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Regular Meeting Agenda 10/21/2025

Page 1


Steve Rader, Commissioner District 1

Steven L. Ferrell, Commissioner District 2

Richard R. Dahl, Commissioner District 3

Kelly Grayson, Clerk of the Board

Regular Public Meeting

October 21 , 202 5 , 9:00 a.m.

Board Meeting Convenes at 9:00 a.m.

 Invocation by Invitation

 Pledge of Allegiance

 Minutes of October 6-8 & October 13-15, 2025

 Consent Agenda of October 21, 2025

 Proclamation

 Motion Items

 Public Hearing – 9:30 a.m.

 Workshop – 10:00 a.m.

 Public Comments

o Citizen Participation may be anonymous. See RCW 42.30.040

Special Guest

 Representative Peter Abbarno Proclamation

 Resolution Proclaiming October 23-31, 2025, as Red Ribbon Week in Cowlitz County. (14433)

Consent Agenda

Call for Bids

1. Call for Bids - Camelot Large Onsite Septic System (LOSS) Project for the installation of a new 24,000-gallon concrete septic tank and associated drain field to replace the existing onsite system scheduled for November 17, 2025, at 1:30 p.m. (14418)

2. Call for Bids - for as-needed electrical services at the Headquarters Landfill scheduled for November 17, 2025, at 1:30 p.m. (14427)

Regular Public Meeting

October 21, 2025, 9:00 a.m.

3. Call for Bids - For as-needed electrical and mechanical services at the Tennant Way Landfill scheduled for November 17, 2025, at 1:30 p.m. (14428)

Agreements/Contracts/Bid Awards

4. Contract Completion Letter to Lakeside Industries for the 2025 Countywide Pavement Overlay project. The total project is $2,908,870.72. (14402)

5. Bid Award to L Rock Industries, Inc. for the purchase of snow sand. The total amount is $62,290.24. (14404)

6. Supplemental Agreement No. 1 with Otak, Inc. for the Pleasant Hill Road Temporary Bridge Replacement Project to extend the expiration date to December 31, 2027, due to a lengthy environmental review process being conducted by FEMA. (14415)

7. Contract and a Bond in Lieu of Retainage with Advanced Excavating Specialists, LLC for an Emergency to Repair a Collapsed Storm Drain on Sweet Birch Drive. (14420)

8. Amendment No. 1 to the Personal Services Agreement with Appraisal and Consulting Group for Appraisal Services for Various Public Works Projects to Extend the Contract through December 31, 2026. (14423)

9. Amendment No. 1 to the Material Sales Agreement with JL Storedahl & Sons for the removal of dredged materials to update the name change to JLS Newco, LLC, to extend to December 31, 2026, and to increase the minimum quantity to be removed to 175,000 cubic yards. (14430)

10. Amendment One to the Interlocal Grant Agreement with the City of Longview for the Minit Valley Pro Golf Shop Roof and Siding Replacement to extend the end date of the agreement to June 30, 2026. (14414)

Resolution

11. Resolution Certifying the 2026 Budget for Silver Lake Flood Control District. (14417)

12. Resolution Certifying the 2026 Budget for Lexington Flood Control Zone District. (14419)

13. Resolution Certifying the 2026 Budget Consolidated Diking Improvement District No. 1. (14431)

Board Correspondence

14. Letters/Notices

a. Letter dated 10/12/2025 to Col. Kathryn P. Sanborn, Commander, Seattle District, U.S. Army Corps of Engineers regarding the Accelerating Sedimentation Issues in the Toutle, Cowlitz, and Columbia River systems. (14406)

b. Letter dated 10/21/2025 to Raymond Van Tongeren reappointing him to the Great Rivers Behavioral Health Advisory Board. This is a 3-year term that expires September 30, 2028. (14407)

Regular Public Meeting

October 21, 2025, 9:00 a.m.

c. Letter dated 10/21/2025 to Marin Fox reappointing her to the Great Rivers Behavioral Health Advisory Board. This is a 3-year term that expires September 30, 2028. (14408)

d. Letter dated 10/21/2025 to Gena James reappointing her to the Great Rivers Behavioral Health Advisory Board. This is a 3-year term that expires September 30, 2028. (14409)

e. Letter dated 10/21/2025 to Beth Follows reappointing her to the Great Rivers Behavioral Health Advisory Board. This is a 3-year term that expires September 30, 2028. (14410)

f. Letter dated 10/21/2025 to Carol Searing reappointing her to the Fair Board. This is a 4-year term that expires October 31, 2029. (14412)

g. Letter dated 10/21/2025 to Mary Grochow reappointing her to the Fair Board. This is a 4-year term that expires October 31, 2029. (14413)

h. Letter dated 10/9/25 from Patrick Harbison, Diking Engineer, Silver Lake Flood Control District of Cowlitz County regarding the Silver Lake Regulating Structure Inspection Report. (14432)

i. Federal Energy Regulatory Commission (FERC) Notice dated 9/26/25 regarding the 2025 Site-Specific Seismic Hazard Analysis Update, Yale Project. (14436)

15. Executed Contracts/Agreements/Letters

a. Recorded Possession and Use Agreement and Right of Entry between 141 Sweet Birch Drive to Relocate the Storm Drainpipe. (14422)

b. Recorded Perpetual Road and Utility Easement from R.H. Emmerson for the Ryderwood Supplemental Water Source to address drought resiliency for the residents of Ryderwood, WA. (14424)

c. Recorded Warranty Deed from R.H. Emmerson Ryderwood Supplemental Water Source to address drought resiliency for the residents of Ryderwood, WA. (14425)

d. Recorded Perpetual Road and Utility Easement from Dennis and Sally Hall for the Ryderwood Supplemental Water Source to address drought resiliency for the residents of Ryderwood, WA. (14426)

Vouchers

The following vouchers/warrants are approved for payment.

16. Voucher Ratification from the Drainage Improvement District No. 1 for August 2025 in the amount of $29,652.84. (14416)

Regular Public Meeting

October 21, 2025, 9:00 a.m.

Motion Items

Health & Human Services

17. Contract with Goodwill of the Olympics and Rainier Region to provide for the delivery of Development Disability Employment and Day Services until June 30, 2026. The total cost is $87,000.00. (14368)

Public Hearings

Prosecuting Attorney

18. 9:30 a.m. - Ordinance to Reflect Codification of Amendment by the state Office of Code Reviser to RCW 36.32.120(10), Re-numbering it as RCW 36.32.120(11), effective July of 2025, and Amending Cowlitz County Code Sections 12.55.070, 15.50.120, 15.50.130, 16.20.100, and 16.22.110, and updating Section 2.06.120 to Incorporate said Statutory Amendment. (14405)

Citizen Comments – Citizen participation may be anonymous. See RCW 42.30.040

Workshop 10:00 a.m.

 Department of Ecology  Local Homeless/Housing Plan

Regular Public Meeting

October 21, 2025, 9:00 a.m.

Updates

Chairman Updates

Upcoming Events:

 Tuesday, October 28 @ 10:00 a.m. – Board of Health

 Tuesday, November 4 @ 10:00 a.m. – Excellence in Service

Upcoming Cancelations:

 Tuesday, November 11th – Canceled (Holiday)

 Tuesday, November 18th – Canceled (No Quorum)

2026 Budget Calendar:

Tuesday, October 21st – Specialized Workshops – 1:30 p.m.

 Fee Setting  6-year Road Plan

 Café

Wednesday, October 22nd – Specialized Workshops – 2:30 p.m.

 Equipment Revolving Reserve  Public Works-Roads/Solid Waste

 Public Works-Water/Sewer, Stormwater  Public Works-Shooting Range

Monday, October 27th – 9:00 a.m.

 Drug Court

 Superior Court

Tuesday, October 28th – 1:30 p.m.

 Juvenile

 Summary Revenue & Expenses  General Fund Levy

 Road Fund Levy

Wednesday, October 29th - 1:30 p.m.

 5-Year Capital Improvement Plan

RCW 42.30.040 - Conditions of attendance not to be required. A member of the public shall not be required, as a condition to attendance at a meeting of a governing body, to register his or her name and other information, to complete a questionnaire, or otherwise to fulfill any condition precedent to his or her attendance. People may remain anonymous when logging on to Zoom by creating any name and email of their choosing. In a meeting, public comment will be received, either or both, orally (raise hand in Zoom or use *9 on phone) and by writing. Note: Written comments may be sent to the Board at any time. For oral presentations, the Board may set a time for comments and speakers.

All matters listed with the Consent Agenda were previously distributed to each Board Member for reading and study, were available for public viewing, are considered items of regular County business, and will be approved, without separate discussion, by one motion of the Board of County Commissioners. An item may be removed from the Consent Agenda and placed on the Regular Agenda for separate discussion and voting at the request of any Board Member.

The Board of Commissioners may add and take action on other items not listed on this Agenda.

 Agenda Online Address: https://www.co.cowlitz.wa.us/535/Agendas Regular-Public-Meetings

 ZOOM Invitation Address (for all meeting days): o https://us06web.zoom.us/j/82019613917

 KLTV Live Feed Address: http://www.kltv.org

BOCC Agenda

Meeting Date: 10/21/2025

Proclamation Declaring October 23-31, 2025 as Red Ribbon Week in Cowlitz County

Submitted For: Kelly Grayson, Clerk of the Board

Submitted By: Kelly Grayson, Clerk of the Board

Department: Commissioners Office

Subject and Summary Statement

Information

Resolution Proclaming October 23-31, 2025 as Red Ribbon Week in Cowlitz County.

Will Staff Attend - NAME OF STAFF

Department Recommendation

Proclamation

Form Started By: Kelly Grayson

Attachments

Form Review

Started On: 10/15/2025 12:08 PM Final Approval Date: 10/15/2025

PROCLAMATION

BEFORE THE BOARD OF COMMISSIONERS OF COWLITZ COUNTY, WA

In the Matter of declaring October 23-31 )

2025 As Red Ribbon Week in Cowlitz ) Resolution:______________ County )

WHEREAS, Alcohol and other drugs abuse in this nation has reached epidemic stages; and

WHEREAS, It is imperative that visible, unified prevention education efforts by community members be launched to eliminate the demand for drugs; and

WHEREAS, The National Family Partnership is sponsoring the National Red Ribbon Campaign offering citizens the opportunity to demonstrate their commitment to drug-free lifestyles (no use of illegal drugs, no illegal use of legal drugs); and

WHEREAS, The National Red Ribbon Campaign will be celebrated in every community in American during “Red Ribbon Week”, October 23-31; and

WHEREAS, Business, government, parents, law enforcement, media, medical, religious institutions, schools, senior citizens, service organizations and youth will demonstrate their commitment to healthy, drug-free lifestyles by wearing and displaying Red Ribbons during this week long campaign; and

WHEREAS, Cowlitz County further commits its resources to ensure the success of the Red Ribbon Campaign;

NOW THEREFORE, BE IT RESOLVED, that Cowlitz County does hereby proclaim October 23-31, 2025, as Red Ribbon Week and encourages its citizens to participate in drug prevention education activities, making a visible statement that we are strongly committed to a drug-free state.

Board of County Commissioners Of Cowlitz County, Washington

ATTEST:

Kelly Grayson, Clerk of the Board

Richard R. Dahl, Chairman

Steve Rader, Commissioner

Steven L. Ferrell, Commissioner

Meeting Date: 10/21/2025

CALL FOR BIDS - Camelot Large Onsite Septic System (LOSS) - Project No. 2947

Submitted For: Susan Eugenis, Public Works

Submitted By: Emilie Cochrane, Public Works Department: Public Works

Information

Subject and Summary Statement

Attached are the necessary documents to issue the Call for Bids for the Camelot Large Onsite Septic System (LOSS) Project.  This project consists of the installation of a new 24,000 gallon concrete septic tank and associated drain field to replace the existing onsite system that serves the Camelot residents.   The existing system has reached end of life and needs to be replaced to maintain permit compliance.

Will Staff Attend - NAME OF STAFF or No

yes

Department Recommendation

It is the recommendation of the Department of Public Works that the Board move to approve the Call for Bids, set the bid opening for November 17, 2025, at 1:30 p.m. and publish the Notice to Contractors in the usual manner.

Fiscal Impact

Expenditure Required $: 655,000

Budget Sufficient Y-N: Y

Amendment Required Y-N: N

Source of Funds - What Dept ? : Water/Sewer

Grant Y-N:

Call for Bids

Notice to Contractors

Inbox

Chris Andrews

Susan Eugenis

Mike Moss, Public Works

Form Started By: Emilie Cochrane

Attachments

Form Review

Reviewed By Date

Chris Andrews 10/14/2025 09:56 AM

Susan Eugenis 10/14/2025 10:18 AM

Mike Moss 10/14/2025 03:09 PM

Started On: 10/14/2025 08:20 AM

CALL FOR BIDS

The Board of County Commissioners of Cowlitz County, Washington will receive sealed bids until Monday, November 17, 2025, prior to 1:30 p.m., for the following work: 2025 CAMELOT LARGE ONSITE SEPTIC SYSTEM (LOSS) PROJECT.

Work performed under this contract consists of the following:

Installation of a new (replacement) Large Onsite Septic System (LOSS) including a new tank, drainfield and distribution system, and other work to serve the Camelot development in Cowlitz County.

At that time all bids will be publicly opened and read in the Board's hearing room. Bids must be addressed to:

Cowlitz County Department of Public Works

Attn: County Engineer

1600 13th Avenue South Kelso WA 98626

Project bid documents (Plans, specifications, addenda, bid documents, bidders list and plan holders list) for this project are available online for inspection during the bidding period through the Builders Exchange of Washington (BXWA) website at www.bxwa.com. Click on Posted Projects, then Public Works, then Cowlitz County and then Projects Bidding. These documents are available for viewing, downloading and printing on your own equipment free of charge. This service is provided to Prime Bidders, Subcontractors, and Vendors bidding on this project. Bidders will need to “Register as a Bidder” through the BXWA in order to receive automatic e-mail notification of future addenda and to be placed on the Bidders List. Bidders should contact Builder’s Exchange of Washington at (425) 258-1303 for questions regarding access or registration.

Contractor Qualifications:

The Contractor shall be a licensed septic system installer and shall:

1. Be currently approved by the local health jurisdiction in the county where the LOSS is to be constructed.

2. Have the following experience:

a. Four or more years’ experience installing OSS; and

b. A minimum of three years continuous licensing in Cowlitz County, and

c. A record of successful completion of at least one similar installation, including a pressure distribution drainfield, and

d. Installed at least 4 individual Sewage treatment and disposal systems in Cowlitz County in the previous two years, and

e. At least three years of installation experience within Cowlitz County

It is the sole responsibility of the Bidder to obtain Addenda, if any. Addenda information will be available on the BXWA web site at www.bxwa.com. Cowlitz County accepts no responsibility or liability and will provide no accommodation to bidders who fail to check for addenda and thereby submit inadequate or incomplete responses.

Cowlitz County will not provide paper copies of the Project bid documents for this project for bidding purposes. A copy of the plans and specifications may be reviewed at the office of the Clerk of the Board of County Commissioners.

All bid proposals shall be accompanied by a bid proposal deposit in cash, certified check, cashier’s check, or surety bond in an amount equal to five percent (5%) of the amount of such bid proposal. Should the successful bidder fail to enter into such contract and furnish satisfactory performance bond within the time stated in the specifications, the bid proposal deposit shall be forfeited to Cowlitz County.

All documents received in response to this invitation to bid will become a matter of public record and subject to the Washington public disclosure act under chapter 42.56 RCW.

Cowlitz County, in accordance with the provisions of Title VI of the Civil Rights Act of 1964 (78 Stat. 252, 42 U.S.C. 2000d to 2000d-4) and the Regulations, hereby notifies all bidders that it will affirmatively ensure that in any contract entered into pursuant to this advertisement, disadvantaged business enterprises will be afforded full and fair opportunity to submit bids in response to this invitation and will not be discriminated against on the grounds of race, color, or national origin in consideration for an award.

The Board reserves the right to reject any and all bids and to waive any immaterial irregularities or informalities in any bid or in the bidding.

DATED 21st day of October, 2025.

BOARD OF COUNTY COMMISSIONERS OF COWLITZ COUNTY, WASHINGTON

Richard R. Dahl, Chairman

Steve Rader, Commissioner

Steven L. Ferrell, Commissioner

ATTEST:

Kelly Grayson, Clerk of the Board

NOTICE TO CONTRACTORS CALL FOR BIDS

The Board of County Commissioners of Cowlitz County, Washington will receive sealed bids until Monday, November 17, 2025, prior to 1:30 p.m., for the following work: 2025 CAMELOT LARGE ONSITE SEPTIC SYSTEM (LOSS) PROJECT.

Work performed under this contract consists of the following:

Installation of a new (replacement) Large Onsite Septic System (LOSS) including a new tank, drainfield and distribution system, and other work to serve the Camelot development in Cowlitz County.

At that time all bids will be publicly opened and read in the Board's hearing room. Bids must be addressed to:

Cowlitz County Department of Public Works

Attn: County Engineer

1600 13th Avenue South Kelso WA 98626

Project bid documents (Plans, specifications, addenda, bid documents, bidders list and plan holders list) for this project are available online for inspection during the bidding period through the Builders Exchange of Washington (BXWA) website at www.bxwa.com. Click on Posted Projects, then Public Works, then Cowlitz County and then Projects Bidding. These documents are available for viewing, downloading and printing on your own equipment free of charge. This service is provided to Prime Bidders, Subcontractors, and Vendors bidding on this project. Bidders will need to “Register as a Bidder” through the BXWA in order to receive automatic e-mail notification of future addenda and to be placed on the Bidders List. Bidders should contact Builder’s Exchange of Washington at (425) 258-1303 for questions regarding access or registration.

Contractor Qualifications:

The Contractor shall be a licensed septic system installer and shall:

1. Be currently approved by the local health jurisdiction in the county where the LOSS is to be constructed.

2. Have the following experience:

a. Four or more years’ experience installing OSS; and

b. A minimum of three years continuous licensing in Cowlitz County, and

c. A record of successful completion of at least one similar installation, including a pressure distribution drainfield, and

d. Installed at least 4 individual Sewage treatment and disposal systems in Cowlitz County in the previous two years, and

e. At least three years of installation experience within Cowlitz County

It is the sole responsibility of the Bidder to obtain Addenda, if any. Addenda information will be available on the BXWA web site at www.bxwa.com. Cowlitz County accepts no responsibility or liability and will provide no accommodation to bidders who fail to check for addenda and thereby submit inadequate or incomplete responses.

Cowlitz County will not provide paper copies of the Project bid documents for this project for bidding purposes. A copy of the plans and specifications may be reviewed at the office of the Clerk of the Board of County Commissioners.

All bid proposals shall be accompanied by a bid proposal deposit in cash, certified check, cashier’s check, or surety bond in an amount equal to five percent (5%) of the amount of such bid proposal. Should the successful bidder fail to enter into such contract and furnish satisfactory performance bond within the time stated in the specifications, the bid proposal deposit shall be forfeited to Cowlitz County.

All documents received in response to this invitation to bid will become a matter of public record and subject to the Washington public disclosure act under chapter 42.56 RCW.

Cowlitz County, in accordance with the provisions of Title VI of the Civil Rights Act of 1964 (78 Stat. 252, 42 U.S.C. 2000d to 2000d-4) and the Regulations, hereby notifies all bidders that it will affirmatively ensure that in any contract entered into pursuant to this advertisement, disadvantaged business enterprises will be afforded full and fair opportunity to submit bids in response to this invitation and will not be discriminated against on the grounds of race, color, or national origin in consideration for an award.

The Board reserves the right to reject any and all bids and to waive any immaterial irregularities or informalities in any bid or in the bidding.

DATED 21st day of October, 2025.

PUBLISHED:

BOARD OF COUNTY COMMISSIONERS OF COWLITZ COUNTY, WASHINGTON

PUBLICATION REQUIREMENT: To be published in two issues prior to November 10, 2025.

