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HomeMy WebLinkAboutWTR2703551_3CITY OF RENTON FAIR PRACTICES POLICY �� _�� �:V'1~ AFFIDAVIT OF COMPLIANCE Q • L• PILIP GOfnpp" hereby confirms and declares that ( Name of contractor/subcontractor/consultant) I. It is the policy of R -L ALAA Co of-t-iti to offer equal ( Name of contractor/subcontractor/consultant) opportunity to all qualified employees and applicants for employment without regard to the race, creed, color, sex, national origin, age, disability or veteran status. II. ??.L AUA ComPRNV complies with all applicable ( :Name of contractor/subcontractor/consultant) federal, state and local laws governing non-discrimination in employment. II. When applicable, Z.L. AL4A ComPAaY will seek out and ( Name of contractor/subcontra�onsultant) negotiate with minority and women contractors for the award of subcontracts. RIcRAft L_� AL.,+ Print Agent/Representative's Name Print Agent/Repr a ative's Title Agent/Representat ve's Signature Date Signed Instructions: This document MUST be completed by each contractor, subcontractor and consultant. Include or attach this document(s) with the contract. Page 20 Fair Practices Policy Affidavit of Compliance Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa com - Always Verify Scale PUBLIC WORKS DEPARTMENT City of e (t M E M O R A N D U M DATE: May 10, 2011 TO: Colleen Shannon, Human Resources Systems Technician FROM: Andrew Weygandt, Water Utility Civil Engineer (ext 7208) SUBJECT: Insurance Review for Benson Road 16" Water Main Replacement Project, CAG-11-044 The Water Utility wants to enter into a construction contract with R.L. Alia Company to construct the Benson Road 16" Water Main Replacement Project. The contract amount is $591,738.00. Enclosed please find a copy of the Certificate of Liability Insurance with endorsement pages, and the Insurance Information Form with accompanying information submitted by R.L. Alia Company. Also enclosed is a copy of the contract for your reference. The original of the Certificate of Liability Insurance will be submitted to the City Clerk, upon execution of the contract by the Mayor of the City of Renton. Please review these forms for Risk Management requirements. If you have any questions regarding the agreement or need additional information, please contact me. Thank you for your assistance. Enclosures Gtitl of a^� S u 1COS & �� a Ot H R sk N`aaa9e��e� h:\file sys\wtr - drinking water utility\wtr-27 - water project files\wtr-27-3551 - benson rd 16in water main replace me nt\co nstruction contract\wtr-27-3551_insurance review memo.doc\AWah e City of Renton Human Resources & Risk Management Department Insurance Information Form FOR: R.L.ALIA COMPANY (Name of Contractor) PROJECT NAME: Benson Road 16" Water Main Replacement Project PROJECT NO.: WTR-27-3551 STAFF CONTACT: Andrew Weyeandt Certificate of Insurance indicates the coverages/limits specified in Fx� Yes ❑ No contract? Are the following coverages and/or conditions in effect? Q Yes ❑ No The Commercial General Liability policy form is an ISO 1993 ® Yes ❑ No OCCU1Tence Form or Equivalent? (If no, attach a copy of the policy with required coverages clearly identified) CG 0043 Amendatory Endorsement provided?* actual endorsement is nYes �} No attached to policy but rather coverage is included in the carrier's equivalen coverage form General Aggregate provided on a "per project basis (CG2503)?* Q Yes ❑ No Additional Insured wording provided?* © Yes ❑ No Coverage on a primary basis and non-contributing basis?* Q Yes ❑ No Waiver of Subrogation Clause applies?* © Yes ❑ No Severability of Interest Clause (Cross Liability) applies? ® Yes ❑ No Notice of Cancel lation/Non-Renewal amended to 45 days?* © Yes OR BETTE❑ No *To be shown on certifrcote of insurance* NEWEST CERT FORM DOES NOT INCLUDE NUMBER OF DAYS. WE CAN SUPPLY THE POLICY ENDORSEMENT OR STATE RCW SPECIFYING CANCELLATION AM BEST'S RATING FOR CARRIER GL A Ix Auto A Ix Umb A xv Professional N/A This Questionnaire is issued as a matter of information. This questionnaire is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies indicated on the attached CERTIFICATE OF INSURANCE. The CITY OF RENTON, at its option, shall obtain copies of the policies and/or specific declaration pages FROM awarded bidder prior to execution of contract. PARKER SMITH & FEEK INC ---1131 _ 17.29 U--A"_ D7 A>�it Address S�tSAn `�rc��c Name of person to contact SUSAN R BROCK Ch3�# y o Tint amc) Com ted By (Signature) ,-ta- s. -709 _^3tr T -� Telephone Number NOTE: THIS QUESTIONNAIRE MUST BE COMPLETED FOR EACH LINE OF COVERAGE AND ATTACHED TO CERTIFICATE OF INSURANCE ACORO® CERTIFICATE OF LIABILITY INSURANCE �� DATE(MM/DD/YYYY) 05/03/2011 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 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER Parker, Smith & Feek, Inc. 2233 112th Avenue NE Bellevue, WA 98004 CONTACT NAME: PHONE FAX AI • 425-709-3600 A/c No): 425-709-7460 E-MAIL ADDRESS: PRODUCER CUSTOMER ID P INSURER(S) AFFORDING COVERAGE NAIC # INSURED R. L. Alia Company 107 Williams Ave. S. INSURERA: Alaska National Ins. Co. INSURER B : Liberty Mutual Fire Insurance Company INSURER C Renton, WA 98055 INSURER D 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 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. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MMIDDIYYY POLICY EXP MM/DDIYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY I OJPS31945 10/1/2010 10/1/2011 EACH OCCURRENCE $ 1.000.000 DA AGE To RENTE17- PREMISES Ea occurrence) $ 300,000 CLAIMS -MADE I —XI OCCUR FT F MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 $ POLICY X JEOT LOC1 A AUTOMOBILE X LIABILITY ANY AUTO I v v I I ^ 10JAS31945 10/1/2010 10/1/2011 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident) $ $ NON -OWNED AUTOS B UMBRELLALIAB X OCCUR TH2661066159010 10/1/2010 10/1/2011 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 X EXCESS LIAB CLAIMS -MADE '1^ DEDUCTIBLE $ 1^ - $ X RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN N r 10JPS31945 �� WA Stop Gap Employers 10/1/2010 10/1/2011 ORY IMTS X OER E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA 1 Liability E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 f yes, describe under �1717 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) RE: Benson Road 16" Water Main Replacement. The City of Renton is included as additional insured and coverage is primary noncontributory as set forth in the terms and conditions of endorsement ANIC GL 1061 03 08 (GL), CA 0 01 03 06 pgs 2 and 3 (Auto) and TH 99 17 10 09 (Excess), attached. Waiver of ... (See Attached Description) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Renton AUTHORIZED REPRESENTATIVE 1055 South Grady Way Renton, WA 98057 ACORD 25 (2009/09) 1 of 16 ©1988- 2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ALIACOMP (TLJ01) DESCRIPTIONS (Continued from Page 1) subrogation is included per endorsement ANIC GL 702 05 95 (GL), ANIC CA 705 12 05 (Auto) and TH 24 01 02 06 (Excess), attached. Per project aggregate is included per endorsement CG 25 03 05 09 (GL) and TH 25 23 05 08 (Excess), attached. Separtion of insureds is included per attached endorsement. Cancellation terms apply per attached endorsement. ALIACQMP (TLJ01) Alaska N lonal INSURANCE C..MPANY 19 Mobile Only those "autos" that are land vehicles and that would qualify under the definition Equipment of "mobile equipment" under this policy if they were not subject to a compulsory or Subject To financial responsibility law or other motor vehicle insurance law where they are Compulsory Or licensed or principally garaged. Financial Responsibility Or Other Motor Vehicle Insurance Law Only B. Owned Autos You Acquire After The Policy Begins 1. If Symbols 1, 2, 3, 4, 5, 6 or 19 are entered next to a coverage in Item Two of the Declarations, then you have coverage for "autos" that you acquire of the type described for the remainder of the policy period. 2. But, if Symbol 7 is entered next to a coverage in Item Two of the Declarations, an "auto" you acquire will be a covered "auto" for that coverage only if: a. We already cover all "autos" that you own for that coverage or it replaces an "auto" you previously owned that had that coverage; and b. You tell us within 30 days after you acquire it that you want us to cover it for that coverage. C. Certain Trailers, Mobile Equipment And Temporary Substitute Autos If Liability Coverage is provided by this Coverage Form, the following types of vehicles are also covered "autos" for Liability Coverage: 1. "Trailers" with a load capacity of 2,000 pounds or less designed primarily for travel on public roads. 2. "Mobile equipment" while being carried or towed by a covered "auto". 3. Any "auto" you do not own while used with the permission of its owner as a temporary substitute for a covered "auto" you own that is out of service because of its: a. Breakdown; b. Repair; c. Servicing, d. "Loss"; or e. Destruction. SECTION II — LIABILITY COVERAGE A. Coverage We will pay all sums an "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, caused by an "accident" and resulting from the ownership, maintenance or use of a covered "auto". We will also pay all sums an "insured" legally must pay as a "covered pollution cost or expense" to which this insurance applies, caused by an "accident" and resulting from the ownership, maintenance or use of covered "autos". However, we will only pay for the "covered pollution cost or expense" if there is either "bodily injury" or "property damage" to which this insurance applies that is caused by the same "accident". We have the right and duty to defend any "insured" against a "suit" asking for such damages or a "covered pollution cost or expense". However, we have no duty to defend any "insured" against a "suit" seeking damages for "bodily injury" or "property damage" or a "covered pollution cost or expense" to which this insurance does not apply. We may investigate and settle any claim or "suit" as we consider appropriate. Our duty to defend or settle ends when the Liability Coverage Limit of Insurance has been exhausted by payment of judgments or settlements. 1. Who Is An Insured The following are "insureds": a. You for any covered "auto". b. Anyone else while using with your permission a covered "auto" you own, hire or borrow except: CA 00 01 03 06 Producer Copy Page 2 of 12 3 or 16 ALIACn[.1P (TLJ01) Alaska NrIonal INSURANCE C.,MPANY (1) The owner or anyone else from whom you hire or borrow a covered "auto". This exception does not apply if the covered "auto" is a "trailer" connected to a covered "auto" you own. (2) Your "employee" if the covered "auto" is owned by that "employee" or a member of his or her household. (3) Someone using a covered "auto" while he or she is working in a business of selling, servicing, repairing, parking or storing "autos" unless that business is yours. (4) Anyone other than your "employees", partners (if you are a partnership), members (if you are a limited liability company), or a lessee or borrower or any of their "employees", while moving property to or from a covered "auto". (5) A partner (if you are a partnership), or a member (if you are a limited liability company) for a covered "auto" owned by him or her or a member of his or her household. c. Anyone liable for the conduct of an "insured" described above but only to the extent of that liability. 2. Coverage Extensions a. Supplementary Payments We will pay for the "insured": (1) All expenses we incur. (2) Up to $2,000 for cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. (3) The cost of bonds to release attachments in any "suit" against the "Insured" we defend, but only for bond amounts within our Limit of Insurance. (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $250 a day because of time off from work. (5) All costs taxed against the "insured" in any "suit" against the "insured" we -....-defend. (6) All interest on the full amount of any judgment that accrues after entry of the judgment in any "suit" against the "insured" we defend, but our duty to pay interest ends when we have paid, offered to pay or deposited in court the part of the judgment that is within our Limit of Insurance. These payments will not reduce the Limit of Insurance. b. Out -Of -State Coverage Extensions While a covered "auto" is away from the state where it is licensed we will: (1) Increase the Limit of Insurance for Liability Coverage to meet the limits specified by a compulsory or Financial responsibility law of the jurisdiction where the covered "auto" is being used. This extension does not apply to the limit or limits specified by any law governing motor carriers of passengers or property. (2) Provide the minimum amounts and types of other coverages, such as no-fault, required of out-of-state vehicles by the jurisdiction where the covered "auto" is being used. We will not pay anyone more than once for the same elements of loss because of these extensions. B. Exclusions This insurance does not apply to any of the following: 1. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the "insured". 