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HomeMy WebLinkAboutCAG2024-114 - Insurance Certificate - Drain-Pro, Inc. - Sanican Services at Various Locations - 04/01/2024 Client#: 191212 DRAIPR01 DATE(MM/DD/YYYY) ACORD.. CERTIFICATE OF LIABILITY INSURANCE 3/29/2024 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 policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Ashlee Topinka Propel Insurance PHONE 800 499-0933 FAX 866 577-1326 A/C,No,Ext: A/C,No Seattle Commercial Insurance E-MAIL ADDRESS: pI• @p p ashlee.to nka ro elinsurance.com 601 Union Street, Suite 3400 INSURER(S)AFFORDING COVERAGE NAIC# Seattle,WA 98101-1371 INSURER A:Crum 8r Forster Specialty Insurance 44520 INSURED INSURER B:SAIF Corporation 36196 Drain-Pro, Inc. The Hanover Insurance Company 22292 INSURER C: p Y 1903 17th St. NE, Building C-2 Continental Western Insurance Company 10804 INSURER D: P Y Puyallup,WA 98371 INSURER E INSURER F: 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 INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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. LT R TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY EPK147336 4/01/2024 04/01/2025 EACH OCCURRENCE $1,000,000 CLAIMS-MADE �X OCCUR PREMISES ERENTED .0 nce $100,000 X BI/PD Ded:$5,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GENT AGGREGGATTELIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY X1 JECOT LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: $ D AUTOMOBILE LIABILITY CPA605502326 4/01/2024 04/01/202 CMINED Ea acciden SINGLE LIMIT $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY Per accident $ A UMBRELLA LIAB X OCCUR EFX125008 4/01/2024 04/01/2025 EACH OCCURRENCE s5,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE s5,000,000 DED RETENTION$ $ A WORKERS COMPENSATION EPK147336 04/01/2024 04/01/202 X PER OTH- AND EMPLOYERS'LIABILITY TAT TE X ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N WA Stop Gap E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes describe under 100042865 OR WC 10/01/2023 10/01/202 E.L.DISEASE-POLICY LIMIT $1,000,000 B DESCRIPTION OF OPERATIONS below A Pollution EPK147336 04/01/2024 04/01/202 $1M/$2M Ded: $25k A Professional EPK147336 04/01/2024 04/01/202 $1M/$2M Ded: $25k C Leased/Rent Equip IH2J67932800 04/01/2024 04/01/202 $50,000/Ded: $1,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: Park Operations-Sanican Services Additional Insured status applies to the City of Kent per the attached endorsements. CERTIFICATE HOLDER CANCELLATION City of Kent SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 220 Fourth Avenue South ACCORDANCE WITH THE POLICY PROVISIONS. Kent,WA 98032 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S6519505/M6515599 JXH03 This page has been left blank intentionally. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDED WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART ERRORS AND OMISSIONS LIABILITY COVERAGE PART THIRD PARTY POLLUTION LIABILITY COVERAGE PART ONSITE CLEANUP COVERAGE PART SCHEDULE Name of Person(s) or Organization(s) Blanket when specifically required in a written contract with the named insured. SECTION VI — COMMON CONDITIONS, item 17. Transfer Of Rights of Recovery Against Others To Us within the Common Provisions is amended by the addition of the following: Solely as respects the person(s) or organization(s) indicated in the Schedule shown above, we waive any right of recovery we may have against the person(s) or organization(s) indicated in the Schedule shown above because of payments we make for "damages" arising out of your ongoing operations or "your work" performed under a written contract with that person(s) or organization(s) and included in the "products- completed operations hazard". However, this waiver shall not apply to "damages" resulting from the sole negligence of the person(s) or organization(s) indicated in the Schedule shown above. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. EN0109-0211 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - LESSOR OF LEASED EQUIPMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART ERRORS AND OMISSIONS LIABILITY COVERAGE PART THIRD PARTY POLLUTION LIABILITY COVERAGE PART ONSITE CLEANUP COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) or Organization(s) Blanket when specifically required in a written contract with the named insured. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. SECTION III — WHO IS AN INSURED within the Common Provisions is amended to include as an additional insured the person(s) or organization(s) indicated in the Schedule shown above, but only with respect to: a. Liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s); and b. When you and the person(s) or organization(s) shown in the Schedule have agreed in writing in a lease, contract or agreement that such person(s) or organization(s) be added as an additional insured on your policy. A person's or organization's status as an additional insured under this Endorsement ends when their lease, contract or agreement with you ends. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. EN0113-0211 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED WITH WAIVER OF SUBROGATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART ERRORS AND OMISSIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) or Organization(s) Blanket when specifically required in a written contract with the named insured. A. SECTION III — WHO IS AN INSURED within the Common Provisions is amended to include as an additional insured the person(s) or organization(s) indicated in the Schedule shown above, but only with respect to liability arising out of "your work" for that person or organization performed by you, or by those acting on your behalf. B. As respects additional insureds as defined above, this insurance also applies to "bodily injury" or "property damage" arising out of your negligence when the following written contract requirements are applicable: 1. Coverage available under this coverage part shall apply as primary insurance. Any other insurance available to these additional insureds shall apply as excess and not contribute as primary to the insurance afforded by this endorsement. 