BILLING INFORMATION:

1) AFFIDAVIT TO: Cowlitz County Commissioners

Attn: Clerk of the Board

207 4th Avenue N Kelso, WA 98626

2) BILL TO:

Cowlitz County Department of Public Works

1600 – 13th Avenue South Kelso, WA 98626

P.O. 001033

Meeting Date: 10/21/2025

Call for Bids: Headquarters Landfill On-Call Electrical Services ITB# 2025-0065-01

Submitted For: Shawn Roewe

Submitted By: Ashley Claussen Department: Public Works

Information

Subject and Summary Statement

Attached are the necessary documents to issue the Call for Bids for as-needed electrical services at the Headquarters Landfill.

Bids will be due to Purchasing Services by 1:30 PM on November 17, 2025.

Will Staff Attend - NAME OF STAFF No.

Department Recommendation

It is the recommendation of the Department of Public Works that the Board move to approve the Call for Bids and publish the Notice to Contractors in the usual manner.

Attachments

Notice to Contractors

Call for Bids

Invitation to Bid

Form Started By: Ashley Claussen

Form Review

Started On: 10/14/2025 05:06 PM

NOTICE TO CONTRACTORS

Cowlitz County Purchasing Services will receive separate sealed bids, each clearly marked and submitted individually, for the following public works projects. Bids are due by November 17, 2025, at 1:30 PM (Pacific Time).

Headquarters Landfill On-Call Electrical Services

Estimated Contract Amount: $150,000.00

Submit To: Cowlitz County Public Works

Attn: Ashley Claussen, Purchasing Services

Headquarters Landfill On-Call Electrical: ITB #2025-0065-01

1600 13th Avenue S Kelso, WA 98626

Tennant Way Landfill On-Call Services

Estimated Contract Amount: $75,000.00

Submit To: Cowlitz County Public Works

Attn: Ashley Claussen, Purchasing Services

Tennant Way Landfill On-Call: ITB #2025-0066-01

1600 13th Avenue S Kelso, WA 98626

Each project requires a standalone bid package, addressed accordingly, and will be awarded independently. Combined bids will not be accepted and will be deemed non-responsive. Bids must be mailed or delivered in person to the address above. Late, faxed, or emailed bids will not be accepted. The County’s decision on bid receipt time is final.

The bid opening will take place in the Cowlitz County Public Works Training Room. Members of the public may attend in person, or virtually via Zoom at https://us06web.zoom.us/j/84447159296. Following the opening, a recorded video and bid results will be posted on the County’s website.

Bid documents and addenda are available online at https://www.co.cowlitz.wa.us/bids.aspx. Bidders are responsible for checking for addenda. No paper copies will be provided, but plans may be reviewed at the Clerk of the Board’s office.

All bid proposals shall be accompanied by a bid proposal deposit in cash, certified check, cashier’s check, or surety bond in an amount equal to five percent (5%) of such bid proposal. Should the successful bidder fail to enter into such contract and furnish satisfactory performance bond within the time stated in the specifications, the bid proposal deposit shall be forfeited to Cowlitz County.

All documents received in response to this invitation to bid will become a matter of public record and subject to the Washington public disclosure act under chapter 42.56 RCW.

TheBoardreservestheright torejectany andall bidsandtowaiveany immaterialirregularities or informalities in any bid or in the bidding.

DATED this 21st day of October 2025.

BOARD OF COUNTY COMMISSIONERS OF COWLITZ COUNTY, WASHINGTON

PUBLISHED:

PUBLICATION REQUIREMENT: To be published in one issue.

BILLING INFORMATION:

1) AFFIDAVIT TO: Cowlitz County Commissioners Attn: Clerk of the Board

2) BILL TO: Cowlitz County Public Works Solid Waste Division 1600 13th Ave S Kelso, WA 98626

CALL FOR BIDS

Cowlitz County Purchasing Services will receive sealed bids until November 17, 2025, at 1:30 PM (Pacific Time) for the following work: HEADQUARTERS LANDFILL ON-CALL ELECTRICAL SERVICES

At that time all bids will be publicly opened and read in the Public Works Training Room. Bids must be addressed to:

Cowlitz County Public Works

Attn: Ashley Claussen, Purchasing Services Headquarters Landfill On-Call Electrical: ITB #2025-0065-01 1600 13th Avenue S Kelso, WA 98626

Bids must be mailed or delivered in person to the address above. Late, faxed, or emailed bids will not be accepted. The County’s decision on bid receipt time is final.

The bid opening will be accessible via Zoom by visiting https://us06web.zoom.us/j/84447159296. Following the opening, a recorded video and bid results will be posted on the County’s website

Bid documents and addenda are available online at https://www.co.cowlitz.wa.us/bids.aspx. Bidders are responsible for checking for addenda. No paper copies will be provided, but plans may be reviewed at the Clerk of the Board’s office.

All bid proposals shall be accompanied by a bid proposal deposit in cash, certified check, cashier’s check, or surety bond in an amount equal to five percent (5%) of such bid proposal. Should the successful bidder fail to enter into such contract and furnish satisfactory performance bond within the time stated in the specifications, the bid proposal deposit shall be forfeited to Cowlitz County.

All documents received in response to this invitation to bid will become a matter of public record and subject to the Washington public disclosure act under chapter 42.56 RCW.

The Board reserves the right to reject any and all bids and to waive any immaterial irregularities or informalities in any bid or in the bidding.

DATED this 21st day of October 2025.

BOARD OF COUNTY COMMISSIONERS OF COWLITZ COUNTY, WASHINGTON

Richard R. Dahl, Chairman

Attest: Kelly Grayson, Clerk of the Board

Steve Rader, Commissioner

Steven L. Ferrell, Commissioner

INVITATION FOR BIDS

Cowlitz County invites interested and qualified contractors to submit sealed bids for the following project:

TITLE: Headquarters Landfill On-Call Electrical Services

ESTIMATED CONTRACT AMOUNT: $150,000.00

BID SUBMITTAL TIME/DATE/LOCATION: Prior to 1:30 PM local time on November 17, 2025 to:

Cowlitz County Public Works

Attn: Ashley Claussen, Purchasing Services

Headquarters Landfill On-Call Electrical: ITB #2025-0065-01 1600 13th Avenue S Kelso, WA 98626

Bids can be mailed or delivered in person to the address listed above. Cowlitz County will assume no responsibility for any delay in U.S., County, or any other delivery service resulting in a bid being received late. Faxed and/or E-mailed bids will not be accepted.

PUBLIC BID OPENING:

PRE-BID CONFERENCE:

ITEM FOR BID:

Bids will be opened and read aloud at the time and place specified above The bid opening will take place in the Cowlitz County Public Works Training Room. Members of the public may attend in person, or virtually via Zoom at https://us06web.zoom.us/j/84447159296. Following the opening, a recorded video and bid results will be posted on the County’s website at https://www.co.cowlitz.wa.us/Bids.aspx?BidID=458.

No pre-bid conference will be held. Questions regarding the project will be received until October 31, 2025 at 4:00 PM.

Cowlitz County is seeking bids for as-needed electrical services at the Cowlitz County Headquarters Landfill located at 3434 S Silver Lake Road in Castle Rock, Washington. The contractor shall provide labor, materials, subcontracting, fees, permitting, and supervision to perform troubleshooting, diagnostics, maintenance, repairs, and other agreed upon work. One agreement will be awarded as a result of this solicitation. The initial term of the resulting agreement will be for one year, with the option to extend for one additional year at the discretion of the County.

BID SUBMITTAL ENVELOPE:

Upon submittal, bids will be recorded by Cowlitz County as to time and date received and secured until the time set for public bid opening. All bid submittals shall be sealed in an opaque envelope which has been clearly marked with “Headquarters Landfill On-Call Electrical: ITB #2025-0065-01.” NO BIDS WILL BE ACCEPTED AFTER THE BID SUBMITTAL TIME.

CONTRACTOR REGISTRATION:

Pursuant to RCW 39.06, the bidder shall be registered and licensed as required by the laws of the State of Washington, including but not limited to RCW 18.27. In order to perform public work, the successful bidder and subcontractors, prior to contract award, shall hold or obtain such licenses and registrations as required by State Statutes and Coded, and Federal and local laws and regulations.

BID SECURITY:

Certified check,bankcashier’s check, orbid bond congruentwith theBid Bond Security Formas identified in the “Instructions to Bidders” section is required to be submitted with each bid in response to this solicitation.

SUMMARY OF WORK

1. The project location is the Headquarters Landfill located at 3434 S Silver Lake Road in Castle Rock, Washington.

2. Contractor shall perform troubleshooting, diagnostics, maintenance, repair, installation, inspection, testing, and calibration on a variety of electrical and industrial equipment, including but not limited to:

a. Low and medium voltage systems (up to 12.4kV)

b. Uninterruptible Power Supplies (UPS)

c. Motor Control Centers (MCC)

d. Automatic Transfer Switches (ATC)

e. Actuators

f. Transformers

g. Switchgear

h. Panels

i. Protection Relays

j. Battery Banks

k. DC Chargers

l. Inverters

m. Power Converters

n. Breakers

o. Motors

p. Pumps

q. Generators

3. The Contractor shall perform services including, but not limited to:

a. Troubleshooting, diagnostics, maintenance, and repair of equipment listed above.

b. Coordination and subcontracting with manufacturers to provide factory-trained and certified technicians when required to maintain warranty or UL listing.

c. Coordination and subcontracting with highly specialized firms when expertise is beyond the Contractor’s workforce.

d. Installation, inspection, testing, and calibration of components involved in industrial systems including thermostats, direct digital control systems, VFDs, electrical control circuits, etc.

e. Rebuild and/or replacement of pumps and motors.

f. Inspection, rebuilding, or replacement of electrical devices including panels, starters, contactors, signal cables, and receptacles. Includes electrical wiring, switches, and lighting.

g. Inspection, repair,programming, or replacementofbuilding systems such asfire alarm panels,building controls, sensors, alarms, interlocked controls, leak detection systems, generators, door controls, lighting systems, and fire suppression equipment.

h. Support services including material purchasing and equipment rental.

i. Other services as required by the County and mutually agreed upon.

4. Contractor is responsible for all necessary permits including filing, payments, and scheduling.

5. All work shall be performed in accordance with local, state, and federal codes, including the National Electrical Code (NEC), and shall comply with all applicable occupational safety regulations. Contractor is responsible for ensuring that all personnel follow OSHA regulations and relevant industry safety standards, including but not limited to:

a. Lockout/Tagout (LOTO) procedures

b. Arc Flash Protection (NFPA 70E)

c. Confined Space Entry (when applicable)

d. Fall Protection

6. Contractor shall provide all required personal protective equipment (PPE) and ensure that staff are trained and certified in applicable safety procedures. The County reserves the right to request proof of training and compliance at any time.

7. All work shall be performed by appropriately licensed electricians or qualified technicians experienced in industrial electrical systems. Contractor shall provide documentation of licensing, certifications, or manufacturer training upon request.

8. Contractor must be capable of providing qualified technical personnel from its own workforce to respond to all service requests.

9. The successful contractor will receive task order requests for individual projects from a specified Cowlitz County representative. Upon receipt of task order requests, the contractor shall provide a written estimate for County approval prior to commencement of services. Quotes shall be firm fixed not to exceed cost and shall be inclusive of all labor, materials, equipment, supervision, taxes, etc. Overtime rates shall not be billed unless specifically approved in writing by the Cowlitz County representative prior to the commencement of work.

10. Routine (non-emergency) projects shall be scheduled during normal business hours from 8:00 a.m. to 5:00 p.m., Monday through Fridayexceptfor theCounty’s officialholidays.Outside hours workwill include all other times Monday through Friday, and all day on Saturday, Sunday, and official holidays.

11. TheContractorshallbeexpectedtoprovideemergencyresponses/serviceswhenrequestedbytheCounty.TheContractor shall respond to the County within one (1) hour of the request and shall be on specified location for such emergency requests for repairs within two (2) hours from the time of the initial on-call service request.

12. All work is to be billed on a unit-priced basis as provided by the contractor on the attached bid form. Invoices may be submitted upon completion of each task order, or monthlyfor larger projects. Each taskorder shall be invoiced separately with both the contract number and task order number included. Unless otherwise specified or mutually agreed to in writing, all prices shall be fixed throughout the duration of the contract. The contractor shall give Cowlitz County at least thirty (30) days’ written notice of change in rates and the effective date of the proposed change. In the event the County and the contractor cannot agree on an adjustment request, Cowlitz County may terminate the agreement.

13. Mobilization shall be included in the base unit price for each work order and shall consist of preparatory work and operations performed by Contractor, including his personnel, equipment, supplies, and incidentals to the project site. No separate measurement or payment will be made for costs associated with mobilization and demobilization.

14. The services outlined in this scope are not exclusive. Cowlitz County reserves the right to solicit competitive bids and contract for repairs and services with other providers.

15. Poor or unsatisfactory performance may result in reduced task order execution or contract termination. Cowlitz County reserves the right to conduct periodic performance reviews, assessing:

a. Timeliness and responsiveness

b. Quality of workmanship

c. Compliance with safety and code requirements

d. Accuracy of documentation and invoicing

e. Communication and professionalism END OF SECTION

INFORMATION FOR BIDDERS

1.01 PREPARATION OF BIDS

A. Bids must be: (1) submitted on the bid proposal forms, or copies of forms, furnished by the County and (2) signed in ink. The person signing a bid must initial each change appearing on any bid form. If the bid is made by a corporation, it shall be signed by the corporation’s designee. The address of the bidder shall be typed or printed on the bid form in the space provided.

B. If the solicitation includes alternate bid items, failure to bid on the alternates may disqualify the bid. If bidding on all items is not required, bidders should insert the words “no bid” in the space provided for any item on which no price is submitted.

C. Substitute bid proposals will not be considered unless this solicitation authorizes their submission.

D. It will be the responsibility of the bidder to conform to the requirements; failure to comply with exact specifications could result in rejection of bid documents.

1.02 BID GUARANTEE

A. A bid guarantee in the amount of 5% of the entire bid amount is required. Failure of the bidder to provide bid guarantee when required shall render the bid non-responsive.

B. Acceptable forms of bid guarantee are a bid bond or postal money order, or certified check or cashier’s check made payable to Cowlitz County

The County will return bid guarantees (other than bid bond) to unsuccessful bidders as soon as practicable, but not sooner than the execution of a contract with the successful bidder. The successful bidder’s bid guarantee will be returned to the successful bidder with its official notice to proceed with the work of the contract.

1.03 ADDITIVE OR DEDUCTIVE BID ITEMS

The low bidder, for purposes of award, shall be the responsive bidder offering the low aggregate amount for the base bid item, plus additive or deductive bid alternates selected by the County, and within funds available for the project.

The bidder agrees to hold all bid alternate prices for sixty (60) days from date of bid opening.

1.04 ACKNOWLEDGEMENT OF ADDENDA

All official clarifications or interpretations of this Invitation to Bid will be by written addenda and issued by the Purchasing Department. Bidders shall acknowledge receipt of all addenda to this solicitation by identifying the addenda numbers in the space provided for this purpose on the bid proposal form. Failure to do so may result in the bid being declared non-responsive.

1.05 SITE INVESTIGATION AND CONDITIONS AFFECTING THE WORK

The bidder acknowledges that it has taken steps necessary to ascertain the nature and location of the work, and that it has investigated and satisfied itself as to the general and local conditions which can affect the work or its cost, including but not limited to (1) conditions bearing upon transportation, disposal, handling, and storage of materials; (2) the availability of labor, water, electric power, and road; (3) uncertainties of weather, river stages, tides, or similar physical conditions at the site; (4) the conformation and conditions of the ground; and (5) the character of equipment and facilities needed preliminary to and during the work. The bidder also acknowledges that is has satisfied itself as to character, quality, and quantity of surface and subsurface materials or obstacles to be encountered insofar as this information is reasonably ascertainable from an inspection of the site, including exploratory work done by the County, as well as from the drawing and specifications made a part of this contract. Any failure of the bidder to take the actions described and acknowledged in this paragraph will not relieve the bidder from responsibility for estimating properly the difficulty and cost of successfully performing the work.

1.06 BID AMOUNTS

A. The bid prices shown for each item on the bid proposal shall include all labor, material, equipment, overhead and compensation to complete all of the work for that item. All prices including bid prices are in US funds.

B. The actual cost of building permit (only) and the public utility hookup fees will be a direct reimbursement to the Contractor or paid directly by the permitting agency by the County. Fees for these permits should not be included by the bidder in the bid amount.

C. The bidder agrees to hold the base prices for sixty (60) days from the date of bid opening.

1.07 TAXES

The County is required to pay Washington State Sales Tax on all purchases and contracts. Sales tax should be added as a separate item only, not to be included in the base bid price. All bidders whether inside or outside the state of Washington shall show the tax rate applicable to this bid. All taxes payable by the County as a result of this contract are considered part of the bid evaluation. Washington State tax is payable by the County direct to the state of Washington on awards made to out-of- state contractors who do not have a Washington State Sales Tax number. If you have any questions concerning the appropriate rate, contact the Washington State Department of Revenue.

If a cash discount is offered and taken it is understood that sales tax will be applied to the discounted amount.

It shall be the contractor's responsibility to furnish Federal Excise Tax Exemption Certificate, when applicable.

1.08 SUBMISSION OF BIDS

A. Bid proposals must be submitted on or before the time specified in the Invitation to Bid.

B. If the base bid and the sum of additive alternates is one million dollars or more, the bid proposal shall comply with the following requirements:

1. Pursuant to RCW 39.30.060, if the base bid and the sum of bid additive alternates is one million dollars or more, the bidder shall provide names of the subcontractors with whom the bidder will subcontract for performance of heating, ventilation and air condition (HVAC), plumbing, and electrical.

2. The bidder can name itself for the performance of the work.

3. The bidder shall not list more than one subcontractor for each category of work identified UNLESS subcontractors vary with bid alternates, in which case the bidder must indicate with subcontractors will be used for which alternate.

4. Failure of the bidder to submit as part of the bid the names of such subcontractors or to name itself to perform such work shall render the bid non-responses and, therefore, void.

C. The bid proposal shall be submitted in a sealed envelope addressed to the office specified in the Invitation to Bid. The envelope shall have printed outside:

1. The project number.

2. The name and address of the bidder.

3. Identification as bid proposal.

D. Prior to the bid opening, the County’s representative will designate the official bid clock. Any part of the bid proposal or bid modification not received prior to the times specified, per the designated bid clock, will not be considered and the bid will be returned to the bidder unopened.

E. A bid may only be withdrawn in person by a bidder’s authorized representative prior to the opening of the bids. Bidder(s) representative will be required to show ID and sign on bid summary sheet before it will be released.

F. A change to the bid already received will be considered only if the changes are received prior to the opening of the bids. All changes shall be made in writing, executed, and submitted in the same form and manner as the original bid

G. People with disabilities who wish to request special accommodation, (e.g., sign language interpreters, Braille, etc.) need to

contact the County ten (10) working days prior to the scheduled bid opening.

1.09 BID OPENING

A. At the time and place included in this Invitation to Bid, each bid that has been received, except those thathave been properly withdrawn, will be opened and evaluation shall begin.

B. The County reserves the right to postpone the date and time last announced for receiving bids and such postponement may be made at any time prior to the opening of the bids. The County will give written notice by issuance of an addendum confirming the changing of the announced date and time for receiving bids.

C. In the event a bidder discovers an error in its bid following the bid opening, the bidder may request to withdraw its bid under the following conditions:

1. Written notification is received by the County within 24 hours following bid opening.

2. The bidder provides written documentation of the claimed error to the satisfaction of the County within 72 hours following the bid opening.

D. TheCountywillapproveordisapprovetherequestforwithdrawalofthebidinwriting.Ifthebidder’srequestforwithdrawal of its bid is approved, the bidder will be released from further obligation to the County without penalty. If it is disapproved, the County may retain the bidder’s bid guarantee.