2. Contractual Liability assumed under any contract or agreement. But this exclusion does not apply to liability for damages: a. Assumed in a contract or agreement that is an "insured contract' provided the "bodily injury" or "property damage" occurs subsequent to the execution of the contract or agreement; or b. That the "insured" would have in the absence of the contract or agreement. 3. Workers' Compensation Any obligation for which the "insured" or the "insured's" insurer may be held liable under any workers' compensation, disability benefits or unemployment compensation law or any similar law. 4. Employee Indemnification And Employer's Liability "Bodily injury" to: a. An "employee" of the "insured" arising out of and in the course of: (1) Employment by the "insured'; or CA 00 01 03 06 Producer Copy Page 3 of 12 4 o` 16 ALIAMAP (TLJ01 j BLANKET WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM We waive any right of recovery we may have against The waiver applies only to the person or organization any person or organization because of payments we you contracted with and then only if the contract make for injury or damage arising out of the requires you to obtain this agreement from us. ownership, maintenance or use of "autos" covered by this policy. This endorsement changes the policy to which it is attached and, unless otherwise stated, is effective on the date issued at 12:01 A.M. standard time at your mailing address shown in the policy. The information below is required only when this endorsement is issued subsequent to commencement of the policy. Endorsement Effective October 1, 2009 Policy No. 09JAS31945 Insured R. L. Alia Company Endorsement No. Countersigned By William R . Stewart cc: Parker, Smith & Feek, Inc./Bellevue, WA AN IC CA 705 12 05 5 of 16 ALIACOMP (TLJ01) MF Alaska National INSURANCE COMPANY DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): All Projects Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. For all sums which the insured becomes legally 3. Any payments made under Coverage A for obligated to pay as damages caused by damages or under Coverage C for medical "occurrences" under Section I — Coverage A, and expenses shall reduce the Designated for all medical expenses caused by accidents Construction Project General Aggregate Limit under Section I — Coverage C, which can be for that designated construction project. Such attributed only to ongoing operations at a single payments shall not reduce the General designated construction project shown in the Aggregate Limit shown in the Declarations nor Schedule above: shall they reduce any other Designated I. A separate Designated Construction Project Construction Project General Aggregate Limit General Aggregate Limit applies to each for any other designated construction project designated construction project, and that limit shown in the Schedule above. is equal to the amount of the General 4. The limits shown in the Declarations for Each Aggregate Limit shown in the Declarations. Occurrence, Damage To Premises Rented To 2. The Designated Construction Project General You and Medical Expense continue to apply. Aggregate Limit is the most we will pay fior the However,. instead of being subject to the sum of all damages under Coverage A, except Genera! Aggregate Limit shown t the damages because of "bodily injury" or Declarations, such limits will be subject to the "property damage" included in the "products- applicable Designated Construction Project completed operations hazard", and for medical General Aggregate Limit. expenses under Coverage C regardless of the number of. a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". CG 25 03 05 09 Insured Copy Page 1 of 2 A,�" Alaska National INSURANCE COMPANY B. For all sums which the insured becomes legally C. obligated to pay as damages caused by "occurrences" under Section I — Coverage A, and for all medical expenses caused by accidents under Section I — Coverage C, which cannot be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. Any payments made under Coverage A for damages or under Coverage C for medical D. expenses shall reduce the amount available under the General Aggregate Limit or the Products -completed Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Designated Construction Project General Aggregate Limit. When coverage for liability arising out of the "products -completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard" will reduce the Products -completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Designated Construction Project General Aggregate Limit. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E. The provisions of Section III — Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated. This endorsement changes the policy to which it is attached and, unless otherwise stated, is effective on the date issued at 12:01 A.M. standard time at your mailing address shown in the policy. The information below is required only when this endorsement Is issued subsequent to commencement of the policy. Endorsement Effective Insured Countersigned By Policy No. O Insurance Services Office, Inc., 2008 Endorsement No. 22 CG 25 03 05 09 Insured Copy Page 2 of 2 Alaska Nafional INSURANCE COMPANY WASHINGTON CANCELLATION ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: Ali Coverage Parts included in this policy. Paragraph A.2.a. and A.2.b. of form 1L 01 46, Common Policy Conditions, shall not apply. The above paragraphs are replaced by the following: A. CANCELLATION a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium; or b. 60 days before the effective date of cancellation if we cancel for any other reason. This endorsement changes the policy to which it is attached and, unless otherwise stated, is effective on the date issued at 12:01 A.M. standard time at your mailing address shown in the policy. The information below is required only when this endorsement is issued subsequent to commencement of the policy. Endorsement Effective Insured Countersigned By Policy No. Endorsement No. 39 ANIC 037 10 91 Insured Copy ADDITIONAL INSURED (CONTRACTORS) - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Who Is An Insured (Section II) is amended to include as an insured any person or organization (herein referred to as an additional insured), but only if you are required to add that person or organization as an insured to this policy by a written contract that is in effect prior to the "bodily injury", "property damage", or "personal and advertising injury". 2. The insurance provided to the additional insured is limited as follows: a. That person or organization is only an additional insured if, and only to the extent that, the injury or damage is caused by negligent acts or omissions of you or your subcontractor in the performance of "your work" to which the written contract applies. The person or organization does not qualify as an additional insured with respect to injury or damage caused in whole or in part by independent negligent acts or omissions of such person or organization. The insurance provided to the additional insured does not apply to "bodily injury", "property damage", or "personal and advertising injury" arising out of an architect's, engineer's, or surveyor's rendering of or failure to render any professional services including: the preparing, approving, or failing to prepare or approve maps, drawings, opinions, reports, surveys, change orders, design or specifications; and ii. supervisory, inspection, or engineering services. c. The insurance provided to the additional insured, referred to in paragraph 1. of this endorsement, does not cover "bodily injury" or "property damage" caused by your negligent acts and omissions in the performance of "your work" that occurs within the "products -completed operations hazard," unless the written contract, referred to in paragraph 1. of this endorsement, contains a specific requirement that you procure completed operations coverage or coverage within the "products -completed operations hazard" for the additional insured. However, even if coverage within the "products -completed operations hazard" is required by the written contact, such coverage is available to the additional insured only if the "bodily injury" or "property damage" occurs prior to the end of the time period during which you are required by the written contact to provide such coverage or the expiration date of the policy, whichever comes first. If other valid and collectible insurance, whether on a primary, excess, contingent or any other basis, is available to the additional insured for a loss we cover under this endorsement, then the insurance provided by this endorsement is excess over that other insurance. However, the insurance provided by this endorsement will be primary to other insurance on which the additional insured is a named insured for the covered loss, if the written contract, referred to in paragraph 1. of this ANIC GL 1061 03 08 Page 1 of 2 9 of 16 ALIACOMP (TU01) endorsement, contains a specific requirement that this insurance be primary or primary and non-contributory. In that case we will not share with that other insurance on a pro-rata or other basis. If the other insurance available to the additional insured, whether on a primary, excess, contingent or any other basis, is coverage for which it has been named as an additional insured, then the coverage provided by this endorsement is excess over that other insurance. This endorsement changes the policy to which it is attached and, unless otherwise stated, is effective on the date issued at 12:01 A.M. standard time at your mailing address shown in the policy. The information below is required only when this endorsement is issued subsequent to commencement of the policy. Endorsement Effective 10/01/2009 Policy No. 09JPS31945 Insured R.L. Alia Company Countersigned By Endorsement No. ANIC GL 1061 03 08 Page 2 of 2 10 of 16 ALIACQ v1P (T U01) Alaska National INSURANCE COMPANY (2) When this insurance is excess, we will have no duty under Coverages A or B to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. (3j When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (a) The total amount that all such other insurance would pay for the loss in the absence of this insurance: and (b) The total of all deductible and self -insured amounts under all that other insurance. (d) We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method Of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. 5. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the eamed premium, we will return the excess to the first Named Insured. c. The first Named insured must keep records of the information we need for premium computation, and send us copies at such times as we may request. 6. Representations By accepting this policy, you agree: a. The statements in the Declarations are accurate and complete; b. Those statements are based upon representations you made to us; and c. We have issued this policy in reliance upon your representations. 7. Separation Of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this Coverage Part to the first Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom claim is made or "suit" is brought. 8. Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. 9. When We Do Not Renew If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expiration date. If notice is mailed, proof of mailing will be sufficient proof of notice. SECTION V — DEFINITIONS 1. "Advertisement" means a notice that is broadcast or published to the general public or specific market segments about your goods, products or services for the purpose of attracting customers or supporters. For the purposes of this definition: a. Notices that are published include material placed on the Internet or on similar electronic means of communication; and b. Regarding web -sites, only that part of a web -site that is about your goods, products or services for the purposes of attracting customers or supporters is considered an advertisement. CG 00 01 1207 Insured Copy Page 12 of 16 jLr Alaska National INSURANCE COMPANY BLANKET WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following. - COMMERCIAL GENERAL LIABILITY COVERAGE PART We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of "your work" done under a written contract with that person or organization. The waiver applies only to the person or organization you contracted with and then only if the contract requires you to obtain this agreement from us. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. The information below is required only when this endorsement is issued subsequent to preparation of the policy. Endorsement Effective Police No. Insured R.L. Alia Compan} Countersigned by ANIC GL 702 05 95 Producer Copy Endorsement No. 12 of 1 c ALIACOMP (TLJ01) Policy number:TH2-661-066159-010 Endorsement Number: 31 Issued by: LIBERTY MUTUAI, FIRI INSURANCE COMPANY Endorsement Effective Date: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED — PRIMARY INSURANCE This amendment modifies insurance prodded under the following: UMBRELLA EXCESS LLiBILITY PO=ICE' The following is added to Section IV — Definitions, Definition 12, Retained Limit:: Except that, udien required by written contract; (1) coverage under this policy afforded to an additional insured uill be subject only to paragraph (a)(1) of the retained limit definition and will apply beforeand will not contribute with any insurance issued to or on behalf of such additional insured; (2) insurance issued to or on behalf of such additional insured will net be considered other insurance under this policy; and (3) the limits of insurance a-,-ailable to the additional insured will be the lesser cf a. the amount shown in the Declarations of this policy; or b. the amount of insurance you are required to provide the additional insured in the writtrn contract or agreement TH 99 17 10 09 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PER CONSTRUCTION PROJECT AND PER LOCATION AGGREGATES SUBJECT TO OVERALL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: UMBRELLA EXCESS LIABILITY POLICY SCHEDULE Overall Aggregate Limit: $ limit as stated per attached Certificate of Insurance A. For all sums which the insured becomes legally obligated to pay as damages because of bodily injury or property damage caused by occurrences which can be attributed only to ongoing operations at a single construction project or location: 1. A separate Designated General Aggregate Limit applies to each construction project or location, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Designated General Aggregate Limit is the most we will pay for the sum of all damages because of bodily injury or property damage, except damages because of bodily injury or property damage included in the products - completed operations hazard, regardless of the number of: a. Insureds; b. Claims made or suits brought; or c. Persons or organizations making claims or bringing suits. 3. All payments made for damages, except damages because of bodily injury or property damage included in the prod- ucts -completed operations hazard, will reduce the Designated General Aggregate Limit for that construction pro- ject or location. 4. The limit shown in the Declarations for Each Occurrence continue to apply. However, instead of being subject to the policy's General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated General Aggregate Limit for each construction project or location and the Overall Aggregate limit, if any, shown in the Schedule. The Overall Aggregate Limit shown in the Schedule, if any, is the most we will pay for all such bodily in- jury or property damage from all construction projects or locations. B. For those sums which the insured becomes legally obligated to pay as damages because of bodily injury or property dam- age caused by occurrences which cannot be attributed only to ongoing operations at a single construction project or loca- tion: 1. Any payments for damages shall reduce the amount available under the policy's General Aggregate Limit or the Products -Completed Operations .Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Designated General Aggregate Limit. C. When coverage for liability arising out of the products -completed operations hazard is provided, any payments for dam- ages because of bodily injury or property damage included in the products -completed operations hazard will reduce the Products -Completed Operations Aggregate Limit, and not reduce the policy's General Aggregate Limit or the Desig- nated General Aggregate Limit. TH 25 23 05 08 Pagel of 2 14 of 16 ALIACOMP (TLJ01) D. If the applicable construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the construction project will still be deemed to be the same construction project. E. For purposes of this endorsements, the Definition Section is amended by the addition of the following definitions: Location means any premise that you occupy for permanent operations as part of your business, but does not include any premises at which you are performing operations as part of a construction project. All premises involving the same or con- necting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad shall be considered a single location. Construction project has the same meaning as construction project or a similar term used in the underlying insurance to determine the applicable aggregate limit. If the underlying insurance does not include such a definition, construction Project means all the work called for in a single construction contract, including change orders. F. The provisions of Section III — Limits Of Insurance Section not otherwise modified by this endorsement will continue to apply as stipulated. G. This endorsement applies only to bodily injury and property damage for which a per construction project, per location or similar limit of insurance applies on the underlying insurance. H.Also, this endorsement applies only to construction projects for which you are obligated by written contract to procure a separate Limit of Insurance for such construction projects. This endorsement is executed by the LIBERTY MUTUAL FIRE INSURANCE COMPANY Premium i Effective Date 10/01/2010 Expiration Date 10/01/2011 For attachment to Policy No. TH2-661-066159-010 Audit Basis Issued To R.L. ALIA COMPANY 107 WILLIAMS AVENUE S. , p / RENTON, WA 98055 SECRETARI { PRESIDENT Countersigned by Authorized Representative Issued Sales Office and No. End. Serial No. TH 25 23 05 08 Page 2 of 2 15 of 16 ALIACOMP (TLJ01) 0 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF SUBROGATION This endorsement modifies insurance provided under the following: UMBRELLA EXCESS LIABILITY POLICY SCHEDULE Name Of Person Or Organization: ANY PERSON OR ORGANIZATION WHEN REQUIRED BY WRITTEN CONTRACT. COPIES OF THE APPLICABLE AGREEMENTS MUST BE KEPT BY YOU OR YOUR DESIGNATED REPRESENTATIVE AND MADE AVAILABLE UPON REQUEST BY US. The following is added to Section V — Conditions, paragraph 7. Subrogation: If you are required by a written contract or agreement, which is executed before a loss, to waive your rights of recovery from others shown in the Schedule above, we agree to waive our rights of recovery. This waiver of rights applies only with respect to such contract or agreement and shall not be construed to be a waiver with respect to any other operations in which the insured has no contractual interest. This endorsement is executed by the LIBERTY MUTUAL FIRE INSURANCE COMPANY Premium S Effective Date 10/01/2010 Expiration Date 10/01/2011 For attachment to Policy No. TH2-661-066159-010 Audit Basis Issued To R.L. ALIA COMPANY 107 WILLIAMS AVENUE S. RENTON, WA 98055 Issued Y'r""t '"'TJl, , SECRETARY ' Countersigned by Sales Office and No. 7 PRESIDENT Authorized Representatme End. Serial No. 16 of 16 TH 24 0102 06 ALIACOMP (TLJ01) Received OCT 05 2011 Hilmnn Dew..,...,__ • ACORD CERTIFICATE OF L'iAgfuTY INSURANCE DAT1[MM /040/04'/ 201D/11 1 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 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER Parker, Smith & Feek, Inc. 2233 112th Avenue NE Bellevue, WA 98004 CONTACT NAME: PHONE FAX Alc No EXt1. 425-709-3600 (A/c Not: 425-709-7460 E-MAIL ADDRESS: PRODUCER CUSTOMER ID M INSURER(S) AFFORDING COVERAGE NAIC # INSURED R. L. Alia Company INSURER A: Continental Western Insurance Company 107 Williams Ave. S. INSURERS: INSURER C : Renton, WA 98055 INSURER D : INSURER E : INSURER F : K61611A:7a[ei:Ilhnl:ly: 71Y11,9rsizgwnihT: 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 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. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDDIYYYY LIMITS A GENERAL LIABILITY x COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR �rX � I X CWP2950501 10/1/2011 10/1/2012 EACHHOCCURRENCE $ 1,000,000 DAMAGE To TED PREMISES Ea occurrence $ 100000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 $ POLICY X PRO LOC JECT A AUTOMOBILE X LIABILITY ANY AUTO r I X ' �1------ I V ' CWP2950501 10/1/2011 10/1/2012 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident) $ $ NON -OWNED AUTOS A UMBRELLALIAS X OCCUR CU2950502 10/1/2011 10/1/2012 EACH OCCURRENCE $ 1,000,000 X EXCESS LIAB CLAIMS -MADE ( X JC (� JC AGGREGATE $ 1,000,0I00 DEDUCTIBLE $ ( I $ X RETENTION $ 10,000 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I NER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N / A CWP2950501 10/1/2011 10/1/2012 WC STATU M T X OT E.L. EACH ACCIDENT $ 1 OQQ 000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT I $ 1,000,000 r i l DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Benson Road 16" Water Main Replacement. The City of Renton is included as additional insured and coverage is primary noncontributory as set forth in the terms and conditions of Endorsements CLCGO020 0307 pg1-2 of 6 (GL), Al CA 59 02 06 page 1 of 7 (Auto) and CU 00 01 12 07 (Excess) attached. Waiver ... (See Attached Description) CERTIFICATE HOLDER CANCELLATION City of Renton 1055 South Grady Way Renton, WA 98057 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE *kj,F;6( w ACORD 25 (2009/09) 1 of 12 ©1988- 2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ALIACOMP (MAK00) DESCRIPTIONS (Continued from Page 1) of Subrogation is included per Endorsements CLCGO020 0307 pg 4-5 of 6 (GL). Al CLCGO020 0307 pg 4-5 of 6 (Auto) and CU 24 03 09 00 (Excess) attached. Per project aggregate is included per Endorsements CLCGO020 0307 pg 3 of 6 (GL), attached. Per Project Aggregate applies per attached Endorsements CLCGO020 0307 pg 3 of 6 (GL) and CU 24 05 06 08 (Excess). 2 of 12 ALIACOMP (MAK00) Sage Document: Company Fonns I Al CA 59 Expansion Endorsement 102 06 Edition Page 1 of 7 CWG I Auto 102/01/06 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AI CA590206 COMMERCIAL AUTOMOBILE EXPANSION ENDORSEMENT This endorsement modifies insurance provided under the following. - BUSINESS AUTO COVERAGE FORM The following provides a broad range of coverage in addition to that provided by the basic policy. In some instances, a higher limit or broader coverage is available. Should the policy indicate broader coverage or higher limits than provided by this endorsement, the higher limits or broader coverage shall apply. A. BROADENED NAMED INSURED The Named Insured shown in the Declarations is amended to include: Any organization, other than a joint venture, over which you maintain ownership or majority interest of more than 50%, unless that organization is an "insured" under any other automobile policy or would be an "insured" under such a policy but for the exhaustion of its Limit of Insurance, however, 1. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier. 2. Coverage does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization. B. ADDITIONAL INSURED BY CONTRACT OR AGREEMENT The following is added to Section II - Liability Coverage, Paragraph A.1.: d. Any person or organization for whom you are performing operations if you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. (1) Such person or organization is an additional insured only with respect to liability for "bodily injury" or property damage": a. Caused by an "accident", and b. Resulting from the ownership, maintenance or use of a covered "auto". (2) A person's or organization's status as an additional insured exists only while you are performing operations for that additional insured. (3) Section II, Paragraph C. Limits of Insurance for person or organization added as additional insured are those specified in the written contract or agreement, or in this coverage form, whichever is less. These limits of insurance are inclusive of and are not in addition to the Limits of Insurance shown in the Declarations. (4) This insurance applies on a primary and non-contributory basis if that is required by the written contract or agreement. (5) This insurance does not apply unless the written contract or agreement has been executed prior to the "bodily injury" or "property damage". C. ADDITIONAL INSURED - EMPLOYEES Section II — Liability Coverage, Paragraph A.1.b.(2) is deleted and replaced by the following: (2) Your "employee" if the covered "auto" is owned by that "employee" or a member of his or her household, but this exclusion does not apply if the covered "auto" is being used in your business or your personal affairs. D. EXTENDED COVERAGE - BAIL BONDS Section II — Liability Coverage, Paragraph A.2.a.(2) is deleted and replaced by the following: (2) Up to $3,000 for cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. E. EXTENDED COVERAGE - LOSS OF EARNINGS 3 of 12 https:/iwww.silverplume.coni/sponline/SPSage.asp?cmd=doc&id=ew i46136&rd=920315... 1 /24/2011 ALIACOMP (MAK00) Sage Document: Company Forms I Al CA 59 Expansion Endorsement 102 06 Edition Pa<>e 7 of 7 c. Your members or managers, if you are designated in the Declarations as a limited liability company; d. Your "executive officers", if you are designed in the Declarations as an organization other than an individual, partnership, joint venture or limited liability company, and e. The spouse of any person named in R.1.a. through R.1.d. while a resident of the same household. 2. The following "autos" are not covered: a. Any "auto" owned by a person named in R.1.a. through R.1.e. or by any member of his or her household. b. Any "auto" used by a person named in RA.a. through R.1.e. while working in the business of selling, servicing, repairing or parking "autos". 