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CAG2022-021 - Amendment - #2 - A & M Consulting - 224th Street Phase II - 11/02/2023
FOR CITY OF KENT OFFICIAL USE ONLY Sup/Mgr: Agreement Routing Form DirAsst: • For Approvals,Signatures and Records Management Dlr/Dep: KE N T This form combines&replaces the Request for Mayor's Signature and Contract Cover (optional) W ASH INGTGN Sheet forms. Originator: Department: Karin Bayes for Abdulnaser A. Public Works Date Sent: Date Required: 0 11/02/2023 11/7/2023 Q Director or Designee to Sign. Date of Council Approval: Q N/A Budget Account Number: Grant?:Yes:No R90110 Budget?W]YesDNo Type: N/A Vendor Name: Category: A&M Consulting Contract Vendor Number: Sub-Category: Amendment 0 Project Name: 224th Street Phase 3 (West) S. 216th St & 98th Ave S E Project Details: Extend the time of completion to December 31, 2024 c c Agreement Amount: $0 Basis for Selection of Contractor: Direct Negotiation *Memo to Mayor must be attached i Start Date: 11/2/2023 Termination Date: 12/31/2024 Q Local Business?0YesF--]No* If meets requirements per KCC3.70.100,please complete'Vendor Purchase-Local Exceptions"formonCityspoce. Business License Verification:YesElln-ProcessElExempt(KCC 5.01.045) Notice required prior to disclosure? Contract Number: F_IYesF�No CAG2022-021 Comments: 3 GJ y •� i GJ 3 M C N Date Routed to the City Clerk's Office: Interlocal Agreement has been uploaded to website: ❑ ad«W22373_1_20 Visit Documents.KentWA.gov to obtain copies of all agreements rev.20210513 �•�KK FE 14N T WASQlo AMENDMENT NO. 2 NAME OF CONSULTANT OR VENDOR: A & M Consulting CONTRACT NAME & PROJECT NUMBER: 224 1h Street Project Phase III ORIGINAL AGREEMENT DATE: January 24. 2022 This Amendment is made between the City and the above-referenced Consultant or Vendor and amends the original Agreement and all prior Amendments. All other provisions of the original Agreement or prior Amendments not inconsistent with this Amendment shall remain in full force and effect. For valuable consideration and by mutual consent of the parties, Consultant or Vendor's work is modified as follows: 1. Section I of the Agreement, entitled "Description of Work," is hereby modified to add additional work or revise existing work as follows: In addition to work required under the original Agreement and any prior Amendments, the Consultant or Vendor shall: No change to the scope of work, however an amendment is needed to extend the time of completion to December 31, 2024 to coordinate with PSE, Lumen, and Comcast for all utilities relocation and undergrounding work. 2. The contract amount and time for performance provisions of Section II "Time of Completion," and Section III, "Compensation," are modified as follows: Original Contract Sum, $9,450 including applicable WSST Net Change by Previous Amendments $0 including applicable WSST Current Contract Amount $9,450 including all previous amendments Current Amendment Sum $0 Applicable WSST Tax on this $0 Amendment Revised Contract Sum $9,450 AMENDMENT - 1 OF 2 Original Time for Completion 12/3112022 (insert date) Revised Time for Completion under 12/31/2023 prior Amendments (insert date) Add`I Days Required (±) for this 365 calendar days Amendment Revised Time for Completion 12/31/2024 (insert date) The Consultant or Vendor accepts all requirements of this Amendment by signing below, by its signature waives any protest or claim it may have regarding this Amendment, and acknowledges and accepts that this Amendment constitutes full payment and final settlement of all claims of any kind or nature arising from or connected with any work either covered or affected by this Amendment, including, without limitation, claims related to contract time, contract acceleration, onsite or home office overhead, or lost profits. This Amendment, unless otherwise provided, does not relieve the Consultant or Vendor from strict compliance with the guarantee and warranty provisions of the original Agreement. All acts consistent with the authority of the Agreement, previous Amendments (if any), and this Amendment, prior to the effective date of this Amendment, are hereby ratified and affirmed, and the terms of the Agreement, previous Amendments (if any), and this Amendment shall be deemed to have applied. The parties whose names appear below swear under penalty of perjury that they are authorized to enter into this Amendment, which is binding on the parties of this contract. IN WITNESS, the parties below have executed this Amendment, which will become effective on the last date written below. CONSULTANT/VENDOR: CITY OF KENT: 1r6�� By: , il� By: Print Name: r/Ad Ty /ft/X G Print Name: carp Maloney, P.E. Its Its: Desi n nqineering Manager DATE: Gl 12 12 DATE: 2 ATTEST: APPROVED AS TO FORM: (applicable if Mayor's signature required) kesla Kent City Clerk Kent Law Department AMENDMENT - 2 OF 2 1 -4cQ TE CERTIFICATE OF LIABILITY INSURANCE D 1a1os12023Y) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATIONIS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT A J GALLAGHER RISK MGMNT SVCSIPHS NAMEd PHONE (888)9e0-6259 FAx 83556228 (AIC,No Ext): (AIC,NoI: The Hartford Business Service Center 3600 Wiseman Blvd E-MAIL ADDRESS: San Antonio,Tx 78251 INSURERS)AFFORDING COVERAGE NAICN INSURED INSURERA: Hartford Casualty insurance Company 29424 ARNOLD TOMAC DBA A&M CONSULTING INSURER B: 18119 NE 30TH ST INSURER C: REDMOND WA 9B052-5902 INSURER D INSURER E: N INSURER F: w COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD o INDICATED.NOTWITHSTANDI NG ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR I WVD M DD YY M COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $2,000,000 CLAIMS-MADE-OCCUR DAMAGE TO RENTED $300,000 PREWS c rc c* X General Liab#lity ME I)EXP(Any one person) $10,a0a A x 63 SBM UK5025 11/01/2023 11101/2024 PERSONAL&ADV INJURY $2 00Q Opp GEW_AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 POLICY❑PRO LOG PRODUCTS-COMPIOP AGG $4,000.000 JECT OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $2 aa0,00a ANY AUTO BODILY INJURY(Per person) ALL OWNED SCHEDULED 83 SBM UK5025 1110V2023 11101/2024 300ILY INJURY(PeraocWent) AUTOS AUTOS HIRED NON-OWNED PROPERTY DAMAGE :Ile x AUTOS x AUTOS (Per accident) L u: �ull:I UMBRELS A LIAR OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS- AGGREGATE MADE ED I RETENTION$ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY TE ANY YIN E.L.EACH ACCIDENT $1,000.000 A PROPRIETORIPARTNERIEXECUTIVE NIA 83 SBM UK5025 11/01/2023 11/01/2024 OFFICERIMEMEER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $1,000,000 (Mandatory In NH) It yes,descrbe under E.L.DISEASE-POLICY LIMIT $1.000,000 OESCRIPTION OF OPE RATIO A EMPLOYMENT PRACTICES 83 SBM UK5a25 11/01/2023 11/01/2024 Each Claim Limit $5,000 LIABILITY Aggregate Limit $5,000 DESCRIPTION OF OPERA TIONSILOCATIONSI VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Those usual to the Insured's Operations.CertiflCate Holder is an Additional Insured per the Business Liability Coverage Form SS0008 attached to this policy. CERTIFICATE HOLDER CANCELLATION The City of Kent SHOULD ANY OF THE ABOVE DESCRIBER POLICIES BE CANCELLED Public Works Engineering BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED 222 4TH AVE S IN ACCORDANCE WITH THE POLICY PROVISIONS. KENT WA 9B032 AUTHORIZED REPRESENTATIVE C_J lle_ r7 Q1. rl�&Izl� Q 1988.2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD I /k � § hi § m / kGf q c � z - o § }lam § o _ §/ / § t \f � k m2r -. a oAo = o � mCo - � § ( � \ @ § ® I / Ul _ r . w• R"K G�..; i� ��.: S 0 m 0 a p❑ p THANK YOU FOR