1.10 BID RESULTS

After bid openings, bid results can be obtained from the Procurement Services office by calling (360) 577-3030 ext. 6856 or by visiting the County website at: https://www.co.cowlitz.wa.us/Bids.aspx?BidID=458

1.11 LOW RESPONSIBLE BIDDER

Beforeawardofapublicworkscontract,abiddermustmeetthefollowingmandatoryresponsibilitycriteriaunderRCW39.04.350 (1) to be considered a responsible bidder and qualified to be awarded a public works project. The bidder must:

A. At the time of bid submittal, have a certificate of registration in compliance with chapter 18.27 RCW;

B. Have a current state unified business identifier number;

C. If applicable, have industrial insurance coverage for the bidder's employees working in Washington as required in Title 51 RCW; an employment security department number as required in Title 50 RCW; and a state excise tax registration number as required in Title 82 RCW;

D. Not be disqualified from bidding on any public works contract under RCW 39.06.010 or 39.12.065(3);

E. If bidding on a public works project subject to the apprenticeship utilization requirements in RCW 39.04.320, not have been found out of compliance by the Washington state apprenticeship and training council for working apprentices out of ratio, without appropriate supervision, or outside their approved work processes as outlined in their standards of apprenticeship under chapter 49.04 RCW for the one-year period immediately preceding the date of the bid solicitation;

F. Have received training on the requirements related to public works and prevailing wageunder this chapter and chapter 39.12 RCW. The bidder must designate a person or persons to be trained on these requirements. The training must be provided by the department of labor and industries or by a training provider whose curriculum is approved by the department. The department, in consultation with the prevailing wage advisory committee, must determine the length of the training. Bidders that have completed three or more public works projects and have had a valid business license in Washington for three or more years are exempt from this subsection. The department of labor and industries must keep records of entities that have satisfied the training requirement or are exempt and make the records available on its web site. Responsible parties may rely on the records made available by the department regarding satisfaction of the training requirement or exemption; and

G. Within the three-year period immediately preceding the date of the bid solicitation, not have been determined by a final and binding citation and notice of assessment issued by the department of labor and industries or through a civil judgment

entered by a court of limited or general jurisdiction to have willfully violated, as defined in RCW 49.48.082, any provision of chapter 49.46, 49.48, or 49.52 RCW.

1.12 BID EVALUATION

A. The County will evaluate bids responsiveness and responsibility.

1. A bid will be considered responsive it if meets the following requirements:

a) It is received at the proper time and place.

b) It meets the stated requirements of the bid proposal.

c) It is submitted by a licensed/registered contractor within the state of Washington at the time of bid opening and is not banned from bidding by the Department of Labor and Industries.

d) It is accompanied by a bid guarantee.

2. A bid will be considered responsible if it meets the following requirements:

a) It meets the mandatory responsibility criteria established in RCW 39.05.350 and an overall accounting of the supplemental responsibility criteria established for the project.

B. The Board or their designee reserves the right to reject any or all bids for good cause shown, to waive minor deviations from the specifications, and to waive any informality in bids received when such acceptance, rejection, or waiver is in the best interest of the County. Without limiting the generality of the foregoing, the County may reject any Bid which is incomplete, non-responsive, obscure or irregular, any Bid which omits a bid on any items for which bids are required, any Bid which omits unit prices, if unit prices are required, any Bid in which unit prices are unbalanced in the opinion of the County, and any Bid from a Bidder which has previously failed to perform satisfactorily or which has failed to meet contract deadlines to complete construction or delivery of any nature. All bids or proposals are likely to be rejected if the lowest responsive bid received exceeds the project’s estimate by an unreasonable amount or the budget by any amount. If all bids are rejected for either of these reasons, the project may be deferred and re-bid when more competitive conditions exist.

C. The County may negotiate bid price adjustments with the low responsive bidder, including changes to the contract documents, to bring the bid within the available funding per RCW 39.04.015

D. The apparent low bidder, for purpose of award, shall be the responsive and responsible bidder offering the low aggregate amount for the base bid plus selected additive or deductive bid alternates and meeting all other bid submittal requirements.

1.13 BID PROTESTS

When the County receives a written protest from a bidder for a public works project which is the subject of competitive bids, the County will not execute a contract for the project with anyone other than the protesting bidder without first providing at least two full business days' written notice of the County's intent to execute a contract for the project; provided that the protesting bidder submitsnoticeinwritingofitsprotestnolaterthantwofullbusinessdaysfollowingbidopening.IntermediateSaturdays,Sundays, and legal holidays are not counted.

A protest submittal will be delivered to the Cowlitz County Purchasing Services Department, 1600 13th Ave S, Kelso WA 98626, with the words "Bid Protest" prominently and clearly displayed on any outer cover containing the protest notice as well as on the notice itself. The following minimum information should be included in the written protest notice: 1) The name, address and phone number (including area code) of the bidder; and 2) the bidder contact person's name and telephone number (including area code); and 3) a statement(s) describing the nature of the protest; and 4) the County bid number and title.

1.14 BID AWARD

A. The bidder will allow 60 days from bid opening date for acceptance of its bid and award of agreement made by the County.

B. Agreement will be awarded to the lowest responsible and responsive bidder.

C. The acceptance of a bid willbe evidenced by a Notice ofAward inwriting signed by a duly authorized official of the County and delivered to the bidder whose bid is accepted, in the manner provided for written notices. No other action or notice shall constitute acceptance of a bid. The Notice of Award shall not entitle the Bidder to any contractual or other remedies against the County.

D. Bid award does not itself constitute a contract. The bidder will have ten (10) days from the date of the notice of award, exclusive of the day of notice, to provide:

1. A signed agreement form.

2. Contractor’s Payment and Performance Bond.

3. Certificate of Insurance.

E. If the apparent successful bidder fails to sign all contractual documents or provide the bond and insurance as required or return documents within 10 days after receipt of the contract, the County may terminate the award of the contract.

F. No bid shall be binding upon the County until an agreement has been properly executed by the Contractor and County.

1.15 INSURANCE

A. The successful bidder shall be required to pay for, provide, and maintain insurance coverage that satisfies the requirements of the Cowlitz County Risk Management Department and that meets all terms and conditions of the contract bid and/or award. The insurance shall be provided at the Contractor’s sole expense and maintained for the duration of the contract. Any exclusion that may restrict required coverage must be pre-approved by the County Risk Management Department.

B. A certificate of insurance shall be provided in the specified amounts and with the following additional insured endorsement: "Cowlitz County, its officers, agents and employees are named as an additional insured as respects to project number SWR#2024-0030-xx ” The certificate holder will be Cowlitz County, C/O Cowlitz County Purchasing Services, 1600 13th Ave S, Kelso, WA 98626.

C. REQUIRED COVERAGE:The insurance shall provide the minimum coverage as set forth below:

1. GENERALLIABILITY INSURANCE:The Contractor shallhave Commercial General Liability coveragewith limits of $1,000,000.00peroccurrence,$2,000,000aggregate.Thiscoverageshallincludeproducts,completeoperations,personal injury, fire damage, and medicalexpenses.

2. PROOFOFAUTOMOBILE INSURANCE:The Contractor shall carry, for the duration of this Agreement, comprehensive automobile liabilitycoverageof $1,000,000.00 for anyvehicle used in conjunction with the provision of services under the termsof this Contract.Saidpolicy shall provide that it shall not be canceled, materially changed, or renewedwithoutfortyfive(45)dayswrittennotice priortheretotoCowlitzCounty.

3. WORKERS COMPENSATION: When the Contractor has employees of the company, the Contractor shall carry Worker’s Compensation Industrial Injury Insurance coverage and effective in Washington State. Proof of insurance shall be reflected on the Contractor’s Certificate of Insurance or by providing the Contractor’s State Industrial Account Identification Number.

D. All insurance policies must be issued by insurers licensed to do business in the State of Washington, name Cowlitz County as an additional insured on General and Automobile Liability policies and be primary and non-contributory to any insurance maintained by the County. Policies must also include a severability of interests clause, applying coverage separately to each insured, and provide at least 30 days’ written notice to the County prior to cancellation or material change, unless otherwise specified.

E. Upon satisfactory fulfillment of these requirements and contract signature by the Cowlitz County Board of County Commissioners the contract will be considered to be executed and a written Notice to Proceed will be issued.

1.16 CONTRACTOR’S PAYMENT AND PERFORMANCE BOND

A. The Contractor willbe required to pay for and file a Paymentand Performance Bond tothe State of Washington and Cowlitz

County (dual obligees) which will always be, at a minimum, equal to one hundred percent (100%) of the contract price, including sales tax and all additions, deletions, or extensions in time. Any additions, deletions or extensions in time shall not relieve a surety of its liability in any manner whatsoever.

B. The bond shall be executed by a Surety Company acceptable to the County and shall remain in effect for one (1) year following the formal acceptance of the work.

C. In lieu of a Payment and Performance bond, the County may, on contracts of one hundred fifty thousand dollars ($150,000) or less, hold retainage in an amount equal to ten percent (10%) of the contract including tax.

1.17 WAGE RATES AND EMPLOYMENT

A. The work outlined in this Invitation to Bid is considered Public Work and requires payment of prevailing wages in accordance with RCW 39.12 and WAC 296-127-023. No less than the applicable prevailing rate of wage must be paid to any worker, laborer, or mechanic employed in the performance of any part of the stated work.

B. The bidder is solely responsible for determining the applicable labor classification(s) and utilizing the appropriate and correct prevailing wage and benefit rate(s) in submitting its bid based on these specifications. Current wage rates for work to be performed in Cowlitz County can be found at https://secure.lni.wa.gov/wagelookup/rates/journey-level-rates using the effective date of November 17, 2025

C. The successful bidder shall complete and file State of Washington, Department of Labor and Industries Statement of Intent to Pay Prevailing Wages on Public Contract form and shall familiarize itself with all of the provisions of Chapter 39.12 RCW.

1.18 RETAINAGE AND PAYMENTS

A. Payments of an invoice for work performed will be for ninety-five percent (95%) of the principal amount, plus one hundred percent (100%) of the tax amount. The balance of the invoice payment will be held by the County as retainage.

B. For contracts of less than one hundred fifty thousand dollars ($150,000) in value, when requested by the Contractor and approved by the County, a retainage amount of ten percent (10%) of work performed (including tax) will be held in lieu of providing a Contractor's Payment and Performance bond. Payments of an invoice for work performed will be for ninety percent (90%) of the total of the principal amount, plus tax. The balance of the payment request will be held by the County as retainage.

C. Retainage will not be paid sooner than forty-five (45) days after project acceptance. Before the release of retainage, the Cowlitz County Purchasing Services Department must be in possession of the five (5) items listed below, in proper form.

1. Notice of Completion from the Board of County Commissioners or designee.

2. Certificate of Payment of Contributions, Penalties, and Interest on Public Works Contract (required on projects over $35,000.00) received from the State Department of Revenue. (Requested by the County when the Notice of Completion is received).

3. Certification of Payment of Contributions from the Washington State Employment Security Department (Requested by the County when the Notice of Completion is received).

4. Affidavits of Prevailing Wages Paid approved by the Department of Labor & Industries on the Contractor and each Subcontractor.

5. Reports on Claims (liens) filed against the project or Contractor from the County Auditor, Clerk of the Board of County Commissions and Department, 45 days from date of Resolution of Acceptance.

1.19 COMPLIANCE WITH LAWS AND REGULATIONS

A. The bidder, upon execution of an agreement, warrants full compliance with all applicable local, state or federal laws, ordinances and regulations of any public authority for the safety of persons and property, including requirements of the Washington Industrial Safety and Health Administration (W.I.S.H.A.), per the Revised Code of Washington (RCW),

Chapter 49.17, and the Washington Administrative Code (WAC) 296-24.

B. If the Contractor performs works out of compliance or contrary to laws, building codes, statutes, regulations, and rules, withoutwrittennoticetotheCounty,thentheContractorassumesfullresponsibilityfortheworkandwillbeheldresponsible for bearing the costs associated with returning those portions of the project into compliance with the appropriate governance and agencies.

C. Should the Contractor find inconsistencies in the Contract Documentation with respect to governmental laws, rules, regulations and codes, then the Contractor shall notify the County in writing.

D. The Contractor agrees to indemnify and defend the County against any loss, cost, liability or damage (including reasonable attorney fees) due to the Contractor's violation of this section.

1.20 ARBITRATION

There will be no arbitration arising out of or relating to any contract resulting from this Invitation to Bid.

1.21 COMPLIANCE WITH TERMS

The County may at any time insist upon strict compliance with these terms and conditions, notwithstanding any previous custom, practice, or course of dealing to the contrary.

1.22 NON-DISCRIMINATION

Upon execution of agreement, the Contractor and its subcontractors, if used, shall not discriminate on the basis of race, color, sex, sexual orientation, religion, national origin, creed, marital status, age or the presence of any sensory, mental or physical handicaps in employment or application for employment or in the administration or delivery of services or any other benefits under the contract except to the extent permitted by bona fide occupation qualifications.

1.23 INTERPRETATION OF DOCUMENTS

The successful Contractor shall provide any work or materials clearly implied in the contract resulting from this Invitation to Bid, even if the contract documents do not mention it specifically. If the contract documents use words that are not defined therein but have a commonly accepted technical or trade meaning, the words shall be understood in accordance with that meaning. If any part of the contract requires work to be performed without describing how it is to be performed, the work shall be performed in accordance with standard trade practices. A "standard trade practice" is one having such regularity of observance in the trade as tojustifyanexpectationthatitwillbeobservedbytheContractorindoingthework.Onanyplansordrawings,figured dimensions shall take precedence over scaled dimensions. In case of any ambiguity or dispute over interpreting the contract, the Department's decision will be final.

BIDDER CHECKLIST

The omission or deletion of any bid item may be considered non-responsive and may be cause for the rejection of the bid.

1. Has a bid bond or certified check been enclosed with bid? Is the amount of the guarantee at least 5 percent of the total amount of the bid?

2. Has the bid been properly completed and signed in all required areas?

3. Have all addenda, if any, been acknowledged in the Bid Form?

4. Has the bidder reviewed the Bidder Qualifications and Bidder Responsibility Criteria and understand these obligations if selected as the apparent low bidder?

5. The following items must be completed and included within the sealed envelope:

A. Bidder Qualification Form

B. Bid Form

C. Bidder Representations and Certifications

D. Bid Surety Bond Form

6. The following items are to be executed after the contract is awarded to the lowest responsible bidder:

A. Agreement Form

B. Performance and Payment Bond

C. Certificates of Insurance END OF SECTION

BIDDER QUALIFICATIONS

Each bidder submitting a proposal for this project shall submit, as part of its bid, the following information:

1. Registered Name of Firm Submitting Bid:

2. Business Address:

3. Telephone Number (with Area Code):

4. E-mail address:

5. IRS Federal Employer’s Identification Number:

6. Current State Unified Business Identification (UBI) Number:

7. Washington State Contractor Registration Number:

8. Receipt of the following Addenda is hereby acknowledged:

1. Addendum No. _____ dated __________________

2. Addendum No. _____ dated __________________

3. Addendum No. _____ dated __________________

4. Addendum No. _____ dated __________________

5. Addendum No. _____ dated __________________

9. In compliance with the invitation to bid, bidder hereby proposes to perform all work for this project in strict accordance with the contract documents, within the time set forth therein, and at the prices bid. YES NO

10. The bidder certifies below that their bid complies in all respects with the attached specification documents, including the minimum specifications. YES NO

*If NO, attach additional pages detailing all proposed deviations.

11. In accordance with Chapter 42.23 RCW bidders must disclose any and all personal relatives, or any relatives of the bidder’s employees or subcontractors, who are presently employed by Cowlitz County, or who stand to realize any financial gain, or beneficial interest, if this contract is awarded to the bidder or any subcontractor of the bidder for the work of this invitation to bid.

The bidder certifies below that there are no persons meeting the criteria above that have any beneficial interest in the work of this invitation to bid. YES NO

*If NO, attach additional pages detailing the name of any person, organization, relationship and interest

Signature of Authorized Person:

Title: Date: END OF SECTION

BID FORM

NAME OF PROJECT: Headquarters Landfill On-Call Electrical Services PROJECT NUMBER: 2025-0065-01

Having carefully examined all bid documents provided by Cowlitz County, as well as the premises and conditions affecting the work, the Undersigned proposes to furnish all labor, equipment,and materials and perform all work inaccordance withthe terms & conditions attached Quantity of hours is estimated for determining low bidder – actual hours will vary.

BIDDER RESPONSIBILITY CRITERIA

Low Responsible Bidder

It is the intent of the County to award a contract to the low responsible bidder. In addition, the County shall consider an overall accounting of the items listed below, which the Bidder must meet. The Bidder must submit the Non-Collusion, Bidder Responsibility, and Minimum Wage Certification Form demonstrating that the meet the following criteria:

Bid Procedures and Conditions

Qualifications of Bidder

A. Bidders mustmeetthe minimumqualifications of RCW 39.04.350, as amended. Beforeaward of a public works contract, a bidder must meet the following responsibility criteria to be considered a responsible bidder and qualified to be awarded a public works project. The bidder must:

a. At the time of bid submittal, have a certificate of registration in compliance with chapter 18.27 RCW;

b. Have a current state unified business identifier number;

c. If applicable, have industrial insurance coverage for the bidder's employees working in Washington as required in Title 51 RCW; an employment security department number as required in Title 50 RCW; and a state excise tax registration number as required in Title 82 RCW;

d. Not be disqualified from bidding on any public works contract under RCW 39.06.010 or 39.12.065(3);

e. If bidding on a public works project subject to the apprenticeship utilization requirements in RCW 39.04.320, not have been found out of compliance by the Washington state apprenticeship and training council for working apprentices out of ratio, without appropriate supervision, or outside their approved work processes as outlined in their standards of apprenticeship under chapter 49.04 RCW for the one-year period immediately preceding the date of the bid solicitation;

f. Have received training on the requirements related to public works and prevailing wage under this chapter and chapter 39.12 RCW. The bidder must designate a person or persons to be trained on these requirements. The training must be provided by the department of labor and industries or by a training provider whose curriculum is approved by the department. The department, in consultation with the prevailing wage advisory committee, must determine the length of the training. Bidders that have completed three or more public works projects and have had a valid business license in Washington for three or more years are exempt from this subsection. The department of labor and industries must keep records of entities that have satisfied the training requirement or are exempt and make the records available on its web site. Responsible parties may rely on the records made available by the department regarding satisfaction of the training requirement or exemption; and

g. Within the three-year period immediately preceding the date of the bid solicitation, not have been determined by a final and binding citation and notice of assessment issued by the department of labor and industries or through a civil judgment entered by a court of limited or general jurisdiction to have willfully violated, as defined in RCW 49.48.082, any provision of chapter 49.46, 49.48, or 49.52 RCW.

B. In addition to the bidder responsibility criteria above, the Bidder must also meet the following relevant supplemental bidder responsibility criteria applicable to the project:

a. The Bidder shall not currently be debarred or suspended by the Federal government. The Bidder shall not be listed as a current debarred or suspended bidder on the U.S. General Services Administration’s “Excluded Parties List System” website. Bidder debarment or suspension status may be verified through this website: http://www.sam.gov/. The County may also use other sources of information that may be available to otherwise determine whether the Bidder is in compliance with these supplemental criteria.

b. The Bidder shall not have been convicted of a crime involving bidding on a public works contract within five (5) years prior to the bid submittal deadline. The Bidder shall provide a duly executed sworn statement (on the included form, or on a form otherwise determined to be acceptable by the County), that the Bidder has not been

convicted of a crime involving bidding on a public works contract. The County may also use other sources of information that may be available to determine whether the Bidder is in compliance with these supplemental criteria.

c. The Bidder’s standard subcontract form shall include the subcontractor responsibility language required by RCW 39.06.020, and the Bidder shall have an established written procedure which the Bidder uses to validate the responsibility of each of its subcontractors. The Bidder’s subcontract form shall also include a requirement that each of its subcontractors shall have and document a similar procedure to determine whether the sub-tier subcontractors with whom it contracts are also “responsible” contractors as defined per RCW 39.06.020. The County may also use other sources of information that may be available to determine whether the Bidder is in compliance with these supplemental criteria.

d. The Bidder shall not have a record of prevailing wage complaints filed against the Bidder within five (5) years prior to the bid submittal date that demonstrates a pattern of failing to pay workers prevailing wages, unless there are extenuating circumstances that are acceptable to the County. The County may also use other sources of information that may be available to determine whether the Bidder is in compliance with these supplemental criteria.

e. The Bidder shall not have had any public works contract terminated for cause by a government agency during the five (5) year period immediately preceding the bid submittal deadline for the project, unless there are extenuating circumstances acceptable to the County. The Bidder shall provide a duly executed sworn statement (on the included form, or in a form otherwise determined to the acceptable by the County), that the Bidder has not had any public works contract terminated for cause by a government agency during the five (5) year period immediately preceding the bid submittal deadline for the project. The County may also use other sources of information that may be available to determine whether the Bidder is in compliance with these supplemental criteria.

f. Within two (2) years prior to the bid submittal date the Bidder shall not have had a project construction site shut down due to a safety violation (i.e., WISHA/OSHA written citations) from the Washington State Department of Labor & Industries or analogous agency with jurisdiction in the location the work was performed, regardless of whether such willful and/or serious safety violations have been abated or not. The Bidder shall maintain compliance with all safety and health requirements (i.e., WISHA/OSHA) from the Washington State Departmentof Labor & Industries (or analogous agency with jurisdiction in the location the work is performed). The County mayverify suchinformation provided with the Washington StateDepartmentof Labor& Industries or analogous agency with jurisdiction in the location the work was performed. The County may also use other sources of information that may be available to determine whether the Bidder is in compliance with these supplemental criteria.