2. We waive any right of recovery we may have against the person(s) or organization(s) indicated in the Schedule shown above because of payments we make for injury or damage arising out of "your work" performed under a written contract with that person(s) or organization(s). 3. The term "additional insured" is used separately and not collectively, but the inclusion of more than one "additional insured" shall not increase the limits or coverage provided by this insurance. This Endorsement does not reinstate or increase the Limits of Insurance applicable to any "claim" to which the coverage afforded by this Endorsement applies. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. EN0147-1111 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LIMITED NOTICE OF CANCELLATION ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART ERRORS AND OMISSIONS LIABILITY COVERAGE PART ONSITE CLEANUP COVERAGE PART THIRD PARTY POLLUTION LIABILITY COVERAGE PART In consideration of the premium charged and solely with respect to the coverage parts shown above, it is hereby agreed that the Common Provisions, Section VI—Common Conditions is amended by the addition of the following: Limited Notice Of Cancellation In the event that we cancel this Policy for any reason other than non-payment of premium and; a. The effective date of cancellation is prior to the expiration date of this Policy; and b. You are under an existing written contractual obligation to notify a certificate holder when this Policy is canceled and have provided to us, either directly or through your broker of record, the email address of a contact at each such certificate holder; and c. We received this information after you received notice of cancellation of this Policy and prior to the effective date of cancellation, via an electronic spreadsheet that is acceptable to us, We will provide notice of cancellation via email to each such certificate holder within thirty (30) days of your providing such information to us. Proof of our emailing the notice of cancellation, using the information provided by you, will serve as evidence that we have satisfied our obligations under this condition. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. EN0165 0117 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Person(s) or Organization(s): Location And Description Of Completed Operations Blanket when specifically required in a written contract with the Blanket when specifically required in a written named insured. contract with the named insured. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section III — Who Is An Insured within the Common Provisions is amended to include as an insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". EN0320-0211 Page 1 of 1 21 R U M & FO RTE R' THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL CHANGE ENDORSEMENT Policy Change Number A POLICY NUMBER POLICY CHANGES COMPANY EFFECTIVE Crum and Forster Specialty EPK-143423 04/01/2023 Insurance Company NAMED INSURED Drain-Pro, Inc. COVERAGE PARTS AFFECTED COMMERCIAL GENERAL LIABILITY COVERAGE PART CHANGES AGGREGATE LIMITS OF INSURANCE PER PROJECT AND MAXIMUM PER PROJECT GENERAL AGGREGATE LIMIT Maximum Per Project General Aggregate Limit: $5,000,000 A. For all sums the insured becomes legally obligated to pay as "damages" caused by an "occurrence"which can be attributed solely to ongoing operations at a single defined project: 1. A separate Per Project General Aggregate Limit applies to each project when required in a written contract with the Named Insured, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Per Project General Aggregate Limit is the most we will pay for the sum of all "damages", except for "damages" because of"bodily injury" or"property damage" included in the"products-completed operations hazard" and for medical expenses under the Commercial General Liability Coverage Part, Insuring Agreement C —Medical Payments. 3. Any payments made under the Commercial General Liability Coverage Part for"damages", or as medical payments under the Commercial General Liability Coverage Part, Insuring Agreement C- Medical Payments, except for"damages" paid under the "products-completed operations hazard", shall reduce the Per Project General Aggregate Limit for that project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations, nor shall they reduce any other Per Project General Aggregate Limit for any other project. 4. All other limits applicable to the Commercial General Liability Coverage Part shown in the Declarations continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Per Project General Aggregate Limit. 5. The Maximum Per Project General Aggregate Limit shown in the Schedule above is the most we will pay for the sum of all Per Project General Aggregate Limits and the General Aggregate Limit shown in the Declarations regardless of the number of: EN0137-0211 Page 1 of 1 a. Insureds; b. "Claims" made or"suits" brought; c. Persons or organizations making "claims" or bringing "suits"; or d. Projects B. For all sums the insured becomes legally obligated to pay as "damages" under the Commercial General Liability Coverage Part, or as medical payments under the Commercial General Liability Coverage Part, Insuring Agreement C— Medical Payments, which cannot be attributed only to your ongoing operations at a single defined project: 1. Any payments made under the Commercial General Liability Coverage Part or as medical payments under the Commercial General Liability Coverage Part, Insuring Agreement C- Medical Payments, shall reduce the General Aggregate Limit shown in the Declarations, or the