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Home My WebLink AboutAdden 1CAG-20-012, Adden #1-21 (approved via email from Cheryl Beyer) Last updated: January 1, 2020 Winter 2021 COVID-19 Operational Plan First Tee Greater Seattle Guidelines to ensure the safety & health of youth, adults, and the community. 'ͲϮϬͲϬϭϮŵĞŶĚŵĞŶƚηϭy,//dͲϭ͘ϭ Guiding Principles Children should only attend programs in their local, geographic area. The more people interact with others from outside their own household, the closer that interaction, and the longer that interaction, the higher the risk of COVID-19 spread. Families who are able to keep their children and youth home should continue to do so as much as possible, but the value of positive youth development is significant enough for many to spend some time away from home and in carefully managed learning environments. Preface For the sake of this document: All First Tee representatives on-site and involved in programming are referred to as “coaches,” whether they are full-time staff, part-time staff, adult volunteers, interns, or junior coaches. All player engaged in the learning environment are referred to as “players.” All procedures are based on the most recent guidelines provided by local government and its agencies. This includes, but not limited to: Washington State, King County, and its cities, U.S. Centers for Disease Control, Washington State Department of Health, and the Washington Office of the Superintendent of Public Instruction. Guidance is subject to change, and based on the applicable jurisdiction(s), so this remains a living document. Planning & Program Structure Staffing & Training Pre-season training provided for all coaches. Documentation and guidelines are shared with all coaches. Virtual workshop is held to provide training and preparation, and is recorded for those not able to attend. In-person trainings are provided for small groups so that coaches can practice all aspects of program management. Communication throughout the programming season is maintained to respond to questions and provide solutions. Coaches indicate full understanding of importance and details of virus prevention procedures, and agree to adhere to and execute them. Coaches should be in good personal health before the season begins, and regular testing is encouraged. Registration for programs is all online. No paper or in-person registrations are allowed. Pre-season orientations are conducted online and/or small groups. Player materials (e.g., yardage book, bag tag, membership card) are made available as a “grab and go” procedure at the end of the first class. Class times All class times are one hour (60 minutes), including the higher levels of the program that are typically two, three or four hours in length. Shorter visit times reduce transmission risk. All classes have between 30 and 60 minutes in between, increased from between 0 and 30 minutes. This ensures that consecutive groups do not overlap, so only one group is present at a time. It is also ample time for coaches to clean, sanitize and disinfect the learning environment and materials as needed, as well as for them to take a break, wash their hands thoroughly, and be prepared for the next class. Group characteristics TARGET level (age 5 & 6) is not available. Minimum age is 7, and the majority of players are returning from previous seasons. While this limits our ability to introduce new youth to the game and the program, the higher average age and familiarity with the program makes managing behavior more predictable. Group sizes Every person counts toward group size, including coaches & players. Suggested class structures: ● Scenario 1: groups at 5 or fewer individuals: ○ 4 players, 1 coach ● Scenario 2: groups at 10 or fewer individuals: ○ 8 players, 2 coaches ○ 6 players, 3 coaches ● Scenario 3: groups at 50 or fewer individuals: ○ Standard class sizes (12-18) ○ Smaller class sizes (6-10) Eliminate hard copy materials whenever possible. Weekly assignments have been made electronic via Google Classroom, so no hard copy assignments will be handed out. Facilities Ensure that adequate space is available and designated for program use. If space is not reserved and reliable, groups will have more difficulty controlling the safety of their learning environment. Remove hard-to-clean items from classrooms and learning areas. Everything that is touched needs to be sanitized, so only have out what you need for the day. For items not needed on a regular basis, put in cabinets or storage. Organize materials, supplies and equipment in secure compartments, and lock when possible. Virus Prevention Procedures Health and safety screening for coaches & players: Check temperature (over 100.4°F is considered a fever). Screening questions: Has medication been used to lower temperature? Has person recently been exposed to or in close contact with anyone who has confirmed or suspected COVID-19 infection? Is person awaiting test results from the last 14 days? Has person had any of the following symptoms in the past 3 days: cough, shortness of breath or difficulty breathing, fever of 100.4°F, sore throat, chills, new loss of taste or smell, muscle or body aches, nausea/vomiting/diarrhea, congestion/runny nose, or unusual fat igue. If any of the above conditions are true, person cannot participate and must remain inactive until at least 3 days since fever or symptoms were last seen and at least 10 days since symptoms first appeared. Routine Measures: Hygiene Practices Hand sanitizer and extra facial coverings are made regularly available. Coaches will wear facial coverings when in the presence of and in close proximity to others during programming time. While wearing facial coverings, physical distancing should still be observed. Facial coverings for players is recommended, but not required. Adequate handwashing facilities are available on-site. All coaches and players are encouraged to wash hands thoroughly and frequently. Hands should be washed with soap and water for at least 20 seconds. Coaches should wash hands before and after every class. Coaches and players should avoid touching their eyes, nose and mouth with unwashed hands. Coughs and sneezes are covered with a tissue, which is then thrown away. If a tissue is not available, one should cover with their clothing, or cough or sneeze into their mask. After coughing or sneezing, hands should be washed or sanitized. Physical Distancing Six feet of distance is kept between all individuals, at all times. Physical contact is avoided at all times, and unless emergency care is necessary. High-fives and handshakes should be replaced with non-contact alternatives, such as a tip of the hat, wave, or nod. Utilize outdoor and well-ventilated areas as much as possible. Where the use of a door is unavoidable, try to leave the door propped in an open position. Where the use of a door (and room) can be avoided, try to keep door closed and locked. Program Specifics: Only disinfected equipment is used, and classes avoid the sharing of equipment and materials as much as possible. Starting with the check-in area, and to include all learning stations, setup allows for and encourages at least six feet of distance between players. Each activity station will typically be set up for four players: Two hitting stations, six feet or more apart, and two safety zones, six feet or more behind