C. If a Bidder fails to supply the required bidder responsibility documentation, information, or materials, the Bidder may be determined by the County to be non-responsive, and the bid may be rejected on this basis. If the County determines the apparent successful bidder does not meet the bidder responsibility criteria above and is therefore not a responsible bidder, the County shall notify the bidder in writing with the reasons for its determination. If the bidder disagrees with thedetermination,itmayappealthedeterminationwithintwenty-four(24)hoursofreceiptoftheCounty’sdetermination by presenting additional written information to the County. The County will consider the additional information before issuing its final determination. If the County’s final determination affirms that the bidder is not responsible, the County will not execute a contract with any other bidder until two (2) business days after the bidder determined to be not responsible has received the final determination. Please note that the above-described information, materials, and documentation requested by the County for purposes of determining bidder responsibility is not necessarily exclusive, and the County expressly reserves the right to request additional information, materials, and documentation as may be determined to be necessary or desirable by the County in order to evaluate and determine Bidder’s compliance with the above-described bidder responsibility criteria. At all times, the County may also use other sources of information that may be available to otherwise determine whether the Bidder is in compliance with the forgoing bidder responsibility criteria.

NOTICE TO ALL BIDDERS

To report bid rigging activities call: 1-800-424-9071

The U.S. Department of Transportation (USDOT) operates the above toll-free “hotline” Monday through Friday, 8:00 a.m. to 5:00 p.m., ET. Anyone with knowledge of possible bid rigging, bidder collusion, or other fraudulent activities should use the “hotline” to report such activities.

The “hotline” is part of USDOT’s continuing effort to identify and investigate highway construction contract fraud and abuse and is operated under the direction of USDOT Inspector General. All information will be treated confidentially, and caller anonymity will be respected.

END OF SECTION

BIDDER REPRESENTATIONS AND CERTIFICATIONS

In accordance with the Contract Documents, the Bidder must provide the following sworn statement and certification:

I, , the undersigned declarant, as the duly authorized representative on behalf of

(herein the “Bidder”) hereby make this declaration on the basis of facts within the scope of my firsthand knowledge and authority to which I am competent to testify:

1. I hereby certify, swear, and affirm under penalty of perjury, that the Bidder, as of the date of this declaration (below) meets all of the minimum bidder responsibility qualifications of RCW 39.04.250, as amended.

2. I hereby certify, swear, and affirm under penalty of perjury, that the Bidder, as of the date of this declaration (below) meets all of the minimum project bidding requirements.

3. I hereby certify, swear, and affirm under penalty of perjury, that the Bidder, as of the date of this declaration (below) meets all of the supplemental bidder responsibility criteria as set forth in the Bidder Responsibility Criteria, Section B.

4. I hereby certify, swear, and affirm under penalty of perjury, that the undersigned is the person that submitted the bid herewith, that such bid is genuine and not a sham or collusive, or made in the interest of any person not therein named; and he/she further says that said Bidder has not directly or indirectly induced or solicited any Bidder on the above work and supplies to put in a sham bid, or any other person or corporation to refrain from bidding; and that said Bidder has not in any manner sought by collusion to secure himself to any other person an advantage over any other Bidder or Bidders.

5. I hereby certify, swear, and affirm under penalty of perjury, that no officer or employee of the County, having the power or duty to perform an official act or action related to this submittal, shall have or acquire any interest in this submittal, or have solicited, accepted or granted a present or future gift, favor, service, or other thing of value from or to any person involved in this submittal.

6. I hereby certify, swear, and affirm under penalty of perjury, that in connection with the performance of the work of this project, if awarded, I will pay each classification of laborer, workman, or mechanic employed in the performance of such work not less than the prevailing rate of wage or not less than the minimum rate of wages as specified in the Contract Documents.

7. Iherebycertify,swear,andaffirmunderpenaltyofperjury,thatinsubmittingthisbid werepresentthatthebiddocuments have been read in their entirety and are understood, that the site has been visited or that we have familiarized ourselves with the local conditions under which the work is to be performed, that by signature of this proposal we acknowledge all requirements and that we have signed all certificates contained herein.

8. I hereby certify, swear, and affirm under penalty of perjury, that in submitting this bid we acknowledge the requirements and conditions applicable to deposit in the form of a bid surety bond

9. I hereby certify, swear, and affirm under penalty of perjury, that to the best of my knowledge the information contained inthisproposalisaccurateandcompleteandthatIhavethelegalauthoritytocommitthisFirmtoacontractualagreement. I realize the final funding for any service is based upon budget levels and the approval of the County.

Signature of Authorized Person:

Title:

Date:

BID SURETY BOND FORM

NAME OF PROJECT: Headquarters Landfill On-Call Electrical Services PROJECT NUMBER: 2025-0065-01

FIRM NAME:

ADDRESS:

We, ______________________________________ as Principal, and as Surety, are held and firmly bound unto the COUNTY OF COWLITZ, a Washington State County, in the penal sum of $____________ ( ___________________ & ______/100dollars),forthepaymentofwhich we jointly and severally bind ourselves, and our legal representatives andsuccessors.

THE CONDITIONS OF THE OBLIGATION are that if the County of Cowlitz shall make timely award to the Principal according to the terms of the bid documents; and the Principal shall, within ten (10) days after notice of the award, exclusive of the day of notice, enter into the contract with the County of Cowlitz and furnishes the contractor's bond (performance and payment bond) with Surety satisfactory to Cowlitz County in an amount equal to one hundred percent (100%) of the amount of the bid proposed including Washington State Sales Tax then this obligation shall be null and void; otherwise if the Principal fails to enter into the contract and furnish the contractor's bond within ten (10) days after notice of the award, exclusive of the day of notice, the amount of the penal sum shall be forfeited to the County; but in no event will the Surety's liability exceed this bond's face amount.

SIGNED ANDSEALED THIS DAYOF YEAR20

SURETY

PRINCIPAL

TITLE:

CONTRACT SUMMARY

Contract Value: [$ ]

SAMPLE AGREEMENT FORM

COWLITZ COUNTY

CONSTRUCTION SERVICES AGREEMENT

PROJECT #2023- -01

Estimated Completion Date: ( ) continuous days after Notice to Proceed

Contract Type: Lump Sum, Cost Not-To-Exceed

Contract Administrator:

Email:

PARTIES

COUNTY:

Cowlitz County Washington

CONTRACTOR:

Company Name C/O Department Address

207 N. Fourth Ave, Room 308

City, State, Zip Kelso, WA 98626

Project Coordinator:

Phone:

Email:

Contact:

Phone:

Fax:

Email:

THIS AGREEMENT made and entered into effective the [ ] by and between COWLITZ COUNTY, a political subdivision of the State of Washington having offices for the transaction of business indicated above and hereinafter referred to as the “County”, and the “Contractor”, named and having offices for the transaction of business indicated above jointly, hereinafter referred to along with the County as the “Parties”.

WHEREAS, the Board of County Commissioners of Cowlitz County pursuant to the provisions of the Revised Code of Washington Section 36.32.120(6) has the care of County property and the management of County funds and business; and

WHEREAS, the Board of County Commissioners of Cowlitz County pursuant to the above cited statutory section and those provisions as set forth in the Revised Code of Washington Section 39.04.155, et seq. did let out for bid the Cowlitz County Morgue; Project #2020-0020-01.

WHEREAS, the Purchasing Service Department on behalf of Cowlitz County did on [ ]open said bid and did on [__________] accept the bid of the Contractor herein as the lowest responsible bidder for Cowlitz County bid [ ]

NOW, THEREFORE, for and in consideration of the mutual promises set forth herein, the parties hereto do mutually agree as follows:

ARTICLE 1. COMPENSATION, WORK AND SERVICES

The Contractor for the consideration of [________________________________] ($___________.__), not including sales tax, for work performed as specified in the “Contract Documents” as enumerated herein below, shall in strict accordance with all of the provisions therein, perform all work and provide all materials called for by the Contract Documents Project #2020-0020-01 The County agrees to pay the Contractor for said work as specified in the “Contract Documents.”

SAMPLE

ARTICLE 2. CONTRACT DOCUMENTS

The Contract Documents consist of this Agreement and other documents listed below issued prior to the execution of this Agreement and all modifications and change orders issued subsequent thereto. These form a contract and all are as fully a part of the contract as if attached to this Agreement or repeated herein. In the event of a conflict between documents the order of precedence will be the order listed below. An enumeration of the contract documents is set forth below:

1.Change Orders;and 2.Notice to Proceed; and 3.Notice of Award; and 4.Agreement;and 5.Addenda; and

6.Procurement & Contract Requirements, Project Specifications and Drawings;and 7.The provisions of Cowlitz County Bid No. [ ];and

8.The bid proposal of the contractor dated [ ]

ARTICLE 3. RELATIONSHIP OF THE PARTIES

The parties intend that an independent contractor relationship will be created by this Agreement. The County is interested only in the results to be achieved, and the conduct and control of all services or work will lie solely with the Contractor. No agent, employee, servant or otherwise of the Contractor shall be or shall be deemed to be an employee, agent, servant or otherwise of the County for any purpose, and the employees of the Contractor are not entitled to any of the benefits that the County provides for County employees. The Contractor will be solely and entirely responsible for its acts and for the acts of its agents, employees, servants, subcontractors, or otherwise during the performance of his Contract. In the performance of the services herein contemplated, the Contractor is an independent contractor with the authority to control and direct the performance and details of the work, the County being interested only in the results obtained; however, the work contemplated herein must meet the approval of the County pursuant to the provisions of the agreement under which the services and work were let to the Contractor.

ARTICLE 4. INDEMNIFICATION

The Contractor is an independent contractor and not the agent or employee of the County. No liability shall attach to the County for entering into this Contract or because of any act or omission of the Contractor except as expressly provided.

The Contractor agrees to defend, indemnify and hold the County and the County's Consultant(s), when used on the project, harmless from any and all claims, including but not limited to reasonable attorney fees, demands, losses and liabilities to or by third parties arising from, resulting from or connected with services performed or to be performed under this contract by the Contractor, its agents or employees to the fullest extent permitted by law. The Contractor's duty to indemnify the County and Consultant shall not apply to liability for damages arising out of bodily injury to persons or damage to property caused by or resulting from the sole negligence of the County or Consultant, their agents or employees. The Contractor's duty to indemnify the CountyandConsultantforliabilityfordamagesarisingoutofbodilyinjurytopersonsordamagetopropertycausedbyorresulting from the concurrent negligence or (a) the County or Consultant, their agents or employees, and (b) Contractor, its agents or employees shall apply only to the extent of negligence of the Contractor or its agents or employees. Contractor's duty to defend, indemnify and hold the County harmless shall include, as to all claims, demands, losses and liability to which it applies, the County's personnel-related costs, reasonable attorney's fees, court costs and all other claim-related expenses.

The Contractor's indemnification shall specifically include all claims for loss liability because of wrongful payments under the Uniform Commercial Code, or other statutory or contractual liens or rights or third parties, including taxes, accrued or accruing as a result of this contract or work performed or materials furnished directly or indirectly because of this contract.

Contractor further agrees that this duty to indemnify County applies regardless of any provisions in RCW Title 51 to the contrary, including but not limited to any immunity of Contractor for liability for injuries to Contractor's workers and employees, and Contractor hereby waives any such immunity for the purpose of this duty to indemnifyCounty.

ARTICLE 5. TERMINATION

Contract(s) resulting from this bid may be terminated, in whole or in part, under the following conditions: 1) by mutual written agreement; 2) by the County for breach by the bidder of any of the obligations or requirements set forth in the contract documents. The County retains the option to require the bidder to assume liability for all damages, including the excess of re-procuring similar products or services; 3) for the convenience of the County; or 4) by the County for non-appropriation of funds.

ARTICLE 6. TERMINATION BY THE COUNTY WITHOUT CAUSE

SAMPLE

Notwithstanding any other provisions contained herein, the County, without cause, may terminate the contract between the parties by providing notice to the Contractor. Upon termination under this section: 1) All remaining obligations of the parties are discharged, but any right based upon breach or performance occurring prior to termination survives; 2) If the reasonable costs of performance incurred by the Contractor prior to termination exceed the amount paid by the County to the Contractor on the Contract Sum, the County shall reimburse the Contractor in the amount of such excess; 3) If the amount paid by the County to the Contractor on the Contract Sum exceeds the reasonable costs of performance incurred by the Contractor prior to termination, the Contractor shall reimburse the County in the amount of such excess; 4) Any funds obtained or retained by the Contractor as provided in 2) or 3) of this paragraph, shall constitute full payment and consideration for the services performed by the Contractor prior to termination.

ARTICLE 7. MAINTENANCE OF RECORDS

The Firm will maintain, for at least three (3) years after completion of this contract, all relevant records pertaining to this contract. The Firm shall make available to the County or the Washington State Auditor or their duly authorized representatives, at any time during their normal operating hours, all records, books or pertinent information which the Firm shall have kept in conjunction with this Agreement and which the County may be required by law to include or make part of its auditing procedures, an audit trail or which may be required for the purpose of funding the services contracted for herein.

ARTICLE 8. VENUE STIPULATION

This Agreement has and shall be construed as having been made and delivered in the State of Washington, and the laws of the State of Washington shallbeapplicable to its constructionand enforcement.Anyactionatlaw, suit in equity or judicialproceeding for the enforcement of this Agreement or any provisions hereto shall be instituted only in courts of competent jurisdiction within

Cowlitz County, Washington, unless relocation or commencement elsewhere is required by law.

ARTICLE 9. COMPLIANCE WITH LAWS

The Contractor in the performance of this Agreement agrees to comply with all applicable federal, state and local laws, ordinances and regulations including but not limited to those pertaining to civil rights. The Contractor may not, without the prior written approval of the County, assign, sublet or transfer in whole or in part his interest in this Agreement.

ARTICLE 10. INTEGRATION

This Agreement contains all the terms and conditions agreed upon by the Parties. No other understanding, oral or otherwise regarding the subject matter of this Agreement shall be deemed to exist or to bind any of the parties. All Parties have read and understand the above contract and now state that no representations, promises, or agreements not expressed by this Agreement have been made to induce the other to execute the same.

ARTICLE 11. LIQUIDATED DAMAGES

Time is of the essence in the performance of the contract. Because the County finds it impractical to calculate the actual costs of delays, it has adopted the Liquidated Damage Table in the Bid Documents.

Liquidated damages will not be assessed for any days for which an extension of time is granted. No deduction or payments of liquidated damages will in any degree, release the Contractor from further obligation and liabilities to complete the entire work.

ARTICLE 12. RECOVERY OF FUNDS

Whenever, under the contract, any sum of money shall be recoverable from or payable by the Contractor to Cowlitz County the same amount may be deducted from any sum due to the Contractor under the contract or under any other contract between the contractor and Cowlitz County. The rights of Cowlitz County are in addition and without prejudice to any other right Cowlitz County may have to claim the amount of any loss or damage suffered by Cowlitz County on account of the acts or omissions of the Contractor.

ARTICLE 13. ENFORCEMENT COSTS

If any legal action or other proceeding is brought for the enforcement of this Contract, or because of an alleged dispute, breach, default or misrepresentation in connection with any provisions of this Contract, the successful or prevailing party or parties shall be entitled to recover reasonable attorney's fees, court costs, and all expenses (including taxes) even if not taxable as court costs (including, without limitation, all such fees, costs, and expenses incident to appeals), incurred in that action or proceeding, in addition to any other relief to which such party or parties may be entitled.

ARTICLE 14. ANTI-KICKBACK

No officer or employee of the County, having the power or duty to perform an official act or action related to this Agreement, shall have or acquire any interest in this agreement, or have solicited, accepted or granted a present or future gift, favor, service, or other thing of value from or to any person involved in this Agreement.

ARTICLE 15. WAIVER

No officer, employee, agent or otherwise of the COUNTY has the power, right or authority to waive any of the conditions or provisions to this Agreement. No waiver of any breach of this Agreement shall be held to be a waiver of any other or subsequent breach. All remedies afforded in this Agreement or at law shall be taken and construed as cumulative, that is, in addition to every other remedy provided herein or by law. Failure of the COUNTY to enforce at any time any of the provisions of this Agreement or to require at any time performance by CONTRACTOR of any provision hereof, shall in no way be construed to be a waiver of such provisions, nor in any way affect the validity of this Agreement or any part hereof, or the right of the COUNTY to hereafter enforce each and every such provision.

ARTICLE 16. EXECUTION

The PARTIES warrant that the officers/individuals executing below have been duly authorized to act for and on behalf of the Party for purposes of confirming this Agreement.

SAMPLE

ARTICLE 17. COUNTERPARTS

This Agreement may be executed in any number of counterparts, each of which, when so executed and delivered, shall be an original, but such counterparts shall together constitute but one and the same.

ARTICLE 18. THIRD PARTY BENEFICIARIES

This Agreement is intended for the benefit of the COUNTY and CONTRACTOR and not for the benefit of any third parties.

ARTICLE 19. SURVIVAL

Without being exclusive, the Article for Indemnification and the Article for Venue Stipulation of this Agreement shall survive any termination, expiration or determination of invalidity of this Agreement in whole or in part. Any other Articles of this Agreement which, by their sense and context, are intended to survive shall also survive.

IN WITNESS WHEREOF, the said Contractor has executed this instrument, and the said Board of County Commissioners

pursuant to resolution duly adopted, has caused this instrument to be executed by and in the name of said Board on the day and year set forth herein. CONTRACTOR

BOARD OF

COUNTY COMMISSIONERS OF COWLITZ COUNTY, WASHINGTON

Signature

Print Name

Title

Date: _____________________, 20 ______

Richard R. Dahl, Chairman

Steve Rader, Commissioner

SAMPLE

Steven L. Ferrell, Commissioner

ATTEST:

Kelly Grayson, Clerk of the Board

Meeting Date: 10/21/2025

Call for Bids: Tennant Way Landfill On-Call Services ITB# 2025-0066-01

Submitted For: Shawn Roewe

Department: Public Works

Subject and Summary Statement

Submitted By: Ashley Claussen

Information

Attached are the necessary documents to issue the Call for Bids for as-needed electrical and mechanical services at the Tennant Way Landfill.

Bids will be due to Purchasing Services by 1:30 PM on November 17, 2025.

Will Staff Attend - NAME OF STAFF No.

Department Recommendation

It is the recommendation of the Department of Public Works that the Board move to approve the Call for Bids and publish the Notice to Contractors in the usual manner.