3. The most we will pay for the total of all damages under LIABILITY COVERAGE, AUTO MEDICAL PAYMENTS, UNINSURED MOTORISTS COVERAGE and UNDERINSURED MOTORISTS COVERAGE is the LIMIT OF INSURANCE shown in the Declarations as applicable to owned "autos". 4. Our obligation to pay for, repair, return or replace damaged or stolen property under PHYSICAL DAMAGE COVERAGE, will be reduced by a deductible equal to the amount of the largest deductible shown for any owned private passenger type "auto" applicable to that coverage. If there are no owned private passenger type autos", the deductible shall be $50 for Comprehensive Coverage and $100 for Collision Coverage. No deductible will apply to "loss" caused by fire or lightning. S. KNOWLEDGE OF OCCURRENCE The following is added to Section IV — Business Auto Conditions, Paragraph A.2.: d. Notice of an "accident" or "loss" will be considered knowledge of yours only if reported to you, if you are an individual, a partner, an executive officer or an employee designated by you to give us such notice. e. Notice of an "accident" or "loss" to your Workers Compensation insurer, for an event which later develops into a claim for which there is coverage under this policy, shall be considered notice to us, but only if we are notified as soon as you know that the claim should be addressed by this policy, rather than your Workers Compensation policy. f. Your rights under this policy shall not be prejudiced if you fail to give us notice of an "accident" or "loss", solely due to your reasonable and documented belief that the event is not covered by this policy. The following is added to Section IV — Business Auto Conditions.. Paragraph 2.b.: (6) Knowledge of the receipt of documents concerning a claim or "suit" will be considered knowledge of yours only if receipt of such documents is known to you, if you are an individual, a partner, an executive officer or an employee designated by you to forward such documents to us. T. WAIVER OF SUBROGATION BY CONTRACT OR AGREEMENT The following is added to Section IV - Business Auto Conditions, Paragraph A.5.: We waive any right of recovery we may have against any "insured" provided coverage under this endorsement under B., ADDITIONAL INSURED BY CONTRACT, PERMIT OR AGREEMENT, but only as respects "loss" arising out of the operation, maintenance or use of a covered "auto" pursuant to the provisions or conditions of the written contract or agreement. U. UNINTENTIONAL OMISSIONS The following is added Section IV - Business Auto Conditions, Paragraph B.2.: We will not deny coverage under this policy if you fail to disclose all hazards existing as of the inception date of the policy, provided such failure is not intentional. (DContinental Western Group 02011 Vertafore, Inc. All Rights Reserved 4 of 12 httpsJi`www.silvei-pl ume.cotii(sponline/SPSage.asp?cmd=doc&id=cwi46136&rd=920315... 1/24/2011 ALIACOMP (MAK00) 3. The insurance provided by this endorsement is primary insurance and we will not seek contribution under any insurance policy un- der which such additional insured is a named insured, if such policy was procured and paid for by such additional insured, or a parent or related entity of such additional in- sured. 4. With respect to the insurance afforded to these additional insureds, SECTION III — LIMITS OF INSURANCE is amended as fol- lows: The limits applicable to the additional in- sured are those specified in the written con- tract or agreement or the limits stated in the Declarations, whichever is less. If no limits are specified in the written contract or agreement, the limits applicable to the addi- tional insured are those specified in the Dec- larations. The limits of insurance are inclu- sive of and not in addition to the limits of in- surance shown in the Declarations. G. PROPERTY DAMAGE TO BORROWED EQUIPMENT 1. Paragraph 2J. of SECTION I - COVERAG- ES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY is amended as follows: Paragraphs (3) and (4) of this exclusion do not apply to tools or equipment loaned to you, provided they are not being used to per- form operations at the time of loss. 2. SECTION III — LIMITS OF INSURANCE is deleted and replaced by the following: The most we will pay in any one "occur- rence' for "property damage' to borrowed equipment is $15,000. This limit of insur- ance is the most we will pay regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 3. Deductible Our obligation to pay damages on behalf of the insured applies only to the amount of damages in excess of $250 as appli- cable to "property damage" as the result of any one 'occurrence', regardless of the number of persons or organizations who sustain damages because of that "occurrence'. c. We may pay any part or all of the de- ductible amount to effect settlement of any claim or suit and, upon notification of the action taken; you shall promptly reimburse us for such part of the deduct- ible amount as we have paid. H. BROADENED NAMED INSURED Paragraph 3. of SECTION II - WHO IS AN IN- SURED is deleted and replaced by the following: Any organization, other than a joint venture, over which you maintain ownership or majority inter- est of more than 50% will be a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier. b. COVERAGE A does not apply to "bodily in- jury" or "property damage' that occurred be- fore you acquired or formed the organiza- tion. c. COVERAGE B does not apply to "personal and advertising injury" arising out of an of- fense committed before you acquired or formed the organization. I. CONSTRUCTION PROJECT GENERAL AG- GREGATE LIMIT For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under COVERAGE A (SECTION 1), and for all medical expenses caused by accidents under COVERAGE C (SECTION 1), which can be attributed only to ongoing operations at a single construction project away from premises owned by or rented to the insured: a. A Single Construction Project General Aggregate Limit applies to each con- struction project away from premises owned by or rented to the insured, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. b. The Single Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under COV- ERAGE A, except damages because of "bodily injury" or "property damage' in- cluded in the "products -completed oper- ations hazard", and for medical ex- penses under COVERAGE C regardless of the number of: b. The terms of this insurance, including (1) Insureds; those with respect to our right and duty (2) Claims made or "suits" brought; or to defend the insured against any "suits" (3) Persons or organizations making seeking those damages; and your duties claims or bringing suits". in the event of an "occurrence', claim, or g g "suit" apply irrespective of the application of the deductible amount. CL CG 00 20 03 07 Includes copyrighted material of Insurance Services Page 3 of 6 Office, Inc., with its permission 5 of 12 ALIACOMP (MAK00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS' COMMERCIAL GENERAL LIABILITY ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. MEDICAL PAYMENTS If SECTION I — COVERAGE C MEDICAL PAY- MENTS is not otherwise excluded from this Coverage Part: 1. The Medical Expense Limit provided by this policy, subject to the terms of SECTION III - LIMITS OF INSURANCE, shall be the greater of: a. $10,000; or b. The Medical Expense Limit shown in the Declarations of this Coverage Part. B. FIRE, LIGHTNING, EXPLOSION, SMOKE AND SPRINKLER LEAKAGE DAMAGE TO PRE- MISES YOU RENT If damage to premises rented to you under Cov- erage A. is not otherwise excluded from this pol- icy, the following applies: 1. The last paragraph of SECTION I — COV- ERAGE A.2. Exclusions is deleted and re- placed by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion or sprinkler leakage to premises while rented to your or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as de- scribed in SECTION III — LIMITS OF IN- SURANCE. 2. Paragraph 6. of SECTION III — LIMITS OF INSURANCE is deleted and replaced by the following: 6. Subject to 5. above, the greater of a. $300,000; or b. the Damage To Premises Rented To You Limit shown in the Declara- tions; is the most we will pay under COVER- AGE A for damages because of "proper- ty damage" to any one premises, while rented to you, or temporarily occupied by you with the permission of the owner arising out of any one fire, lightning, ex- plosion or sprinkler leakage incident. 3. Paragraph 4.b.(1)(b) Other Insurance of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS is deleted and re- placed by the following: (b) That is Fire, Lightning, Explosion or Sprinkler Leakage insurance for premis- es rented to you or temporarily occupied by you with the permission of the owner; 4. Paragraph 9.a. of SECTION V — DEFINI- TIONS is deleted and replaced by the follow- ing: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion or sprinkler lea- kage to premises while rented to you or temporarily occupied by you with per- mission of the owner is not an "insured contract'; C. NON -OWNED WATERCRAFT 1. Paragraph g.(2) of SECTION I — COVER- AGE A.2. Exclusions is deleted and re- placed by the following: A watercraft you do not own that is: (a) Less than 51 feet long; and (b) Not used to carry persons or property for a charge. D. SUPPLEMENTARY PAYMENTS SECTION I — SUPPLEMENTARY PAYMENTS — COVERAGES A AND B is amended as fol- lows: 1. The limit of insurance in paragraph 1.b. is increased from $250 to $2,500; and 2. The limit of insurance in paragraph 1.d. is increased from $250 to $500. E. AUTOMATIC ADDITIONAL INSURED — SPE- CIFIED RELATIONSHIPS The following is added to Paragraph 2. of SEC- TION II - WHO IS AN INSURED: e. Any person or organization described in pa- ragraph f. below, whom you and such per- son or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional in- sured on your policy. CL CG 00 20 03 07 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 1 of 6 6 of 12 ALIACOMP (MAK00) Such person or organization is an insured (c) The ownership, maintenance, or use provided: of any elevators. (1) The written or oral contract or agree- F. ADDITIONAL INSURED — OWNERS, LESSEES ment is: OR CONTRACTORS — AUTOMATIC STATUS (a) Currently in effect or becomes effec- 1. SECTION II — WHO IS AN INSURED is tive during the policy period; and amended to include as an additional insured (b) Executed prior to an "occurrence" or any person or organization for whom you are offense to which this insurance performing operations when you and such would apply. person or organization have agreed in writ- ing in a contract or agreement that such per- (2) They are not specifically designated as son or organization be added as an addi- an additional insured under any other tional insured on your policy. Such person or provision of, or endorsement added to, organization is an additional insured only this policy. with respect to liability for "bodily injury", f. Only the following persons or organizations "property damage" or "personal and adver- tising injury" caused, in whole or in part, by: are additional insureds under this endorse- ment, and coverage provided to such addi- a. Your acts or omissions; or tional insureds is limited as provided herein: b. The acts or omissions of those acting on (1) The manager or lessor of a premise your behalf; leased to you, but only with respect to liability arising from the ownership, main- in the performance of your ongoing opera- tenance or use of that part of the pre- tions for the additional insured. mises leased to you and subject to the A person's or organization's status as an ad - following additional exclusions: ditional insured under this policy ends when This insurance does not apply to: your operations for that additional insured are completed. (a) Any "occurrence" which takes place after you cease to be a tenant of that 2. With respect to the insurance afforded to premises. these additional insureds, the following addi- (b) Structural alterations, new construc- tional exclusions apply: tion or demolition operations per- This insurance does not apply to: formed by or on behalf of the man- ager or lessor. a. "Bodily injury", "property damage" or personal and advertising injury' arising (2) Any person or organization from whom out of the rendering of, or the failure to you lease equipment, but only with re- render, any professional architectural, spect to liability for "bodily injury", "prop- engineering or surveying services, in- erty damage" or "personal and advertis- cluding: ing injury" caused, in whole or in part, by your maintenance, operation or use of (1) The preparing, approving, or failing equipment leased to you by such per- to prepare or approve, maps, shop son(s) or organization(s). drawings, opinions, reports, surveys, field orders, change orders or draw - However, this insurance does not apply ings and specifications; or to any "occurrence" which takes place after the equipment lease expires. (2) Supervisory, inspection, architectur- al or engineering activities. (3) Any state or political subdivision, subject to the following additional provision: b. "Bodily injury" or "property damage" This insurance applies only with respect occurring after: to the following hazards for which the (1) All work, including materials, parts state or political subdivision has issued a or equipment furnished in connec- permit in connection with premises you tion with such work, on the project own, rent, or control and to which this in- (other than service, maintenance or surance applies: repairs) to be performed by or on (a) The existence, maintenance, repair, behalf of the additional insured(s) at the location of the covered opera - construction, erection, or removal of tions has been completed; or advertising signs, awnings, cano- pies, cellar entrances, coal holes, (2) That portion of "your work" out of driveways, manholes, marquees, which the injury or damage arises hoist away openings, sidewalk has been put to its intended use by vaults, street banners, or decora- any person or organization other tions and similar exposures; or than another contractor or subcon- (b) The construction, erection, or re- tractor engaged in performing op- erations for a principal as a part of moval of elevators; or the same project. CL CG 00 20 03 07 Includes copyrighted material of Insurance Services Page 2 of 6 Office, Inc., with its permission 7 of 12 ALIACOMP (MAK00) c. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the Single Construction Project General Ag- gregate Limit for that construction project away from premises owned by or rented to the insured. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Single Construc- tion Project General Aggregate Limit for any other separate construction project away from premises owned by or rented to the insured. d. The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Expense 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 Single Construction Project General Aggregate Limit. 2. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under COVERAGE A (SECTION 1), and for all medical expenses caused by accidents under COVERAGE C (SECTION 1), which cannot be attributed on- ly to ongoing operations at a single desig- nated construction project away from pre- mises owned by or rented to the insured: a. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the amount available under the General Ag- gregate Limit or the Products -Completed Operations Aggregate Limit, whichever is applicable; and b. Such payments shall not reduce any Single Construction Project General Ag- gregate Limit. 3. When coverage for liability arising out of the "products -completed operations hazard" is provided, any payments for damages be- cause of "bodily injury" or "property damage" included in the "products -completed opera- tions hazard" will reduce the Products - Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Single Construction Project General Ag- gregate Limit. 4. If the applicable construction project away from premises owned by or rented to the in- sured has been abandoned, delayed, or abandoned and then restarted, or if the au- thorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. 5. The provisions of Limits Of Insurance (SECTION III) not otherwise modified by this endorsement shall continue to apply as sti- pulated. J. KNOWLEDGE OF OCCURRENCE The following is added to paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of SECTION IV — COMMERCIAL GENER- AL LIABILITY CONDITIONS: e. A report of an "occurrence", offense, claim or "suit" to: (1) You, if you are an individual, (2) A partner, if you are a partnership, (3) An executive officer, if you are a corporation, or (4) A manager, if you are a limited liability company; is considered knowledge and requires you to notify us of the "occurrence", offense, claim, or "suit" as soon as practicable. We are considered on notice of an "occurrence", offense, claim or "suit" that is reported to your Workers' Compensation insurer for an event which later develops into an "occurrence", offense, claim or "suit" for which there is coverage under this policy. However, we will only be considered on notice if you notify us as soon as you know the claim should be addressed by this policy rather than your Workers' Compensation policy. K. UNINTENTIONAL OMISSIONS The following is added to paragraph 6. Repre- sentations of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: d. If you unintentionally fail to disclose any ex- posures existing at the inception date of your policy, we will not deny coverage under this Coverage Part solely because of such failure to disclose. However, this provision does not affect our right to collect additional pre- mium or exercise our right of cancellation or non -renewal. This provision does not apply to any known injury or damage which is excluded under any other provision of this policy. L. MENTAL ANGUISH Paragraph 3. of SECTION V — DEFINITIONS is deleted and replaced by the following: 3. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including mental anguish or death resulting from any of these at any time. M. WAIVER OF TRANSFER OF RIGHTS OF RE- COVERY AGAINST OTHERS Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of SECTION IV — COM- MERCIAL GENERAL LIABILITY CONDITIONS is amended by the addition of the following: CL CG 00 20 03 07 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 4 of 6 8 of 12 ALIACOMP (MAK00) We waive any right of recovery we may have be- cause of payments we make for injury or dam- age arising out of your ongoing operations or "your work" done under a contract requiring such waiver with that person or organization and in- cluded in the "products -completed operations hazard". However, our rights may only be waived prior to the "occurrence" giving rise to the injury or dam- age for which we make payment under this Cov- erage Part. The insured must do nothing after a loss to impair our rights. At our request, the in- sured will bring "suit" or transfer those rights to us and help us enforce those rights. N. LIMITED JOB SITE POLLUTION 1. Exclusion f. under Section I — Coverage A is replaced by the following: 2. Exclusions This insurance does not apply to: f. Pollution (1) "Bodily injury" or "property dam- age" arising out of the actual, al- leged or threatened discharge, dispersal, seepage, migration, release or escape of "pollu- tants": (a) At or from any premises, site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured's behalf are per- forming operations if the operations are to test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way re- spond to, or assess the ef- fects of, "pollutants"; or (b) At or from a storage tank or other container, ducts or piping which is below or par- tially below the surface of the ground or water or which, at any time, has been buried under the surface of the ground or water and then subsequently exposed by erosion, excavation or any other means if the ac- tual, alleged or threatened discharge, dispersal, see- page, migration, release or escape of "pollutants" arises at or from any premises, site or location which any in- sured or any contractors or subcontractors working di- rectly or indirectly on any in- sured's behalf are perform- ing operations if the "pollu- tants" are brought on or to the premises, site or loca- tion in connection with such operations by such insured, contractor or subcontractor. Subparagraph (b) does not apply to "bodily injury" or "property damage" arising out of heat, smoke or fumes from a "hostile fire". (2) Any loss, cost or expense aris- ing out of any: (a) Request, demand, order or statutory or regulatory re- quirement issued or made pursuant to any environ- mental protection or envi- ronmental liability statutes or regulations that any insured test for, monitor, clean up, remove, contain, treat, de- toxify or neutralize, or in any way respond to, or assess the effects of, "pollutants'; or (b) Claim or suit by or on behalf of a governmental authority for damages because of testing for, monitoring, cleaning up, removing, con- taining, treating, detoxifying or neutralizing or in any way responding to or assessing the effects of, "pollutants". However, this paragraph does not apply to liability for those sums the insured becomes le- gally obligated to pay as dam- ages because of "property dam- age" that the insured would have in the absence of such re- quest, demand, order or statuto- ry or regulatory requirement, or such claim or "suit" by or on be- half of a governmental authority. 2. With respect to "bodily injury" or "property damage" arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of "pollutants": a. The "Each Occurrence Limit" shown in the Declarations does not apply. b. Paragraph 7. of Limits Of Insurance (Section III) does not apply. c. Paragraph 1. of Section III — Limits Of Insurance is replaced by the following: The Limits Of Insurance shown in this endorsement, or in the Declarations and the rules below fix the most we will pay regardless of the number of: (1) Insureds; CL CG 00 20 03 07 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 5 of 6 9 of 12 ALIACOMP (MAK00) (b) "Property damage" to property: (i) Owned, occupied or used by, (ii) Rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by you, any of your "employees", "volunteer workers", any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability company). (2) Any person (other than your "employee" or "volunteer worker"), or any organization while acting as your real estate manager. (3) Any person or organization having proper temporary custody of your property if you die, but only: (a) With respect to liability arising out of the maintenance or use of that property; and (b) Until your legal representative has been appointed. (4) Your legal representative if you die, but only with respect to duties as such. That repre- sentative will have all your rights and duties under this Coverage Part. c. Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar in- surance available to that organization. How- ever: (1) Coverage under this provision is afforded only until the 90th day after you acquire or form the organization or the end of the pol- icy period, whichever is earlier; (2) Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and (3) Coverage B does not apply to "personal and advertising injury" arising out of an of- fense committed before you acquired or formed the organization. 2. Only with respect to liability arising out of the own- ership, maintenance or use of "covered autos": a. You are an insured. b. Anyone else while using with your permission a "covered auto" you own, hire or borrow is also an insured except: (1) The owner or anyone else from whom you hire or borrow a "covered auto". This excep- tion does not apply if the "covered auto" is a trailer or semitrailer connected to a "cov- ered auto" you own. (2) Your "employee" if the "covered auto" is owned by that "employee" or a member of his or her household. (3) Someone using a "covered auto" while he or she is working in a business of selling, servicing, repairing, parking or storing "autos" unless that business is yours. (4) Anyone other than your "employees", part- ners (if you are a partnership), members (if you are a limited liability company), or a lessee or borrower or any of their "employ- ees", while moving property to or from a "covered auto". (5) A partner (if you are a partnership), or a member (if you are a limited liability com- pany) for a "covered auto" owned by him or her or a member of his or her household. (6) "Employees" with respect to "bodily injury" to any fellow "employee" of the insured aris- ing out of and in the course of the fellow "employee's" employment or while perform- ing duties related to the conduct of your business. c. Anyone liable for the conduct of an insured described above is also an insured, but only to the extent of that liability. 3. Any additional insured under any policy of "under- lying insurance" will automatically be an insured under this insurance. If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance required by the contract, less any amounts payable by any "underlying insur- ance". Additional insured coverage provided by this in- surance will not be broader than coverage pro- vided by the "underlying insurance". No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. Page 10 of 17 © ISO Properties, Inc., 2007 CU 00 01 12 07 ❑ 10 of 12 ALIACOMP (MAK00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PER LOCATION, PER PROJECT AND PRODUCTS -COMPLETED OPERATIONS AGGREGATE LIMITS OF INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL LIABILITY UMBRELLA COVERAGE PART Section III — Limits Of Insurance is replaced by the 3. The Products -Completed Operations Aggregate following: Limit shown in the Declarations of this policy is 1. The Limits Of Insurance shown in the Declara- the most we will pay for the sum of all "ultimate tions and the Schedule of this endorsement, and net loss" under Coverage A for damages be - the following rules fix the most we will pay re- cause of "bodily injury" and "property damage" gardless of the number of: included in the "products -completed operations hazard". a. Insureds; b. Claims made, "suits" brought, or number of vehicles involved; or c. Persons or organizations making claims or bringing "suits". 2. The Aggregate Limit is the most we will pay for the sum of all "ultimate net loss" under: a. Coverage A, except "ultimate net loss" be- cause of "bodily injury" or "property dam- age": 4. Subject to Paragraph 2. or 3. above, whichever applies, the Each Occurrence Limit is the most we will pay for the sum of all "ultimate net loss" under Coverage A because of all "bodily injury" and "property damage" arising out of any one "occurrence". 