RENEWING YOUR POLICY WITH U5 If you're receiving this renewal through the mail directly from The Hartford, please note that we've only attached new, changed or updated documents. These include your new declarations page, which outlines your coverage, as well as any notices and brochures with updated information. We leave out unchanged documents to help cut down on paperwork and mailing costs. You can keep the attached documents filed alongside those from your previous policy if you wish. If you're receiving this renewal electronically, or it's been mailed by your agent, it may include all of your documents- even ones that haven't changed. In either case, keep in mind that you can view, download or print any of these documents online. Just register or log into your account https:llbusiness.thehartford.corn and click on "documents". For added convenience,you can also pay your hill, request a Certificate of Insurance, check claims status, update preferences and more. Form G-4169-0 0 2019,The Hartford page 1 of 1 i 0 w ARNOLD TONAC DBA A & N THE 28129 N.N. 30TH STREET HARTFQRD REDMOND WA 98052 Policy Number: 83 5BM UK5025 Renewal Bate: 11/01/2 3 Thank you for being a loyal customer of The Hartford. #1: Your Hartford Policy Enclosed are renewal documents for your policy, which is scheduled to renew on 11/01/23 . Along with a new Declarations Page, which details the coverages provided by your policy, we are enclosing important policy documents. Please be aware that you will receive an invoice separately for this new policy term approximately 30 days prior to the renewal date; no action is required now. To ensure the premium you paid for this past policy term was accurate, we may contact you by letter, phone or email to conduct a premium audit. If contacted, we will advise what information is needed to complete the audit. #2: Your Business Insurance Coverage Checkup Now is a great time to complete a business insurance coverage checkup with a Hartford Insurance Professional. Because you wear so many hats each day, you may not be thinking about how changes to your business can impact the type and amount of insurance coverage needed to protect it. Together we will evaluate how your needs may have changed over the past year. Examples include: - Has your mailing address and/or the physical location of your business changed? - Has there been any increase/decrease in the amount of business property/equipment you own? - Has there been any increase/decrease in your company's payroll or sales? - Have you added or eliminated any vehicles used in your business operations? _ Are the bill plan and deductible on your policy right for your business? During the review we may make coverage recommendations, provide peace of mind solutions, •-; and possibly reduce your costs. Here is all you need to do: .i': - Call toll free (666) 467-8730 , and select our renewal review service option any weekday from 7 A.M.to 7 P.M.CST and request your business insurance check-up. - To best serve you, please have your Policy Number or Account Number and a Copy of your current Renewal Policy in hand when you call. # 3: Servicing Your Needs To login or register for our Online Business Service Center, go to www.thehartford•comiservicecenter where any time,day or night you can: Pay your bill,view payment history and enroll in Auto Pay Request Auto ID Cards and Certificates of Insurance View electronic copies of billing and policy documents and sign up for pap erless delivery #4: if You've Had A loss or Accident... Report It Immediately We want to help! Contact us as quickly as possible at 1-800-327-3636. - Representatives are available 24-7 to assist in helping you recover from your loss. On behalf of A J GALLAGHER RISK NLUINT SVCS/PRS and The Hartford, we appreciate the opportunity to have been of service to you this past year and look forward to serving your business insurance needs for the upcoming year. ' Sincerely, Your Hartford Team d m IMPORTANT NOTICE TO POLICYHOLDERS Q THE HARTFORD CYBER CENTER WEBSITE ACCESS Thank you for choosing The Hartford for your business insurance needs. You are receiving this Notice because you purchased a business owner's policy from The Hartford, (your Policy was issued by The Hartford writing company identified on your policy Declarations page) which includes access to The Hartford Cyber Center. This portal was created because we recognize that businesses face a variety of cyber-related exposures and need help managing the related risks. These exposures include data breaches, computer virus attacks and cyber extortion threats. Through The Hartford Cyber Center, you have access to: o A panel of third party incident response service providers o Third party cybersecurity pre-incident service providers and a list of approved services to help protect your business before a cyber-threat occurs a Risk management tools, including self-assessments, best practice guides, templates, sample incident response plans, and data breach cost calculators o White papers, blogs and webinars from leading privacy and security practitioners o Up-to-date cyber-related news and events, including examples of privacy and security related events Accessing The Hartford Cyber Center is easy 1. Visit www.thehartford.comlcybercenter 2. Enter policyholder information 3. Access code: 952&89 4. Login to The Hartford Cyber Center This Notice does not amend or otherwise affect the provisions of your business owner's policy. i...: Coverage Options: The Hartford offers a variety of endorsements to your business owner's policy that can help protect your business from a broad range of cyber-related threats. Please review your coverage with your insurance agent or broker to determine the most appropriate cyber coverages and limits for your business. Claims Reporting: If you have a claim,you can report it by calling The Hartfo d's toll-free claims line at 1-804-327-3636. Should you have any questions, please contact your insurance agent, broker or you may contact us directly. We appreciate your business and look forward to being of continued service to you, Please be aware that: The Hartford Cyber Center is a proprietary web portal exclusively provided to customers of The Hartford. Please d❑ not share the access code with anyone outside your organization. a Registration is required to access the Cyber Center. You may register as many users as necessary. o Contacting a service provider about any issue does not constitute providing The Hartford notice of a claim as required under your insurance policy. Read your insurance policy and discuss any questions with your agent or broker. The Hartford Cyber Center provides third party service provider references and materials for educational purposes only. The Hartford does not specifically endorse any such service provider within The Hartford Cyber Center and hereby disclaims all liability with respect to use of or reliance on such service providers. All service providers are independent contractors and not agents of The Hartford. The Hartford does not warrant the performance of the service providers, even if such services are covered under your Business Owners Policy. We strongly encourage you to conduct your own assessments of the service providers' services and the fitness or adequacy of such services for your particular needs. Form SS 89 93 07 16 Page 1 of 1 0 2016. The Hartford 4 �� :� Insurance Policy Billing Information Thank you for selecting The Hartford for your business insurance needs. w Shortly, you will receive your first bill from us. You are receiving this Notice