Attachments

Call for Bids

Invitation to Bid

Form Started By: Ashley Claussen

Form Review

Started On: 10/14/2025 05:07 PM

CALL FOR BIDS

Cowlitz County Purchasing Services will receive sealed bids until November 17, 2025, at 1:30 PM (Pacific Time) for the following work: TENNANT WAY LANDFILL ON-CALL SERVICES

At that time all bids will be publicly opened and read in the Public Works Training Room. Bids must be addressed to:

Cowlitz County Public Works

Attn: Ashley Claussen, Purchasing Services

Tennant Way Landfill On-Call Services: ITB #2025-0066-01 1600 13th Avenue S Kelso, WA 98626

Bids must be mailed or delivered in person to the address above. Late, faxed, or emailed bids will not be accepted. The County’s decision on bid receipt time is final.

The bid opening will be accessible via Zoom by visiting https://us06web.zoom.us/j/84447159296. Following the opening, a recorded video and bid results will be posted on the County’s website

Bid documents and addenda are available online at https://www.co.cowlitz.wa.us/bids.aspx. Bidders are responsible for checking for addenda. No paper copies will be provided, but plans may be reviewed at the Clerk of the Board’s office.

All bid proposals shall be accompanied by a bid proposal deposit in cash, certified check, cashier’s check, or surety bond in an amount equal to five percent (5%) of such bid proposal. Should the successful bidder fail to enter into such contract and furnish satisfactory performance bond within the time stated in the specifications, the bid proposal deposit shall be forfeited to Cowlitz County.

All documents received in response to this invitation to bid will become a matter of public record and subject to the Washington public disclosure act under chapter 42.56 RCW.

The Board reserves the right to reject any and all bids and to waive any immaterial irregularities or informalities in any bid or in the bidding.

DATED this 21st day of October 2025.

BOARD OF COUNTY COMMISSIONERS OF COWLITZ COUNTY, WASHINGTON

Richard R. Dahl, Chairman

Attest: Kelly Grayson, Clerk of the Board

Steve Rader, Commissioner

Steven

INVITATION FOR BIDS

Cowlitz County invites interested and qualified contractors to submit sealed bids for the following project:

TITLE: Tennant Way Landfill On-Call Services

ESTIMATED CONTRACT AMOUNT: $75,000.00

BID SUBMITTAL TIME/DATE/LOCATION: Prior to 1:30 PM local time on November 17, 2025 to:

Cowlitz County Public Works

Attn: Ashley Claussen, Purchasing Services

Tennant Way Landfill On-Call Services: ITB #2025-0066-01 1600 13th Avenue S Kelso, WA 98626

Bids can be mailed or delivered in person to the address listed above. Cowlitz County will assume no responsibility for any delay in U.S., County, or any other delivery service resulting in a bid being received late. Faxed and/or E-mailed bids will not be accepted.

PUBLIC BID OPENING:

PRE-BID CONFERENCE:

ITEM FOR BID:

Bids will be opened and read aloud at the time and place specified above The bid opening will take place in the Cowlitz County Public Works Training Room. Members of the public may attend in person, or virtually via Zoom at https://us06web.zoom.us/j/84447159296. Following the opening, a recorded video and bid results will be posted on the County’s website at https://www.co.cowlitz.wa.us/Bids.aspx?BidID=459.

No pre-bid conference will be held. Questions regarding the project will be received until October 31, 2025 at 4:00 PM.

Cowlitz County is seeking bids for as-needed electrical and mechanical services at the Cowlitz County Tennant Way Landfill located at 85 Tennant Way in Longview, Washington. The contractor shall provide labor, materials, subcontracting, fees, permitting, and supervision to perform troubleshooting, diagnostics, maintenance, repairs, and other agreed upon work. One agreement will be awarded as a result of this solicitation. The initial term of the resulting agreement will be for one year, with the option to extend for one additional year at the discretion of the County.

BID SUBMITTAL ENVELOPE:

Upon submittal, bids will be recorded by Cowlitz County as to time and date received and secured until the time set for public bid opening. All bid submittals shall be sealed in an opaque envelope which has been clearly marked with “Tennant Way LandfillOn-Call Services: ITB #2025-0066-01.” NO BIDS WILLBEACCEPTED AFTER THEBID SUBMITTAL TIME.

CONTRACTOR REGISTRATION:

Pursuant to RCW 39.06, the bidder shall be registered and licensed as required by the laws of the State of Washington, including but not limited to RCW 18.27. In order to perform public work, the successful bidder and subcontractors, prior to contract award, shall hold or obtain such licenses and registrations as required by State Statutes and Coded, and Federal and local laws and regulations.

BID SECURITY:

Certified check,bankcashier’s check, orbid bond congruentwith theBid Bond Security Formas identified in the “Instructions to Bidders” section is required to be submitted with each bid in response to this solicitation.

SUMMARY OF WORK

1. The project location is Tennant Way Landfill located at 85 Tennant Way in Longview, Washington.

2. Contractor shall perform troubleshooting, diagnostics, maintenance, repair, installation, inspection, testing, and calibration on a variety of electrical and industrial equipment, including but not limited to:

a. Low and medium voltage systems (up to 12.4kV)

b. Uninterruptible Power Supplies (UPS)

c. Motor Control Centers (MCC)

d. Automatic Transfer Switches (ATC)

e. Actuators

f. Transformers

g. Switchgear

h. Panels

i. Protection Relays

j. Battery Banks

k. DC Chargers

l. Inverters

m. Power Converters

n. Breakers

o. Motors

p. Pumps

q. Generators

r. Process Valves and Pumps

s. Hydraulic/Pneumatic Systems

t. Mechanical staging, erection, and/or rigging of equipment

u. Mechanical fabrication

3. The Contractor shall perform services including, but not limited to:

a. Troubleshooting, diagnostics, maintenance, and repair of equipment listed above.

b. Coordination and subcontracting with manufacturers to provide factory-trained and certified technicians when required to maintain warranty or UL listing.

c. Coordination and subcontracting with highly specialized firms when expertise is beyond the Contractor’s workforce.

d. Installation, inspection, testing, and calibration of components involved in industrial systems including thermostats, direct digital control systems, VFDs, electrical control circuits, etc.

e. Rebuild and/or replacement of pumps and motors.

f. Inspection, rebuilding, or replacement of electrical devices including panels, starters, contactors, signal cables, and receptacles. Includes electrical wiring, switches, and lighting.

g. Inspection, repair,programming, or replacementofbuilding systems such asfire alarm panels,building controls, sensors, alarms, interlocked controls, leak detection systems, generators, door controls, lighting systems, and fire suppression equipment.

h. Mechanical services including hydraulic and pneumatic system maintenance, mechanical staging, erection, rigging, and fabrication as required.

i. Support services including material purchasing and equipment rental.

j. Other services as required by the County and mutually agreed upon.

4. Contractor is responsible for all necessary permits including filing, payments, and scheduling.

5. All work shall be performed in accordance with local, state, and federal codes, including the National Electrical Code (NEC), and shall comply with all applicable occupational safety regulations. Contractor is responsible for ensuring that all personnel follow OSHA regulations and relevant industry safety standards, including but not limited to:

a. Lockout/Tagout (LOTO) procedures

b. Arc Flash Protection (NFPA 70E)

c. Confined Space Entry (when applicable)

d. Fall Protection

6. Contractor shall provide all required personal protective equipment (PPE) and ensure that staff are trained and certified in applicable safety procedures. The County reserves the right to request proof of training and compliance at any time.

7. All work shall be performed by appropriately licensed electricians or qualified technicians experienced in industrial electrical systems. Contractor shall provide documentation of licensing, certifications, or manufacturer training upon request.

8. Contractor must be capable of providing qualified technical personnel from its own workforce to respond to all service requests.

9. The successful contractor will receive task order requests for individual projects from a specified Cowlitz County representative. Upon receipt of task order requests, the contractor shall provide a written estimate for County approval prior to commencement of services. Quotes shall be firm fixed not to exceed cost and shall be inclusive of all labor, materials, equipment, supervision, taxes, etc. Overtime rates shall not be billed unless specifically approved in writing by the Cowlitz County representative prior to the commencement of work.

10. Routine (non-emergency) projects shall be scheduled during normal business hours from 8:00 a.m. to 5:00 p.m., Monday through Fridayexceptfor theCounty’s officialholidays.Outside hours workwill include all other times Monday through Friday, and all day on Saturday, Sunday, and official holidays.

11. TheContractorshallbeexpectedtoprovideemergencyresponses/serviceswhenrequestedbytheCounty.TheContractor shall respond to the County within one (1) hour of the request and shall be on specified location for such emergency requests for repairs within two (2) hours from the time of the initial on-call service request.

12. All work is to be billed on a unit-priced basis as provided by the contractor on the attached bid form. Invoices may be submitted upon completion of each task order, or monthlyfor larger projects. Each taskorder shall be invoiced separately with both the contract number and task order number included. Unless otherwise specified or mutually agreed to in writing, all prices shall be fixed throughout the duration of the contract. The contractor shall give Cowlitz County at least thirty (30) days’ written notice of change in rates and the effective date of the proposed change. In the event the County and the contractor cannot agree on an adjustment request, Cowlitz County may terminate the agreement.

13. Mobilization shall be included in the base unit price for each work order and shall consist of preparatory work and operations performed by Contractor, including his personnel, equipment, supplies, and incidentals to the project site. No separate measurement or payment will be made for costs associated with mobilization and demobilization.

14. The services outlined in this scope are not exclusive. Cowlitz County reserves the right to solicit competitive bids and contract for repairs and services with other providers.

15. Poor or unsatisfactory performance may result in reduced task order execution or contract termination. Cowlitz County reserves the right to conduct periodic performance reviews, assessing:

a. Timeliness and responsiveness

b. Quality of workmanship

c. Compliance with safety and code requirements

d. Accuracy of documentation and invoicing

e. Communication and professionalism

INFORMATION FOR BIDDERS

1.01 PREPARATION OF BIDS

A. Bids must be: (1) submitted on the bid proposal forms, or copies of forms, furnished by the County and (2) signed in ink. The person signing a bid must initial each change appearing on any bid form. If the bid is made by a corporation, it shall be signed by the corporation’s designee. The address of the bidder shall be typed or printed on the bid form in the space provided.

B. If the solicitation includes alternate bid items, failure to bid on the alternates may disqualify the bid. If bidding on all items is not required, bidders should insert the words “no bid” in the space provided for any item on which no price is submitted.

C. Substitute bid proposals will not be considered unless this solicitation authorizes their submission.

D. It will be the responsibility of the bidder to conform to the requirements; failure to comply with exact specifications could result in rejection of bid documents.

1.02 BID GUARANTEE

A. A bid guarantee in the amount of 5% of the entire bid amount is required. Failure of the bidder to provide bid guarantee when required shall render the bid non-responsive.

B. Acceptable forms of bid guarantee are a bid bond or postal money order, or certified check or cashier’s check made payable to Cowlitz County

The County will return bid guarantees (other than bid bond) to unsuccessful bidders as soon as practicable, but not sooner than the execution of a contract with the successful bidder. The successful bidder’s bid guarantee will be returned to the successful bidder with its official notice to proceed with the work of the contract.

1.03 ADDITIVE OR DEDUCTIVE BID ITEMS

The low bidder, for purposes of award, shall be the responsive bidder offering the low aggregate amount for the base bid item, plus additive or deductive bid alternates selected by the County, and within funds available for the project.

The bidder agrees to hold all bid alternate prices for sixty (60) days from date of bid opening.

1.04 ACKNOWLEDGEMENT OF ADDENDA

All official clarifications or interpretations of this Invitation to Bid will be by written addenda and issued by the Purchasing Department. Bidders shall acknowledge receipt of all addenda to this solicitation by identifying the addenda numbers in the space provided for this purpose on the bid proposal form. Failure to do so may result in the bid being declared non-responsive.

1.05 SITE INVESTIGATION AND CONDITIONS AFFECTING THE WORK

The bidder acknowledges that it has taken steps necessary to ascertain the nature and location of the work, and that it has investigated and satisfied itself as to the general and local conditions which can affect the work or its cost, including but not limited to (1) conditions bearing upon transportation, disposal, handling, and storage of materials; (2) the availability of labor, water, electric power, and road; (3) uncertainties of weather, river stages, tides, or similar physical conditions at the site; (4) the conformation and conditions of the ground; and (5) the character of equipment and facilities needed preliminary to and during the work. The bidder also acknowledges that is has satisfied itself as to character, quality, and quantity of surface and subsurface materials or obstacles to be encountered insofar as this information is reasonably ascertainable from an inspection of the site, including exploratory work done by the County, as well as from the drawing and specifications made a part of this contract. Any failure of the bidder to take the actions described and acknowledged in this paragraph will not relieve the bidder from responsibility for estimating properly the difficulty and cost of successfully performing the work.

1.06 BID AMOUNTS

A. The bid prices shown for each item on the bid proposal shall include all labor, material, equipment, overhead and compensation to complete all of the work for that item. All prices including bid prices are in US funds.

B. The actual cost of building permit (only) and the public utility hookup fees will be a direct reimbursement to the Contractor or paid directly by the permitting agency by the County. Fees for these permits should not be included by the bidder in the bid amount.

C. The bidder agrees to hold the base prices for sixty (60) days from the date of bid opening.

1.07 TAXES

The County is required to pay Washington State Sales Tax on all purchases and contracts. Sales tax should be added as a separate item only, not to be included in the base bid price. All bidders whether inside or outside the state of Washington shall show the tax rate applicable to this bid. All taxes payable by the County as a result of this contract are considered part of the bid evaluation. Washington State tax is payable by the County direct to the state of Washington on awards made to out-of- state contractors who do not have a Washington State Sales Tax number. If you have any questions concerning the appropriate rate, contact the Washington State Department of Revenue.

If a cash discount is offered and taken it is understood that sales tax will be applied to the discounted amount.

It shall be the contractor's responsibility to furnish Federal Excise Tax Exemption Certificate, when applicable.

1.08 SUBMISSION OF BIDS

A. Bid proposals must be submitted on or before the time specified in the Invitation to Bid.

B. If the base bid and the sum of additive alternates is one million dollars or more, the bid proposal shall comply with the following requirements:

1. Pursuant to RCW 39.30.060, if the base bid and the sum of bid additive alternates is one million dollars or more, the bidder shall provide names of the subcontractors with whom the bidder will subcontract for performance of heating, ventilation and air condition (HVAC), plumbing, and electrical.

2. The bidder can name itself for the performance of the work.

3. The bidder shall not list more than one subcontractor for each category of work identified UNLESS subcontractors vary with bid alternates, in which case the bidder must indicate with subcontractors will be used for which alternate.

4. Failure of the bidder to submit as part of the bid the names of such subcontractors or to name itself to perform such work shall render the bid non-responses and, therefore, void.

C. The bid proposal shall be submitted in a sealed envelope addressed to the office specified in the Invitation to Bid. The envelope shall have printed outside:

1. The project number.

2. The name and address of the bidder.

3. Identification as bid proposal.

D. Prior to the bid opening, the County’s representative will designate the official bid clock. Any part of the bid proposal or bid modification not received prior to the times specified, per the designated bid clock, will not be considered and the bid will be returned to the bidder unopened.

E. A bid may only be withdrawn in person by a bidder’s authorized representative prior to the opening of the bids. Bidder(s) representative will be required to show ID and sign on bid summary sheet before it will be released.

F. A change to the bid already received will be considered only if the changes are received prior to the opening of the bids. All changes shall be made in writing, executed, and submitted in the same form and manner as the original bid

G. People with disabilities who wish to request special accommodation, (e.g., sign language interpreters, Braille, etc.) need to

contact the County ten (10) working days prior to the scheduled bid opening.

1.09 BID OPENING

A. At the time and place included in this Invitation to Bid, each bid that has been received, except those thathave been properly withdrawn, will be opened and evaluation shall begin.

B. The County reserves the right to postpone the date and time last announced for receiving bids and such postponement may be made at any time prior to the opening of the bids. The County will give written notice by issuance of an addendum confirming the changing of the announced date and time for receiving bids.

C. In the event a bidder discovers an error in its bid following the bid opening, the bidder may request to withdraw its bid under the following conditions:

1. Written notification is received by the County within 24 hours following bid opening.

2. The bidder provides written documentation of the claimed error to the satisfaction of the County within 72 hours following the bid opening.

D. TheCountywillapproveordisapprovetherequestforwithdrawalofthebidinwriting.Ifthebidder’srequestforwithdrawal of its bid is approved, the bidder will be released from further obligation to the County without penalty. If it is disapproved, the County may retain the bidder’s bid guarantee.

1.10 BID RESULTS

After bid openings, bid results can be obtained from the Procurement Services office by calling (360) 577-3030 ext. 6856 or by visiting the County website at: https://www.co.cowlitz.wa.us/Bids.aspx?BidID=459

1.11 LOW RESPONSIBLE BIDDER

Beforeawardofapublicworkscontract,abiddermustmeetthefollowingmandatoryresponsibilitycriteriaunderRCW39.04.350 (1) to be considered a responsible bidder and qualified to be awarded a public works project. The bidder must:

A. At the time of bid submittal, have a certificate of registration in compliance with chapter 18.27 RCW;

B. Have a current state unified business identifier number;

C. If applicable, have industrial insurance coverage for the bidder's employees working in Washington as required in Title 51 RCW; an employment security department number as required in Title 50 RCW; and a state excise tax registration number as required in Title 82 RCW;

D. Not be disqualified from bidding on any public works contract under RCW 39.06.010 or 39.12.065(3);

E. If bidding on a public works project subject to the apprenticeship utilization requirements in RCW 39.04.320, not have been found out of compliance by the Washington state apprenticeship and training council for working apprentices out of ratio, without appropriate supervision, or outside their approved work processes as outlined in their standards of apprenticeship under chapter 49.04 RCW for the one-year period immediately preceding the date of the bid solicitation;

F. Have received training on the requirements related to public works and prevailing wageunder this chapter and chapter 39.12 RCW. The bidder must designate a person or persons to be trained on these requirements. The training must be provided by the department of labor and industries or by a training provider whose curriculum is approved by the department. The department, in consultation with the prevailing wage advisory committee, must determine the length of the training. Bidders that have completed three or more public works projects and have had a valid business license in Washington for three or more years are exempt from this subsection. The department of labor and industries must keep records of entities that have satisfied the training requirement or are exempt and make the records available on its web site. Responsible parties may rely on the records made available by the department regarding satisfaction of the training requirement or exemption; and

G. Within the three-year period immediately preceding the date of the bid solicitation, not have been determined by a final and binding citation and notice of assessment issued by the department of labor and industries or through a civil judgment

entered by a court of limited or general jurisdiction to have willfully violated, as defined in RCW 49.48.082, any provision of chapter 49.46, 49.48, or 49.52 RCW.

1.12 BID EVALUATION

A. The County will evaluate bids responsiveness and responsibility.

1. A bid will be considered responsive it if meets the following requirements:

a) It is received at the proper time and place.

b) It meets the stated requirements of the bid proposal.

c) It is submitted by a licensed/registered contractor within the state of Washington at the time of bid opening and is not banned from bidding by the Department of Labor and Industries.

d) It is accompanied by a bid guarantee.

2. A bid will be considered responsible if it meets the following requirements:

a) It meets the mandatory responsibility criteria established in RCW 39.05.350 and an overall accounting of the supplemental responsibility criteria established for the project.

B. The Board or their designee reserves the right to reject any or all bids for good cause shown, to waive minor deviations from the specifications, and to waive any informality in bids received when such acceptance, rejection, or waiver is in the best interest of the County. Without limiting the generality of the foregoing, the County may reject any Bid which is incomplete, non-responsive, obscure or irregular, any Bid which omits a bid on any items for which bids are required, any Bid which omits unit prices, if unit prices are required, any Bid in which unit prices are unbalanced in the opinion of the County, and any Bid from a Bidder which has previously failed to perform satisfactorily or which has failed to meet contract deadlines to complete construction or delivery of any nature. All bids or proposals are likely to be rejected if the lowest responsive bid received exceeds the project’s estimate by an unreasonable amount or the budget by any amount. If all bids are rejected for either of these reasons, the project may be deferred and re-bid when more competitive conditions exist.

C. The County may negotiate bid price adjustments with the low responsive bidder, including changes to the contract documents, to bring the bid within the available funding per RCW 39.04.015

D. The apparent low bidder, for purpose of award, shall be the responsive and responsible bidder offering the low aggregate amount for the base bid plus selected additive or deductive bid alternates and meeting all other bid submittal requirements.