each hitting station, OR Four hitting stations, each six feet or more apart. Golf instruction should always be given from at least six feet away. Coaches may use modeling, demonstration, and verbal cues to guide players, but avoid physical contact or close proximity. Golf balls are not to be shared and touched by multiple players. Either: Certain golf balls are designated (e.g., by color) to each player in the group, and are only used by that player, or Golf balls are shared among the group, but never touched. All golf balls are soaked in a “bleach bucket” between classes, so that they are fully disinfected before the next use. Golf clubs shall never be shared by multiple players in the same class. Golf clubs owned by each player should be their primary club. If a player does not have the club they need for an activity, they may only borrow from First Tee inventory, and not each other. Golf clubs in First Tee inventory are disinfected after each use, and only disinfected clubs are made available to borrow. Golf tees are not to be shared during class. Used tees are either kept by the user or disinfected between classes. Teeing up golf balls by coaches should be avoided. Players should tee up their own golf balls whenever possible. Driving range use requires the distribution of golf balls by basket from the machine to trays. Only coaches will distribute golf balls. If golf cups on the course are not modified for minimal contact, then a “gimme circle” should be designated so that putts do not need to be holed. Maximum group size is 10, including coaches and players, but preferred group size is 5. Group size should never exceed the current guidelines provided by local governmental agencies. Different groups or individuals shall not be mixed or commingled. No time is designated for meals and snacks during First Tee programming. If a player chooses or needs to consume snacks during class, they must bring and dispose of those on their own and away from others, but within range of supervision. Coaches are provided with one full hour break between classes to ensure proper pick-up of players, wash their hands, reset and disinfect equipment as necessary, take breaks, and then prepare for next class and ensure proper drop- off of the next group of players. During breaks, coaches should follow proper distancing and hygiene measures to avoid transmission of the virus. Parents and Families: Parents and family members of players should drop off their children and either exit the learning environment. If parents and family members remain on property during class, they must stay well outside of the learning environment. If a parent must be present with their child during programming, due to special needs or for medical reasons, then that parent must be designated as a coach and counted toward the group size. Drop-off & Pick-up: Youth are dropped off and picked up curbside, and parents and families are encouraged to avoid getting out of the car. One coach is assigned to greet families curbside and direct players to their check-in location. Health screenings are conducted at drop-off, and prior to check-in. At the end of class, players are directed to the “pick-up” zone, which is curbside and in the same place as “drop-off”. Check-in process Upon drop-off, players are independent of families and proceed on their own to the check-in table. Check-in process is brisk and designed for players to pass through quickly on their way to the first learning station. Check-in table has only the following items to physically interact with: hand sanitizer, masks, and pre-printed nametags for players to peel and stick to their shirt. Coaches manage the player roster and mark attendance. Six feet of distance is marked by flags or cones, in the event that a short line forms at the check-in table. Players should arrive at or near class start time and follow instructions from their coaches to the learning area. Make-up classes are not allowed. Players must only attend the class time they are registered for, to ensure group sizes remain the same. Equipment use Avoid sharing of equipment or materials. Any sharing necessitates sanitization between uses. Players are provided with a golf club of their own at the beginning of the season so that sharing is not necessary. Keep track of all equipment and materials used on a daily basis, so it can be sanitized after use. Rotate equipment shared or used during programming, so there is adequate time for equipment to be cleaned and sanitized. Cleaning and Disinfecting Procedures Cleaning removes germs, dirt, food, bodily fluids, and other material. Cleaning increases the benefit of sanitizing or disinfecting. Sanitizing reduces germs on surfaces to levels that are safe. Disinfecting kills germs on surfaces of a clean object. Shared areas and materials should be cleaned, sanitized and disinfected as often as possible. At least once between classes and at the end of each day. During the cleaning, sanitizing and disinfecting process, players or any children should not be present. Windows and doors should be opened in indoor areas for ventilation. Bleach solution: 1/3 cup (5 tbsp) bleach per gallon of water. Coaches should wear facial covering and gloves during all sanitization procedures, after which point gloves should be discarded and masks discarded or sanitized. Disinfecting solution should be left wet on surface for at least 10 minutes. Coaches should also wear eye protection if chemicals are being sprayed. If masks and eye protection are not available, chemicals should be applied with a rag or towel, rather than being sprayed. Surfaces (tables, countertops, desks, floors, toilets, sinks): First, clean with standard soap or detergent and water. Once cleaned, surface is disinfected with bleach solution. For porous surfaces (carpets, floors, drapes): vacuum, then clean using a washing machine at the hottest water setting. Equipment, chairs, office equipment, and any other items: All items fully sanitized with bleach solution. Computers wiped down with rubbing alcohol (not Clorox/Lysol). For porous or cloth/fabric items, use a washing machine at the highest possible setting. Towels, clothing, linens (and other items that are laundered): If possible, do not shake laundry, to prevent dispersion of virus. Launder items at the hottest water setting (within tag instructions). Clean and disinfect any hampers or laundry baskets as a “surface”. Troubleshooting When should someone stay home? If any of the Health & Screening guidelines above or not met. If the person is unable to comply with guidelines for any reason. People who are at a higher risk may choose to stay home, including those: age 60+, with weakened immune systems, who are pregnant, and those with underlying health conditions including cancer, heart disease, lung disease, or diabetes. What if a coach or player does not pass the screening? Those who do not pass the screening are not permitted to participate, and must return home. It is recommended to that person or family that they monitor symptoms and see a doctor if serious or infection is suspected. What if a player passes the health and safety screening, but then shows symptoms during class? The person should be separated from the group, maintaining at least six feet of space from others and preferably more. They should also be asked to wear a mask if not already wearing one. If the person is a player, they should be supervised. If the person is a coach, then another coach should take their place. The coach taking their place should be following all guidelines, including wearing a facial covering and having washed their hands. When can an individual who exhibited symptoms return to the program? When at least three full days have passed since recovery (no fever, no use of medication, and improvement in respiratory effects), AND 10 days have passed since symptoms first appeared. What if a player does not comply with the guidelines? A “three strike” process will be in place. 