so you know what to expect as a valued customer of The Hartford. Should you have any questions after reviewing this information, please contact us at 866-467-8730, and we will be happy to assist you. a Your total policy premium will appear on your policy's Declarations Page. You will be billed based on the payment plan you selected. o You may pay the "minimum due" as it appears on your insurance bill or pay the policy balance in full. o An installment service fee is added to each installment. A late fee wilt also be applied if the "minimum due" is not received by the due date shown on your hill. Service and late payment fees do not apply in all states. o if you selected installment billing, any credit or additional premium due as the result of a change made to your policy, will be spread over the remaining billing installments. Additional premium due as a result of an audit will be billed in full on your next bill date following the completion of the audit. o If you elected Electronic Funds Transfer (EFT), policy changes may result in changes to the amount automatically withdrawn from your bank account. The invoice you receive following a policy change will include future withdrawal amounts. if you need to adjust or stop your next scheduled EFT withdrawal, please contact us at least 3 days prior to the scheduled withdrawal date at the telephone number shown below. o If you selected installment billing and pay the premiums for your first policy term on time, at renewal, your account may qualify for our"Equal Installment"feature.This means that the percentage due for each installment, including the initial renewal installment, will be the same throughout the policy term -- helping you better manage cash flow. Equal installments will continue as long as you pay your premiums on time and no cancellation notices are issued for any policy on your account. If you no longer qualify for Equal Installments, future renewals will be billed based on the payment plan you selected, which includes a higher initial installment amount. .,E I y roximatel 30 da sa 1f your policy is eligible for renewal, your bill for the upcoming policy term will be sent to au app Y Y prior to your policy's renewal date. If your insurance needs change, please contact us at least 60 days prior to your renewal date so we can properly address any adjustments needed• o One bill convenience -- you have the option of combining all eligible Hartford policies on one single bill allowing you to make one payment for all policies on your account as payments are due. You're In Control In addition to selecting a bill plan option that best meets your budget, you have the flexibility to decide how you r payments are made ... o Repetitive EFT:Sign up far Repetitive EFT payments and have payments automatically withdrawn from your bank account.This option saves you money by reducing the amount of the installment service fee. o pay Online. Register at www.thehartford.com/servic ccenter.Online Bill Pay is Quick, Easy and Securel o Pay by Check: Send a check with your remittance stub in the envelope provided with your bill. v Pay by Phone: Call toll-free 1-866-467-8730. Should you have any questions about your bill,please call Customer Service toll-free number: 1-866-467-8730-7AM -7PM CST. We look forward to being of service to you. Form 100722 11th Rev, Printed in U.S.A. POLICY NUMBER: 83 SSM UX5025 THIS ENDORSEMENT IS ATTACHED TO AND MADE PART OF YOUR POLICY IN RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT. DISCLOSUREICAP ON LOSSES - TERRORISM RISK INSURANCE ACT SCHEDULE Terrorism Premium: $ $6.00 A. Disclosure Of Premium United States or to influence the policy or In accordance with the federal Terrorism Risk affect the conduct of the United States Insurance Act, as amended (TRIA), we are required Government by coercion to provide you with a notice disclosing the portion of C. Disclosure Of Federal Share Of Terrorism your premium, if any, attributable to coverage for Lasses "certified acts of terrorism" under TRIA. The portion The United States Department of the Treasury will of your premium attributable to terrorism coverage is reimburse insurers for 80% of insured losses shown in the above Schedule of this endorsement. attributable to certified acts of terrorism" under`E«€: B. The following definition is added with respect to the TRIA that exceeds the applicable insurer deductible. E3sl provisions of this endorsement: However, if aggregate industry insured losses>.j,.'.: ": 1. A "certified act of terrorism" means an act that is I...,. attributable t❑ "certified acts of terrorism" under certified by the Secretary of the Treasury, in TRIA exceed $100 billion in a calendar year, the accordance with the provisions of TRIA, to be an Treasury shall not make any payment for any portion act of terrorism under TRIA. The criteria of the amount of such losses that exceeds $100 contained in TRIA for a "certified act of terrorism" billion. The United States government has not include the following: charged any premium for their participation in a. The act results in insured losses in excess of covering terrorism losses. $5 million in the aggregate, attributable to all D. Cap On Insurer liability for Terrorism Losses types of insurance subject to TRIA; and If aggregate industry insured losses attributable to b. The act results in damage within the United I,certified acts of terrorism" under TRIA exceed $100 States, or outside the United States in the billion in a calendar year and we have met, or will case of certain air carriers or vessels or the meet, our insurer deductible under TRIA, we shall premises of an United States mission; and not be liable for the payment of any portion of the c. The act is a violent act or an act that is amount of such losses that exceed $100 billion. in dangerous to human life, property or such case, your coverage for terrorism losses may infrastructure and is committed by an be reduced on a pro-rata basis in accordance with individual or individuals as part of an effort to procedures established by the Treasury, based on its coerce the civilian population of the estimates of aggregate industry losses and our estimate that we will exceed our insurer deductible. Form SS 83 76 12 20 Page 1 of 2 @ 2020,The Hartford (Includes copyrighted material of Insurance Services office, Inc., with its permission) In accordance with the Treasury's procedures, would otherwise be excluded under this Coverage' amounts paid for losses may be subject to further Form, Coverage Part or Policy, such as losses adjustments based on differences between actual excluded by any pollution, pathogenic, nuclear losses and estimates. hazard or war exclusions which may be included on E. Application of Other Exclusions this Policy. The terms and limitations of any terrorism exclusion, F. All other terms and conditions remain the same the inapplicability or omission of a terrorism exclusion, or the inclusion of terrorism coverage, do not serve to create coverage for any loss which Page 2 of 2 Farm 88 83 76 12 20 a m 0 0 0 IMPORTANT NOTICE TO POLICYHOLDERS 4 To help your insurance keep pace with increasing costs, we have increased your amount of insurance . . , giving you better protection in case of either a partial,or total loss to your property. if you feel the new amount is not the proper one, please contact your agent or broker. Eu Farm PC-374-0 Printed in U.S.A. 25 This Spectrum Policy consists of the Declarations,Coverage Forms, Common Policy Conditions and any 5 0 other Forms and Endorsements issued to be a part of the