Products-Completed Operations Aggregate Limit shown in the Declarations, whichever is applicable; and 2. Such payments shall not reduce any Per Project General Aggregate Limit. C. When coverage for liability arising out of the "products-completed operations hazard" is provided, any payments for"damages" included in the "products-completed operations hazard" will reduce the Products- Completed Operations Aggregate Limit shown in the Declarations, and not reduce the General Aggregate Limit shown in the Declarations nor any applicable Per Project General Aggregate Limit. D. If the applicable project has been abandoned, delayed, or restarted, or if the authorized contracting parties deviate from the original plans, blueprints, designs, specifications, or timetables, the project will still be deemed to be the same construction project and only the original Per Project General Aggregate Limit shall apply, encumbered or not. E. The provisions of the Common Provisions, Section IV—Limits Of Insurance And Deductible not otherwise modified by this endorsement shall continue to apply. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED Authorized Representative Signature EN0137-0211 Page 2 of 2 RU II & FRTER THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL CHANGE ENDORSEMENT Policy Change Number B POLICY NUMBER POLICY CHANGES COMPANY EFFECTIVE Crum and Forster Specialty EPK-143423 04/01/2023 Insurance Company NAMEDINSURED Drain-Pro, Inc. COVERAGE PARTS AFFECTED COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIAIBLITY COVERAGE PART ERRORS & OMISSIONS LIABILITY COVERAGE PART CHANGES ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: As required by written contract in effect prior to any related Claim. Information required to complete this Schedule,if not shown above, will be shown in the Declarations. Under the Common Provisions, Section III — Who Is An Insured Paragraph 1 is amended to include as an insured any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. EN0137-0211 Page 1 of 2 2. This insurance does not apply to: a. "Bodily injury", "property damage" "personal and advertising injury", a "pollution condition" or a "wrongful act" arising out of operations performed for the federal government, state or municipality; or b. "Bodily injury" or"property damage" included within the "products-completed operations hazard". B. With respect to the insurance afforded to these additional insureds, the following is added to Section IV— Limits of Insurance and Deductible Paragraph 5: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED Authorized Representative Signature EN0137-0211 Page 2 of 2 Schedule of Forms and Endorsements Form No. Form Title EN0001 Environmental Package Policy Declarations EN0002 Schedule of Forms and Endorsements CS07001 Signature Page EN0004 Claims Reporting EN0005 Service of Process Clause EN0007 Exclusion of Certified Acts of Terrorism and Exclusion of Other Acts of Terrorism Committed Outside the United States EN0009 Deductible Schedule Endorsement EN0010 Minimum Premium and Minimum Retained Premium EN0011 Privacy Notice EN0020 Common Provisions EN0021 Commercial General Liability Occurrence Coverage Part EN0023 Contractors Pollution Liability Occurrence Coverage Part EN0025 Errors and Omissions Liability Coverage Part EN0050 Policyholder Notice- Emergency Response Hotline EN0052 Notice of Loss EN0106 Low Level Radioactive/Mixed Waste Coverage EN0109 Amended Waiver of Transfer of Rights of Recovery Against Others To Us EN0113 Additional Insured—Lessor of Leased Equipment EN0147 Primary& Non-Contributory Al with Waiver of Subrogation EN0161 Emergency Environmental Response Costs Endorsement EN0165 Limited Notice Of Cancellation Endorsement EN0166 Named Insured Endorsement EN0169 Exclusion—Communicable Disease EN0171 Exclusion -Glyphosate EN0172 Exclusion - PFAS EN0302 Employee Benefits Liability Coverage EN0304 Stop Gap—Employers Liability Coverage EN0311 Products Pollution Liability Coverage Extension EN0320 Additional Insured—Owners, Lessees Or Contractors—Completed Operations EN0325 Contractual Liability—Railroads EN0346 Amendment to Damage to Your Work Exclusion EN0404 Limited Defense Expenses Outside the Limits of Insurance (CPL) EN0405 Transportation Pollution Liability Blanket Endorsement EN0412 Mold Definition Giveback EN0417 Regulated Non-Owned Disposal Site Coverage EN0420 Natural Resource Damages Endorsement EN0421 Bodily Injury Amendment EN0503 Limited Defense Expense Outside the Limits of Insurance (E&O) EN0728 Washington Common Policy Conditions E N 0002-0211 Schedule of Forms and Endorsements EN0137A EN0352-0523 Aggregate Limits of Insurance Per Project and Maximum Per Project General Aggregate Limit EN0137B Additional Insured -State or Governmental Agency of Subdivison or Political Subdivision - Permits or Authorizations IL P 001 01 04 U.S Treasury Department's Office of Foreign Assets Control ("OFAC")Advisory Notice to Policyholders EN0002-0211 This page has been left blank intentionally. COMMERCIAL AUTO CL CA 01 4912 22 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTOMOBILE EXPANSION ENDORSEMENT - PLATINUM This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to the coverages provided by this endorsement, the provisions of the Business Auto Coverage Form apply unless modified by this endorsement. A. NEWLY ACQUIRED OR FORMED 1. Such person or organization is an additional ORGANIZATIONS "insured" only to the extent such person or The following is added to Paragraph A.1.Who Is organization is liable for "bodily injury" or An Insured of Section II -Covered Autos Liability "property damage": because of the conduct of Coverage: an "insured" under Paragraphs a. or b. under Paragraph A.I. Who Is An Insured of Section Any organization you newly acquire or form, other II -Covered Autos Liability Coverage, caused than a partnership,joint venture or limited liability by an "accident" and resulting