1) Strike 1: Warning. Revisit the expectations with the player, and obtain their agreement to follow them going forward. 2) Strike 2: Sit out. Ask the player to remove themselves from the learning environment, either still within supervised area of coach or under supervision of another coach or family member. After class, make immediate contact with a parent or guardian in person or by phone. Report the incident to the Program Director. 3) Strike 3: Withdrawal: Follow steps in Strike 2, informing parent or guardian that their season enrollment will be cancelled and fee will be refunded. How do we provide first aid or medical care while maintaining proper distancing? In the event that medical care is required, that is first priority. While the coach should not hesitate to follow First Aid & CPR procedures, including Check, Call & Care, they should first put on a face mask and disposable gloves. What if there’s an emergency, and evacuation procedures require us to gather in a smaller space or larger group? In the event of emergency, where evacuation is necessary, the immediate physical safety of individuals and the group is first priority. Coaches should ensure that is taken care of, and then try to ensure COVID-19 prevention procedures are followed as possible. Supplies On-Hand Disinfectant spray Spray bottles Hand sanitizer Cloth or paper towels Bleach (and water) Rubbing alcohol (90%) Buckets/receptacles Thermometers Disposable gloves Face masks Eye protection (eye glasses/sunglasses) Contacts Public Health Phone Number: (206) 296-4600 King County Health Department: (206) 477-8000 First Tee Greater Seattle Office: (206) 762-2334 Dan Wartelle, Executive Director, First Tee Greater Seattle: (206) 795-0965 Evan Johnsen, Program Director, First Tee Greater Seattle: (425) 503-4851 Resources (COVID-19) CDC Guidelines OSHA Guidelines WA OSPI Guidelines & Resources WSDOH Workplace & Employer Resources & Recommendations Back2Golf Operations Playbook 2.0 (PGA of America) Safe Start Washington: A Phased Approach to Recovery WSDOH Schools & Child Care Guidance Contact Us information@thefirstteeseattle.org (206) 762-2334 www.firstteeseattle.org Mailing Address: PO Box 31020 Seattle, WA 98103 Physical Address: 4101 Beacon Ave S Seattle, WA 98108 1 | P a g e GOLF RESTART, PHASE 2 COVID-19 REQUIREMENTS AND RECOMMENDATIONS All golf courses have a general obligation to keep a safe and healthy facility in accordance with state and federal law. They must also comply with the following COVID-19 worksite-specific safety practices, as outlined in Gov. Jay Inslee’s “Stay Home, Stay Healthy” Proclamation 20-25, and in accordance with the Washington State Department of Labor and Industries General Coronavirus Prevention Under Stay Home-Stay Healthy Order (DOSH Directive 1.70: https://www.lni.wa.gov/safety-health/safety-rules/enforcement-policies/DD170.pdf) and the Washington State Department of Health Workplace and Employer Resources & Recommendations at https://www.doh.wa.gov/Coronavirus/workplace. Golf courses should stay updated on advice from the National Golf Course Owners Association (NGCOA) “Park and Play” program -https://www.ngcoa.org/info-centers/covid19/park-and- play-program. Golf is widely seen as an activity that is viable and relatively low risk, however there are additional precautions that need to be in place to ensure the safety of players, golf course staff and club/course officials. In order to operate, the following requirements must be implemented at golf courses. UPDATES FROM PHASE 1 Section 3 now allows unrestricted golf groups. Section 15 requires the use of social media to disseminate Phase 2 guidance. Section 25 adds new language concerning practice facilities. Section 26 adds new language concerning guest supplies. Section 27 now allows in-clubhouse pro shops to operate in accordance with this document and standalone pro shops to operate in accordance with Phase 2 Curbside Retail Guidance. Section 28 now allows food service to operate in accordance with Phase 2 Restaurant and Tavern Guidance. Section 29 now allows for limited caddying. Section 30 now allows for limited use of locker rooms. Section 31 now allows junior golf events to resume with under five attendees. Section 32 now allows for curbside club service. Section 33 now permits tournaments to resume without giving rise to gatherings. &$*$PHQGPHQW(;+,%,7$ 2 | P a g e PHASE 2 Golf Operations (These items will be assessed, and potentially modified, on a weekly basis.) Any course planning to reopen under Phase 2 must comply with the following: 1. Utilize on-line or phone tee time reservation systems to pre-pay and limit interactions, and restrict payments to credit cards only to eliminate the handling of cash. 2. Maintain a log of all customers, including contact information. For purposes of this log, customers are not obligated to provide their information, and the business should not condition service on a customer’s willingness to do so. 3. Normal golf groups are permitted, although strict social distancing from members in other households is still required. Any additional restrictions will vary by locality. 4. Restrict play to one rider per power cart, unless all riders are from the same household. 5. Regularly sanitize counter tops, door knobs, other common surfaces, range buckets, golf carts, push carts, cash registers, score posting kiosks, and other frequently touched surfaces including employee used equipment. 6. Ensure that the flagstick remains in at all times. Players will be educated to avoid touching the flagstick for any reason. 7. Be creative with cup liners to avoid having players reaching into the hole to retrieve golf balls, such as installing cups upside down or partly above ground. 8. Eliminate cups and holes on practice greens. 9. Discontinue club and equipment rentals. 10. Outdoor golf course driving ranges and practice areas, as well as standalone driving ranges, are functionally equivalent to golf courses and may be utilized if the operation meets the same standards that apply to golf courses. Operators must ensure their procedures incorporate the safety measures set forth in this document. 11. Remove bunker rakes and other on-course furniture like benches, ball washers, water coolers, etc. 12. On-course garbage cans are permitted. Lids must be removed to avoid any physical contact with the receptacle. 13. Modify driving range hitting areas to ensure a minimum 10-foot separation between players. 14. Install signage to discourage group congregation, or to limit numbers of people in a certain area of the club or pro shop. Golfers will be reminded to be especially mindful of 3 | P a g e social distancing in the parking lot, and around tees and greens. 