Policy.This insurance is provided by the stock ❑K insurance company of The Hartford Insurance Group shown below. SBM o INSURER: HARTFORD CASUALTY INSURANCE COMPANY kD ONE HARTFORD PLAZA, HARTFORD, CT 06155 a COMPANY CODE: 3 0 THE Policy Number: 83 SBM UK5025 DV HARTFORD SPECTRUM POLICY DECLARATIONS ORIGINAL Named insured and Mailing Address: ARNOLD TOMAC DBA A & M. (No., Street,Town, State,Zip Code) CONSULTING 18119 N.E. 30TH STREET REDMOND wA 98052 Policy Period: From 11/01/23 To 11/01/24 1 YEAR 12:01 a.m., Standard time at your mailing address shown above. Exception: 12 noon in New Hampshire. Name ofAgent/Broker: A J GALLAGHER RISK MGMNT SVCSIPHS Code: 556226 Previous Policy Number: 72 SBM UK5025 Named Insured is: INDIVIDUAL Audit Period: NON-AUDITABLE Type of Property Coverage: NONE Insurance Provided: In return for the payment of the premium and subject to all of the terms of this policy, we agree with you to provide insurance as stated in this policy. TOTAL ANNUAL PREMIUM IS: $425 MP is i�l•i Countersigned by 08/04/23 Authorized Representative Date Form SS 00 02 12 OS Page 001 (CONTINUED ON NEXT PAGE) Process Date: 08/04/23 Policy Expiration Date: 11/01/24 INSURED COPY SPECTRUM POLICY ❑ECLARATIONS (Continued) POLICYNUMBER: 83 SSM UR5025 Locations), Building(s), Business of Named Insured and Schedule of Coverages for Premises as designated by Number below. Location: 001 Building: 00i 18119 N.E. 30TH STREET REDMOND WA 98052 Description of Business: REAL ESTATE APPRAISER Deductible: NO COVERAGE BUILDING AND BUSINESS PERSONAL PROPERTY LIMITS DP INSURANCE BUILDING NO COVERAGE BUSINESS PERSONAL PROPERTY REPLACEMENT COST NO COVERAGE PERSONAL PROPERTY OF OTHERS REPLACEMENT COST NO COVERAGE MONEY AND SECURITIES INSIDE THE PREMISES 140 COVERAGE OUTSIDE THE PREMISES NO COVERAGE Form 5S 00 02 12 06 Page 002 (CONTINUED ON NEXT PAGE) Process Date: 08/04/23 Policy Expiration Date: 11/01/24 SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 83 SBM UK5025 BUSINESS LIABILITY LIMITS OF INSURANCE m LIABILITY AND MEDICAL EXPENSES $2, 000,000 v v 0 MEDICAL EXPENSES -ANY ONE PERSON $ 10, 000 PERSONAL AND ADVERTISING INJURY $2,000,000 DAMAGES TO PREMISES RENTED TO YOU $ 300,000 ANY ONE PREMISES AGGREGATE LIMITS $4, 000,000 PRODUCTS-COMPLETED OPERATIONS GENERAL AGGREGATE $4,000, 000 EMPLOYMENT PRACTICES LIABILITY COVERAGE: FORM SS 09 01 EACH CLAIM LIMIT $ 5, 000 DEDUCTIBLE -EACH CLAIM LIMIT NOT APPLICABLE AGGREGATE LIMIT $ 51000 RETROACTIVE DATE:110 12 0 0 5 This Employment Practices Liability Coverage contains claims made coverage. Except as may be otherwise provided herein, specified coverages of this insurance are limited generally to liability for injuries for which claims are first made against the insured while the insurance is in force. Please read and review the insurance carefully and discuss the coverage with your Hartford Agent or Broker. The Limits of Insurance stated in this Declarations will be reduced, and may be completely exhausted, by the payment of "defense expense" and, in such event, The Company will not be obligated to pay any further "defense expense" or sums which the insured is or may become legally obligated to pay as "damages". BUSINESS LIABILITY OPTIONAL COVERAGES HIRED/NON-OWNED AUTO LIABILITY $2,000, 000 FORM: SS 01 70 x Form SS QQ 02 12 46 Page 003 (CONTINUED ON NEXT PAGE) Process Date: 0 8/0 4/2 3 Policy Expiration Data: 11/01/24 SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 83 SBM UX5025 BUSINESS LIA131LITY OPTIONAL COVERAGES LIMITS OF INSURANCE (Continued) EMPLOYERS LIABILITY AND STOP G&P BODILY INKY BY ACCID=T EACH ACCIDENT $1, 000, 000 BODILY INJURY BY DISEASE EACH EMPLOYEE $1, 000,000 BODILY INJURY BY DISEASE POLICY LIMIT $1,000, 000 APPLICABLE TO LOCATIONS IN THIS FOLLOWING STATE(s) : WASHINGTON WAIVER Or Sl=OAATION= FORM 88 12 13 LOC&TION: 001 BUILDING: 001 NAXE: IV ANY r, Form SS 00 02 12 06 Page 004 (CONTINUED ON NEXT PAGE) Process Date: 08/04/23 Policy Expiration Date: 11101.124 SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 83 SBM UK5025 a v rr m `o 9 A v v 0 ADDITIONAL INSUREDS: THE FOLLOWING ARE ADDITIONAL INSUREDS FOR BUSINESS LIABILITY COVERAGE IN THIS POLICY. LOCATIOR 001 BUXLDIM 001 TypI3 MMMER LESSOR NAm SEE row IS 12 00 Farm SS 00 02 12 06 Page 005 (CONTINUED ON NEXT PAGE) Process Date: 08/04/23 Policy Expiration Date: 11/01/24 SPECTRUM POLICY DECLARATIONS (Continued) PQLICYNUMBER: 83 SBN UK5025 Form Numbers of Forms and Endorsements that apply: SS 00 01 03 14 SS 00 05 12 06 SS 00 08 04 05 SS 00 45 12 06 SS 00 64 09 16 SS 01 28 05 17 SS 01 70 09 09 SS 89 93 07 16 SS 00 60 09 15 SS 41 02 04 05 SS 41 63 06 11 SS 05 03 03 00 SS 05 47 09 15 SS 51 10 03 17 IH 12 07 02 21 SS 09 01 12 14 SS 09 25 12 14 SS 09 67 09 14 SS 09 70 12 14 SS 09 71 12 14 SS 10 04 09 98 SS 12 15 03 00 IH 99 40 04 09 IH 99 41 04 09 SS 83 76 12 20 IH 12 00 11 85 ADDITIONAL INSURED - MANAGER/LESSOR m Form SS 00 02 12 06 Page 006 Process Date: 08/04/23 Policy Expiration Date: 11/01/24 SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 83 SBM UK5025 SUPPLEMENTAL DECLARATIONS: 0 s 0 0 0 A service fee of$ 5.00 is charged for each installment when your premium is paid in installments. The service fee is $ 6.00 per withdrawal when you select an electronic fund transfer payment plan. The service fee will be added to the premium amount shown on your premium billing statement. i.1 Form SS 00 45 12 06 Process Date: 08/04/23 Policy Expiration Date: 11/01/2 4 k OI Q 0 H w a 0 0 0 O O COMMON POLICY CONDITIONS 1.3�f is r==: Form SS 00 05 12 06 0 2005, The Hartford QUICK REFERENCE - SPECTRUM POLICY DECLARATIONS and COMMON POLICY CONDITIONS I. DECLARATIONS Named Insured and Mailing Address Policy Period Description and Business Location Coverages and Limits of insurance II. COMMON POLICY CONDITIONS Beginning on Page A. Cancellation 1 B. Changes 1 C. Concealment, Misrepresentation Or Fraud T D. Examination Of Your Books And Records 2 E. inspections And Surveys 2 F. Insurance Under Two Or More Coverages 2 G. Liberalization 2 H. Other Insurance- Property Coverage 2 i. Premiums 2 J. Transfer Of Rights Of Recovery Against Others To Us 2 K. Transfer Of Your Rights And Duties Under This Policy 3 L. Premium Audit 3 Form S5 00 05 12 06 COMMON POLICY CONDITIONS N m All coverages of this policy are subject to the following conditions. v A v A. Cancellation (5) Failure to: 11. The first Named Insured shown in the (a) Furnish necessary heat, water, Declarations may cancel this policy by mailing sewer service or electricity for 30 or delivering to us advance written notice of consecutive days or more, except cancellation. during a period of seasonal 2. We may cancel this policy by mailing or unoccupancy; or delivering to the first Named Insured written (b) Pay property taxes that are owing notice of cancellation at least: and have been outstanding for a. 5 days before the effective date of more than one year following the cancellation if any one of the following date due, except that this provision conditions exists at any building that is will not apply where you are in a Covered Property in this policy: bona fide dispute with the taxing authority regarding payment of (1) The building has been vacant or such taxes. unoccupied 60 or more consecutive b. 10 days before the effective date of days. This does not apply to: cancellation if we cancel for nonpayment (a) Seasonal unoccupancy; or of premium. (b) Buildings in the course of c. 30 days before the effective date of construction, renovation or cancellation if we cancel for any other addition. reason. Buildings with 65% or more of the rental 3. We will mail or deliver our notice to the first units or floor area vacant or unoccupied are Named Insured's last mailing address known to considered unoccupied under this us. provision. 