from the company or any organization excluded either by ownership, maintenance or use of a covered this Coverage Part or by endorsement, and over "auto"; which you maintain ownership or majority interest 2. The written contract or agreement described of more than 50 percent will qualify as a Named above must have been executed prior to the Insured. However: "accident"that caused the "bodily injury" or 1. This insurance does not apply to any newly "property damage"and be in effect at the time acquired or formed organization that is an of such"accident"; "insured"underany otherautomobile policy or 3. The insurance afforded to any such additional would be an "insured" under such policy but "insured" does not apply to any "accident" for its termination or the exhaustion of its Limit beyond the period of time required by the of Insurance. written contract or agreement described 2. Coverage does not apply to "bodily injury" or above; "property damage" that occurred before you 4. The most we will pay on behalf of such acquired or formed the organization. additional"insured(s)"is the lesser of: 3. Coverage under this provision is afforded only until the 180th day after you acquire or form a. The Limits of Insurance specified in the the organization or the end of the policy written contract or agreement described period, whichever is earlier. above; or B. ADDITIONAL INSURED BY CONTRACT OR b. The Limits of Insurance shown in the AGREEMENT Declarations. The following is added to Paragraph A.1., Who Is This provision shall not increase the Limit of An Insured of Section II -Covered Autos Liability Insurance shown in the Declarations in this Coverage: policy or coverage part; and When you have agreed in a written contract or 5. The following changes are made to Paragraph agreement to include a person or organization as 5. Other Insurance of B. General Conditions an additional "insured", such person or under Section IV-Business Auto Conditions: organization is included as an"insured"su4ect to a. The following is added to Paragraph 5.a.: the following: If required by the written contract or agreement described above, the CL CA 01 4912 22 Includes copyrighted material of Insurance Services Page 1 of 5 Office, Inc., with its permission insurance afforded to the additional Paragraph A.4.a. Transportation Expenses of insured under this provision will be Section III -Physical Damage Coverage is primary to, and will not seek contribution amended as follows: from, the additional insured's own 1. The Limits of Insurance are increased to$75 insurance. per day to a maximum of$2,500. b. Paragraph 5.c. is deleted in its entirety. 2. We will also pay reasonable and necessary 6. Paragraph A.1.c. under Section II- Covered expenses to facilitate the return of the stolen Autos Liability Coverage is deleted in its "auto"to you. entirety. 3. It is agreed and understood and it is our stated 7. The definition of "insured contract" under intent that expenses incurred by you underthe Section V-Definitions is amended to add the Transportation Expenses Coverage following: Extension will not also be covered or paid An "insured contract" does not include that under the Rental Reimbursement Coverage part of any contract or agreement: provided by this endorsement or any rental reimbursement coverage added by separate That pertains to the ownership, maintenance endorsement to this policy. or use of an "auto" and which indemnifies a H. EXTENDED COVERAGE-AIRBAGS person or organization for other than the vicarious liability of such person or The following is added to Exclusion B.3.a. of organization for "bodily injury" or "property Section III-Physical Damage Coverage: damage" caused by your operation or use of However, this exclusion does not apply to the a covered "auto". unintended discharge of an airbag. However, a person or organization is an This coverage is excess over any other collectible additional"insured" under this provision only insurance or warranty providing such airbag to the extent such person or organization is not named as an "insured" by separate coverage. endorsement to this policy. I. AUTO LOAN/LEASE GAP COVERAGE C. EMPLOYEES AS INSUREDS The following is added to Section III - Physical The following is added to Paragraph A.I.Who Is Damage Coverage, Paragraph C. Limits of An Insured Section II - Covered Autos Liability Insurance. Coverage: 4. In the event of a total "loss" to a covered Any "employee" of yours is an "insured" while "auto", we will pay the lesser of using a covered "auto" you don't own, hire or a. Any unpaid amount due on the lease or borrow in your business or your personal affairs. loan for a covered "auto", less: D. INCREASED COVERAGE- BAIL BONDS (1) The amount under the Physical The Supplementary Payments Coverage Damage Coverage section of the Extension of Section II - Covered Autos Liability policy; and Coverage is amended as follows: (2) Any: The Limit of Insurance in paragraph A.2.a.(2) is (a) Overdue lease/loan payments at increased to$5,000. the time of the"loss"; E. INCREASED COVERAGE - LOSS OF (b) Financial penalties imposed EARNINGS under a lease for excessive use, The Supplementary Payments Coverage abnormal wear and tear or high Extension of Section II - Covered Autos Liability mileage; Coverage is amended as follows: (c) Security deposits not returned by The Limit of Insurance in paragraph A.2.a.