15. Place appropriate signage outside the pro shop and clubhouse plus at the first tee entries briefly outlining the social distancing guidelines in place. Use social media to outline Phase 2 requirements. 16. Keep up to date on all changes that are happening daily. 17. Marshall the course to ensure physical distancing by reminding golfers, and where necessary, warning repeat offenders. 18. Ask golfers to leave the golf course immediately after playing to eliminate congestion/gathering on the property or in the parking lot. Other Facility Operations 19. Increase the number of hand sanitizing stations throughout the clubhouse area and check- in areas. 20. Restrict access where unauthorized visitors may enter, most specifically “back of the house” doors and entry points. 21. Increase frequency of HVAC system filter changing. 22. Ensure restrooms are frequently cleaned and appropriately sanitized throughout the day. 23. Eliminate sit-down food and beverage services, and recommend customers use pre-order “take-out” or “to go” services only. Consider offering cart-to-cart delivery if feasible. 24. Outdoor lessons are permitted as long as the instructor and student(s) follow the safety measures set forth in this document. Small group clinics are permitted based upon the practice facility space available to ensure social distancing. 25. Indoor practice facilities may be open practicing strict social distancing. Facilities must implement practice ball sanitation protocols. 26. Guest supplies (scorecards, tees, pencils) will be made available in sanitized bags upon request. Water may be available on the course in sealed bags. 27. Golf shops within a clubhouse where golfers purchase rounds may sell other products. Standalone golf or pro shops must operate in accordance with Phase 2 retail guidance. 28. Clubhouses, beverage carts, and halfway houses may operate in accordance with Phase 2 restaurant guidance. 29. Caddies are permitted subject to other rules in this document regarding golf carts and social distancing. 4 | P a g e 30. Locker rooms are available for limited use, including restrooms, changing rooms, and assigned lockers. Course staff must ensure social distancing in the locker rooms and must sanitize the area every hour of operation. Showers, towel services, and similar amenities are not permitted. 31. Junior golf may resume with less than five people at an event. 32. Limited curbside club and equipment service is available. Curbside staff must follow the social distancing and PPE guidelines provided for throughout this and other workplace regulations. Club storage is not available. 33. For golf tournaments, as long as an event organizer can have protocols in place to ensure no large gatherings (ex. scoreboard area, clubhouse, registration, etc.), organizations can conduct a golf event. Any event must comply with all other provisions of this document. The tournament must be conducted via normal tee times. Shotgun starts are prohibited. Employee Safety and Health 34. Ensure operations follow L&I requirements to protect workers, including: x Maintain minimum six-foot separation between staff and customers in all interactions. When strict social distancing is not feasible for a specific task, other prevention measures are required, such as use of barriers, personal protective equipment or other acceptable protection. x Ensure frequent and adequate hand washing. Use gloves when possible (if not disposal, then ensure they are regularly washed). x Make sure sick employees stay home or go home if they feel or appear sick, identify and isolate workers who exhibit signs or symptoms of COVID-19 illness, and follow cleaning guidelines set by the CDC to deep clean after reports of an employee with suspected or confirmed COVID-19 illness. x Educate workers in the language they understand best about coronavirus and how to prevent transmission. x See the L&I Coronavirus (COVID-19) Prevention: General Requirements and Prevention Ideas for Workplaces for more information. No golf course may operate until they can meet and maintain all the requirements in this document, including providing materials, schedules and equipment required to comply. x All issues regarding worker safety and health are subject to enforcement action under L&I’s Division of Occupational Safety and Health (DOSH). Workplace safety and health complaints may be submitted to the L&I Call Center: (1-800-423-7233) or via e-mail to adag235@lni.wa.gov. 5 | P a g e x General questions about how to comply with safety practices can be submitted to the state’s Business Response Center at https://app.smartsheet.com/b/form/2562f1caf5814c46a6bf163762263aa5. x All other violations related to Proclamation 20-25 can be submitted at https://bit.ly/covid-compliance. Updated May 27, 2020 To request this document in another format, call 1-800-525-0127. Deaf or hard of hearing customers, please call 711 (Washington Relay) or email civil.rights@doh.wa.gov. 1 Child Care, Youth Development, and Summer Day Camps During the Covid-19 Outbreak Many parents and guardians need child care for children birth t hrough school-age, as well as youth development opportunities for children age 13 through high school. As Washington State progresses through the phases of reopening, more families will return to work. This means the availability of care and youth development opportunities are critical as we move through the summer. In order to reduce the risk of virus transmission between children, youth, and staff; businesses, non-profits, cities, counties, and other entities planning for summer 2020 should use this guidance for all programs serving groups of children and youth from multiple households. Authorization to open specific types of programs is governed by Governor Inslee’s Safe Start Washington Recovery Plan and the ongoing guidance issued under the Plan. In keeping with the public health approach, it is anticipated t hat this guidance will be in effect through the summer months. This guidance focuses on practices for children and youth activities that lower the risk for spread of COVID-19. x The more people interact with others from outside their own household, the closer that interaction, and the longer that interaction, the higher the risk of COVID-19 spread. x Families who are able to safely keep their children and youth home should continue to do so, but we understand this is not always possible. x Children should only attend programs in their local, geographic area. Program Types Included in this guide: x DCYF licensed programs and the Early Childhood Education and Assistance Program (ECEAP) x Licensed-exempt programs x Day camps, including includes specialty camps like sports camps (please note: any day camp including sports related activities must also following forthcoming guidance for youth sports) x Outdoor preschool, including part day and license exempt x Youth Development programs such as activities and experiences that help youth develop social, emotional, physical, and cognitive abilities x Expanded learning opportunities, including programs for youth a fter-school and in the summer that complement academic and/or social emotional learning, such as Boys & Girls Clubs, YMCA youth development programming, other culturally-based and identify-based programs. This includes programs funded under the federal Nita M. Lowery 21st Century Community Learning Centers program. 