4. Notice of cancellation will state the effective (2) After damage by a Covered Cause of date of cancellation. The policy period will end E.,,..,. Loss, permanent repairs to the building: on that date. " (a) Have not started; and 5. if this policy is canceled, we will send the first (b) Have not been contracted for, Named Insured any premium refund due. Such �;i within 30 days of initial payment of refund will be pro rats. The cancellation will be loss. effective even if we have not made or offered a refund. (3) The building has: g. If notice is mailed, proof of mailing will be (a) An outstanding order to vacate; sufficient proof of notice. (to) An outstanding demolition order; or 7. If the first Named Insured cancels this policy, (c) Been declared unsafe by we will retain no less than $100 of the governmental authority, premium. (4) Fixed and salvageable items have B. Changes been or are being removed from the This policy contains all the agreements between building and are not being replaced. you and us concerning the insurance afforded. This does not apply to such removal The first Named Insured shown in the Declarations that is necessary or incidental to any is authorized to make changes in the terms of this renovation or remodeling. policy with our consent. This policy's terms can be amended or waived only by endorsement issued by us and made a part of this policy. Farm 5S 00 05 12 06 Page 1 of 3 © 2006, The Hartford COMMON POLICY CONDITIONS C. Concealment, Misrepresentation Or Fraud I. Premiums This policy is void in any case of fraud by you as it 1. The first Named Insured shown in the relates to this policy at any time. It is also void if Declarations: you or any other insured, at any time, intentionally a. Is responsible for the payment of all conceal or misrepresent a material fact concerning: premiums; and 1. This policy; b. Will be the payee for any return premiums 2. The Covered Property; we pay. 3. Your interest in the Covered Property, or 2. The premium shown in the Declarations was 4. A claim under this policy, computed based on rates in effect at the time D. Examination Of Your Books And Records the policy was issued. If applicable, on each renewal, continuation or anniversary of the We may examine and audit your books and records effective date of this policy, we will compute the as they relate to the policy at any time during the premium in accordance with our rates and rules policy period and up to three years afterward. then in effect. E. Inspections And Surveys 3. With our consent, you may continue this policy We have the right but are not obligated to: in force by paying a continuation premium for 1. Make inspections and surveys at any time; each successive one-year period. The premium must be: 2. Give you reports on the conditions we find; and a. Paid to us prior to the anniversary date; and 3. Recommend changes. b. Determined in accordance with Paragraph Any inspections, surveys, reports or 2. above, recommendations relate only to insurability and the Our forms then in effect will apply. If you do premiums to be charged. We do not make safety not pay the continuation premium, this policy inspections. We do not undertake to perform the will expire on the first anniversary date that we duty of any person or organization to provide for the have not received the premium. health or safety of any person. And we do not represent or warrant that conditions: 4. Changes in exposures or changes in your 1. Are safe or healthful; or business operation, acquisition or use of locations that are not shown in the Declarations 2. Comply with laws, regulations, codes or may occur during the policy period, If so, we standards. may require an additional premium. That This condition applies not only to us, but also to any premium will be determined in accordance with rating, advisory, rate service or similar organization our rates and rules then in effect. which makes insurance inspections, surveys, reports J. Transfer Of Rights Of Recovery Against Others or recommendations. To Lis F. Insurance Under Two Or More Coverages Applicable to Property Coverage: If two or more of this policy's coverages apply to the If any person or organization to or for whom we same loss or damage, we will not pay more than the make payment under this policy has rights to ' actual amount of the loss ❑r damage, recover damages from another, those rights are G. Liberalization transferred to us to the extent of our payment. That If we adopt any revision that would broaden the person or organization must do everything coverage under this policy without additional necessary to secure our rights and must do nothing premium within 45 days prior to or during the policy after loss to impair them. But you may waive your period, the broadened coverage will immediately rights against another party in writing: apply to this policy. 1. Prior to a loss to your Covered Property. H. Other Insurance -Property Coverage 2. After a loss to your Covered Property only if, at If there Is other insurance covering the same loss or time of loss, that party is one of the following: damage, we will pay only for the amount of covered a. Someone insured by this insurance; loss or damage in excess of the amount due from b. A business firm: that other insurance, whether you can collect on it or not. But we will not pay more than the applicable t I) Owned or controlled by you; or Limit of Insurance. (2) That owns or controls you; or Page 2 of 3 Form SS 00 05 12 06 COMMON POLICY CONDITIONS c. Your tenant. L. Premium Audit You may also accept the usual bills of lading or a. We will compute all premiums for this policy in shipping receipts limiting the liability of carriers. accordance with our rules and rates. This will not restrict your insurance. b. The premium amount shown in the Declarations K. Transfer Of Your Rights And Duties Under This is a deposit premium only. At the close of each o Y audit period we will compute the earned o PoIEe premium for that period. Any additional Your rights and duties under this policy may not be premium found to be due as a result of the transferred without our written consent except in the audit are due and payable on notice to the first case of death of an individual Named Insured. Named Insured. If the deposit premium paid If you die, your rights and duties will be transferred for the policy term is greater than the earned to your legal representative but only while acting premium, we will return the excess to the first within the scope of duties as your legal Named Insured. representative. Until your legal representative is c. The first Named Insured must maintain all appointed, anyone having proper temporary custody records related to the coverage provided by this of your property will have your rights and duties but policy and necessary to finalize the premium only with respect to that property. audit, and send us copies of the same upon our request. Our President and Secretary have signed this policy. Where required by law, the Declarations page has also been countersigned by our duly authorized representative. 