. Contractual Liability is amended to include the following: (3) Based on the named insured's request at the time of claim, \rve agree to indemnify the named insured for their liability assumed in a contract or agreement regarding the rental or lease of a premises on behalf of their client, up to $50,000. This coverage extension only applies to rental lease agreements, This coverage is excess over any renter's liability insurancs of the client. C. Non-Owned Watercraft SECTION I. COVERAGE$, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2, Exclusions, Paragraph g. (2) is deleted in its entirety and replaced by the following: (2) A watercraft you do not own that is: (a) Less than 58 feet long; and (b) Not being used to carry persons or property for a charge; This provision applies to any person, who with your consent, either uses or is responsible for the use of a watercrafi. This insurance is excess over any other valid and colloctible insurance available to the insured whether primary, excess or contingent' D. Damage to Property You Own, Rent or Occupy SECTION I. COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE Page?ol12 lncludos copyrighted materialof lnsurance $ervices Office, lnc., with its permission' @ 2011 Philadelphia lndemnity lnsurance Company ffi ,u $6.t o o\ o\ zt! P526002tto02 q I P|-GLD-HS (10/11) LIABI!-ITY, Subsection 2. Exclusions, Paragraph j. Damage to Froperty, ltem (1) is deleted in its entirety and replaced with the following: (1) Property you own, rent, or occupy, including any costs or expenses incurred 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 anotheCs property, unless the damage to property is caused by your client, up to a $30,000 limit. A clisnt is defined as a person under your direct care and supervision. E. Damage to Premises Rented to You 1. lf damage by fire to premises rented to you is not otherwise excluded from this Coverage Part, the word "fire" is changed to "fire, lightning, explosion, smoke, or leakage from automatic fire protective systems" where it appears in: a. The last paragraph of sEGTloN l- covERAGEs, covERAGE A BoDtLy tNJURy AND PROPERTY DAMAGE LlABlLlTY, Subsection 2. Exclusions; is deleted in its entirety and replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, $moke, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in SECTION ttl- LIM|TS OF TNSURANCE. b. SECTION lll- LIMITS OF INSURANCE, Paragraph 6. is deleted in its entirety and replaced by the following: subject to Paragraph 5. above, the Damage To Premises Rented ro you Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems while rented to you or temporarily occupied by you with permission of the owner. c. SECTION V - DEFINITIONS, Paragraph 9.a., is deleted in its ontirety and replaced by the following: A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective syslems to premises while rented to you or temporarily occupied by you with permission of the owner is not an "iRsured contract"; 2. SEGTION lV - COMMERCIAL GENERAL LIABILIW CONDITIONS, Subsection 4. Other lnsurance, Paragraph b. Excess lnsurance, (1) (a) (ii) is deleted in its entirety and replaced by the following: That is insurance for fire, lightning, explosion, smoke, or leakage from automatic fire protective systems for premises rented to you or temporarily occupied by you with permission of the owner; 3. The Damage To Premises Rented To You Limit section of the Declarations is amended to the greater of: Page 3 of 12 lncludes copyrighted material of lnsurance servicos office, lnc., with its permission O 2011 Philadelphia lndernnity lnsurance Company o <f,N t 01 o\ O, zE] P5260028m2 + ffi Pr-GLD-HS (10/11) a. $1,000,000; or b. The amount shown in the Declarations as the Damage to Premises Ronted to You Limit. This is the most we will pay for all damage proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective systems or any combination thereof. F. HIPAA SECTION I- COVERAGE$, COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY, is amended as follows: 1. Paragraph L lnsuring Agreement is amended to include the following: We will pay those sums that the insured becomes legally obligated to pay as damages because of a "violation(s)" of the Health lnsurance Portability and Accountability Act (HIPAA). We have the right and the duty to defend the insured against any "suit," "investigation," or "civil proceeding" seeking these damage$. However, we will have no duty to defend the insured against any "suit" seeking damages, "investigation," or "civil proceeding" to which this insurance does not apply. 2. Paragraph 2. Exclusions is amended to include the following additional exclusions: This insurance does not apply to: a. Intentional, Willful, or Deliberate Violations Any willful, intentional, or deliberate "violation(s)" by any insured. b" CriminalActs Any "violation" which results in any criminal penalties under the HIPAA. c. Other Remedies Any remedy other than monetary damages for penalties assessed. d. Compliance Reviews or Audite Any compliance reviews by the Department of Health and Human Services' 3. SECTION V * DEFINITIONS is amended to include the following additional definitions: a. "Civil proceeding" means an aclion by the Department of Health and Human Services (HHS) arising out of "violations." b. "lnvestigation" means an examination of an actual or alleged "violation(s)" by HHS. However, "investigation" does not include a Compliance Review. 