1.13 BID PROTESTS

When the County receives a written protest from a bidder for a public works project which is the subject of competitive bids, the County will not execute a contract for the project with anyone other than the protesting bidder without first providing at least two full business days' written notice of the County's intent to execute a contract for the project; provided that the protesting bidder submitsnoticeinwritingofitsprotestnolaterthantwofullbusinessdaysfollowingbidopening.IntermediateSaturdays,Sundays, and legal holidays are not counted.

A protest submittal will be delivered to the Cowlitz County Purchasing Services Department, 1600 13th Ave S, Kelso WA 98626, with the words "Bid Protest" prominently and clearly displayed on any outer cover containing the protest notice as well as on the notice itself. The following minimum information should be included in the written protest notice: 1) The name, address and phone number (including area code) of the bidder; and 2) the bidder contact person's name and telephone number (including area code); and 3) a statement(s) describing the nature of the protest; and 4) the County bid number and title.

1.14 BID AWARD

A. The bidder will allow 60 days from bid opening date for acceptance of its bid and award of agreement made by the County.

B. Agreement will be awarded to the lowest responsible and responsive bidder.

C. The acceptance of a bid willbe evidenced by a Notice ofAward inwriting signed by a duly authorized official of the County and delivered to the bidder whose bid is accepted, in the manner provided for written notices. No other action or notice shall constitute acceptance of a bid. The Notice of Award shall not entitle the Bidder to any contractual or other remedies against the County.

D. Bid award does not itself constitute a contract. The bidder will have ten (10) days from the date of the notice of award, exclusive of the day of notice, to provide:

1. A signed agreement form.

2. Contractor’s Payment and Performance Bond.

3. Certificate of Insurance.

E. If the apparent successful bidder fails to sign all contractual documents or provide the bond and insurance as required or return documents within 10 days after receipt of the contract, the County may terminate the award of the contract.

F. No bid shall be binding upon the County until an agreement has been properly executed by the Contractor and County.

1.15 INSURANCE

A. The successful bidder shall be required to pay for, provide, and maintain insurance coverage that satisfies the requirements of the Cowlitz County Risk Management Department and that meets all terms and conditions of the contract bid and/or award. The insurance shall be provided at the Contractor’s sole expense and maintained for the duration of the contract. Any exclusion that may restrict required coverage must be pre-approved by the County Risk Management Department.

B. A certificate of insurance shall be provided in the specified amounts and with the following additional insured endorsement: "Cowlitz County, its officers, agents and employees are named as an additional insured as respects to project number SWR#2024-0030-xx ” The certificate holder will be Cowlitz County, C/O Cowlitz County Purchasing Services, 1600 13th Ave S, Kelso, WA 98626.

C. REQUIRED COVERAGE:The insurance shall provide the minimum coverage as set forth below:

1. GENERALLIABILITY INSURANCE:The Contractor shallhave Commercial General Liability coveragewith limits of $1,000,000.00peroccurrence,$2,000,000aggregate.Thiscoverageshallincludeproducts,completeoperations,personal injury, fire damage, and medicalexpenses.

2. PROOFOFAUTOMOBILE INSURANCE:The Contractor shall carry, for the duration of this Agreement, comprehensive automobile liabilitycoverageof $1,000,000.00 for anyvehicle used in conjunction with the provision of services under the termsof this Contract.Saidpolicy shall provide that it shall not be canceled, materially changed, or renewedwithoutfortyfive(45)dayswrittennotice priortheretotoCowlitzCounty.

3. WORKERS COMPENSATION: When the Contractor has employees of the company, the Contractor shall carry Worker’s Compensation Industrial Injury Insurance coverage and effective in Washington State. Proof of insurance shall be reflected on the Contractor’s Certificate of Insurance or by providing the Contractor’s State Industrial Account Identification Number.

D. All insurance policies must be issued by insurers licensed to do business in the State of Washington, name Cowlitz County as an additional insured on General and Automobile Liability policies and be primary and non-contributory to any insurance maintained by the County. Policies must also include a severability of interests clause, applying coverage separately to each insured, and provide at least 30 days’ written notice to the County prior to cancellation or material change, unless otherwise specified.

E. Upon satisfactory fulfillment of these requirements and contract signature by the Cowlitz County Board of County Commissioners the contract will be considered to be executed and a written Notice to Proceed will be issued.

1.16 CONTRACTOR’S PAYMENT AND PERFORMANCE BOND

A. The Contractor willbe required to pay for and file a Paymentand Performance Bond tothe State of Washington and Cowlitz

County (dual obligees) which will always be, at a minimum, equal to one hundred percent (100%) of the contract price, including sales tax and all additions, deletions, or extensions in time. Any additions, deletions or extensions in time shall not relieve a surety of its liability in any manner whatsoever.

B. The bond shall be executed by a Surety Company acceptable to the County and shall remain in effect for one (1) year following the formal acceptance of the work.

C. In lieu of a Payment and Performance bond, the County may, on contracts of one hundred fifty thousand dollars ($150,000) or less, hold retainage in an amount equal to ten percent (10%) of the contract including tax.

1.17 WAGE RATES AND EMPLOYMENT

A. The work outlined in this Invitation to Bid is considered Public Work and requires payment of prevailing wages in accordance with RCW 39.12 and WAC 296-127-023. No less than the applicable prevailing rate of wage must be paid to any worker, laborer, or mechanic employed in the performance of any part of the stated work.

B. The bidder is solely responsible for determining the applicable labor classification(s) and utilizing the appropriate and correct prevailing wage and benefit rate(s) in submitting its bid based on these specifications. Current wage rates for work to be performed in Cowlitz County can be found at https://secure.lni.wa.gov/wagelookup/rates/journey-level-rates using the effective date of November 17, 2025

C. The successful bidder shall complete and file State of Washington, Department of Labor and Industries Statement of Intent to Pay Prevailing Wages on Public Contract form and shall familiarize itself with all of the provisions of Chapter 39.12 RCW.

1.18 RETAINAGE AND PAYMENTS

A. Payments of an invoice for work performed will be for ninety-five percent (95%) of the principal amount, plus one hundred percent (100%) of the tax amount. The balance of the invoice payment will be held by the County as retainage.

B. For contracts of less than one hundred fifty thousand dollars ($150,000) in value, when requested by the Contractor and approved by the County, a retainage amount of ten percent (10%) of work performed (including tax) will be held in lieu of providing a Contractor's Payment and Performance bond. Payments of an invoice for work performed will be for ninety percent (90%) of the total of the principal amount, plus tax. The balance of the payment request will be held by the County as retainage.

C. Retainage will not be paid sooner than forty-five (45) days after project acceptance. Before the release of retainage, the Cowlitz County Purchasing Services Department must be in possession of the five (5) items listed below, in proper form.

1. Notice of Completion from the Board of County Commissioners or designee.

2. Certificate of Payment of Contributions, Penalties, and Interest on Public Works Contract (required on projects over $35,000.00) received from the State Department of Revenue. (Requested by the County when the Notice of Completion is received).

3. Certification of Payment of Contributions from the Washington State Employment Security Department (Requested by the County when the Notice of Completion is received).

4. Affidavits of Prevailing Wages Paid approved by the Department of Labor & Industries on the Contractor and each Subcontractor.

5. Reports on Claims (liens) filed against the project or Contractor from the County Auditor, Clerk of the Board of County Commissions and Department, 45 days from date of Resolution of Acceptance.

1.19 COMPLIANCE WITH LAWS AND REGULATIONS

A. The bidder, upon execution of an agreement, warrants full compliance with all applicable local, state or federal laws, ordinances and regulations of any public authority for the safety of persons and property, including requirements of the Washington Industrial Safety and Health Administration (W.I.S.H.A.), per the Revised Code of Washington (RCW),

Chapter 49.17, and the Washington Administrative Code (WAC) 296-24.

B. If the Contractor performs works out of compliance or contrary to laws, building codes, statutes, regulations, and rules, withoutwrittennoticetotheCounty,thentheContractorassumesfullresponsibilityfortheworkandwillbeheldresponsible for bearing the costs associated with returning those portions of the project into compliance with the appropriate governance and agencies.

C. Should the Contractor find inconsistencies in the Contract Documentation with respect to governmental laws, rules, regulations and codes, then the Contractor shall notify the County in writing.

D. The Contractor agrees to indemnify and defend the County against any loss, cost, liability or damage (including reasonable attorney fees) due to the Contractor's violation of this section.

1.20 ARBITRATION

There will be no arbitration arising out of or relating to any contract resulting from this Invitation to Bid.

1.21 COMPLIANCE WITH TERMS

The County may at any time insist upon strict compliance with these terms and conditions, notwithstanding any previous custom, practice, or course of dealing to the contrary.

1.22 NON-DISCRIMINATION

Upon execution of agreement, the Contractor and its subcontractors, if used, shall not discriminate on the basis of race, color, sex, sexual orientation, religion, national origin, creed, marital status, age or the presence of any sensory, mental or physical handicaps in employment or application for employment or in the administration or delivery of services or any other benefits under the contract except to the extent permitted by bona fide occupation qualifications.

1.23 INTERPRETATION OF DOCUMENTS

The successful Contractor shall provide any work or materials clearly implied in the contract resulting from this Invitation to Bid, even if the contract documents do not mention it specifically. If the contract documents use words that are not defined therein but have a commonly accepted technical or trade meaning, the words shall be understood in accordance with that meaning. If any part of the contract requires work to be performed without describing how it is to be performed, the work shall be performed in accordance with standard trade practices. A "standard trade practice" is one having such regularity of observance in the trade as tojustifyanexpectationthatitwillbeobservedbytheContractorindoingthework.Onanyplansordrawings,figured dimensions shall take precedence over scaled dimensions. In case of any ambiguity or dispute over interpreting the contract, the Department's decision will be final.

BIDDER CHECKLIST

The omission or deletion of any bid item may be considered non-responsive and may be cause for the rejection of the bid.

1. Has a bid bond or certified check been enclosed with bid? Is the amount of the guarantee at least 5 percent of the total amount of the bid?

2. Has the bid been properly completed and signed in all required areas?

3. Have all addenda, if any, been acknowledged in the Bid Form?

4. Has the bidder reviewed the Bidder Qualifications and Bidder Responsibility Criteria and understand these obligations if selected as the apparent low bidder?

5. The following items must be completed and included within the sealed envelope:

A. Bidder Qualification Form

B. Bid Form

C. Bidder Representations and Certifications

D. Bid Surety Bond Form

6. The following items are to be executed after the contract is awarded to the lowest responsible bidder:

A. Agreement Form

B. Performance and Payment Bond

C. Certificates of Insurance END OF SECTION

BIDDER QUALIFICATIONS

Each bidder submitting a proposal for this project shall submit, as part of its bid, the following information:

1. Registered Name of Firm Submitting Bid:

2. Business Address:

3. Telephone Number (with Area Code):

4. E-mail address:

5. IRS Federal Employer’s Identification Number:

6. Current State Unified Business Identification (UBI) Number:

7. Washington State Contractor Registration Number:

8. Receipt of the following Addenda is hereby acknowledged:

1. Addendum No. _____ dated __________________

2. Addendum No. _____ dated __________________

3. Addendum No. _____ dated __________________

4. Addendum No. _____ dated __________________

5. Addendum No. _____ dated __________________

9. In compliance with the invitation to bid, bidder hereby proposes to perform all work for this project in strict accordance with the contract documents, within the time set forth therein, and at the prices bid. YES NO

10. The bidder certifies below that their bid complies in all respects with the attached specification documents, including the minimum specifications. YES NO

*If NO, attach additional pages detailing all proposed deviations.

11. In accordance with Chapter 42.23 RCW bidders must disclose any and all personal relatives, or any relatives of the bidder’s employees or subcontractors, who are presently employed by Cowlitz County, or who stand to realize any financial gain, or beneficial interest, if this contract is awarded to the bidder or any subcontractor of the bidder for the work of this invitation to bid.

The bidder certifies below that there are no persons meeting the criteria above that have any beneficial interest in the work of this invitation to bid. YES NO

*If NO, attach additional pages detailing the name of any person, organization, relationship and interest

Signature of Authorized Person:

Title: Date: END OF SECTION

BID FORM

NAME OF PROJECT: Tennant Way Landfill On-Call Services PROJECT NUMBER: 2025-0066-01

Having carefully examined all bid documents provided by Cowlitz County, as well as the premises and conditions affecting the work, the Undersigned proposes to furnish all labor, equipment,and materials and perform all work inaccordance withthe terms & conditions attached Quantity of hours is estimated for determining low bidder – actual hours will vary.

Labor – After Hours, Holidays,

BIDDER RESPONSIBILITY CRITERIA

Low Responsible Bidder

It is the intent of the County to award a contract to the low responsible bidder. In addition, the County shall consider an overall accounting of the items listed below, which the Bidder must meet. The Bidder must submit the Non-Collusion, Bidder Responsibility, and Minimum Wage Certification Form demonstrating that the meet the following criteria:

Bid Procedures and Conditions

Qualifications of Bidder

A. Bidders mustmeetthe minimumqualifications of RCW 39.04.350, as amended. Beforeaward of a public works contract, a bidder must meet the following responsibility criteria to be considered a responsible bidder and qualified to be awarded a public works project. The bidder must:

a. At the time of bid submittal, have a certificate of registration in compliance with chapter 18.27 RCW;

b. Have a current state unified business identifier number;

c. If applicable, have industrial insurance coverage for the bidder's employees working in Washington as required in Title 51 RCW; an employment security department number as required in Title 50 RCW; and a state excise tax registration number as required in Title 82 RCW;

d. Not be disqualified from bidding on any public works contract under RCW 39.06.010 or 39.12.065(3);

e. If bidding on a public works project subject to the apprenticeship utilization requirements in RCW 39.04.320, not have been found out of compliance by the Washington state apprenticeship and training council for working apprentices out of ratio, without appropriate supervision, or outside their approved work processes as outlined in their standards of apprenticeship under chapter 49.04 RCW for the one-year period immediately preceding the date of the bid solicitation;

f. Have received training on the requirements related to public works and prevailing wage under this chapter and chapter 39.12 RCW. The bidder must designate a person or persons to be trained on these requirements. The training must be provided by the department of labor and industries or by a training provider whose curriculum is approved by the department. The department, in consultation with the prevailing wage advisory committee, must determine the length of the training. Bidders that have completed three or more public works projects and have had a valid business license in Washington for three or more years are exempt from this subsection. The department of labor and industries must keep records of entities that have satisfied the training requirement or are exempt and make the records available on its web site. Responsible parties may rely on the records made available by the department regarding satisfaction of the training requirement or exemption; and

g. Within the three-year period immediately preceding the date of the bid solicitation, not have been determined by a final and binding citation and notice of assessment issued by the department of labor and industries or through a civil judgment entered by a court of limited or general jurisdiction to have willfully violated, as defined in RCW 49.48.082, any provision of chapter 49.46, 49.48, or 49.52 RCW.

B. In addition to the bidder responsibility criteria above, the Bidder must also meet the following relevant supplemental bidder responsibility criteria applicable to the project:

a. The Bidder shall not currently be debarred or suspended by the Federal government. The Bidder shall not be listed as a current debarred or suspended bidder on the U.S. General Services Administration’s “Excluded Parties List System” website. Bidder debarment or suspension status may be verified through this website: http://www.sam.gov/. The County may also use other sources of information that may be available to otherwise determine whether the Bidder is in compliance with these supplemental criteria.

b. The Bidder shall not have been convicted of a crime involving bidding on a public works contract within five (5) years prior to the bid submittal deadline. The Bidder shall provide a duly executed sworn statement (on the included form, or on a form otherwise determined to be acceptable by the County), that the Bidder has not been

convicted of a crime involving bidding on a public works contract. The County may also use other sources of information that may be available to determine whether the Bidder is in compliance with these supplemental criteria.

c. The Bidder’s standard subcontract form shall include the subcontractor responsibility language required by RCW 39.06.020, and the Bidder shall have an established written procedure which the Bidder uses to validate the responsibility of each of its subcontractors. The Bidder’s subcontract form shall also include a requirement that each of its subcontractors shall have and document a similar procedure to determine whether the sub-tier subcontractors with whom it contracts are also “responsible” contractors as defined per RCW 39.06.020. The County may also use other sources of information that may be available to determine whether the Bidder is in compliance with these supplemental criteria.

d. The Bidder shall not have a record of prevailing wage complaints filed against the Bidder within five (5) years prior to the bid submittal date that demonstrates a pattern of failing to pay workers prevailing wages, unless there are extenuating circumstances that are acceptable to the County. The County may also use other sources of information that may be available to determine whether the Bidder is in compliance with these supplemental criteria.

e. The Bidder shall not have had any public works contract terminated for cause by a government agency during the five (5) year period immediately preceding the bid submittal deadline for the project, unless there are extenuating circumstances acceptable to the County. The Bidder shall provide a duly executed sworn statement (on the included form, or in a form otherwise determined to the acceptable by the County), that the Bidder has not had any public works contract terminated for cause by a government agency during the five (5) year period immediately preceding the bid submittal deadline for the project. The County may also use other sources of information that may be available to determine whether the Bidder is in compliance with these supplemental criteria.

f. Within two (2) years prior to the bid submittal date the Bidder shall not have had a project construction site shut down due to a safety violation (i.e., WISHA/OSHA written citations) from the Washington State Department of Labor & Industries or analogous agency with jurisdiction in the location the work was performed, regardless of whether such willful and/or serious safety violations have been abated or not. The Bidder shall maintain compliance with all safety and health requirements (i.e., WISHA/OSHA) from the Washington State Departmentof Labor & Industries (or analogous agency with jurisdiction in the location the work is performed). The County mayverify suchinformation provided with the Washington StateDepartmentof Labor& Industries or analogous agency with jurisdiction in the location the work was performed. The County may also use other sources of information that may be available to determine whether the Bidder is in compliance with these supplemental criteria.

C. If a Bidder fails to supply the required bidder responsibility documentation, information, or materials, the Bidder may be determined by the County to be non-responsive, and the bid may be rejected on this basis. If the County determines the apparent successful bidder does not meet the bidder responsibility criteria above and is therefore not a responsible bidder, the County shall notify the bidder in writing with the reasons for its determination. If the bidder disagrees with thedetermination,itmayappealthedeterminationwithintwenty-four(24)hoursofreceiptoftheCounty’sdetermination by presenting additional written information to the County. The County will consider the additional information before issuing its final determination. If the County’s final determination affirms that the bidder is not responsible, the County will not execute a contract with any other bidder until two (2) business days after the bidder determined to be not responsible has received the final determination. Please note that the above-described information, materials, and documentation requested by the County for purposes of determining bidder responsibility is not necessarily exclusive, and the County expressly reserves the right to request additional information, materials, and documentation as may be determined to be necessary or desirable by the County in order to evaluate and determine Bidder’s compliance with the above-described bidder responsibility criteria. At all times, the County may also use other sources of information that may be available to otherwise determine whether the Bidder is in compliance with the forgoing bidder responsibility criteria.

NOTICE TO ALL BIDDERS

To report bid rigging activities call: 1-800-424-9071

The U.S. Department of Transportation (USDOT) operates the above toll-free “hotline” Monday through Friday, 8:00 a.m. to 5:00 p.m., ET. Anyone with knowledge of possible bid rigging, bidder collusion, or other fraudulent activities should use the “hotline” to report such activities.

The “hotline” is part of USDOT’s continuing effort to identify and investigate highway construction contract fraud and abuse and is operated under the direction of USDOT Inspector General. All information will be treated confidentially, and caller anonymity will be respected.

END OF SECTION

BIDDER REPRESENTATIONS AND CERTIFICATIONS

In accordance with the Contract Documents, the Bidder must provide the following sworn statement and certification:

I, , the undersigned declarant, as the duly authorized representative on behalf of

(herein the “Bidder”) hereby make this declaration on the basis of facts within the scope of my firsthand knowledge and authority to which I am competent to testify:

1. I hereby certify, swear, and affirm under penalty of perjury, that the Bidder, as of the date of this declaration (below) meets all of the minimum bidder responsibility qualifications of RCW 39.04.250, as amended.