'ͲϮϬͲϬϭϮŵĞŶĚŵĞŶƚηϭy,//dͲϭ͘ϯ Updated May 27, 2020 To request this document in another format, call 1-800-525-0127. Deaf or hard of hearing customers, please call 711 (Washington Relay) or email civil.rights@doh.wa.gov. 2 x Extended academic learning such as formal mentoring programs, t utoring-only programming, college prep x Child care, youth development and summer day camps held in K-12 facilities Not included in this guide: x Overnight Camps x Youth sports and athletics (example: leagues, recreation teams, clubs) x Activities included as part of K-12 basic education or special education programs Contents General guidance .................................................................................................................................. 3 People at High Risk for Serious Health Problems from COVID-19 .................................................. 3 Drop-Off and Pick-Up ......................................................................................................................... 3 Health Screening at Entry .................................................................................................................. 3 Reducing Transmission ......................................................................................................................... 4 Physical Distancing ............................................................................................................................. 4 Providing staff required breaks ......................................................................................................... 5 Outside Play ........................................................................................................................................ 6 Meals and Snack Time........................................................................................................................ 6 Infant and Toddler Care ..................................................................................................................... 7 Hygiene Practices ............................................................................................................................... 7 Cloth Face Coverings .......................................................................................................................... 7 Transportation .................................................................................................................................... 8 What to do if someone develops signs of COVID-19 ......................................................................... 8 Returning to a program after suspected signs of COVID-19 ........................................................... 8 Cleaning and disinfecting procedures ................................................................................................. 9 Carpets .............................................................................................................................................. 10 Ventilation ........................................................................................................................................ 10 Hands-On Materials and Equipment .............................................................................................. 10 More COVID-19 Information and Resources .................................................................................... 1 1 Updated May 27, 2020 To request this document in another format, call 1-800-525-0127. Deaf or hard of hearing customers, please call 711 (Washington Relay) or email civil.rights@doh.wa.gov. 3 General guidance Do not allow children, youth, staff, vendors, parents/guardians, or guests on-site if they: x are showing symptoms of COVID-19 . x have been in close contact* with someone who has confirmed or s uspected COVID-19 in the last 14 days. *Health care providers and EMS workers who wore proper personal protective equipment (PPE) are OK. Ensure staff are trained in health and safety protocols for your site, including how to screen for symptoms, maintain physical distance, and what to do if someone develops signs of COVID-19. Communicate regularly with families and staff, and emphasize the importance of staying home when sick, physical distancing, hand hygiene, as well as the use of cloth face coverings when appropriate. Monitor child and employee attendance and absences, have flexible leave policies and practices, and have access to trained substitutes to support employee absences. People at High Risk for Serious Health Problems from COVID-19 Those at high risk* for health problems from COVID-19 should consult with their health care provider when considering whether to provide or participate in child care, youth development opportunities, or summer day camps. Drop-Off and Pick-Up • Develop a system for drop off and pick up that keeps families physically distant from each other and reduces the need for families to enter the program space. This may include staggering drop off and pick up times for various groups, one-w ay traffic flows, greeting children and youth at their vehicle, or placing distancing markers on walkways. • Wash hands or use hand gel before and after signing in and out. If you can, place hand gel near sign-in station. Hand gel should be at least 60% alcohol, fragrance-free whenever possible, and kept out of the reach of children. • Parents should use their own pen when signing in. If check-in is electronic, provide alcohol wipes with 70% alcohol to clean screens or keyboards often. • Monitor child and employee attendance and absences, have flexible leave policies and practices, and have access to trained substitutes to support employee absences. • Suggest families have the same adult drop off and pick up the child each day and avoid carpooling when possible. Health Screening at Entry Check for signs of being sick for all staff, children, and yout h at entry each day. Ask the parent or guardian to take the child’s temperature at home, or on site in front of you, at least 6 feet away. At drop-off and pick-up times with the child’s family, ke ep at least a 6-foot distance. Updated May 27, 2020 To request this document in another format, call 1-800-525-0127. Deaf or hard of hearing customers, please call 711 (Washington Relay) or email civil.rights@doh.wa.gov. 4 For more information or options for temperature checking, see the CDC guidance. Staff, children, or youth sick with any illness must stay home. Ask the parents or guardians the following questions: x Does your child/youth have any of the following symptoms [on the first day for a new program or for a new child/youth, please ask about symptoms in the past 3 days (72 hours)]: o A cough o Shortness of breath or difficulty breathing o A fever of 100.4°F or higher or a sense of having a fever o A sore throat o Chills o New loss of taste or smell o Muscle or body aches o Nausea/vomiting/diarrhea o Congestion/running nose – not related to seasonal allergies o Unusual fatigue x Does anyone in your household have any of the above symptoms? x Has your child/youth been in close contact with anyone with suspected or confirmed COVID-19? x Has your child/youth had any medication to reduce a fever befor e coming to care? Do not care for the child or youth if the answer to any of the above questions is “yes.” Refer to “Returning to a site after suspected COVID-19 symptoms” below. If the answer to all of the above