(4) is the lessor; increased to$1,000. (d) Costs for extended warranties, F. FELLOW EMPLOYEE COVERAGE Credit Life Insurance, Health, Accident or Disability Insurance The Fellow Employee Exclusion contained in purchased with the loan or lease; Section II-Covered Autos Liability Coverage does and not apply. This coverage is excess over any other collectable insurance. (e) Carry-over balances from previous loans or leases; or G. COVERAGE EXTENSION-TRANSPORTATION b. $5,000. EXPENSES Page 2 of 5 Includes copyrighted material of Insurance Services CL CA 01 4912 22 Office, Inc., with its permission However, this provision does not apply to the disabled. However, the labor must be performed extent loan/lease gap coverage has been at the place of disablement. provided by separate endorsement to this policy. N. FIRE EXTINGUISHER RECHARGE J. GLASS REPAIR-NO DEDUCTIBLE The following is added to Paragraph A.4k Coverage Extensions of Section IV - Physical The following is added to Paragraph D.Deductible Damage Coverage: of Section III-Physical Damage Coverage: When fire extinguishers are kept in your covered Any Comprehensive Coverage deductible shown "auto" and any are discharged in an attempt to in the Declarations does not apply to "loss" to extinguish a fire, we will pay the lesser of the glass breakage when you elect to patch or repair actual cost of recharging or replacing such fire rather than replace the glass. extinguisher(s). This provision does not apply to any covered No deductible applies to this coverage. "auto"provided Physical Damage Coverage under O. HIRED AUTO PHYSICAL DAMAGE CA 04 21 - Full Safety Glass Coverage. COVERAGE K. INCREASED COVERAGE - ELECTRONIC The following is added to Paragraph A.4. EQUIPMENT Coverage Extensions of Section III - Physical The $1,000 limit indicated in Paragraph C.1.b. Damage Coverage: under Section III-Physical Damage Coverage is If hired "autos" are covered "autos" for Covered increased to$2,500. Autos Liability Coverage and if Physical Damage L. EXTENDED COVERAGE - PERSONAL Coverage is provided for any "auto"you own,then PROPERTY the Physical Damage coverages provided are The following is added to Paragraph A.4k extended to"autos"you lease,rent, hire or borrow Coverage Extensions of Section III - Physical from someone other than your "employees", Damage Coverage: partners or members of their households subject to the following: Physical Damage Coverage on a covered "auto" 1. The most we will pay in any one "loss" is the may be extended to "loss" to your personal lesser of: property or, if you are an individual, the personal property of a family member, that is in the covered a. The actual cash value of the"auto"; "auto" at the time of "loss" and caused by an b. The cost to repair or replace the"auto';or "accident" and resulting from the ownership, maintenance or use of a covered "auto". c. $100,000. The insurance provided by this coverage 2. Paragraph 1. above is subject to a deductible. extension is excess over any other collectible The deductible shall be equal to the amount of insurance. The most we will pay for anyone"loss" the highest deductible shown for any owned under this coverage extension is $500. However, "auto" of the same classification for that our payment for "loss" to personal property will coverage. In the event there is no owned only be for the account of the owner of the "auto" of the same classification, the highest property. deductible for any owned "auto"will apply for Under this provision, personal property does not that coverage. include and we will not pay for "loss"of currency, No deductible will apply to "loss" caused by coins, securities or contraband. fire or lightning. No deductible applies to this coverage extension. 3. Hired Auto Physical Damage Coverage is M. TOWING subject to the following: Paragraph A.2. Towing of Section III - Physical a. If symbol 8 is shown in the Covered Auto Damage Coverage, is replaced by the following: section of the Declarations page for any of the Physical Damage coverages, then the If a private passenger type "auto" or light truck Hired Auto Physical Damage coverage "auto" (0-10,000 Lbs. GVW) is provided both described in this endorsement does not Comprehensive and Collision Coverage, we will apply. pay up to$150 for towing and labor costs incurred b. Other than indicated in Paragraphs a. each time such "auto" is disabled. If a medium, heavy or extra-heavy truck or extra-heavy Truck- directly above, coverage provided under this provision will be excess over any tractor"auto" (greater than 10,000 Lbs. GVW)is provided both Comprehensive and Collision other collectible insurance or coverage. Coverage, we will pay up to $250 for towing and labor costs incurred each time such "auto" is CL CA 01 4912 22 Includes copyrighted material of Insurance Services Page 3 of 5 Office, Inc., with its permission 4. In addition to the limit set forth in Paragraph 1. However, this provision does not apply to the above we will pay up to $500 per day, to a extent that rental reimbursement is provided maximum of$3,500 per"loss"for: by separate endorsement to this policy. a. Any costs or fees associated with the Q. DRIVE OTHER CAR COVERAGE "loss"to a hired"auto"; and 1. The following is added to Section II-Covered b. Loss of use of the hired"auto", provided it Autos Liability Coverage: is the consequence of an "accident"for a. Any"auto"you don't own, hire or borrow which you are legally liable, and as a is a covered "auto"for Liability Coverage result of which a monetary loss is while being used by: sustained by the leasing or rental concern. (1) You, if you are designated in the However, Paragraph A.4.b. Loss of Use Declarations as an individual; Expenses under Section III - Physical Damage (2) Your partners or members, if you are Coverage of the Business Auto Coverage Form designated in the Declarations as a does not apply. partnership orjoint venture; P. RENTAL REIMBURSEMENT COVERAGE (3) Your members or managers, if you We will pay for rental reimbursement expenses are designated in the Declarations as incurred by you for the rental of an"auto"because a limited liability company; of"loss"to a covered"auto". (4) Your executive officers if you are 1. Payment applies in addition to the otherwise designated in the Declarations as an applicable amount ofeach coverage you have organization other than an individual, on the covered "auto". partnership, joint venture or limited liability company;and 2. No deductible applies to this coverage. (5) The spouse of any person named in 3. We will pay only for those expenses incurred Paragraphs Q.1.a.