6. "Violation" means the actual or alleged failure to comply with the regulations included in the HIPAA. Page 4 of 12 lncludes copyrighted materialof lnsurance Services Office, lnc., with its permission. O 2011 Philadelphia lndemnity lnsurance Company t! <{'N LLo al O, o\ zt! P-5260028002 II PI-GLD-HS (10/11) G. Medical Payments * Limit lncreased to $20,000, Extended Reporting Poriod lf COVERAGE C MEDICAL PAYMENT$ is not othenuise excluded from this Coverage Part: '1. The Medical Expense Limit is changed subjeet to all of the terms of SECTION lll . LIMITS OF INSURANCE to the greater of: a. $20,000; or b, The Medical Expense Limit shown in the Declaralions of this Coverage Part" 2. SECTION l- COVERAGE, COVERAGE c MEDICAL PAYMENTS, Subsection {. Insuring Agreement, a. (3) (b) is deleted in its entirety and reptaced by the following: (b) The expenses are incurred and reported to us within three years of the date of the accident. H. Athletic Activities $ECTION l- COVERAGES, COVERAGE C MEDICAL PAYMENTS, $ubsection 2. Exclusions, Paragraph e. Athletic Activities is deleted in its entiroty and replaced with the following: e. Athletic Activities To a person injured while taking part in athletics. L SupplemcntaryPayments $ECTION I * COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGE A AND B are amended as follows: 1. b. is deleted in its entirety and replaced by the following: {. b. Up to $5000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily lnjury Liability Coverage applies. We do not have to furnish these. 1.d. is deleted in its entirety and replaced by the following: 1. d- All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to 91,000 a day becauso of time off from work. J. Employee lndemnification Defense Coverage $ECTION I - COVERAGES, $UPPLEMENTARY PAYMHNT$ - COVERAGES A AND B thE following is added: We will pay, on your behalf, defense costs incurred by an "employee" in a criminal proceeding occurring in the course of employment. The most we will pay for any "employee" who is alleged lo be directly involved in a criminal proceeding is $25,000 regardless of the numbers of "employees," claims or "suits" brought or persons or organizations making claims or bringing "suiis, Page 5 of '12 lncludes copyrighted material of lnsurance Services Office, lnc., with its permission. O 2011 Philadelphia lndemnity lnsurance Company c0 o.tl! an o\ o\ z t!1 I P|-GLD-HS (10t11) K. Key and Lock Replacement * Janitorial $eryices Glient Coverage SECTION I - COVERAGES, SUPFLEMENTARY PAYMENT$ * COVERAGE$ A AND B iS amended to include the following: We will pay for the cost to replace keys and locks at the "clients" premises due to theft or other loso to keys entrusted to you by your "client," up to a $10,000 limit per occurrence and $10,000 policy aggregate. We will not pay for loss or damage resulting from theft or any other dishonest or criminal act that you or any of your partners, members, officers, "employees", "managers", directors, trustees, authorized representatives or any one to whom you entrust the keys of a "client" for any purpose commit, whether acting alone or in collusion with other person$. The following, when used on this coverage, are defined as follows: a. "Client" means an individual, company or organization with whom you have a written contract or work order for your services for a described premises and havs billed for your services. b. "Employee" means: (1) Any natural person: (a) While in your service or for 30 days after termination of service; (b) Who you compensate directly by salary, wages or commissions; and (c) Who you have the right to direct and control while performing sorvices for you; or (2) Any natural person who is furnished temporarily to you: (a) To substitute for a permanent "employee" as defined in Paragraph (1) above, who is on leave; or (b) To meet seasonal or short-term workload conditions; while that person is subject to your direction and control and pedorming sorvices for you. {3) "Employee" does not mean: (a) Any agent, broker, persoR leased to you by a labor leasing firm, factor, commission merchant, consignee, independent contractor or representative of the same general character; or (b) Any "manager," director or trustee except while performing acts coming within the scopo of tho usual duties of an "employee," c. "Manager" means a person serving in a directorial capacity for a limited liability company, L" Additionallnsureds SECTION ll-WHO lS AN INSURED is amended as follows: 1, lf coverage for newly acquired or formed organizations is not otherwise excluded from this Page 6 of 12 lncludes copyrighted material of lnsurance Services Office, lnc., with its permission' CI 2011 Philadelphia lndemnity lnsurance Company ffi tJ. a.l IL a.t o\ zE] P5260028002 I PI-GLD-HS (10/11) Coverage Part, Paragraph 3.a. is deleted in its entirely and replaced by the following: a. Coverago under this provision is afforded until the end of the policy period. 