questions is “no”, check the child for signs of being sick, such as flushed cheeks, tiredness, and in the case of infants and toddlers, extreme fussiness. Keep a distance of at least 6 feet of space or have a physical barrier between you and the child or youth during assessment. Reducing Transmission Physical Distancing Keep children and youth in small groups with dedicated staff. Group sizes should total no more than 10 people. This includes all children, youth, and adults. For example, one adult and nine children or youth or two adults and eight children or youth. Keep each group together throughout the day. Do not combine groups, including at opening and closing, and keep staffing the same within each group every day. If you can, keep the same groups from day to day to reduce the number of children, youth and staff from multiple households who are interacting. See section below on providing staff required breaks for more information. Updated May 27, 2020 To request this document in another format, call 1-800-525-0127. Deaf or hard of hearing customers, please call 711 (Washington Relay) or email civil.rights@doh.wa.gov. 5 To allow physical distancing between people in the small groups, limit each room or space to 10 people total. You can divide large spaces (like full-size gyms or cafeterias) into separate program areas by creating a barrier with equipment such as cones, chairs, or tables to maintain 6 feet between groups. Practice physical distancing (6 feet) within each group as much as possible. Create space between children and youth and reduce the amount of time childr en and youth are close with each other. Your ability to do this will depend on ages; it will be more possible with school age children and will be challenging with toddlers and preschoolers. Practical tips to maintain physical distancing: • Limit the number of children and youth in each program space. • Increase the distance between children and youth during table w ork and meals. • Plan activities that do not need close physical contact. Any/all sports-related activities must follow forthcoming guidance on youth sports. Until this guidance is released, such activities must be low risk, no contact, and focus on individual skill building versus competition. • Children and youth should have their own set of items to limit sharing of supplies, equipment, etc. • Remove any items that cannot easily be cleaned and disinfected, including sand or water tables, stuffed animals, and play dough. • Maintain 6 feet of distance and reduce time standing in lines. • Increase space between cribs and nap mats to 6 feet if you can. Sleeping head to toe can help increase distance between heads for napping children. • Increase fresh air as much as possible – through the ventilation system and/or opening windows where safe. • Go outside more. • Do not bring separate groups together for activities or other reasons. Providing staff required breaks It is very important that small groups be kept consistent. This means that the staff and children and youth in each group should remain the same from day to day to prevent transmission of the virus. It is best if the staff to child ratio allows for one staff member to take a break without having to bring another individual into the small group space. For example, in a toddler room with 7 children and 2 staff, one staff could take a break and t he group would remain in ratio. If that is not possible due to staff shortages or for financial reasons, and a float person is brought into the room, these practices should be followed: x Any adult who is not a normal part of the group must wash hands immediately upon entering and upon leaving the space. Updated May 27, 2020 To request this document in another format, call 1-800-525-0127. Deaf or hard of hearing customers, please call 711 (Washington Relay) or email civil.rights@doh.wa.gov. 6 x Any person providing breaks who is not a normal part of the group must wear a cloth face covering at all times when they are in the group space. x Consider timing when bringing in adults who are not normally part of a group to minimize close interactions with children. For example, give staff their lunch break during children’s nap time so the float staff can remain 6 feet away from the children while they rest; or give 10 minute breaks when the children have just started a new, engaging activity that does not require much adult interaction; or give breaks when the group is having outside time where the risk of transmission is lower. Staff who are taking breaks should keep a physical distance of at least 6 feet from other staff. Outside Play Offer outdoor play in staggered shifts. If two or more groups are outside at the same time, they should have at least 6 feet of open space between them. Us e cones, flags, tape, or other signs to create boundaries between groups. If you can, have equipment such as balls and jump ropes for each group. Always wash hands right after outdoor play time. Do not use play structures such as climbers. Topical sunscreen can be applied when provided by the parent or guardian without a prescription or note from a licensed health care professional i f the product is regulated for over the counter use. Be familiar with the specific guidance in place for your program. Licensed providers must have annual authorization from the parent or guardian to administer sunscreen. More information for licensed providers can be found in WAC 100-300-0215(3)(iv) Topical sunscreen guidelines for other programs can be found in RCW 28A.210.280. Youth and older children can self-apply sunscreen with proper supervision . Staff applying sunscreen must wear gloves. Meals and Snack Time Provide meals and snacks in the program space and prevent large group gatherings. If you provide meals or snacks in a large lunchroom or dining hall, stagger meal times. Space children and youth as far apart as you can at the table and make sure tables are at least 6 feet apart. Consider having children and youth take their meals outside. Clean and sanitize tables before and after each group eats, and consider the use of disposable plates and meal supplies if items can’t be properly washed, rinsed, and sanitized. Eliminate family style and buffet meals, serve children and youth their snacks and meals, and ensure children and youth are not sharing food with each other. Use a washable plastic table cloth for wooden tables. The provider (not children or youth) should handle utensils and serve food to reduce spread of germs. Food should be individually plated for each child. Updated May 27, 2020 To request this document in another format, call 1-800-525-0127. Deaf or hard of hearing customers, please call 711 (Washington Relay) or email civil.rights@doh.wa.gov. 7 Infant and Toddler Care Infants and toddlers need to be held. To protect themselves, child care providers who care for infants and toddlers should wear a long-sleeved, button down, oversized shirt over their clothing and wear long hair up or tied back. Change outer clothing if body fluids from the child get on it. Change the child’s clothing if body fluids get on it. Place the soiled clothing in a plastic bag until it is washed. Wrap infants in a thin blanket when you hold them. Child care providers should wash their hands and anywhere else the child t ouched them (such as their neck or arm) after holding a child. Hygiene