(1). through during the policy period beginning 24 hours Q.1.a.(4)while a resident of the same after the "loss"and ending, regardless of the household; expiration date of the policy,with the lesser of the following number of days: Except: a. The number of days when the covered (a) Any "auto" owned by that "auto" has been repaired or replaced, or individual orby any memberof his or her household. b. 45 days. (b) Any"auto" used by that individual 4. Our payment is limited to the lesser of the or his orher spouse while working following amounts: in a business of selling,servicing, a. Necessary and actual expenses incurred; repairing or parking"autos". or 2. Changes In Auto Medical Payments And b. Not more than $75 for any one day; Uninsured And Underinsured Motorists Coverages 5. We will pay up to an additional $300 for the The following is added to Who Is An Insured: reasonable and necessary expenses you incur to remove your materials and equipment Any individual named in 1.a above and his or from the covered "auto" and replace such her "family members" are "insured" while materials and equipment on the rental "auto". "occupying"or while a pedestrian when being 6. This coverage does not apply while there are struck by any "auto"you don't own except: spare or reserve "autos" available to you for Any "auto"owned by that individual or by any your operations. "family member". 7. If"loss"results from the total theft ofa covered 3. Changes In Physical Damage Coverage "auto" of the"private passenger type",we will Any private passenger type "auto" you don't pay under this coverage only that amount of own, hire or borrow is a covered "auto"while your rental reimbursement expenses which is in the care,custody or control of any individual not already provided for under the Physical named in Q.1.a. above or his or her spouse Damage Coverage Extension of the Business while a resident of the same house-hold Auto Coverage Form or any endorsements thereto. except: a. Any"auto" owned by that individual or by any member of his or her household; or Page 4 of 5 Includes copyrighted material of Insurance Seances CL CA 01 4912 22 Office, Inc., with its permission b. Any"auto"used by that individual or his or T. UNINTENTIONAL OMISSIONS her spouse while working in a business of The following is added Paragraph B.2. of Section selling, servicing, repairing or parking "autos". IV-Business Auto Conditions: 4. The most we will pay for the total of all If you fail to disclose any hazards existing at the damages under Covered Autos Liability inception date of this policy, such failure will not Uninsured Motorists Coverage and prejudice the coverage provided toyou. However, Underinsured Motorists Coverage is the Limit this provision does not affect our right to collect Of Insurance shown in the Declarations as additional premium or exercise our right of applicable to owned"autos". cancellation or nonrenewal. 5. Our obligation to pay for, repair, return or U. LIBERALIZATION replace damaged or stolen property under If we revise this endorsement to provide greater Physical Damage Coverage, will be reduced coverage without additional premium charge, we by a deductible equal to the amount of the will automatically provide the additional coverage highest deductible shown for any owned to all endorsement holders as of the day the private passenger type "auto" applicable to revision is effective in your state. that coverage. If there are no owned private passenger type "autos", the deductible shall be $250 for Comprehensive Coverage and $500 for Collision Coverage. No deductible will apply to"loss"caused by fire or lightning. 6. Additional Definition As used in this DRIVE OTHER CAR Provision: "Family member" means a person related to the individual named in 1.a. by blood, marriage or adoption who is a resident of the individual's household, including a ward or foster child. R. KNOWLEDGE OF AN ACCIDENT, CLAIM, SUIT OR LOSS The following is added to Paragraph A.2. of Section IV-Business Auto Conditions: Your obligation to provide prompt notice of an "accident", claim,"suit" or"loss" is satisfied if you or a person designated by you to be responsible for insurance matters is notified of, or in any manner made aware of an"accident",claim, "suit" or"loss"and provides us such notice as soon as practicable S. WAIVER OF SUBROGATION BY CONTRACT OR AGREEMENT The following is added to Paragraph A.5 of Section IV-Business Auto Conditions: The Transfer Of Rights Of Recovery Against Others To Us Condition does not apply to any person(s) or organization(s) for whom you have agreed under written contract or agreement to waive subrogation with respect to the coverage provided under this Coverage Form but only to the extent that subrogation is waived prior to the "accident"or"loss". CL CA 01 4912 22 Includes copyrighted material of Insurance Services Page 5 of 5 Office, Inc., with its permission This page has been left blank intentionally. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SCHEDULE OF CONTROLLING UNDERLYING INSURANCE This endorsement modifies insurance provided under the following: ENVIRONMENTAL EXCESS LIABILITY POLICY SCHEDULE Coverage: Commercial General Liability, Contractors Pollution Liability, Errors & Omisisons Liability Insurance Carrier: Crum & Forster Specialty Insurance Company Policy Number: EPK-143423 Per Occurrence Limit $1,000,000 Policy Limits: Aggregate Limit 1$2,000,000 Policy Period: 1 04/01/2023 -04/01/2024 Coverage: Employers Liability Insurance Carrier: Saif Policy Number: 100042865 Policy Limits: Policy Limits j$1,000,000 Policy Period: 10/01/2022 - 10/01/2023 Coverage: Automobile Liability Insurance Carrier: Continental Western Insurance Company Policy Number: CPA 6055023-24 Policy Limits: Combined Single Limit j$1,000,000 Policy Period: 04/01/2023 -04/01/2024 Per Item 5. of the Declarations, the policy or policies, shown in the above Schedule of this endorsement are the "controlling underlying insurance" for this Environmental Excess Liability Policy. This endorsement shall not serve to change or increase our Limits of Insurance as shown in the Declarations and as described in Section IV. LIMIT OF LIABILITY. All other terms, conditions and exclusions under the policy remain unchanged. EN0152-0714 Page 1 of 1 Schedule of Forms and Endorsements Form No. Form Title EN0012 Environmental Excess Liability Policy Declarations EN0002 Schedule of Forms and Endorsements CS07001 Signature Page EN0004 Claims Reporting EN0005 Service of Process Clause EN0007 Exclusion of Certified Acts of Terrorism and Exclusion of Other Acts of Terrorism Committed Outside the United States EN0011 Privacy Notice EN0016 Exclusion of Uninsured Motorist Insurance/Underinsured Motorist Insurance EN0028 Environmental Excess Liability Policy EN0029 Amendatory Endorsement Asbestos, Lead, Pollution EN0050 Policyholder Notice- Emergency Response Hotline EN0052 Notice of Loss EN0150 Maritime Employers Liability(Jones Act) Exclusion EN0151 US Longshoremen's & Harbor Workers' Compensation Act Exclusion EN0152 Schedule of Underlying Insurance Endorsement EN0728 Washington Common Policy Conditions IL P 001 01 04 U.S Treasury Department's Office of Foreign Assets Control("OFAC")Advisory Notice to Policyholders EN0002-0211 ENVIRONMENTAL EXCESS LIABILITY POLICY Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights, duties and what is and is not covered. Throughout this policy, the words "you" and "your" refer to the Named Insured stated in Item 1. of the Declarations. The term Insured means any person or organization qualifying as an insured in the "controlling underlying insurance". The words "we", "us" and 'bur" refer to the Company stated on the Declarations providing this insurance. Other words and phrases that appear in quotation marks have special meaning. Refer to SECTION III DEFINITIONS and other provisions of this policy for such meanings. I. INSURING AGREEMENT We will pay on behalf of the Insured the"ultimate net loss": 1. In excess of all "underlying insurance", 2. Provided the injury or offense takes place during the Policy Period of this policy, and 3. Only after all "underlying insurance" has been exhausted by the payments of the limits of such insurance for losses arising out of 'occurrences", "pollution conditions" or"wrongful acts" insured by all of the policies designated in the Declarations as "underlying insurance". If any "underlying insurance" does not pay a loss for reasons other than the exhaustion of an aggregate limit of insurance, then we shall not pay such loss. We have no obligation under this insurance with respect to any claim or suit settled without our consent. The amount we pay is limited as described in SECTION IV. LIMIT OF LIABILITY. If we are prevented by law from paying on behalf of the Insured for coverage provided under this insurance, then we will indemnify the Insured. The Agreements, Definitions, Terms, Conditions, and Exclusions of the "controlling underlying insurance" scheduled in Item 5. of the Declarations, in effect at the inception date of this policy, apply to this coverage unless: 1. They are inconsistent with provisions of this policy; or 2. There are provisions in this policy for which a similar provision is not contained in the "controlling underlying insurance"; or 3. They relate to premium, subrogation, any obligation to defend, the payment of expenses, Limits of Insurance, cancellation or any renewal agreement. With respect to the exceptions described in 1., 2. or 3. above, the provisions of this policy will apply. II. DEFENSE PROVISIONS AND SUPPLEMENTAL PAYMENTS A. DEFENSE PROVISIONS We shall not be called upon to assume charge of the investigation, settlement or defense of any claim made or suit brought against the Insured, but we shall have the right and be given the opportunity to be associated in the defense and trial of any claims or suits relative to any "occurrence", "pollution condition" or "wrongful act' which, in our opinion, may create liability on the part of us under the terms of this policy. If we assume such right and opportunity, we shall not be obligated to defend any suit after the EN0028-0714 Page 1 of 10 ©2011 United States Fire Insurance Company,all rights reserved. J. LEGAL ACTION AGAINST US No person or organization has a right under this policy to: 1. Join us as a party or otherwise bring us into a suit asking for damages from you; 2. Sue us, unless all of the terms of this policy have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against you obtained after trial. We will not be liable for damages that are not payable under the terms of this policy or that are in excess of the applicable limit of this policy. An agreed settlement means a settlement and release of liability signed by us, you, and the claimant or the claimant's legal representative. K. MAINTENANCE OF UNDERLYING INSURANCE The policy or policies referred to in the Declarations and Schedule of"Underlying Insurance" or renewals or replacements thereof not more restrictive in coverage shall be maintained in full effect during this policy period, except for any reduction in the aggregate limits solely by payment of claims and/or claims expense. If such "underlying insurance" is not maintained in full effect by you, if there is any material change in the coverage of any "underlying insurance", or if any limits of liability of "underlying insurance" are: 1. Less than as stated in the Schedule of"Underlying Insurance"; 2. Unavailable to you due to bankruptcy or insolvency of an underlying insurer; or then the insurance afforded by this policy shall apply in the same manner as if such "underlying insurance" and limits of liability had been in