2. I hereby certify, swear, and affirm under penalty of perjury, that the Bidder, as of the date of this declaration (below) meets all of the minimum project bidding requirements.

3. I hereby certify, swear, and affirm under penalty of perjury, that the Bidder, as of the date of this declaration (below) meets all of the supplemental bidder responsibility criteria as set forth in the Bidder Responsibility Criteria, Section B.

4. I hereby certify, swear, and affirm under penalty of perjury, that the undersigned is the person that submitted the bid herewith, that such bid is genuine and not a sham or collusive, or made in the interest of any person not therein named; and he/she further says that said Bidder has not directly or indirectly induced or solicited any Bidder on the above work and supplies to put in a sham bid, or any other person or corporation to refrain from bidding; and that said Bidder has not in any manner sought by collusion to secure himself to any other person an advantage over any other Bidder or Bidders.

5. I hereby certify, swear, and affirm under penalty of perjury, that no officer or employee of the County, having the power or duty to perform an official act or action related to this submittal, shall have or acquire any interest in this submittal, or have solicited, accepted or granted a present or future gift, favor, service, or other thing of value from or to any person involved in this submittal.

6. I hereby certify, swear, and affirm under penalty of perjury, that in connection with the performance of the work of this project, if awarded, I will pay each classification of laborer, workman, or mechanic employed in the performance of such work not less than the prevailing rate of wage or not less than the minimum rate of wages as specified in the Contract Documents.

7. Iherebycertify,swear,andaffirmunderpenaltyofperjury,thatinsubmittingthisbid werepresentthatthebiddocuments have been read in their entirety and are understood, that the site has been visited or that we have familiarized ourselves with the local conditions under which the work is to be performed, that by signature of this proposal we acknowledge all requirements and that we have signed all certificates contained herein.

8. I hereby certify, swear, and affirm under penalty of perjury, that in submitting this bid we acknowledge the requirements and conditions applicable to deposit in the form of a bid surety bond

9. I hereby certify, swear, and affirm under penalty of perjury, that to the best of my knowledge the information contained inthisproposalisaccurateandcompleteandthatIhavethelegalauthoritytocommitthisFirmtoacontractualagreement. I realize the final funding for any service is based upon budget levels and the approval of the County.

Signature of Authorized Person:

Title:

Date:

BID SURETY BOND FORM

NAME OF PROJECT: Tennant Way Landfill On-Call Services PROJECT NUMBER: 2025-0066-01

FIRM NAME:

ADDRESS:

We, ______________________________________ as Principal, and as Surety, are held and firmly bound unto the COUNTY OF COWLITZ, a Washington State County, in the penal sum of $____________ ( ___________________ & ______/100dollars),forthepaymentofwhich we jointly and severally bind ourselves, and our legal representatives andsuccessors.

THE CONDITIONS OF THE OBLIGATION are that if the County of Cowlitz shall make timely award to the Principal according to the terms of the bid documents; and the Principal shall, within ten (10) days after notice of the award, exclusive of the day of notice, enter into the contract with the County of Cowlitz and furnishes the contractor's bond (performance and payment bond) with Surety satisfactory to Cowlitz County in an amount equal to one hundred percent (100%) of the amount of the bid proposed including Washington State Sales Tax then this obligation shall be null and void; otherwise if the Principal fails to enter into the contract and furnish the contractor's bond within ten (10) days after notice of the award, exclusive of the day of notice, the amount of the penal sum shall be forfeited to the County; but in no event will the Surety's liability exceed this bond's face amount.

SIGNED ANDSEALED THIS DAYOF YEAR20

SURETY

PRINCIPAL

TITLE:

CONTRACT SUMMARY

Contract Value: [$ ]

SAMPLE AGREEMENT FORM

COWLITZ COUNTY

CONSTRUCTION SERVICES AGREEMENT

PROJECT #2023- -01

Estimated Completion Date: ( ) continuous days after Notice to Proceed

Contract Type: Lump Sum, Cost Not-To-Exceed

Contract Administrator:

Email:

PARTIES

COUNTY:

Cowlitz County Washington

CONTRACTOR:

Company Name C/O Department Address

207 N. Fourth Ave, Room 308

City, State, Zip Kelso, WA 98626

Project Coordinator:

Phone:

Email:

Contact:

Phone:

Fax:

Email:

THIS AGREEMENT made and entered into effective the [ ] by and between COWLITZ COUNTY, a political subdivision of the State of Washington having offices for the transaction of business indicated above and hereinafter referred to as the “County”, and the “Contractor”, named and having offices for the transaction of business indicated above jointly, hereinafter referred to along with the County as the “Parties”.

WHEREAS, the Board of County Commissioners of Cowlitz County pursuant to the provisions of the Revised Code of Washington Section 36.32.120(6) has the care of County property and the management of County funds and business; and

WHEREAS, the Board of County Commissioners of Cowlitz County pursuant to the above cited statutory section and those provisions as set forth in the Revised Code of Washington Section 39.04.155, et seq. did let out for bid the Cowlitz County Morgue; Project #2020-0020-01.

WHEREAS, the Purchasing Service Department on behalf of Cowlitz County did on [ ]open said bid and did on [__________] accept the bid of the Contractor herein as the lowest responsible bidder for Cowlitz County bid [ ]

NOW, THEREFORE, for and in consideration of the mutual promises set forth herein, the parties hereto do mutually agree as follows:

ARTICLE 1. COMPENSATION, WORK AND SERVICES

The Contractor for the consideration of [________________________________] ($___________.__), not including sales tax, for work performed as specified in the “Contract Documents” as enumerated herein below, shall in strict accordance with all of the provisions therein, perform all work and provide all materials called for by the Contract Documents Project #2020-0020-01 The County agrees to pay the Contractor for said work as specified in the “Contract Documents.”

SAMPLE

ARTICLE 2. CONTRACT DOCUMENTS

The Contract Documents consist of this Agreement and other documents listed below issued prior to the execution of this Agreement and all modifications and change orders issued subsequent thereto. These form a contract and all are as fully a part of the contract as if attached to this Agreement or repeated herein. In the event of a conflict between documents the order of precedence will be the order listed below. An enumeration of the contract documents is set forth below:

1.Change Orders;and 2.Notice to Proceed; and 3.Notice of Award; and 4.Agreement;and 5.Addenda; and

6.Procurement & Contract Requirements, Project Specifications and Drawings;and 7.The provisions of Cowlitz County Bid No. [ ];and

8.The bid proposal of the contractor dated [ ]

ARTICLE 3. RELATIONSHIP OF THE PARTIES

The parties intend that an independent contractor relationship will be created by this Agreement. The County is interested only in the results to be achieved, and the conduct and control of all services or work will lie solely with the Contractor. No agent, employee, servant or otherwise of the Contractor shall be or shall be deemed to be an employee, agent, servant or otherwise of the County for any purpose, and the employees of the Contractor are not entitled to any of the benefits that the County provides for County employees. The Contractor will be solely and entirely responsible for its acts and for the acts of its agents, employees, servants, subcontractors, or otherwise during the performance of his Contract. In the performance of the services herein contemplated, the Contractor is an independent contractor with the authority to control and direct the performance and details of the work, the County being interested only in the results obtained; however, the work contemplated herein must meet the approval of the County pursuant to the provisions of the agreement under which the services and work were let to the Contractor.

ARTICLE 4. INDEMNIFICATION

The Contractor is an independent contractor and not the agent or employee of the County. No liability shall attach to the County for entering into this Contract or because of any act or omission of the Contractor except as expressly provided.

The Contractor agrees to defend, indemnify and hold the County and the County's Consultant(s), when used on the project, harmless from any and all claims, including but not limited to reasonable attorney fees, demands, losses and liabilities to or by third parties arising from, resulting from or connected with services performed or to be performed under this contract by the Contractor, its agents or employees to the fullest extent permitted by law. The Contractor's duty to indemnify the County and Consultant shall not apply to liability for damages arising out of bodily injury to persons or damage to property caused by or resulting from the sole negligence of the County or Consultant, their agents or employees. The Contractor's duty to indemnify the CountyandConsultantforliabilityfordamagesarisingoutofbodilyinjurytopersonsordamagetopropertycausedbyorresulting from the concurrent negligence or (a) the County or Consultant, their agents or employees, and (b) Contractor, its agents or employees shall apply only to the extent of negligence of the Contractor or its agents or employees. Contractor's duty to defend, indemnify and hold the County harmless shall include, as to all claims, demands, losses and liability to which it applies, the County's personnel-related costs, reasonable attorney's fees, court costs and all other claim-related expenses.

The Contractor's indemnification shall specifically include all claims for loss liability because of wrongful payments under the Uniform Commercial Code, or other statutory or contractual liens or rights or third parties, including taxes, accrued or accruing as a result of this contract or work performed or materials furnished directly or indirectly because of this contract.

Contractor further agrees that this duty to indemnify County applies regardless of any provisions in RCW Title 51 to the contrary, including but not limited to any immunity of Contractor for liability for injuries to Contractor's workers and employees, and Contractor hereby waives any such immunity for the purpose of this duty to indemnifyCounty.

ARTICLE 5. TERMINATION

Contract(s) resulting from this bid may be terminated, in whole or in part, under the following conditions: 1) by mutual written agreement; 2) by the County for breach by the bidder of any of the obligations or requirements set forth in the contract documents. The County retains the option to require the bidder to assume liability for all damages, including the excess of re-procuring similar products or services; 3) for the convenience of the County; or 4) by the County for non-appropriation of funds.

ARTICLE 6. TERMINATION BY THE COUNTY WITHOUT CAUSE

SAMPLE

Notwithstanding any other provisions contained herein, the County, without cause, may terminate the contract between the parties by providing notice to the Contractor. Upon termination under this section: 1) All remaining obligations of the parties are discharged, but any right based upon breach or performance occurring prior to termination survives; 2) If the reasonable costs of performance incurred by the Contractor prior to termination exceed the amount paid by the County to the Contractor on the Contract Sum, the County shall reimburse the Contractor in the amount of such excess; 3) If the amount paid by the County to the Contractor on the Contract Sum exceeds the reasonable costs of performance incurred by the Contractor prior to termination, the Contractor shall reimburse the County in the amount of such excess; 4) Any funds obtained or retained by the Contractor as provided in 2) or 3) of this paragraph, shall constitute full payment and consideration for the services performed by the Contractor prior to termination.

ARTICLE 7. MAINTENANCE OF RECORDS

The Firm will maintain, for at least three (3) years after completion of this contract, all relevant records pertaining to this contract. The Firm shall make available to the County or the Washington State Auditor or their duly authorized representatives, at any time during their normal operating hours, all records, books or pertinent information which the Firm shall have kept in conjunction with this Agreement and which the County may be required by law to include or make part of its auditing procedures, an audit trail or which may be required for the purpose of funding the services contracted for herein.

ARTICLE 8. VENUE STIPULATION

This Agreement has and shall be construed as having been made and delivered in the State of Washington, and the laws of the State of Washington shallbeapplicable to its constructionand enforcement.Anyactionatlaw, suit in equity or judicialproceeding for the enforcement of this Agreement or any provisions hereto shall be instituted only in courts of competent jurisdiction within

Cowlitz County, Washington, unless relocation or commencement elsewhere is required by law.

ARTICLE 9. COMPLIANCE WITH LAWS

The Contractor in the performance of this Agreement agrees to comply with all applicable federal, state and local laws, ordinances and regulations including but not limited to those pertaining to civil rights. The Contractor may not, without the prior written approval of the County, assign, sublet or transfer in whole or in part his interest in this Agreement.

ARTICLE 10. INTEGRATION

This Agreement contains all the terms and conditions agreed upon by the Parties. No other understanding, oral or otherwise regarding the subject matter of this Agreement shall be deemed to exist or to bind any of the parties. All Parties have read and understand the above contract and now state that no representations, promises, or agreements not expressed by this Agreement have been made to induce the other to execute the same.

ARTICLE 11. LIQUIDATED DAMAGES

Time is of the essence in the performance of the contract. Because the County finds it impractical to calculate the actual costs of delays, it has adopted the Liquidated Damage Table in the Bid Documents.

Liquidated damages will not be assessed for any days for which an extension of time is granted. No deduction or payments of liquidated damages will in any degree, release the Contractor from further obligation and liabilities to complete the entire work.

ARTICLE 12. RECOVERY OF FUNDS

Whenever, under the contract, any sum of money shall be recoverable from or payable by the Contractor to Cowlitz County the same amount may be deducted from any sum due to the Contractor under the contract or under any other contract between the contractor and Cowlitz County. The rights of Cowlitz County are in addition and without prejudice to any other right Cowlitz County may have to claim the amount of any loss or damage suffered by Cowlitz County on account of the acts or omissions of the Contractor.

ARTICLE 13. ENFORCEMENT COSTS

If any legal action or other proceeding is brought for the enforcement of this Contract, or because of an alleged dispute, breach, default or misrepresentation in connection with any provisions of this Contract, the successful or prevailing party or parties shall be entitled to recover reasonable attorney's fees, court costs, and all expenses (including taxes) even if not taxable as court costs (including, without limitation, all such fees, costs, and expenses incident to appeals), incurred in that action or proceeding, in addition to any other relief to which such party or parties may be entitled.

ARTICLE 14. ANTI-KICKBACK

No officer or employee of the County, having the power or duty to perform an official act or action related to this Agreement, shall have or acquire any interest in this agreement, or have solicited, accepted or granted a present or future gift, favor, service, or other thing of value from or to any person involved in this Agreement.

ARTICLE 15. WAIVER

No officer, employee, agent or otherwise of the COUNTY has the power, right or authority to waive any of the conditions or provisions to this Agreement. No waiver of any breach of this Agreement shall be held to be a waiver of any other or subsequent breach. All remedies afforded in this Agreement or at law shall be taken and construed as cumulative, that is, in addition to every other remedy provided herein or by law. Failure of the COUNTY to enforce at any time any of the provisions of this Agreement or to require at any time performance by CONTRACTOR of any provision hereof, shall in no way be construed to be a waiver of such provisions, nor in any way affect the validity of this Agreement or any part hereof, or the right of the COUNTY to hereafter enforce each and every such provision.

ARTICLE 16. EXECUTION

SAMPLE

The PARTIES warrant that the officers/individuals executing below have been duly authorized to act for and on behalf of the Party for purposes of confirming this Agreement.

ARTICLE 17. COUNTERPARTS

This Agreement may be executed in any number of counterparts, each of which, when so executed and delivered, shall be an original, but such counterparts shall together constitute but one and the same.

ARTICLE 18. THIRD PARTY BENEFICIARIES

This Agreement is intended for the benefit of the COUNTY and CONTRACTOR and not for the benefit of any third parties.

ARTICLE 19. SURVIVAL

Without being exclusive, the Article for Indemnification and the Article for Venue Stipulation of this Agreement shall survive any termination, expiration or determination of invalidity of this Agreement in whole or in part. Any other Articles of this Agreement which, by their sense and context, are intended to survive shall also survive.

IN WITNESS WHEREOF, the said Contractor has executed this instrument, and the said Board of County Commissioners

pursuant to resolution duly adopted, has caused this instrument to be executed by and in the name of said Board on the day and year set forth herein. CONTRACTOR

BOARD OF COUNTY COMMISSIONERS OF COWLITZ

COUNTY, WASHINGTON

Signature

Print Name

Title

Date: _____________________, 20 ______

Richard R. Dahl, Chairman

Steve Rader, Commissioner

SAMPLE

Steven L. Ferrell, Commissioner

ATTEST:

Kelly Grayson, Clerk of the Board

Meeting Date: 10/21/2025

CONTRACT COMPLETION - 2025 Countywide Pavement Overlay - Project No. 2025 - Lakeside Industries

Submitted For: Rich White, Public Works

Department: Public Works

Subject and Summary Statement

Submitted By: Lynn Ruffe, Public Works

Information

A final inspection of the 2025 Countywide Pavement Overlay project has been made by the Department of Public Works and all phases of the work have been found to be satisfactorily complete. The project was constructed in accordance with the plans and specifications with all material incorporated in the project meeting specifications. The final cost of the project was $2,908,870.72. A copy of the Construction Cost Summary is attached.

Will Staff Attend - NAME OF STAFF or No

Yes

Department Recommendation

It is the recommendation of the Department of Public Works that the Board move to accept the contract with Lakeside Industries for the 2025 Countywide Pavement Overlay project as being complete by signing the attached letter.

Fiscal Impact

Expenditure Required $: 2,908,871

Budget Sufficient Y-N: Y

Amendment Required Y-N: N

Source of Funds - What Dept ? : Roads

Grant Y-N:

Contract Completion Letter

Construction Cost Summary

Inbox

Susan Eugenis

Mike Moss, Public Works

Form Started By: Lynn Ruffe

Attachments

Form Review

Reviewed By Date

Susan Eugenis 10/07/2025 11:36 AM

Mike Moss 10/14/2025 12:44 PM

Started On: 10/06/2025 12:07 PM

Board of Cowlitz County Commissioners

October 21, 2025

Lakeside Industries

P.O. Box 576

Longview, WA 98632

SUBJECT: 2025 Countywide Pavement Overlay Project Project No. 2025 Contract Completion

We have received certification from our Department of Public Works that you have satisfactorily completed your contract with Cowlitz County for the 2025 Countywide Pavement Overlay project. Therefore, we accept your contract as being complete.

Your retainage will be held for thirty (30) days from this date and until releases are received from the Department of Labor and Industries and the Department of Revenue.

Very truly yours,

BOARD OF COUNTY COMMISSIONERS OF COWLITZ COUNTY, WASHINGTON

Richard R. Dahl, Chairman

Steve Rader, Commissioner

Steven L. Ferrell, Commissioner

BOCC:lr

cc: County Auditor Accounting Section

207 North 4th Avenue

cowlitz@cowlitzwa.gov Kelso, WA 98626 www.co.cowlitz.wa.us

June 23, 2025

Completion Date July 24, 2025

BOCC Agenda

Meeting Date: 10/21/2025

BID AWARD - Snow Sand

Submitted For: Shawn Roewe, Public Works

Submitted By: Lynn Ruffe, Public Works Department: Public Works

Information

Subject and Summary Statement

Bids were received and opened on October 6, 2025, for the purchase of snow sand.  Three companies submitted bid proposals: L Rock Industries, JL Storedahl & Sons and Sterling Breen Crushing. The bid tabulation is attached.

Will Staff Attend - NAME OF STAFF or No

Yes

Department Recommendation

It is the recommendation of the Department of Public Works that the Board move to award the purchase of snow sand to the lowest responsible bidder, L Rock Industries, Inc., for the total cost of $62,290.24, which includes Washington State sales tax.

APPROVED this 21st day of October, 2025

BOARD OF COUNTY COMMISSIONERS OF COWLITZ COUNTY, WASHINGTON

Richard R. Dahl, Chairman

Steve Rader, Commissioner

Steven L. Ferrell, Commissioner

ATTEST: Kelly Grayson, Clerk of the Board

Fiscal Impact

Expenditure Required $: 62,290.24

Budget Sufficient Y-N: Y

Amendment Required Y-N: N

Source of Funds - What Dept ? : Roads

Source of Funds - What Dept ? : Roads

Grant Y-N:

Bid Tab

Inbox

Susan Eugenis

Mike Moss, Public Works

Form Started By: Lynn Ruffe

Attachments

Form Review

Reviewed By Date

Susan Eugenis

Mike Moss

10/07/2025 03:39 PM

10/14/2025 12:44 PM

Started On: 10/07/2025 08:54 AM

Cowlitz County Department of Public Works Snow Sand for Roads

Delivered to Stockpile Locations no later than October 27, 2025 BID TAB

BOCC Agenda

Meeting Date: 10/21/2025

AGREEMENT - Supplemental Agreement No. 1 - Otak, Inc.