Practices • Wash hands often with soap and water for at least 20 seconds under running water. Children, youth, and adults should wash hands when they arrive and enter the program space, before meals or snacks, after outside time, after going to the bathroom, after diapering or helping children with toileting, after nose blowing or sneezing, and before leaving to go home. Help young children to make sure they are d oing it right. • All programs, including outdoor programs, should be in areas that have adequate handwashing facilities on site. If a program must operate where there are not sufficient facilities, temporary handwashing stations with running water must be set up. • When soap and water are not readily available, use an alcohol-based hand gel with at least 60% alcohol and preferably fragrance-free. Alcohol-based hand gel is not a substitute for handwashing when hands are dirty, after diapering or toileting, or before eating. Wash hands with soap and water as soon as possible. Per child care r ules, alcohol-based hand gels are not allowed for children under age 2. • Children, youth, families, and staff should not touch their eyes, nose, and mouth with unwashed hands. • Cover coughs or sneezes with a tissue, then throw the tissue in the trash. Clean hands with soap and water or hand gel. Cloth Face Coverings Wearing homemade cloth face coverings may help prevent the spread of COVID-19 and is encouraged for staff and older children. Your local health jurisdiction may have requirements for their use in certain settings. It is up to the program provider to establish rules for their use. See the Washington State Department of Health Guidance on Cloth Face Coverings and CDC Recommendation Regarding the Use of Cloth Face Coverings for more information. x Cloth face coverings should not be worn by children younger tha n age 2 years, anyone who has trouble breathing, or any person who is unable to remove the face covering without assistance. x Even if cloth face coverings are worn, it is important to continue to practice proper physical distancing. Updated May 27, 2020 To request this document in another format, call 1-800-525-0127. Deaf or hard of hearing customers, please call 711 (Washington Relay) or email civil.rights@doh.wa.gov. 8 Transportation Avoid transporting children or youth to the degree possible at this time. If you must provide transportation, create space between riders. For example, one rider per seat in every other row. Transportation that mixes the small groups of children should be avoided. Keep windows open to help reduce the spread of the virus. Cloth face coverings should be worn by all. Clean buses with a third party certified, fragrance-free green cleaner and microfiber cloths. Clean and disinfect handrails. Keep windows open to prevent buildup of chemicals that cause eye and respiratory problems. Per, CDC guidance, avoid activities and events such as field tr ips and special performances. What to do if someone develops signs of COVID-19 To prepare for the potential of program attendees or staff show ing symptoms while at the program, programs should have a response and communication plan in place that includes communication with staff, families, and their local health jurisdiction. If a child, youth or staff member develops signs of COVID-19 (s ee list under health screenings on page 3), separate the person away from others, with supervision at a distance of 6 feet, until the sick person can leave. While waiting to leave the program, the individual with symptoms should wear a cloth face covering or mask if tolerated. Air out and then clean and disinfect the areas the person was in after they leave. The person with symptoms should follow DOH guidance for what to do if you have symptoms for COVID-19 and have not been around anyone who has been diagnosed with COVID-19. Ask the employee or child’s parent or caregiver to inform the progr am right away if the person is diagnosed with COVID-19. If a child, youth or staff member tests positive for COVID-19, all members of the infected person’s group in the program is a close contact and should self-quarantine for 14 days. Refer to “What to do if you were potentially exposed to someone with confirmed coronavirus disease (COVID-19)?”. Returning to a program after suspected signs of COVID-19 A staff member, child, or youth who had signs of suspected or confirmed COVID-19 can return to the program when: • At least 3 days (72 hours) have passed since recovery – defined as no fever without the use of medications and improvement in respiratory signs like cough and shortness of breath; AND • At least 10 days have passed since signs first showed up. Updated May 27, 2020 To request this document in another format, call 1-800-525-0127. Deaf or hard of hearing customers, please call 711 (Washington Relay) or email civil.rights@doh.wa.gov. 9 If a person believes they have had close contact to someone with COVID-19, but they are not sick, they should watch their health for signs of fever, cough, shortness of breath, and other COVID-19 symptoms during the 14 days after the last day they were in close contact with the sick person with COVID-19. They shoul d not go to work, child care, school, or public places for 14 days. Cleaning and disinfecting procedures Clean, sanitize, and disinfect throughout the day. Follow licensing guidance, but increase how often you clean. • Cleaning removes germs, dirt, food, body fluids, and other material. Cleaning increases the benefit of sanitizing or disinfecting. • Sanitizing reduces germs on surfaces to levels that are safe. • Disinfecting kills germs on surfaces of a clean object. • The U.S. Environmental Protection Agency (EPA) regulates sanitizer and disinfectant chemicals. If you sanitize or disinfect without cleaning first, it will reduce how well these chemicals work and may leave more germs on the surface. Current guidance for cleaning and disinfection for COVID-19 from the CDC states that disinfectants should be registered by the EPA for use against the novel coronavirus. See List N: Disinfectants for Use Against SARS-CoV-2 . Disinfectants based on hydrogen peroxide or alcohol are safer. The University of Washington has a handout w ith options for safer cleaning and disinfecting products that work well against COVID-19. If you use a bleach and water mixture for disinfection, mix it at a concentration of 4 teaspoons of 6% bleach per quart of cool water or 5 tablespoons 6% bleach (1/3 cup) per gallon of cool water (1000 ppm). Thoroughly clean surfaces with soap and water and remove the soap with water before applying the bleach solution. Keep the surface wet for at least one minute. Always follow the disinfectant instructions on the label: • Use disinfectants in a ventilated space. Heavy use of disinfectant products should be done when children and youth are not present and the indoor area can air out before the program continues. • Use the proper concentration of disinfectant. • Keep the disinfectant on the surface for the required wet contact time. • Follow the product label warnings and instructions for PPE such as gloves, eye protection, and ventilation. • Keep all chemicals out of reach of children. • Programs must have a Safety Data Sheet (SDS) for each chemical used by the program. Updated May 27, 2020 To request this document in another format, call 1-800-525-0127. Deaf or hard of hearing