effect, available, so maintained unchanged and collectible. L. OTHER INSURANCE If other insurance (whether such insurance is stated to be primary, contributing, excess or contingent) collectable or not, is available to you covering a loss also covered by this policy, other than a policy that is specifically written to apply in excess of this policy, the insurance afforded by this policy shall apply in excess of and shall not contribute with such other insurance. However, if a written contract between you and an additional insured specifically requires that this insurance be primary, then this insurance will be primary to and noncontributing with other insurance maintained by the additional insured; however this primary and noncontributing coverage is limited to the amount of insurance required as specified in the contract. M. PREMIUM The First Named Insured is responsible for the payment of all Premiums. All other Insureds are contingently liable for payment of Premium if the First Named Insured fails to do so. The Premium for this policy, as stated in Item 6. of the Declarations, is a flat Premium. It is not subject to an adjustment unless stated in the Declarations or an endorsement attached to this policy. N. REPRESENTATIONS, FRAUD, OR CONCEALMENT By accepting this policy, you agree that: 1. The statements in the Declarations, Schedule of "Underlying Insurance", and Application for this policy are accurate and complete; 2. Those statements are based upon representations you made to us; 3. This policy has been issued in reliance upon your representations; and EN0028-0714 Page 9 of 10 ©2011 United States Fire Insurance Company,all rights reserved. 4. This policy is void in any case of fraud by you or if you intentionally conceal or misrepresent any material fact as it relates to this policy or any claim under this policy. O. SEPARATION OF INSUREDS Except with respect to the Limits of Insurance, this policy applies: 1. As if each Insured were the only Insured; 2. Separately to each Insured against whom claim is made or suit brought. P. SUBROGATION In the event of any payment under this policy by us, we shall be subrogated to all of your rights of recovery against any person or organization, and you shall execute and deliver instruments and papers and do whatever else is necessary to secure such rights. You shall do nothing after loss to prejudice such rights. The amount recovered as subrogation shall be apportioned in the inverse order of payment of the "ultimate net loss" to the extent of the actual payment. The expenses of all recovery proceedings shall be apportioned in the ratio of respective recoveries. We have no duty to provide coverage under this policy unless you and any other involved insured have fully complied with the conditions of this policy. However, if a written contract between you and an additional insured specifically requires it, we will waive any right of recovery we may have against that person or organization because of payments we make for injury or damage arising out of your work performed for that person or organization under such written contract, but only if the injury or damage does not result from the sole negligence of that person or organization. Q. TITLES OR CAPTIONS OF POLICY PROVISIONS The title or caption of the sections and paragraphs of this policy and any attached endorsements are solely for convenience or reference. They do not affect the provisions to which they relate. R. SERVICE OF SUIT It is agreed that service of process in any suit on this policy against us may be made upon the highest one in authority bearing the title of commissioner, director or superintendent of insurance of the state or commonwealth wherein this policy is delivered or issued. The one in authority bearing the title commissioner, director, or superintendent of insurance of the state or commonwealth where this policy is delivered is hereby authorized and directed to accept service of process on behalf of this Company in any such suit; provided such commissioner, director, or superintendent has a procedure for forwarding suits to insurance companies by registered or certified mail and agrees to abide by such procedure by mailing via certified mail all documents so served to Crum and Forster Specialty Insurance Company, Attention: Claims, 305 Madison Avenue, Morristown, NJ 07960. It is further agreed that the Insured shall, by registered mail, send to Crum and Forster Specialty Insurance Company, Attention: Claims, 305 Madison Avenue, Morristown, NJ 07962 a copy of all documents relating to the service of process and suit as the Insured has delivered to the highest one in authority of the insurance department of the state in which the suit has been instituted. EN0028-0714 Page 10 of 10 ©2011 United States Fire Insurance Company,all rights reserved. This page has been left blank intentionally. www.saif.com ■ saif Work. Life. Oregon. Carrier no: 20001 Endorsement no: WC000313 (Ed. 430B) SAIF policy: 100042865 Drain-Pro Inc OR Waiver of Our Right to Recover from Others Endorsement We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Description: All Operations Contractor name: Persons and/or organizations with whom the insured-employer is required by written contract to waive subrogation rights. This endorsement does not alter the rights of an injured worker to pursue recovery from another party or SAIF to receive a statutory share of recoveries by an injured worker, even from the party listed in the schedule. The premium charge for this endorsement is based on one (1) percent of your manual premium. Effective date: October 01, 2023 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. Countersigned September 26, 2023 at Salem, Oregon 7 WC000313 Chip Terhune (Ed. 430B) President and Chief Executive Officer 400 High Street SE Salem,OR 97312 P:800.285.8525 F:503.373.8020 Pol_PC1_E430B This page has been left blank intentionally.