5. Subject to Paragraph 2. above, the Personal and Advertising Injury Limit is the most we will pay under Coverage B for the sum of all "ulti- mate net loss" because of all "personal and ad- vertising injury" sustained by any one person or organization. (1) Arising out of the ownership, mainte- The Aggregate Limits, as described in Paragraphs 2. nance or use of a "covered auto'; or and 3. above, apply separately to each consecutive (2) Included in the "products - completed annual period and to any remaining period of less operations hazard"; and than 12 months, starting with the beginning of the b. Coverage B. policy period shown in the Declarations, unless the policy period is extended after issuance for an addi- The Aggregate Limit applies separately to each of tional period of less than 12 months. In that case, your: the additional period will be deemed part of the last preceding period for purposes of determining the (1) Projects away from premises owned by or rented Limits of Insurance. to you, and (2) "Locations" owned by or rented to you. Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad. CL CU 24 05 06 08 Includes copyrighted material of Insurance Services Page 1 of 1 Offices, Inc., with its permission 11 of 12 ALIACOMP (MAK00) POLICY NUMBER: COMMERCIAL LIABILITY UMBRELLA CU 24 03 09 00 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL LIABILITY UMBRELLA COVERAGE PART SCHEDULE Name Of Person Or Organization: (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The Transfer Of Rights Of Recovery Against Others To Us Condition under Section IV — Conditions is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CU 24 03 09 00 Copyright, Insurance Services Office, Inc., 2000 Page 1 of 1 ❑ 12 of 12 ALIACOMP (MAK00) ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(M MIDD/YYYY) 09/30/2011 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 TH6 t I �gIHOLDER. IMPORTANT: If the certificate holder is an AD ",L. *,ISURED, the policy(ies) must 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER Parker, Smith & Feek, Inc. OCT 3 201i 2233 112th Avenue NE Bellevue, WA 98004 Human Resources & CONTACT PHOFAX NE � 42 -7 9-36 A/C No : 425-709-7460 E-MAIL ADDRESS: PRODUCER Risk Management C.ST INSURERS AFFORDING COVERAGE NAIC # INSURED R. L. Alia Company INSURERA: Marketin 107 Williams Ave. S. INSURER B : INSURER C : Renton, WA 98055 INSURER D : 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 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. INSR LTR OF INSURANCE ADDLTYPE INSR SUER POLICY NUMBER MMIDDPOLICY/Y YYY MM/DDIYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY APP10JPS31945 10/1/2011 10/1/2012 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 100000 CLAIMS -MADE I —XI OCCUR I7 [ MED EXP (Any one person) $ 5000 PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ 2,000,000 I GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2 ,000.0 $ POLICY X I PE OT- LOC A AUTOMOBILE X LIABILITY ANY AUTO 1 (^ 17 APP10JPS31945 10/1/2011 10/1/2012 COM BINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident) $ $ NONdWNED AUTOS $ AJE BRELLALIAB X OCCUR APPTH2661066159010 10/1/2011 10/1/2012 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 ESSLIABCLAIMS-MADE F $ I ^XDUCTIBLE $ ENTION $ 10,000 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? ❑ NIA APP10JPS31945 10/1/2011 10/1/2012 OR STMIT- X oTH-I ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) E.L. DISEASE- POLICY LIMIT $ 1 f ,at,, describe under F DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Benson Road 16" Water Main Replacement. The City of Renton is included as additional insured and coverage is primary noncontributory as set forth in the terms and conditions of Endorsements CLCGO020 0307 pg1-2 of 6 (GL), Al CA 59 02 06 page 1 of 7 (Auto) and CU 00 01 12 07 (Excess) attached. Waiver ... (See Attached Description) CERTIFICATE HOLDER CANCELLATION City of Renton 1055 South Grady Way Renton, WA 98057 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE fjt��_ w ACORD 25 (2009/09) 1 of 12 © 1988- 2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ALIACOMP (NIAK00) DESCRIPTIONS (Continued from Page 1 ) of Subrogation is included per Endorsements CLCGO020 0307 pg 4-5 of 6 (GL), Al CLCGO020 0307 pg 4-5 of 6 (Auto) and CU 24 03 09 00 (Excess) attached. Per project aggregate is included per Endorsements CLCGO020 0307 pg 3 of 6 (GL), attached. Per Project Aggregate applies per attached Endorsements CLCGO020 0307 pg 3 of 6 (GL) and CU 24 05 06 08 (Excess). ALIACOMP (MAK00) Sage Document: Company Forms j Al CA 59 Expansion Endorsement 102 06 Edition Page I of 7 CWG I Auto j 02/01/06 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Al CA 59 02 06 COMMERCIAL AUTOMOBILE EXPANSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM The following provides a broad range of coverage in addition to that provided by the basic policy. In some instances, a higher limit or broader coverage is available. Should the policy indicate broader coverage or higher limits than provided by this endorsement, the higher limits or broader coverage shall apply. A. BROADENED NAMED INSURED The Named Insured shown in the Declarations is amended to include: Any organization, other than a joint venture, over which you maintain ownership or majority interest of more than 50%, unless that organization is an "insured" under any other automobile policy or would be an "insured" under such a policy but for the exhaustion of its Limit of Insurance, however; 1. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier. 2. Coverage does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization. B. ADDITIONAL INSURED BY CONTRACT OR AGREEMENT The following is added to Section II - Liability Coverage, Paragraph A.1.: d. Any person or organization for whom you are performing operations if you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. (1) Such person or organization is an additional insured only with respect to liability for "bodily injury" or "property damage": a. Caused by an "accident", and b. Resulting from the ownership, maintenance or use of a covered "auto". (2) A person's or organization's status as an additional insured exists only while you are performing operations for that additional insured. (3) Section II, Paragraph C. Limits of Insurance for person or organization added as additional insured are those specified in the written contract or agreement, or in this coverage form, whichever is less. These limits of insurance are inclusive of and are not in addition to the Limits of Insurance shown in the Declarations. (4) This insurance applies on a primary and non-contributory basis if that is required by the written contract or agreement. (5) This insurance does not apply unless the written contract or agreement has been executed prior to the "bodily injury" or "property damage". C. ADDITIONAL INSURED - EMPLOYEES Section II — Liability Coverage, Paragraph A.1.b.(2) is deleted and replaced by the following: (2) Your "employee" if the covered "auto" is owned by that "employee" or a member of his or her household, but this exclusion does not apply if the covered "auto" is being used in your business or your personal affairs. D. EXTENDED COVERAGE - BAIL BONDS Section II — Liability Coverage, Paragraph A.2.a.(2) is deleted and replaced by the following.- (2) Up to $3,000 for cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. E. EXTENDED COVERAGE - LOSS OF EARNINGS 3 of 12 https://www. si Iverplume.com/sponIine/SPSage.asp?cmd=doc&id=cwi46136&rd=920315... 1/24/2011 ALIACOMP (MAK00) Sage Document: Company Forms I Al CA 59 Expansion Endorsement 102 06 Edition Page 7 of 7 c. Your members or managers, if you are designated in the Declarations as a limited liability company; d. Your "executive officers", if you are designed in the Declarations as an organization other than an individual, partnership, joint venture or limited liability company; and e. The spouse of any person named in RA.a. through RA.d. while a resident of the same household. 2. The following "autos" are not covered: a. Any "auto" owned by a person named in R.1.a. through R.1.e. or by any member of his or her household. b. Any "auto" used by a person named in RA.a. through R.1.e. while working in the business of selling, servicing, repairing or parking "autos". 3. The most we will pay for the total of all damages under LIABILITY COVERAGE, AUTO MEDICAL PAYMENTS, UNINSURED MOTORISTS COVERAGE and UNDERINSURED MOTORISTS COVERAGE is the LIMIT OF INSURANCE shown in the Declarations as applicable to owned "autos". 4. Our obligation to pay for, repair, return or replace damaged or stolen property under PHYSICAL DAMAGE COVERAGE, will be reduced by a deductible equal to the amount of the largest deductible shown for any owned private passenger type "auto" applicable to that coverage. If there are no owned private passenger type "autos", the deductible shall be $50 for Comprehensive Coverage and $100 for Collision Coverage. No deductible will apply to "loss" caused by fire or lightning. S. KNOWLEDGE OF OCCURRENCE The following is added to Section IV — Business Auto Conditions, Paragraph A.2.: d. Notice of an "accident" or "loss" will be considered knowledge of yours only if reported to you, if you are an individual, a partner, an executive officer or an employee designated by you to give us such notice. e. Notice of an "accident" or "loss" to your Workers Compensation insurer, for an event which later develops into a claim for which there is coverage under this policy, shall be considered notice to us, but only if we are notified as soon as you know that the claim should be addressed by this policy, rather than your Workers Compensation policy. f. Your rights under this policy shall not be prejudiced if you fail to give us notice of an "accident" or "loss", solely due to your reasonable and documented belief that the event is not covered by this policy. The following is added to Section IV — Business Auto Conditions, Paragraph 2.b.: (6) Knowledge of the receipt of documents concerning a claim or "suit" will be considered knowledge of yours only if receipt of such documents is known to you, if you are an individual, a partner, an executive officer or an employee designated by you to forward such documents to us. (f i��i'T_�trl � Z�T;��l�tiZrT_i �t �7`. r �I�iI► i �LT� t<sI7�Lr] � I=L'i I �►t! f The following is added to Section IV - Business Auto Conditions, Paragraph A.5.: We waive any right of recovery we may have against any "insured" provided coverage under this endorsement under B., ADDITIONAL INSURED BY CONTRACT, PERMIT OR AGREEMENT, but only as respects "loss" arising out of the operation, maintenance or use of a covered "auto" pursuant to the provisions or conditions of the written contract or agreement. U. UNINTENTIONAL OMISSIONS The following is added Section IV - Business Auto Conditions, Paragraph B.2.: We will not deny coverage under this policy if you fail to disclose all hazards existing as of the inception date of the policy, provided such failure is not intentional. OContinental Western Group Q2011 Vertafore, Inc. All Rights Reserved. 4 of 12 https://www.silverplume.com/sponline/SPSage.asp?cmd=doc&1d=cwi46136&rd=920315... 1/24/2011 ALIACOMIP (M1AKOO) 3. The insurance provided by this endorsement is primary insurance and we will not seek contribution under any insurance policy un- der which such additional insured is a named insured, if such policy was procured and paid for by such additional insured, or a parent or related entity of such additional in- sured. 