customers, please call 711 (Washington Relay) or email civil.rights@doh.wa.gov. 10 More information about cleaning, disinfecting and choosing safer products is on the DOH COVID-19 website. If your program is in a public school building, coordinate the use of chemical products with the school maintenance staff. Clean and sanitize toys, equipment, and surfaces in the program space. Clean and disinfect high touch surfaces like doorknobs, faucet handles, check-in counters, and restrooms. Use alcohol wipes or 70% isopropyl alcohol to clean keyboards and electronics. Outdoor areas gener ally require normal routine cleaning and do not require disinfection. Wash hands after you clean. If groups of children or youth are moving from one area to another in shifts, finish cleaning before the new group enters this area. Clean and disinfect high touch surfaces each night after children and youth leave. Carpets Vacuum daily when children and youth are not present. HEPA filter equipped vacuums will help remove dust and particles. Use a blanket or towel on carpe ted floors under infants or young toddlers. For licensed child care programs, follow child care standards for how often you should shampoo the carpet (WAC 100-300-0241(11) cleaning schedules) Ventilation There is no special cleaning or disinfection for heating, ventilation, and air conditioning (HVAC) systems. Ventilation is important to have good indoor ai r quality. Offer more outside time, open windows often, and adjust the HVAC system to allow the maximum amount of outside air to enter the program space. Use of fans f or cooling is okay. They should blow away from people. Hands-On Materials and Equipment Limit shared materials to those you can easily clean, sanitize and disinfect. Clean and sanitize hands-on materials and equipment often and after each use. Individual labeled containers or bins can be used for each child or youth. Examples include sensory bins, art supplies, etc. Use separate bins of toys for each infant or toddler as they tend to put toys in their mouths. Some items cannot be cleaned and sanitized. This includes things like playdough and sensory or water tables, stuffed animals, and dress up cloths. These it ems should be removed from the program unless they are individually assigned and labeled. Rota te toys that are out at any one time, so they can be cleaned and sanitized. Books and other paper-based materials are not high risk for spreading the virus. COVID-19 Resources for Child Care, Youth Development and Summer Day Camps Updated May 27, 2020 To request this document in another format, call 1-800-525-0127. Deaf or hard of hearing customers, please call 711 (Washington Relay) or email civil.rights@doh.wa.gov. 11 • DOH: K-12 School Nurse and Administrator Resources & Recommendations • DOH: Handwashing to Prevent Illness at School • DOH: Classroom Cleaning - Tips for Teachers • DOH: Cleaning and Disinfection for Asthma Safe Schools • DOH: Recommend or Order Closure of Child Care Facilities • CDC: Interim guidance for Schools and Child Cares • CDC: Supplemental Guidance for Childcare Programs that Remain Open • CDC: Considerations for Youth and Summer Camps • Just For Kids: A Comic Exploring the New Coronavirus • Public Health Seattle-King County Child Care Recommendations • Snohomish Health District COVID-19 Information for Schools and Child Cares More COVID-19 Information and Resources Stay up-to-date on the current COVID-19 situation in Washington, Governor Inslee’s proclamations, symptoms , how it spreads , and how and when people should get tested. See our Frequently Asked Questions for more information. The risk of COVID-19 is not connected to race, ethnicity or nationality. Stigma will not help to fight the illness. Share accurate information with others to keep rumors and misinformation from spreading. x WA State Department of Health 2019 Novel Coronavirus Outbreak (COVID-19) x WA State Coronavirus Response (COVID-19) x Find Your Local Health Department or District x CDC Coronavirus (COVID-19) x Stigma Reduction Resources Have more questions about COVID-19? Call our hotline: 1-800-525-0127. For interpretative services, press # when they answer and say your language. (Open from 6 a.m. to 10 p.m.) For questions about your own health, COVID-19 testing, or testing results, please contact your health care provider. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. 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INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of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³RFFXUUHQFH´ZKLFKWDNHVSODFHZKLOH\RXDUHDWHQDQWLQWKH SUHPLVHV E 7KLVLQVXUDQFHGRHVQRWDSSO\WR³ERGLO\LQMXU\´RU³SURSHUW\GDPDJH´UHVXOWLQJIURPVWUXFWXUDO DOWHUDWLRQVQHZFRQVWUXFWLRQRUGHPROLWLRQRSHUDWLRQVSHUIRUPHGE\RURQEHKDOIRIWKHRZQHUDQG RUOHVVRURIWKHSUHPLVHV F 7KLVLQVXUDQFHGRHVQRWDSSO\WROLDELOLW\RIWKHRZQHUVDQGRUOHVVRUVIRU³ERGLO\LQMXU\´RU ³SURSHUW\GDPDJH´DULVLQJRXWRIDQ\GHVLJQGHIHFWRUVWUXFWXUDOPDLQWHQDQFHRIWKHSUHPLVHVRU ORVVFDXVHGE\DSUHPLVHVGHIHFW :LWKUHVSHFWWRDQ\DGGLWLRQDOLQVXUHGLQFOXGHGXQGHUWKLVSROLF\WKLVLQVXUDQFHGRHVQRWDSSO\WRWKH VROHQHJOLJHQFHRIVXFKDGGLWLRQDOLQVXUHG /HVVRURI/HDVHG(TXLSPHQWEXWRQO\ZLWKUHVSHFWWROLDELOLW\IRU³ERGLO\LQMXU\´³SURSHUW\GDPDJH´RU ³SHUVRQDODQGDGYHUWLVLQJLQMXU\´FDXVHGLQZKROHRULQSDUWE\\RXUPDLQWHQDQFHRSHUDWLRQRUXVHRI HTXLSPHQWOHDVHGWR\RXE\VXFKSHUVRQVRURUJDQL]DWLRQVVXEMHFWWRWKHIROORZLQJDGGLWLRQDO H[FOXVLRQV D 7KLVLQVXUDQFHGRHVQRWDSSO\WRDQ\³RFFXUUHQFH´ZKLFKWDNHVSODFHDIWHUWKHHTXLSPHQWOHDVH H[SLUHV 6SRQVRUV &R3URPRWHUV SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. 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INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY -' )XOZLOHU &R ,QVXUDQFH 6 0DFDGDP $YH 3RUWODQG 25 .LP +XWFKLQVRQ NKXWFKLQVRQ#MGIXOZLOHUFRP 3KLODGHOSKLD ,QGHPQLW\ ,QV &R 6($7-81 6HDWWOH -XQLRU *ROI )RXQGDWLRQ GED 7KH )LUVW 7HH RI *UHDWHU 6HDWWOH 32 %R[ 6HDWWOH :$ $; ; ; 3+3. $3+3. $3+3.;:$ 6723 *$3 2SHUDWLRQV RI WKH QDPHG LQVXUHG VXEMHFW WR SROLF\ SURYLVLRQV FRQGLWLRQV DQG H[FOXVLRQV 3URRI RI ,QVXUDQFH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of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³RFFXUUHQFH´ZKLFKWDNHVSODFHZKLOH\RXDUHDWHQDQWLQWKH SUHPLVHV E 7KLVLQVXUDQFHGRHVQRWDSSO\WR³ERGLO\LQMXU\´RU³SURSHUW\GDPDJH´UHVXOWLQJIURPVWUXFWXUDO DOWHUDWLRQVQHZFRQVWUXFWLRQRUGHPROLWLRQRSHUDWLRQVSHUIRUPHGE\RURQEHKDOIRIWKHRZQHUDQG RUOHVVRURIWKHSUHPLVHV F 7KLVLQVXUDQFHGRHVQRWDSSO\WROLDELOLW\RIWKHRZQHUVDQGRUOHVVRUVIRU³ERGLO\LQMXU\´RU ³SURSHUW\GDPDJH´DULVLQJRXWRIDQ\GHVLJQGHIHFWRUVWUXFWXUDOPDLQWHQDQFHRIWKHSUHPLVHVRU ORVVFDXVHGE\DSUHPLVHVGHIHFW :LWKUHVSHFWWRDQ\DGGLWLRQDOLQVXUHGLQFOXGHGXQGHUWKLVSROLF\WKLVLQVXUDQFHGRHVQRWDSSO\WRWKH VROHQHJOLJHQFHRIVXFKDGGLWLRQDOLQVXUHG /HVVRURI/HDVHG(TXLSPHQWEXWRQO\ZLWKUHVSHFWWROLDELOLW\IRU³ERGLO\LQMXU\´³SURSHUW\GDPDJH´RU ³SHUVRQDODQGDGYHUWLVLQJLQMXU\´FDXVHGLQZKROHRULQSDUWE\\RXUPDLQWHQDQFHRSHUDWLRQRUXVHRI HTXLSPHQWOHDVHGWR\RXE\VXFKSHUVRQVRURUJDQL]DWLRQVVXEMHFWWRWKHIROORZLQJDGGLWLRQDO H[FOXVLRQV D 7KLVLQVXUDQFHGRHVQRWDSSO\WRDQ\³RFFXUUHQFH´ZKLFKWDNHVSODFHDIWHUWKHHTXLSPHQWOHDVH H[SLUHV 6SRQVRUV &R3URPRWHUV SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of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o):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of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o):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. 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