4�12 Kevin Barnett,Secretary X Ross Fisher,President I.x 3?s Form SS 00 06 12 06 Page 3 of 3 9 w POLICY NUMBER: 83 SBM UK5025 V 0 cV m THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. s 0 0 P ADDITIONAL INSURED - MANAGER/LESSOR THE CITY OF KENT PUBLIC WORKS ENGINEERING 222 FOURTH AVE. SO. KENT WA 98032 Form IH 12 I011 85 T SEQ.NO. 0 02 Printed in U.S.A. Page 0 01 Process Date: 0 810 412 3 Expiration Date: 1110112 4 INSURED COPY e THE HARTFORD Named Insured: ARHBLD TOMAG DBA A N Policy Number: 63 SBM UK5025 Effective Date: 11/01/2 3 Expiration Date: 11/01/2 4 Company Name: HARTFORD CASUALTY INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. TRADE OR ECONOMIC SANCTIONS ENDORSEMENT This insurance does not apply t❑ the extent that trade ❑r economic sanctions or other laws or regulations prohibit us from providing insurance, including, but not limited to,the payment of claims. All other•terms and conditions remain unchanged. r.r. J i•I w Form IH 99 41 04 09 Page 1 of 1 IIIIIRO ` ',!� � ll' 1 ��.: TI E 4-0P�:�I.. CIVI�9��i.��: ERS 7o help your insuronce keop pace will} increasing costs, we have increased your amount of [nsuranco . . . giving you better prnloctIon In case at either a partial, or!❑tal loss to your property. if you feel the new amount is not the proper one, please contact your agent or broker. Fonn PC-374.0 Printed in U.S.A. In accordance with the Treasury's procedures, would otheiwr,u be excluded under this Coverage arnotints paid for losses may be subject to further Form, Coverage Part or Policy, such as losses adjustments based on differences between actual excluded by any pollution, pathogenic, nuclear tosses and estimates, hazard or war exclusions which may be included ❑n E. Application of Other Exclusions this Policy. The terms and limitations of any terrorism exclusion, F. all other terms and conditions remain the same the inapplicability or omission of a terrorism exclusion, or the inclusion of terrorism coverage, do not serve to create coverage for any loss which Page 2 of 2 Form SS 83 76 12 20 POLICY NUMBER: 72 SSNt U1t5025 THIS ENDORSEMENT IS ATTACHED TO AND MADE PART OF yf7UR POLICY IN RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE'TERRORiSM RISK INSURANCE ACT. DISCLOSURE/CAP ON LOSSES • TERRORS SM RISK MSURANCE ACT SCHEDULr- Terrorism Prefni►un: $ United States or to influence the policy of A. Disclosure of Premium affect the conduct of the United States In �jccardanc(.l with the federal Terroris[n Risk Government by coercion 111sur once Act. as aaneolde ! [f RIA). we aff-t rt:quireti to pfovide you with a 1101W; disclasiny "m portion of C. Disclosure Of Federal Share of Terrorism yrxjr prOn'tiui7r. If any, 0llributable to coverage forLosses "c 'dirietl acts of lerrorism'. urldGf TRIA, The portion The United States Department of the Treasury will of your premium attributable to terrorism coverage is reimlitirse insurers; for fi(l°/') Of insured losses shover]in the above 5cht]tltife of this endorsr,rrres[]t. alt1-ilx1tak)je to "rertif'scd arts of terrarisl]1" u;]der 1+ k3, The following definition is added with respect to the TRIA that exceads tl]e applicable insurer tIe[iuGtil]lia. I•f'I provisions of this endorsement: I.low(,-ver, if aggregate industry insured losses 1. A "certified aGl of terrorism" ntwu]s all act that is attributable to "(;ertified acts of terrorism" VM100) certified by the 5ecretal-y or the Treasury, in TRIA exceed $100 Billion in a calendar year, the accordance will) the provisions of TRIG. to be an Treasury shall not make any payment for any portion Zjcl of teffOl'iSln under TRIA. Tho criteria of ihr: amount of such losses [hat exceeds $100 contained in TRIA for a"certified act of terrorism" billion. The United States government has not include the following: charged any premium for their participation in a. The act r-esults in Insured losses in excess of covering terrorism lasses $5 million in the aggregate, attributable to all D. Cap On Insurer Liability for Terroriser] Losses types of insurance subject to TRIA; and It aggrogatr industry iwt tired hisses attriuislable to b. The act results in damage within the United "c[irtifietl a[:[s of tej•roriStn" rnzdor TRIA exceed $100 Shies. or outside the United Slate% in flee Million if) ai calendai year rtind we havta nret, or will rase of certain air carriers or vossrzls or the meet tyuf insurer deductible. Linder TRIA, we 511011 premises of an United States mission, and jot be liable fOr the payment of any l nriion of tilt: c, The act is a violent act or an act that is rllnount of snCh lasses that exco[ari $'I UO hd;[t]n- 111 dangerous to human life; property or such case, your coverage for terrorism losses may infrastnrcture and is committed by an be reduced on a pro-rats basis in accordance with Individual or individuals as part of an effort to procedures established by the Treasury, based on its coerce the civilian population of the estimates of aggregate industry losses and our estimale that we will exceed our insurer deductibie- Pace 1 of 2 Form SS 83 76 12 20 � 2020,The Hartford (Includes copyrighted rnaterial of Insurance Services office, Inc., with its permission) "11HT F08 D Named Insured- ARWLD TONA1C DRA A rAL N Policy Number: 72 SBM UK5025 Effective Date: 11/01/2 2 Expiration Date: 11/01/23 Cotnpany Name: HARTFORD CASUALTY INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TRADE OR ECONOMIC SANCTIONS ENDORSEMENT This insurance does not apply to the Weill that tinde Or cuonomic sanctiOils or nllx;r laws Or regulations prohibit us from providing in,Alrance, ind"ding,but not limited to,the payment Of clatITIs All other terms and conditions remain unchanged- Form IH 99 41 04 09 Page'I of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GOODS AND SERVICES ENDORSEMENT WASi-iINGTGN This endorsement modifies insurance provided under all Coverage Paris of this Policy. We rn,.ry offer or rnrrku "good% ❑r sr;rviCx.4' available In You through this crrulel"'iting coinparry. a 11011-irasuicri st1t)sidiary. or unaffilh8W(l 11lir(I parties as r: pal-I r)f this fic)li(:y. They %j000s or services" may Ix'. 1)"ovided Icsr il clipigo. it a (lisc:ount, on a subsidized lYrsi:;, ;)i 406, of clwrae. III some rcl ses. aver May Rtrc:eive. a fee fom oo�ci�athe EurrfliliatGri third I}ariies ilea{ pruvicle "r,�ows or services". We y (to Trot Mifriult Or guarantee the " of s;carvir;es' provided by Ilrir'd fxfrrlies, Alld such third patties shall be Solely liable and ,-esponsible for the "c o ud s e?i scr�+ices" they Isr'esvic{rs. The rsi srrvicxr," drlftrr'e:ci of made: available try ir'; may Ise nurclifie�r9 nr discontinued ai any time. This ontlorsernerit is sulkjt 0 to R(;W 413 30.1 500)(r.), which prohibits insurance companies from pruviding prizes, goocla. wares, gift cards, gift c ortific ales. crr rtz{'rchandise of an aggregate value in excess or swo per peiwn in the 300regAie'in ilily CO"![clrlivE'.lma lv(:-rlurrlth period. "Goods or services" means goads, products or services, including but not limited to risk mitigation, safety, and)or loss prevention services or equipment 1IT IH12OTr7221 PageIofI 2021, The Hartford POLICY NUMBER:72 sBm uK5025 , THIS ENDORSEMENT CHANGES THE POLICY- PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - KANAGERILESSOR THE CITY OF KENT pUBLIC WORKS ENGINEERING 222 FOURTH AVE. SO. KENT m 98032 t' Farm IM 12 D011 85 T SEd.NO. 002 Printed in U.S.A. P+19e d4 Expiration Date: 11101I23 Process Data: (19119122 INSURE❑ COPY comMCN POLICY CONDITIONS c. Your tenant. L. Premium Audit Yost may also accept the usual bills of lading or a. We will compute all premiums for this policy in shipping receipts limiting the liability of carriers. accordance with our Riles and rates. This will stet restrict your insurance. b. 