4. With respect to the insurance afforded to these additional insureds, SECTION III — LIMITS OF INSURANCE is amended as fol- lows: The limits applicable to the additional in- sured are those specified in the written con- tract or agreement or the limits stated in the Declarations, whichever is less. If no limits are specified in the written contract or agreement, the limits applicable to the addi- tional insured are those specified in the Dec- larations. The limits of insurance are inclu- sive of and not in addition to the limits of in- surance shown in the Declarations. G. PROPERTY DAMAGE TO BORROWED EQUIPMENT 1. Paragraph 2.j. of SECTION I - COVERAG- ES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY is amended as follows: Paragraphs (3) and (4) of this exclusion do not apply to tools or equipment loaned to you, provided they are not being used to per- form operations at the time of loss. 2. SECTION III — LIMITS OF INSURANCE is deleted and replaced by the following: The most we will pay in any one "occur- rence" for "property damage" to borrowed equipment is $15,000. This limit of insur- ance is the most we will pay regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 3. Deductible a. Our obligation to pay damages on behalf of the insured applies only to the amount of damages in excess of $250 as appli- cable to "property damage" as the result of any one "occurrence", regardless of the number of persons or organizations who sustain damages because of that "occurrence". c. We may pay any part or all of the de- ductible amount to effect settlement of any claim or suit and, upon notification of the action taken; you shall promptly reimburse us for such part of the deduct- ible amount as we have paid. H. BROADENED NAMED INSURED Paragraph 3. of SECTION II - WHO IS AN IN- SURED is deleted and replaced by the following: Any organization, other than a joint venture, over which you maintain ownership or majority inter- est of more than 50% will be a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier. b. COVERAGE A does not apply to "bodily in- jury" or "property damage" that occurred be- fore you acquired or formed the organiza- tion. c. COVERAGE B does not apply to "personal and advertising injury" arising out of an of- fense committed before you acquired or formed the organization. I. CONSTRUCTION PROJECT GENERAL AG- GREGATE LIMIT For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under COVERAGE A (SECTION 1), and for all medical expenses caused by accidents under COVERAGE C (SECTION 1), which can be attributed only to ongoing operations at a single construction project away from premises owned by or rented to the insured: a. A Single Construction Project General Aggregate Limit applies to each con- struction project away from premises owned by or rented to the insured, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. b. The Single Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under COV- ERAGE A, except damages because of "bodily injury" or "property damage" in- cluded in the "products -completed oper- ations hazard", and for medical ex- penses under COVERAGE C regardless of the number of: b. The terms of this insurance, including (1) Insureds; those with respect to our right and duty (2) Claims made or "suits" brought; or to defend the insured against any "suits" (3) Persons or organizations making seeking those damages; and your duties claims or bringing "suits". in the event of an "occurrence", claim, or "suit' apply irrespective of the application of the deductible amount. CL CG 00 20 03 07 Includes copyrighted material of Insurance Services Page 3 of 6 Office, Inc., with its permission of 12, ALIACOMP (MAK00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS' COMMERCIAL GENERAL LIABILITY ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. MEDICAL PAYMENTS If SECTION I — COVERAGE C MEDICAL PAY- MENTS is not otherwise excluded from this Coverage Part: 1. The Medical Expense Limit provided by this policy, subject to the terms of SECTION III - LIMITS OF INSURANCE, shall be the greater of: a. $10,000; or b. The Medical Expense Limit shown in the Declarations of this Coverage Part. B. FIRE, LIGHTNING, EXPLOSION, SMOKE AND SPRINKLER LEAKAGE DAMAGE TO PRE- MISES YOU RENT If damage to premises rented to you under Cov- erage A. is not otherwise excluded from this pol- icy, the following applies: 1. The last paragraph of SECTION I — COV- ERAGE A.2. Exclusions is deleted and re- placed by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion or sprinkler leakage to premises while rented to your or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as de- scribed in SECTION III — LIMITS OF IN- SURANCE. 2. Paragraph 6. of SECTION III — LIMITS OF INSURANCE is deleted and replaced by the following: 6. Subject to 5. above, the greater of a. $300,000; or b. the Damage To Premises Rented To You Limit shown in the Declara- tions; is the most we will pay under COVER- AGE A for damages because of "proper- ty damage" to any one premises, while rented to you, or temporarily occupied by you with the permission of the owner arising out of any one fire, lightning, ex- plosion or sprinkler leakage incident. 3. Paragraph 4.b.(1)(b) Other Insurance of SECTION IV —CO MMERCIAL GENERAL LIABILITY CONDITIONS is deleted and re- placed by the following: (b) That is Fire, Lightning, Explosion or Sprinkler Leakage insurance for premis- es rented to you or temporarily occupied by you with the permission of the owner; 4. Paragraph 9.a. of SECTION V — DEFINI- TIONS is deleted and replaced by the follow- ing: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion or sprinkler lea- kage to premises while rented to you or temporarily occupied by you with per- mission of the owner is not an "insured contract"; C. NON -OWNED WATERCRAFT 1. Paragraph g.(2) of SECTION I — COVER- AGE A.2. Exclusions is deleted and re- placed by the following: A watercraft you do not own that is: (a) Less than 51 feet long; and (b) Not used to carry persons or property for a charge. D. SUPPLEMENTARY PAYMENTS SECTION I — SUPPLEMENTARY PAYMENTS — COVERAGES A AND B is amended as fol- lows: 1. The limit of insurance in paragraph 1.b. is increased from $250 to $2,500; and 2. The limit of insurance in paragraph 1.d. is increased from $250 to $500. E. AUTOMATIC ADDITIONAL INSURED —SP E- CIFIED RELATIONSHIPS The following is added to Paragraph 2. of SEC- TION II - WHO IS AN INSURED: e. Any person or organization described in pa- ragraph f. below, whom you and such per- son or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional in- sured on your policy. CL CG 00 20 03 07 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 1 of 6 6 of 12 ALIACOMP (MAKOO) Such person or organization is an insured (c) The ownership, maintenance, or use provided: of any elevators. (1) The written or oral contract or agree- F. ADDITIONAL INSURED — OWNERS, LESSEES ment is: OR CONTRACTORS — AUTOMATIC STATUS (a) Currently in effect or becomes effec- 1. SECTION II — WHO IS AN INSURED is tive during the policy period; and amended to include as an additional insured (b) Executed prior to an "occurrence" or any person or organization for whom you are performing operations when you and such offense to which this insurance would apply. person or organization have agreed in writ- ing in a contract or agreement that such per- (2) They are not specifically designated as son or organization be added as an addi- an additional insured under any other tional insured on your policy. Such person or provision of, or endorsement added to, organization is an additional insured only this policy. with respect to liability for "bodily injury", f. Only the following persons or organizations "property damage" or "personal and adver- tising injury" caused, in whole or in part, by: are additional insureds under this endorse- ment, and coverage provided to such addi- a. Your acts or omissions; or tional insureds is limited as provided herein: b. The acts or omissions of those acting on (1) The manager or lessor of a premise your behalf; leased to you, but only with respect to liability arising from the ownership, main- in the performance of your ongoing opera- tenance or use of that part of the pre- tions for the additional insured. mises leased to you and subject to the A person's or organization's status as an ad - following additional exclusions: ditional insured under this policy ends when This insurance does not apply to: your operations for that additional insured are completed. (a) Any "occurrence" which takes place after you cease to be a tenant of that 2. With respect to the insurance afforded to premises. these additional insureds, the following addi- (b) Structural alterations, new construc- tional exclusions apply: tion or demolition operations per- This insurance does not apply to: formed by or on behalf of the man- ager or lessor. a. "Bodily injury", "property damage" or "personal and advertising injury' arising (2) Any person or organization from whom out of the rendering of, or the failure to you lease equipment, but only with re- render, any professional architectural, spect to liability for "bodily injury", "prop- engineering or surveying services, in- erty damage" or "personal and advertis- cluding: ing injury" caused, in whole or in part, by your maintenance, operation or use of (1) The preparing, approving, or failing equipment leased to you by such per- to prepare or approve, maps, shop son(s) or organization(s). drawings, opinions, reports, surveys, field orders, change orders or draw - However, this insurance does not apply ings and specifications; or to any "occurrence" which takes place after the equipment lease expires. (2) Supervisory, inspection, architectur- al or engineering activities. (3) Any state or political subdivision, subject to the following additional provision: b. "Bodily injury" or "property damage" This insurance applies only with respect occurring after: to the following hazards for which the (1) All work, including materials, parts state or political subdivision has issued a or equipment furnished in connec- permit in connection with premises you tion with such work, on the project own, rent, or control and to which this in- (other than service, maintenance or surance applies: repairs) to be performed by or on (a) The existence, maintenance, repair, behalf of the additional insured(s) at the location of the covered opera - construction, erection, or removal of tions has been completed; or advertising signs, awnings, cano- pies, cellar entrances, coal holes, (2) That portion of "your work" out of driveways, manholes, marquees, which the injury or damage arises hoist away openings, sidewalk has been put to its intended use by vaults, street banners, or decora- any person or organization other tions and similar exposures; or than another contractor or subcon- (b) The construction, erection, or re- tractor engaged in performing op- erations for a principal as a part of moval of elevators; or the same project. CL CG 00 20 03 07 Includes copyrighted material of Insurance Services Page 2 of 6 Office, Inc., with its permission 7 -f 12 ALIACOMP (MAK00) c. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the Single Construction Project General Ag- gregate Limit for that construction project away from premises owned by or rented to the insured. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Single Construc- tion Project General Aggregate Limit for any other separate construction project away from premises owned by or rented to the insured. d. The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Expense 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 Single Construction Project General Aggregate Limit. 2. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under COVERAGE A (SECTION 1), and for all medical expenses caused by accidents under COVERAGE C (SECTION 1), which cannot be attributed on- ly to ongoing operations at a single desig- nated construction project away from pre- mises owned by or rented to the insured: a. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the amount available under the General Ag- gregate Limit or the Products -Completed Operations Aggregate Limit, whichever is applicable; and b. Such payments shall not reduce any Single Construction Project General Ag- gregate Limit. 3. When coverage for liability arising out of the "products -completed operations hazard" is provided, any payments for damages be- cause of "bodily injury" or "property damage" included in the "products -completed opera- tions hazard" will reduce the Products - Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Single Construction Project General Ag- gregate Limit. 4. If the applicable construction project away from premises owned by or rented to the in- sured has been abandoned, delayed, or abandoned and then restarted, or if the au- thorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. 5. The provisions of Limits Of Insurance (SECTION III) not otherwise modified by this endorsement shall continue to apply as sti- pulated. J. KNOWLEDGE OF OCCURRENCE The following is added to paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of SECTION IV — COMMERCIAL GENER- AL LIABILITY CONDITIONS: e. A report of an "occurrence", offense, claim or "suit" to: (1) You, if you are an individual, (2) A partner, if you are a partnership, (3) An executive officer, if you are a corporation, or (4) A manager, if you are a limited liability company; is considered knowledge and requires you to notify us of the "occurrence", offense, claim, or "suit" as soon as practicable. We are considered on notice of an "occurrence", offense, claim or "suit" that is reported to your Workers' Compensation insurer for an event which later develops into an "occurrence", offense, claim or "suit" for which there is coverage under this policy. However, we will only be considered on notice if you notify us as soon as you know the claim should be addressed by this policy rather than your Workers' Compensation policy. K. UNINTENTIONAL OMISSIONS The following is added to paragraph 6. Repre- sentations of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: d. If you unintentionally fail to disclose any ex- posures existing at the inception date of your policy, we will not deny coverage under this Coverage Part solely because of such failure to disclose. However, this provision does not affect our right to collect additional pre- mium or exercise our right of cancellation or non -renewal. This provision does not apply to any known injury or damage which is excluded under any other provision of this policy. L. MENTAL ANGUISH Paragraph 3. of SECTION V — DEFINITIONS is deleted and replaced by the following: 3. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including mental anguish or death resulting from any of these at any time. M. WAIVER OF TRANSFER OF RIGHTS OF RE- COVERY AGAINST OTHERS Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of SECTION IV — COM- MERCIAL GENERAL LIABILITY CONDITIONS is amended by the addition of the following: CL CG 00 20 03 07 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 4 of 6 8 of 12 ALIACOMP (MAK00) We waive any right of recovery we may have be- cause of payments we make for injury or dam- age arising out of your ongoing operations or "your work" done under a contract requiring such waiver with that person or organization and in- cluded in the "products -completed operations hazard". However, our rights may only be waived prior to the "occurrence" giving rise to the injury or dam- age for which we make payment under this Cov- erage Part. The insured must do nothing after a loss to impair our rights. At our request, the in- sured will bring "suit" or transfer those rights to us and help us enforce those rights. N. LIMITED JOB SITE POLLUTION 1. Exclusion f. under Section I — Coverage A is replaced by the following: 2. Exclusions This insurance does not apply to: f. Pollution (1) "Bodily injury" or "property dam- age" arising out of the actual, al- leged or threatened discharge, dispersal, seepage, migration, release or escape of "pollu- tants": (a) At or from any premises, site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured's behalf are per- forming operations if the operations are to test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way re- spond to, or assess the ef- fects of, "pollutants'; or (b) At or from a storage tank or other container, ducts or piping which is below or par- tially below the surface of the ground or water or which, at any time, has been buried under the surface of the ground or water and then subsequently exposed by erosion, excavation or any other means if the ac- tual, alleged or threatened discharge, dispersal, see- page, migration, release or escape of "pollutants" arises at or from any premises, site or location which any in- sured or any contractors or subcontractors working di- rectly or indirectly on any in- sured's behalf are perform- ing operations if the "pollu- tants" are brought on or to the premises, site or loca- tion in connection with such operations by such insured, contractor or subcontractor. Subparagraph (b) does not apply to "bodily injury" or "property damage" arising out of heat, smoke or fumes from a "hostile fire". (2) Any loss, cost or expense aris- ing out of any: (a) Request, demand, order or statutory or regulatory re- quirement issued or made pursuant to any environ- mental protection or envi- ronmental liability statutes or regulations that any insured test for, monitor, clean up, remove, contain, treat, de- toxify or neutralize, or in any way respond to, or assess the effects of, "pollutants"; or (b) Claim or suit by or on behalf of a governmental authority for damages because of testing for, monitoring, cleaning up, removing, con- taining, treating, detoxifying or neutralizing or in any way responding to or assessing the effects of, "pollutants". However, this paragraph does not apply to liability for those sums the insured becomes le- gally obligated to pay as dam- ages because of "property dam- age" that the insured would have in the absence of such re- quest, demand, order or statuto- ry or regulatory requirement, or such claim or "suit" by or on be- half of a governmental authority. 2. With respect to "bodily injury" or "property damage" arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of "pollutants": a. The "Each Occurrence Limit" shown in the Declarations does not apply. b. Paragraph 7. of Limits Of Insurance (Section III) does not apply. c. Paragraph 1. of Section III — Limits Of Insurance is replaced by the following: The Limits Of Insurance shown in this endorsement, or in the Declarations and the rules below fix the most we will pay regardless of the number of: (1) Insureds; CL CG 00 20 03 07 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 5 of 6 ALIACOMP (MAK00) (b) "Property damage" to property: (i) Owned, occupied or used by, (ii) Rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by you, any of your "employees", "volunteer workers", any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability company). (2) Any person (other than your "employee" or "volunteer worker"), or any organization while acting as your real estate manager. (3) Any person or organization having proper temporary custody of your property if you die, but only: (a) With respect to liability arising out of the maintenance or use of that property; and (b) Until your legal representative has been appointed. (4) Your legal representative if you die, but only with respect to duties as such. That repre- sentative will have all your rights and duties under this Coverage Part. c. Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar in- surance available to that organization. How- ever: (1) Coverage under this provision is afforded only until the 90th day after you acquire or form the organization or the end of the pol- icy period, whichever is earlier; (2) Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and (3) Coverage B does not apply to "personal and advertising injury" arising out of an of- fense committed before you acquired or formed the organization. 2. Only with respect to liability arising out of the own- ership, maintenance or use of "covered autos": a. You are an insured. b. Anyone else while using with your permission a "covered auto" you own, hire or borrow is also an insured except: (1) The owner or anyone else from whom you hire or borrow a "covered auto". This excep- tion does not apply if the "covered auto" is a trailer or semitrailer connected to a "cov- ered auto" you own. (2) Your "employee" if the "covered auto" is owned by that "employee" or a member of his or her household. (3) Someone using a "covered auto" while he or she is working in a business of selling, servicing, repairing, parking or storing "autos" unless that business is yours. (4) Anyone other than your "employees", part- ners (if you are a partnership), members (if you are a limited liability company), or a lessee or borrower or any of their "employ- ees", while moving property to or from a "covered auto". (5) A partner (if you are a partnership), or a member (if you are a limited liability com- pany) for a "covered auto" owned by him or her or a member of his or her household. (6) "Employees" with respect to "bodily injury" to any fellow "employee" of the insured aris- ing out of and in the course of the fellow "employee's" employment or while perform- ing duties related to the conduct of your business. c. Anyone liable for the conduct of an insured described above is also an insured, but only to the extent of that liability. 3. Any additional insured under any policy of "under- lying insurance" will automatically be an insured under this insurance. If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance required by the contract, less any amounts payable by any "underlying insur- ance". Additional insured coverage provided by this in- surance will not be broader than coverage pro- vided by the "underlying insurance". No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. Page 10of17 © ISO Properties, Inc., 2007 CU 00 01 12 07 ❑ I U o` 12 ALIACOMP (MAK00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PER LOCATION, PER PROJECT AND PRODUCTS -COMPLETED OPERATIONS AGGREGATE LIMITS OF INSURANCE This endorsement modifies insurance provided under the following COMMERCIAL LIABILITY UMBRELLA COVERAGE PART Section III — Limits Of Insurance is replaced by the 3. The Products -Completed Operations Aggregate following: Limit shown in the Declarations of this policy is 1. The Limits Of Insurance shown in the Declara- the most we will pay for the sum of all "ultimate tions and the Schedule of this endorsement, and net loss" under Coverage A for damages e- he following rules fix the most we will pay re- cause of "bodily injury" and "property damage" the to of the number of: included in the 'products -completed operations hazard". a. Insureds; b. Claims made, "suits" brought, or number of vehicles involved; or c. Persons or organizations making claims or bringing "suits". 2. The Aggregate Limit is the most we will pay for the sum of all "ultimate net loss" under: Coverage A, except "ultimate net loss" be- cause of "bodily injury" or "property dam- age": (1) Arising out of the ownership, mainte- nance or use of a "covered auto'; or (2) Included in the "products - completed operations hazard"; and b. Coverage B. The Aggregate Limit applies separately to each of your: (1) Projects away from premises owned by or rented to you, and (2) "Locations" owned by or rented to you. Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad. 4. Subject to Paragraph 2. or 3. above, whichever applies, the Each Occurrence Limit is the most we will pay for the sum of all "ultimate net loss" under Coverage A because of all "bodily injury" and "property damage" arising out of any one "occurrence". 5. Subject to Paragraph 2. above, the Personal and Advertising Injury Limit is the most we will pay under Coverage B for the sum of all "ulti- mate net loss" because of all "personal and ad- vertising injury" sustained by any one person or organization. The Aggregate Limits, as described in Paragraphs 2. and 3. above, apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the policy period is extended after issuance for an addi- tional period of less than 12 months. In that case, the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. CL CU 24 05 06 08 Includes copyrighted material of Insurance Services Offices, Inc., with its permission Page 1 of 1 I I 12 ALIACOMP (MAK00) POLICY NUMBER: COMMERCIAL LIABILITY UMBRELLA CU 24 03 09 00 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL LIABILITY UMBRELLA COVERAGE PART SCHEDULE Name Of Person Or Organization: (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The Transfer Of Rights Of Recovery Against Others To Us Condition under Section IV — Conditions is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the ''products -completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CU 24 03 09 00 Copyright, Insurance Services Office, Inc., 2000 Page 1 of 1 ❑ ALIACONAP (MAK00) CITY OF RENTON PUBLIC WORKS DEPARTMENT toA fwk rs NORTH j•�� � � G r i. n 4i u :; .+�s.�rs� Y G f q C% ',ir;�+j rl►ji� E.,.q.FF� 173 rw _._ , _ _- i� • �. _ i.•� ;may ' �w 1 - T c `wa.•. ?_ �t - _ 1 f q• f /f z w Fes, - wh � . •M{,�%`_ - . �+ � __ � ?ice_ �i � / �'� - � a. � — +••, .� t.. i• � �r. G I � w • T 'ter , r '- --�1�yww�. • I1 -R . 1 �r� - ' �., -r 'ra•-.a. F-_' R;=Lot it i r1+Za �� .:y r � vim. ��. �. � � �, - � �.. � � ' � - ( •M � f (i �� +k1' _' ® f -IL AL y- --�1 �� - A"�•,. : � �� : r„ � - i � jib.` • j i � �+►!� � `?��1- it ` � 1 � / iJ J• _� � _! �' i � ...r, ' t' ,.-.�•` - --- - -- iF' •: - .N ' - k ROAD DETOUR DETOUR CLOSED DETOUR END AhE,;D AHEAD ♦� ♦ DETOURIf ook rL +%"fj fit ^� ` .1 '�•• ' ` :�' -1 ' .. Ir` r-+�T- �... ` f t ` ' - 11 iIML3 4 "AYES 4• • ,, � Y • �I.S�iNSf.iSCFM1'IMI� ;� r +d i } • - i� f •�� § CLOSE LY F.ra J i ROAD CLOSED ROAD r THRU TraFFlC aOSED a _law MOW 240 HGA COWS THIS PLAN HAS BEEN PREPARED TO CONVEY THE INTENT OF THE CITY R rMill TO DETOUR TRAFFIC DURING WATER MAIN CONSTRUCTION AND IS NOT ,, 6 INTENTED AS A COMPLETE TRAFFIC CONTROL PLAN. THE CONTRACTOR " / ' A' 1 �� NOTE: SHALL PREPARE A DETAILED TRAFFIC CONTROL PLAN AND SUBMIT TO POLICE OFFICERS AND/OR STATE CERTIFIED THE CITY FOR APPROVAL PRIOR TO CONSTRUCTION. THE APPROVED r" 4 _ FLAGGERS SHALL BE UTILIZED AS REQUIRED TRAFFIC CONTROL PLAN MAY BE REVISED BY THE CONTRACTOR WITH ' r IN ACCORDANCE WITH MANUAL ON UNIFORM CITY APPROVAL AS WORK PROGRESSES. ;d TRAFFIC CONTROL DEVICES (MUTCD). MAIN AVE. S - WATER MAIN REPLACEMENT DATE: 03/14/11 SHEET: 1.0 �► CITY OF RENTON PUBLIC WORKS DEPARTMENT 7 Oulu 01 Lar ?► NORTH 6-4 + y • ' E • ' `"� *t • of . i � J{ .. � _ _ 1 � , v � / :�'� . �3 wan Ilk _ .:••1 It a li � - � ;! • Pit- #[ h ''.tee' — _ r 014 "._-7�'' '� � per` .t ram`.. C�L � _ �� 4 {•- •• � ��i� ji, t �' ~l`4ot----1 , ' � � ~ CLOSED DETOUR DETOURDETOUR DETOUR # I }' : + 17 AHEAD ftL ri O� OO ( U - M f^ a DETOUR END �s ` „ r s - ,1i+� �, • ► t LEFT LANE DETOUR y - 1 5 O � t § ffT.S4MSf.{S(iGUlY61 .� 1 CLOSE r L O i .> n a•d 0 5 ROAD RQAD 11 11 CLOSED CL06® 1=4� RAGGS O r — . . s+lolw�ImlEs THIS PLAN HAS BEEN PREPARED TO CONVEY THE INTENT OF THE CITY Town O TO DETOUR TRAFFIC DURING WATER MAIN CONSTRUCTION AND IS NOT INTENTED AS A COMPLETE TRAFFIC CONTROL PLAN. THE CONTRACTOR NOTE: ' 1 SHALL PREPARE A DETAILED TRAFFIC CONTROL PLAN AND SUBMIT TO POLICE OFFICERS AND/OR STATE CERTIFIED THE CITY FOR APPROVAL PRIOR TO CONSTRUCTION. THE APPROVED FLAGGERS SHALL BE UTILIZED AS REQUIRED o TRAFFIC CONTROL PLAN MAY BE REVISED BY THE CONTRACTOR WITH IN ACCORDANCE WITH MANUAL ON UNIFORM - � CITY APPROVAL AS WORK PROGRESSES. TRAFFIC CONTROL DEVICES (MUTCD). MAIN AVE. S - WATER MAIN REPLACEMENT DATE: 03/14/11 SHEET: 2.0