2. Each of the following is also an insured: a. Medical Directors and Administrators - Your medical directors and adrninistrators, but only while acting within the scope of and during tho course of their duties as such. Such duties do not include the furnishing or failure to furnish professional services of any physician or psychiatrist in the treatment of a paiient. b" Managers and Supervisors - Your managers and supervisors are also insureds, but only with respect to their duties as your managers and supervisors. Managers and supervisors who are your "employees" are also insureds for "bodily injury" to a co- "employee" while in the course of his or her employment by you or performing duties related to the conduct of your business. This provision does not change ltem 2.a.(1)(a) as it applies to managers of a limited liability company. c. Broadened Named lnsured * Any organizalion and subsidiary thereof which you control and actively manage on the effective date of this Coverage Part. However, coverage does not apply to any organization or subsidiary not named in the Declarations as Named lnsured, if they are also insured under another similar policy, but for its termination or the exhaustion of its limiis of insurance. d. Funding $ource - Any person or organization with respect to their liability arising out of: {1} Their financial control of you; or {2} Premises they own, maintain or control while you lease or occupy these premises. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. e. Home Care Providers - At the first Named lnsured's option, any person or organization under your direct supervision and eontrol while providing for you private home respite or foster home care for the developmentally disabled. f. Managers, Landlords, or Lessors of Premises - Any person or organization with respect to their liability arising out of the ownership, maintenance or use of that part of the premises leased or rented to you subject to the following additional exclusions: This insurance does not apply to: {1) Any "occurrence" which takes place after you cease to be a tenant in that premises; or (2) Structural alterations, new construction or demolition operations performed by or on behalf of that porson or organization. g. Lessor of Leased Equipment * Autornatic $tatue When Required in Lease Agreemont With You * Any person or organization from whom you lease equipment when you and such per$on or organization have agreed in writing in a contract or agreement that such person or organization is to be added as an addiiional insured on your policy. such person or Page 7 of 12 lncludes copyrighted material of lnsurance Servicos Office, lnc., with its permission @ 2011 Philadelphia lndernnity lnsurance Company .+c{ (J a.l 01 o\ II P-52(,0028002 PI-GLD-HS (10/11) organization is an insured 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 us€ of equipment leased to you by such person or organization. A person's or organization's $tatus as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires, h. Grantors of Permits - Any state or political subdivision granting you a permit in connection with your premises subject to the following additional provision: (1) This insurance applies only with respect to the following hazards for which the state or political subdivision has issued a permit in connection with the premises you own, rent or control and to which this insurance applies: (a) The existence, maintenance, repair, construction, ereetion, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures; (b) The construction, erection, or removal of elevators; or (c) Tho ownership, maintenance, or use of any elevators covered by this insurance, i. Vendors - Only with respect to .bodily injurf' or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business, subject to the following additional exclusions: (1 ) The insurance afforded the vendor 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 agroement. This exclusion does not apply to liability for damages that the vendor would have in the absence ofthe 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, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under inslructions from the manufacturer, and then repackaged in the original conlainer; (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 operaiions, except such operations performed at the vendor'$ premises in connection with the sale of the product; Page 8 of 12 lncludes copyrighted material of lnsurance Services Office, lnc,, with its permission. O 2011 Philadelphia lndemnity lnsurance Company ffi tli N Nat o\ zr! I P|-GLD-HS (10111) (g) Products which, after dishibution or sale by you, have been labeled or 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 $ub-paragraphs {d) or (f); or (ii) Such inspeetions, 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 tho products, (2) This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing. j. Franchisor - Any person or organization with respect to their liability as the grantor of a franchise to you" k. As Required by Contract - Any person or organization where required by a written contract executed prior to the occurrence of a loss. Such person or organization is an additional insured for "bodily injury," "property damage" or "personal and advertising injury" but only for liability arising out of the negligence of the named insured. The limits of insurance applicable to these additional insureds are the lesser of the policy limits or those limits specified in a contract or agreement. These limits are included within and not in addition to the limits of insurance shown in the Declarations l. Ownersn Lessees or Contractors - Any person or organization, 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 (2) The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured when required by a contract. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insuranca does not apply to "bodily injury" or "property damage" oceurring after: (a) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed;or (b) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than anolher contractor or subcontractor engaged in performing operations for a principal as a part of the same projoct. Page I of 12 lncludes copyrighted material of lnsurance Services Office, lnc., with its permission. O 2011 Philadelphia lndemnity lnsurance Company o.+ N 'LO a.tal o\ o\ zut P5260028002 I PI-GLD-HS (10/11) m. $tate or Political Subdivlsions - Any state or political subdivision as required, subject to the following provisions: (l) This insurance applies only with respect to oporations porformed by you or on your behalf for which the state or political subdivision has issued a permit, and is required by contract. (2) This insurance does not apply to: (a) "Bodily injury," "property damage" or "per$onal and advertising injury" arising out of operations performed for the state or municipality; or (b) "Bodily injury" or "property damage" included within the "products'completed operations hazard." M. Duties ln the Event of Occurrence, Glaim or Suit SECTTON tV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 2. is amended as follows: a. is amended to include: This condition applies only when the "occurrence" or offense is known to: ({) You, if you are an individual; (2) A partner, if you are a partnership; or (3) An executive officer or insurance manager, if you are a corporation. b. is amended to include: This condition will not be considered breached unless the breach occurs after such claim or "suit" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; or (3) An executive officer or insurance manager, if you are a corporation' N. Unintentional Failure To Disclose Hazards $ECT|ON tV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 6. Representatione is amended to include the following: It is agreed that, based on our reliance on your representations as to existing hazards, if you should unintentionally fail to disclose all such hazards prior to the beginning of the policy period of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure. O. Transfer of Rights of Recovery Against Others To Us SECTTON IV * COMMERCIAL cENERAL LIABILITY CONDITIONS, 8. Transfer of Rights of Page 10 of 12 lncludes copyrighted material of lnsurance Services Office, lnc., with its permission. @ 2011 Philadelphia lndemnity lnsurance Company ffi .+ en l!o ct o\ o\ zlll Pi26002E002 I P|-GLD-HS (10/11) Recovery Against Others To Us is deleted in its entiroty and replaced by the following: lf the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transfened to us. The insured must do nothing after loss to impair them" At our request, the insured will bring "$uit" or transfer thoss rights to us and help us enforce them. Therefore, the insured can waive the insurer's rights of recovery prior to the occurrence of a loss, provided the waiver is made in a written contract. P. Liberalization SECTION lV * COMMERCIAL GENERAL LIABILITY CONDITION$, is amended to include the following: lf we revise this endorsement to provide more coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state. Q. Bodily lnjury * Mental Anguish SECTION V - DEFINITION$, Paragraph 3. ls deleted in its entirety and replaced by the following: "Bodily injury" means: a. Bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of lhese; and b. Except for mental anguish, includes death resulting from the foregoing (ltem a. above) at any time. R. Personal and Advertising lnjury * Abuse of Frocess, Discrimination lf COVERAGE B PER$ONAL AND ADVERTI$ING INJURY LIAEILITY COVERAGE is not otherwise excluded from this Coverage Part, the definition of "personal and advertising injury" is amended as follows: 1. SECTION V - DEFINITION$, Paragraph 14"b. is deleted in its entirety and replaced by the following: b. Malicious prosecution or abuse of process; 2. SECTION V - DEFINITIONS, Paragraph 14. is amended by adding the following: Discrimination based on tace, color, religion, sex, age or national origin, except when: a" Done intentionally by or at the direetion of, or with the knowledge or consent of: (1) Any insured; or (2) Any executive officer, director, stockholder, partner or member of the insurod; b. Directly or indirectly related to the employment, former or prospective employment, termination of employment, or application for employment of any person or persons by an insured; Page 11 of 12 lncludes copyrighted materialof lnsurance $ervices office, lnc., with its permission. @ 2011 Philadelphia lndemnity lnsurance Company o r+ol tr c.l CL o\ ztrl P5260028002 + PI-GLD-HS (10r11) c. Directly or indirectly related to the sale, rental, lease or sublease or prospective sales, rental, lease or sub-lease of any room, dwelling or premises by or at the direclion of any insured; or d. lnsurance for such discrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative ruling. The above does not apply to fines or penalties imposed because of discrimination. Page 12 ot 12 lncludes copyrighted material of lnsurance Services Office, lnc., with its permission O 2011 Philadelphia lndemnity lnsurance Company ffiffi r& d Fio $a.l o\mo\ zt! I I