'fits: prerni'll";union! slrraw" in lltt}prat;lar�thnrrs is a deposit }trtrrrritrnr only. Ili lire cln;;cr of u.lch K. Transfer of Your Rights And Duties Under This ALldit I)erirt[t wt: will t:o1111►s.10 111C earlletl Policy prernitim ftrr Thai Ix,fi(td. Any a cldilitrn;li Your rights and duties tinder this policy may not be I)reillit4rrt found Irt Ile clue at.; at result Of 11tc transferred without out written consent except in the midil air; slue and Itiay7hle on Reline 1ti tlrC first case of death of an individual Named Insured. Narita! Iltsnr•ed li the dapoosit 1)rrtntit"11 pa4 if yotr die, your rights and duties will be transferred for the policy !arm is greaser !barn the earned to your legal representative but Only whitO acti(19 prerriiulti, we will return the exct:sti to the first Within the sctspe of duties as your legal Named Insured. represenlative. Until your legal representative is c. The first Named Insured must maintain all appointed. anyone leaving proper lernporary Custody records related to the coverage providers by this Of your {property will have your rights and duties but policy and necessary to finalize the premium only with respect to that property. audit, and send us copies of the same upon our request. Our President and Secretary have signed this policy. Where required by law, the 0eciaratiorts page has also been countersigned by our duly authorized representative. Douglas Elliot.President Kevin Barnett,5ecretery Form SS 00 05 12 06 Page 3 of 3 COMMON POLICY CONDITIONS C. Concealment, Misrepresentation Or Fraud 1. Premiums This policy is void in any case of fraud by you as it 1. The first Narned Insured showo in the relates to this Policy at any tinle-. it is also void if Declarations: you or any outer insured, at Any time, inlonlionally a. Is responsible for the payment of all conceal or misrepresent a material fact concerning: premiums; and t. This policy; b. Will be the payee for any return pfurniums 2. The Covered Property; we pay. 3. Your interest in the Covered Property;or 2. The premium shown in the Declarations was 4. A claim under this policy. computed based on rates in effect at the tune the policy was issued. If applicable, on each D. Examination Of Your Books And Records renewal, conlinuation or anniversary of the We may examine and audit your books and records effective date of this policy,we will compufe the as they relate to the poiicy at any tlt]te during the premium in accordance Witt] Our rates and rules policy period and up to three years afterward, then in effect. E. Inspections And Surveys 3. Willi our consent, you may continue this poijoy We have the right but are not obligated to: ill force by par yijig a continuation prenlium for eaich successive one-year period, The. premium I. Make inspections and surveys at any time; must be: 2. Give you reports on the conditions we find; and a. Paid to us prior to the anniversary date; and 3. Recommend changes. b. Determined in accordance with Paragraph Any inspections• surveys, reports nr 2. above, �:+:+-lr]une:sl(I.rdi(lrls rerlate (,)illy to insurability and til() Our forms !lien ir] effect will apply, it you tin vrernilin]s to tv. chagied. We flo not make safety rx>t pay the coritinuatioit premium, this pofic:y irislll�Cfians, We (to not undnrlake to pertorm thn will expire on the first anniversary date that we duly Of nrly Ix;Irsoll or orga]ni/otiun to provide for the have not received the prernium Iluillill of sa]f[:#y of any peritln, Ailed we (to nul represent or warrant that conditlons: 4. Changes in exposures or changes in your t. Are safe or healthful; of. business operation, acquisition or use of locations that are not shown in the Declarations 2. Comply with laws, regulations, codes or may occur during the policy period. If so, we standards, may require an additional premium. That Tiff:;collditiurl applios not (]Illy to us, bill also to any premium will be determined in accordance Willi Itatirlll, acdvinory. leas service: or sirnilai organization our rates and rules then in effect. which makes isrsuratnrx: ir,speictions, suive'ys, reports J, Transfer Of Rights Of Recovery Against Others 01 rl1)car]Ill r("IId lliolIs. To Us F. Insurance Under Two Or More Coverages Applicable to Property Coverage: If two or more of this policy's rnvr•„ages aliply to the if any person or organization to or for whom we sa ine loss or damage, we will curt p8y murex than the stake payment wider this policy has rights to actual amount of the loss or dair]age. recover darnages from another, those rights are G. Liberalization transferred to us to the extent of our payment. That If we adopt any revision that would broaden the person ur oitlanization must do everytlting coverage under this police without additional necessary to secure Our rights and must clo nothing aftelr loss to impair]item. Bill you may waive yo[n pre�rlriulit ►Hit3lirr 45 days prior to or during the policy poriord, ttu, broadened coverage will immeeliariely rights r]ga'rnst another party Ili writing-- apply la this policy. 1. Prior to a loss to your Covered Property. H. Other Insurance-Property Coverage 2. After a loss to your Covered Property only if, at It ill+-ne is other hisiirancv covering the swine lw.,;or time of loss, that party i5 ono of the following: datirmg[%, we will pray only for the alt3aerni cif [:Irve:ied a. Someone insured by this insurance; loss or damage ill excess of th(: amount due frorn b. A business firm. thal other Insurance, whether you can collect oil it or not. Bill we will not pay more than the applicable ttf Owned or controlled by you:or Limit(it lslsm-mice. (2) That owns or controls you; or Page. 2 of 3 Form SS 00 05 12 06 ,V, COMMON POLICY CONDITIONS All coverages of this policy are subject to the following condilions. ( A. Cancellation 5) Failure to: a Furnish necessary heat, water, 1. The first Named insured show) in the [ � ectricity for 3� Declarations may cancel this policy by mailing consecutive days Sewer service or el more, except or defivc:�ing to us advance written notice of during a period of seasonal cancellation. unaccupancy;or 2. We may cancel this policy by mailing or delivering to the €irst htatn)ed Insured written [lay Pay property taxes that are awing and have been outstanding for notice of cancellation at least: mare than one year following the a. 5 days before: the effective date of date due, except that this provision cancellation if any one of the following will not apply where you are in a conditions exists at any building that is bona fide dispute with the faxing Covered Property in this policy: authority regarding payment of (1) The building has been vacant or such taxes. unoccupied 60 or more consecutive b. 10 days before the effective date of days.This does not apply to: cancellation if we, cancel for nonpayment (a) Seasonal unoccupanw or of premium. (b) Buildings in the course of c. 34 days before the effective date of construction, renovation or cancellation if we cancel for any other addition. reason. Buildings with 65% of more of the rental 3. We will retail or deliver our notice to the first units or floor area vacant or unoccupied are Named insured's fast mailing address Known to considered unoccupied under this as. provision. 4. Notice of cancellation will state the effective (2) Aller da:nagO by a Covered Gmi-e of date of cancellation. The policy period will end toss, perilianont repairs to the ltrrilcltng: on that date. (a) Have not started; and S. if this policy is canceled, we will send the first (try Have not been contracted for, Named Insured any premium refund due. SLlctr within 30 days of initial payment of refund will be pen rats. The cancellation will be effective even if we have not made ar offered loss, a refund. (3) The building has: 6. If notice is mailed, {goof of malli[lg will be (a) An outstanding order to vacate: sufficient proof of notice, (b) An outstanding demolition order: or 7. if the first Named Insured cancels this policy, (c) Been declared unsafe by we will retain no less than $100 of the governmental authority. premium. (4) Fix[d and salvageable items have B. This beet or are beniq removed from the policy contains all the agreements between building and are not being replaced. you and us concerning the insurance afforded. This does not apply to such removal The first Named Insured shown in the Declarations that is necessary or incidental to any is authorized to make changes in the terms of this renovation or remodeling• policy with our consent. This policy's terms can be amended or waived Only by endorsement issued by us and made a part of this policy. Page 1 of 3 Form s5 DO 45 12 06 0 2006,The Hartford QUICK REFERENCE - SPECTRUM POLICY ❑ECL.ARATIONS and COMMON POLICY CONDITIONS I. DECLARATIONS Named In5l11'ed and Mailing Address Policy Period Description and Business Location Coverages and Limits of Insurance II. COMMON POLICY CONDITIONS Beginning ❑n Page A. Cancellation l S. Chanaes 9 C. Concealment, Misrepresentation Or Fraud 2 D. Examination Of Your Books And Records 2 E. Inspections And Surveys 2 F. Insurance Under Two Or More Coverages 2 G. Liberalization 2 H. Other Insurance - Property Coverage 2 I. Pl'e6lirrl5 2 J. Transfer Of Rights Of Recovery Against Others To Us 2 K. Transfer Of Your flights And Duties Under This Policy 3 E, Premium Audit 3 Form SS 00 05 12 06 COMMON POLICY CONDITIONS Farm S5 00 06 12 06 (r) 2008, The Hai1f❑rd SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: `72 sBm 01<5025 SUPPLEMENTAL DECLARATIONS'. A service k-e of $ 6.U0 is charged for each installment when your premium is paid in installrrtents_ The service fee is $ 6 .U D per withdrawal when you select an eiectroric fund transfer payment plan. The service fee will be added to the premium amount shown on your premium billing statement- Form SS 00 45 12 06 Policy Expiration Date: 11101 123 Process mate; 09/19/22 SPECTRUM POLICY ❑ECLARATIONS (Continued) POLICY NUMBER: 72 SBH UK5025 Form Numbers of Forms and Endorsements that apply: SS 00 01 03 14 SS 00 05 12 06 SS 00 08 04 05 SS 00 45 12 06 SS 00 64 09 16 SS 01 28 05 17 SS 01 70 09 09 SS 89 93 07 16 SS 00 60 09 15 SS 41 02 04 05 SS 41 63 66 11 SS 05 03 03 00 SS 05 47 09 15 SS 51 10 03 17 IH 12 07 02 21 SS 09 01 12 14 SS 09 25 12 14 SS 09 67 09 14 SS 09 70 12 14 SS 09 71 1.2 14 Ss 10 04 09 98 SS 12 15 03 00 Ili 99 40 04 09 IH 99 41 04 09 SS 83 76 12 20 IH 12 00 11 85 ADDITIONAL INSur,,ED -- MANAGFRILFSSOR Form 55 00 02 12 06 Page 006 Process ]ate: 0 9/19/22 Policy Expiration Date. 11101/2 3 SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 72 SBM UK5025 ADDITIONAL INSUREDS: THE FOLLOWING ARE ADDITIONAL INSUREDS FOR BUSINESS LIABILITY COVERAGE IN THIS POLICY. LOCATION 001 BUILDING 001 TYPE nUIA(;XR LESSOR NAME SZE FORM IN 12 00 Form SS 00 02 12 06 Page 005 (CONT1N3EIJ OtV NEXT PAGE) Process Date: 09/19/22 Policy Expiration Date: 11/01/23 SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: '72 SHM UK 5025 BUSINESS LIABILITY OPTIONAL COVERAGES LIMITS OF INSURANCE (Continued) WVLOYERS LIABILITY AN[) STOP «Ak" aODILY INJURY BY ACCIDLrt4T MACH ACCxDE= $,L,000, 000 BODILY 10-11TRY BY DTSKUH EACH Z PLOYntP, $1,000,000 BODILY xNJURY BY DISMASS POLICY LIMIT $1,000,000 APPLIC k15L1r TO LOCATIONS IN T11T, FOLT,OWXNG STxmE(S) WASH 0111 ]N WAIVER OF '30L;ztgc,ATION: FORM 5S 12 15 LOCATION: 001 BUILDING. 001 NAM: IF ANY Form SS 00 02 12 06 Page 044 (C017111 NUED ON NEX'1, PAGE) Process fate: 03i14/22 Policy Expiration Date: 11101/2:3 SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 72 S13M UK5025 BUSINESS LIABILITY LIMITS OF INSURANCE LIABILITY AND MEDICAL EXPENSES $2,000,00(1 MEDICAL EXPENSES -ANY ONE PERSON $ 10,000 PERSONAL AND ADVER-riSING INJURY $2,000,000 DAMAGES TO PREMISES RENTED TO YOU $ 300,000 ANY ONE PREMISES AGGREGATE. LIMITS $4,000, 000 PRODUCTS-COMPLETED OPERATIONS $4,060,000 GENERAL AGGREGATE EMPLOYMENT PRACTICES LIABILITY COVERAGE: FORM SS 09 01 EACH CLAIM LIMIT $ 5,DOD DEDUCTIBLE-EACH CLAIM LIMIT NOT APPLICABLE AGGREGATE LIMIT $ 5,000 RETROACTIVE DATE: 11012005 This Employment Practices Liability Coves,(, contains claims mad(: coverage. Except as may be otherwise pravid�:d tu;rc�in, sp►�cifi�:r4 r;r)vr�rcmles of this rr►:,��rance ar linliled[1c`nl?rally to liability for i3ij►jlf s for-which ClUirr�s:+re first I infle .141.9rnst the insured while the insurance is ill force. Please reed arlcl review the illstlrimce carefully artd discuss the c:overzige with yoLu'Fitlrlford Agerlt or Ba ker. The Limits of Insurance stated in this Declarations will be reduced, ar+d may be completely exhausted, by tho payment of "defense expense" and, ill such event, The Company will not be obligated to pay arty further "defense expellse" or sums which the insured is ar r7iay becnrne legally obligated to pay as "damages". BUSINESS LIABILITY OPTIONAL COVERAGES HIREDINON-OWN ED AUTO LIABILITY $2,000,000 FORM: SS 01 70 Form SS 00 02 12 06 Page 003 CCL1NTINUEV ON NEXT PAGE✓ Process Date: 09/19I22 Policy Expiration Date: 11,101./23 I I SPECTRUM POLICY DECLARATIONS (Continued) POLICYNUMBER: 72 SBM UK5025 Lac:citio��{s}, F3uiirlin9(S), BLGSiness of Named II saved and Schedule of Coverages for Premises as designated by Number below Location: 001 Building: 001 18119 N.E. 30TH STREET REDMOND WA 98052 Description Of Business: REAL ,ESTATE APPRAISER Deductible: No COVERAGE BUILDING AND BUSINESS PERSONAL PROPERTY LIMITS OF INSURANCE BUILDING NO COVERAGE BUSINESS PERSONAL PROPERTY REPLACEMENT COST NO CGVEFtAGE PERSONAL PROPERTY OF OTHERS REPLACEMENT COST NO COVERAGE MONEY AND SECURITIES INSIDE THE PREMISES NO COVEP�.AGE OUTSIDE THE PREMISES Na COVERAGE Form 53 00 02 12 46 Page 002 (CONTINUED ON NEXT PAGE) Process Date: 09 j19/22 Policy Expiration Date; 11101/2.3 25 This Spectrum Policy consists of the Ueciaraiions,t.uvu1dlyG F V-1o,—141 11 1 .. -y 50 other forms and Endorsements issued to by a pad of the Policy. This insurance is provided by the stork UK insurance company of The Hartford hisurance Group shown below. S13M 1� INSURER: HARTF'ORD CASUALTY INSURANCE COMPANY NMI ONE HARTFORD PLAZA, HAR`L'FORD, CT 06155 COMPANY CODE' 3 ~ PalicyNumber: 72 S13M UK5025 DX ��Arj SPECTRUM POLICY DECLARATIONS ORIGINAL Named Insured and Mailing Address: ARNOLD TOMAC DBA A & M (No.,Street,Town, State,Zip Code) CONSULTING 18119 N.E. 30TH STREET REDMOND WA 98052 I',olicyPeriod: From 11/01/22 To 11/01/23 1 YEA11 12:01 a.ln.,Standard time at your mailing address shown above.Exception: 12 itoon in New H49rn1),111life Name of Agent/Broker: AJ GALLAGHER & CO INS SRARS CAIPHS Code: 255202 Previous Policy Number: 72 SBM OK5025 Named Insured is: INDIVIDUAL Audit Period: NON-AUDSTABLE Type of Property Coverage: NONE Insurance Provided: In retnlfna fear the paymeIli of the premium and subject to all of the terms of this policy,we iSS.IIee kgitll y[1u to fll'o1,ide lnSL11•:1tire as stated in this polity. TOTAL ANNUAL PREMIUM IS: - $425 MP IN RECOGNITION OF THE MULTIPLE COVERAGES INSURED WITH THE HARTt ORI3, YOUR i POLICY PREMIUM INCLUDES AN ACCOUNT CREDIT. ...- -- .----_.._.. ___—._ �},crEl:.rtr;Gay, �/.l�•�1�Y�r� Countersiglted by 09/19/22 Authorized Representative Date Form SS 00 02 12 06 Page 001 SCON'1`INUL•:1a C01 NHXT PACE] Process Date: 09/19/22 poI icy l=xpiration i)ate: 11/01/23 INSURED COPY