Submitted For: Susan Eugenis, Public Works

Submitted By: Lynn Ruffe, Public Works Department: Public Works

Information

Subject and Summary Statement

Attached is Supplemental Agreement No. 1 to the Local Agency Consultant Agreement dated June 27, 2023 with OTAK, Inc. for the Pleasant Hill Road Temporary Bridge Replacement Project. The purpose of this Supplemental Agreement is to extend the expiration date to December 31, 2027, and to revise the negotiated hourly rate. The supplement is required due to a lengthy environmental review process being conducted by FEMA. There is no change to the total contract amount.

Will Staff Attend - NAME OF STAFF or No

Yes

Department Recommendation

It is the recommendation of the Department of Public Works that the Board move to approve Supplemental Agreement No. 1 with Otak, Inc.to extend the expiration date to December 31, 2027 and authorize the document to be executed.

Attachments

Supplemental Agreement No. 1

Original Local Agency Agreement

Inbox

Chris Andrews

Lynn Ruffe

Chris Andrews

Susan Eugenis

Mike Moss, Public Works

Form Started By: Lynn Ruffe

Form Review

Reviewed By Date

Lynn Ruffe 10/14/2025 07:53 AM

Chris Andrews 10/14/2025 08:46 AM

Susan Eugenis 10/14/2025 09:18 AM

Mike Moss 10/14/2025 03:09 PM

Started On: 10/13/2025 04:17 PM

Supplemental Agreement Number

Original Agreement Number

Project Number

Organization and Address

Phone:

Project Title New Maximum Amount Payable

Description of Work

The Local Agency of desires to supplement the agreement entered in to with and executed on and identified as Agreement No. All provisions in the basic agreement remain in effect except as expressly modified by this supplement. The changes to the agreement are described as follows:

I

Section 1, SCOPE OF WORK, is hereby changed to read:

II

Section IV, TIME FOR BEGINNING AND COMPLETION, is amended to change the number of calendar days for completion of the work to read:

III

Section V, PAYMENT, shall be amended as follows:

as set forth in the attached Exhibit A, and by this reference made a part of this supplement. If you concur with this supplement and agree to the changes as stated above, please sign in the Appropriate spaces below and return to this office for final action.

Approving Authority Signature

COST INFORMATION

BREAKDOWN OF BILLING RATES AND DIRECT NONLABOR RATES

DIRECT LABOR COSTS

EngineeringDesignerVOffice$52.25$90.50$15.67$158.42

EngineeringDesignerIVOffice$46.77$81.02$14.03$141.82

EngineeringDesignerIIIOffice$40.80$70.67$12.24$123.72

EngineeringDesignerIIOffice$36.87$63.87$11.06$111.80

EngineeringDesignerIOffice$33.52$58.06$10.06$101.64

EngineeringTechnicianVIIOffice$54.56$94.50$16.37$165.43

EngineeringTechnicianVIOffice$47.50$82.27$14.25$144.02

EngineeringTechnicianVOffice$43.45$75.26$13.03$131.74

EngineeringTechnicianIVOffice$40.82$70.71$12.25$123.77

EngineeringTechnicianIIIOffice$37.11$64.28$11.13$112.52

EngineeringTechnicianIIOffice$30.00$51.96$9.00$90.96

EngineeringTechnicianIOffice$27.27$47.24$8.18$82.69

PIC/ScientistOffice$80.28$139.05$24.08$243.40

ScientistVIOffice$69.97$121.19$20.99$212.14

ScientistVOffice$55.40$95.96$16.62$167.99

ScientistIVOffice$49.76$86.19$14.93$150.88

ScientistIIIOffice$45.24$78.35$13.57$137.16

ScientistIIOffice$41.12$71.23$12.34$124.69

ScientistIOffice$37.39$64.75$11.22$113.36

EnvironmentalSpecialistOffice$44.77$77.55$13.43$135.75

ConstructionManagerVIField$73.45$90.61$22.04$186.10

COST INFORMATION

ProfessionalLandSurveyorIIField$52.92$65.28$15.88$134.08

ProfessionalLandSurveyorIField$49.45$61.00$14.84$125.29

SurveyCrewChiefIIIField$49.45$61.00$14.84$125.29

SurveyCrewChiefIIField$41.49$51.19$12.45$105.13

SurveyCrewChiefIField$32.05$39.54$9.62$81.21 SurveyOfficeTechnicianIVField$47.77$58.92$14.33$121.02 SurveyOfficeTechnicianIIIField$39.51$48.74$11.85$100.10

SurveyOfficeTechnicianIIField$31.91$39.36$9.57$80.85 SurveyOfficeTechnicianIField$28.00$34.54$8.40$70.94

SurveyFieldTechnicianIIIField$28.78$35.51$8.64$72.93

SurveyFieldTechnicianIIField$27.41$33.81$8.22$69.44

SurveyFieldTechnicianIField$23.24$28.66$6.97$58.87

Sr.PIC/Sr.PMLA/MasterPlannerOffice$115.00$199.19$34.50$348.69 PIC/Sr.PMLA/MasterPlannerOffice$93.15$161.34$27.94$282.44

LandscapeArchitectVIIOffice$69.71$120.74$20.91$211.36

LandscapeArchitectVIOffice$60.00$103.93$18.00$181.93

LandscapeArchitectVOffice$55.00$95.27$16.50$166.77

LandscapeArchitectIVOffice$53.44$92.56$16.03$162.04

LandscapeArchitectIIIOffice$47.00$81.41$14.10$142.51

LandscapeArchitectIIOffice$43.37$75.11$13.01$131.49

LandscapeArchitectIOffice$39.42$68.29$11.83$119.54

LandscapeTechnicianIIIOffice$36.75$63.65$11.03$111.43

LandscapeTechnicianIIOffice$33.41$57.87$10.02$101.30

LandscapeTechnicianIOffice$30.37$52.61$9.11$92.09

PlannerVIOffice$66.29$114.82$19.89$201.00

PlannerVOffice$60.00$103.93$18.00$181.93

PlannerIVOffice$53.00$91.80$15.90$160.70

PlannerIIIOffice$51.92$89.93$15.58$157.43

PlannerIIOffice$43.51$75.36$13.05$131.93

PlannerIOffice$39.18$67.86$11.75$118.80

PlannerAssociateIVOffice$38.50$66.69$11.55$116.74

PlannerAssociateIIIOffice$35.00$60.62$10.50$106.12

Sr.PIC/Sr.PMArchitectureOffice$104.50$181.00$31.35$316.84

ArchitectVIIOffice$89.64$155.27$26.89$271.80

ArchitectVIOffice$81.73$141.56$24.52$247.81

ArchitectVOffice$73.90$128.00$22.17$224.07 ArchitectIVOffice$59.92$103.78$17.97$181.67 ArchitectIIIOffice$50.72$87.84$15.21$153.77

The Indirect Cost Rate (ICR), profit, and max rate per hour listed above are the maximum rates payable under this Agreement. Rates invoiced shall be based on the direct salary of the individual employee plus ICR plus profit and shall not exceed the Max Billing Rate for each Classification listed.

Direct Non-Salary Costs, including subconsultant fees, will be reimbursed at actual cost.

All travel will be invoiced per WSDOT Travel Regulations.

July29,2025

Otak,Inc

808SWThirdAveSte800 Portland,OR97204

Subject:AcceptanceFYE2024ICR–CPAReport

DearJustinMonahan:

Wehaveacceptedyourfirm’sFYE2024IndirectCostRate(ICR)basedonthe“IndependentCPA Report”preparedbyD.L.Purvine,CPA,PLLC,asfollows:

HomeOffice:173.21%ofdirectlabor(rateincludes0.34%FacilitiesCapitalCostof Money)

FieldOffice:123.36%ofdirectlabor(rateincludes0.26%FacilitiesCapitalCostof Money)

ThisratewillbeapplicableforWSDOTAgreementsandLocalAgencyContractsinWashington only.ThisratemaybesubjecttoadditionalreviewifconsiderednecessarybyWSDOT.YourICR mustbeupdatedonanannualbasis.

Costsbilledtoagreements/contractswillstillbesubjecttoauditofactualcosts,basedontheterms andconditionsoftherespectiveagreement/contract.

Thiswasnotacognizantreview.Anyotherentitycontractingwiththefirmisresponsiblefor determiningtheacceptabilityoftheICR.

Ifyouhaveanyquestions,feelfreetocontactourofficeat(360)704-6397orviaemail consultantrates@wsdot.wa.gov

Regards,

SH:kb

Participation for Disadvantaged Business Enterprises (DBE) or Small Business Enterprises (SBE), if required, per 49 CFR Part 26, shall be shown on the heading of this AGREEMENT. If DBE firms are utilized at the commencement of this AGREEMENT, the amounts authorized to each firm and their eertification number will be shown on Exhibit "B" attached hereto and by this reference made part of this AGREEMENT. If the Prime CONSULTANT is, a DBE certified firm they must comply with the Commercial Useful Function (CUE) regulation outlined in the AGENCY's DBE Program Participation Plan" and perform a minimum of 30% of the total amount of this AGREEMENT. It is recommended, but not required, that non-DBE Prime CONSULTANTS perform a minimum of 30% of the total amount of thisAGREEMENT.

In the absenee of a mandatory DBE goal, a voluntary SBE goal amount of ten percent of the Consultant Agreement is established.The Consultant shall develop a SBE Participation Plan prior to commencing work Although the goal is voluntary, the outreach efforts to provide SBE maximum praetieable opportunities are not.

BOCC Agenda

Meeting Date: 10/21/2025

EMERGENCY WORK CONTRACT and BOND IN LIEU OF RETAINAGE - Sweet Birch Drive Emergency Storm Sewer Repair - Advanced Excavating Specialists

Submitted For: Susan Eugenis, Public Works

Department: Public Works

Subject and Summary Statement

Submitted By: Emilie Cochrane, Public Works

Information

On October 7, 2025 the Board of County Commissioners adopted a resolution declaring an emergency to repair a collapsed storm drain on Sweet Birch Drive and enter into an Emergency contract with Advanced Excavating Specialists, LLC.  The attached documents are the required contracts to complete this work including a Bond in Lieu of Retainage from Endurance Assurance Corporation. The Certificate of Liability Insurance has been approved by Risk Management.

Will Staff Attend - NAME OF STAFF or No

Department Recommendation

It is the recommendation of the Department of Public Works that the Board execute the contract for the emergency repair work and acceptance of the Bond in Lieu of Retainage from Endurance Assurance Corporation.

Acceptance of Bond in Lieu of Retainage: Approved this 21st day of October 2025

BOARD OF COUNTY COMMISSIONERS OF COWLITZ COUNTY, WASHINGTON

Richard R. Dahl, Chairman

Steve Rader, Commissioner

Steven L. Ferrell, Commissioner

ATTEST:

Kelly Grayson, Clerk of the Board

Attachments

Emergency Work Contract

Certificate of Liability Insurance

Bond in Lieu of Retainage

Vicinity Map

Inbox

Susan Eugenis

Mike Moss, Public Works

Form Started By: Emilie Cochrane

Form Review

Reviewed By

Susan Eugenis

Mike Moss

Date

10/14/2025 01:03 PM

10/14/2025 03:09 PM

Started On: 10/14/2025 10:07 AM

THISCERTIFICATEISISSUEDASAMATTEROFINFORMATIONONLYANDCONFERSNORIGHTSUPONTHECERTIFICATEHOLDER.THIS CERTIFICATEDOESNOTAFFIRMATIVELYORNEGATIVELYAMEND,EXTENDORALTERTHECOVERAGEAFFORDEDBYTHEPOLICIES BELOW.THISCERTIFICATEOFINSURANCEDOESNOTCONSTITUTEACONTRACTBETWEENTHEISSUINGINSURER(S),AUTHORIZED REPRESENTATIVEORPRODUCER,ANDTHECERTIFICATEHOLDER.

IMPORTANT:IfthecertificateholderisanADDITIONALINSURED,thepolicy(ies)musthaveADDITIONALINSUREDprovisionsorbeendorsed. IfSUBROGATIONISWAIVED,subjecttothetermsandconditionsofthepolicy,certainpoliciesmayrequireanendorsement.Astatementon thiscertificatedoesnotconferrightstothecertificateholderinlieuofsuchendorsement(s).

NAME: CONTACT

Parker Smith & Feek Insurance LLC 1111 Gateway Loop Springfield OR 97477

E-MAIL ADDRESS: PRODUCER

(A/C,No,Ext): PHONE

INSURERC: INSURERB: INSURERA:

INSURERD:

INSURERE:

INSURERF:

(A/C,No): FAX

INSURER(S)AFFORDINGCOVERAGE

THISISTOCERTIFYTHATTHEPOLICIESOFINSURANCELISTEDBELOWHAVEBEENISSUEDTOTHEINSUREDNAMEDABOVEFORTHEPOLICYPERIOD INDICATED.NOTWITHSTANDINGANYREQUIREMENT,TERMORCONDITIONOFANYCONTRACTOROTHERDOCUMENTWITHRESPECTTOWHICHTHIS CERTIFICATEMAYBEISSUEDORMAYPERTAIN,THEINSURANCEAFFORDEDBYTHEPOLICIESDESCRIBEDHEREINISSUBJECTTOALLTHETERMS, EXCLUSIONSANDCONDITIONSOFSUCHPOLICIES.LIMITSSHOWNMAYHAVEBEENREDUCEDBYPAIDCLAIMS.

COMMERCIALGENERALLIABILITY CLAIMS-MADEOCCUR

GEN'LAGGREGATELIMITAPPLIESPER:

$ EACHOCCURRENCE DAMAGETORENTED $ PREMISES(Eaoccurrence)

$ MEDEXP(Anyoneperson)

PERSONAL&ADVINJURY

GENERALAGGREGATE

PRODUCTS-COMP/OPAGG

COMBINEDSINGLELIMIT

(Peraccident) (Eaaccident)

1,000,000

1,000,000 10,000 1,000,000 2,000,000

2,000,000

$ $

1,000,000

(MandatoryinNH)

Ifyes,describeunder

DESCRIPTIONOFOPERATIONS/LOCATIONS/VEHICLES(ACORD101,AdditionalRemarksSchedule,maybeattachedifmorespaceisrequired)

6,000,000

6,000,000

1,000,000 1,000,000 1,000,000

SHOULDANYOFTHEABOVEDESCRIBEDPOLICIESBECANCELLEDBEFORE THEEXPIRATIONDATETHEREOF,NOTICEWILLBEDELIVEREDIN ACCORDANCEWITHTHEPOLICYPROVISIONS.

EMPLOYERSOVERHEADLIABILITY

Thismodifiesinsuranceprovidedunderthefollowing: COMMERCIALGENERALLIABILITYCOVERAGEPART SCHEDULE

LISTOFSTATES LIMITSOFINSURANCE

BODILYINJURYBYACCIDENTEACHACCIDENT

BODILYINJURYBYDISEASEAGGREGATE BODILYINJURYBYDISEASEEACHEMPLOYEE

NoneofthetermsoftheCoverageParttowhichthisployment.The"employee's"lastdayoflast endorsementisattachedapplytotheinsuranceexposuretotheconditionscausingoraggraprovidedbythisendorsement,exceptfortheCOM-vatingsuch"bodilyinjury"bydiseasemust IV occurduringtheendorsementperiod. MONPOLICYCONDITIONSandSection–COMMERCIALGENERALLIABILITYCONDITIONS.

f.Ifyouaresued,theoriginal"suit"andanyreSECTIONI–COVERAGE latedlegalactionsfordamagesfor"bodilyinjury"byaccidentordiseasemustbebrought

1.InsuringAgreement intheUnitedStatesofAmerica,itsterritories

Thisinsuranceappliesto"bodilyinjury"byacci- orpossessions,orCanada. dentor"bodilyinjury"bydiseasetoyour"em-

2.WeWillPay ployees"."Bodilyinjury"includesresultingdeath.

Wewillpayallsumsyoulegallymustpayas

a.The"bodilyinjury"mustariseoutofandinthe damagesbecauseof"bodilyinjury"toyour"em- courseoftheinjured"employee's"employ- ployees",providedthe"bodilyinjury"iscovered mentbyyou. bythisinsurance.Nootherobligationorliabilityto

b.Theemploymentmustbenecessaryorinci- paysumsorperformactsorservicesiscovered dentaltoyourworkinthestate(s)listedinthe 5.unlessexplicitlyprovidedforunderParagraph Scheduleabove. SupplementaryPaymentsofthisCOVERAGE

c. Section. Youmustmaintainforthe"employee"full WorkersCompensationInsurancecoverage Thedamageswewillpay,whererecoveryis intheWorkersCompensationStateFundof permittedbylaw,includedamages: thestate(s)listedintheScheduleabovedur-

a.forwhichyouareliabletoathirdpartyby ingthetermofthisinsuranceorshallbea reasonofaclaimor"suit"againstyoubythat qualifiedselfinsurerapprovedbytheState thirdpartytorecoverthedamagesclaimed WorkersCompensationCommissionandin againstsuchthirdpartyasaresultofinjuryto goodstanding. your"employee";

d."Bodilyinjury"byaccidentmustoccurduring

b.forcareandlossofservices;and theendorsementperiod.

c.forconsequential"bodilyinjury"toaspouse,

e."Bodilyinjury"bydiseasemustbecausedor child,parent,brotherorsisteroftheinjured aggravatedbytheconditionsofyourem- "employee";

f. providedthatthesedamagesarethedirectcon-Anydamagesfor"bodilyinjury"withrespect sequenceof"bodilyinjury"thatarisesoutofandtowhichtheinsuredisdeprivedofanydefenseordefenses; inthecourseoftheinjured"employee's"employmentbyyou;and

3.WeWillDefend

g."Bodilyinjury"occurringoutsidetheUnited

d.becauseof"bodilyinjury"toyour"employee"StatesofAmerica,itsterritoriesorpossesthatarisesoutofandinthecourseofem-sions,andCanada.Thisexclusiondoesnot ployment,claimedagainstyouinacapacityapplyto"bodilyinjury"toacitizenorresident otherthanasanemployer. oftheUnitedStatesofAmericaorCanada whoistemporarilyoutsidethesecountries;

h.Damagesarisingoutofcoercion,criticism,

Wehavetherightanddutytodefendyou,atour demotion,evaluation,reassignment,disci- expense,againstanyclaim,proceedingor"suit" pline,defamation,harassment,humiliation, seekingdamagespayablebythisinsurance.We discriminationagainstorterminationofany havetherighttoinvestigateany"bodilyinjury" "employee",oranypersonnelpractices,poli- andsettletheseclaims,proceedingsand"suits". cies,actsoromissions;

Theamountwewillpayfordamagesislimitedas i."Bodilyinjury"toanypersoninworksubject describedinLIMITSOFINSURANCE(Section totheLongshoreandHarborWorkers'Com- III). pensationAct(33USCSections901-950),

Wehavenodutytodefendyouagainstaclaim, theNonappropriatedFundlnstrumentalities proceedingor"suit"thatisnotcoveredbythisin- Act(5USCSections8171-8173),theOuter surance.Wehavenodutytodefendorcontinue ContinentalShelfLandsAct(43USCSec- defendingyouafterwehavepaidourapplicable tions1331-1356),theDefenseBaseAct(42 limitofliabilityunderthisinsurance. USCSections1651-1654),theFederalCoal

4.Exclusions MineHealthandSafetyActof1969(30USC Sections901-942),anyotherfederalworkers

Thisinsurancedoesnotapplyto: orworkmen'scompensationlaworotherfed-

a.Liabilityassumedunderacontractoragree- eraloccupationaldiseaselaw,orany ment.Thisexclusiondoesnotapplytoawar- amendmentstotheselaws; rantythatyourworkwillbedoneinawork-

j."Bodilyinjury"toanypersoninworksubject manlikemanner; totheFederalEmployers'LiabilityAct(45

b.Punitiveorexemplarydamagesbecauseof USCSections51-60),anyotherfederallaws "bodilyinjury"toan"employee"employedin obligatinganemployertopaydamagestoan violationoflaw; "employee"dueto"bodilyinjury"arisingout

c."Bodilyinjury"toan"employee"whileem-oforinthecourseofemployment,orany amendmentstothoselaws; ployedinviolationoflawwithyouractual knowledgeortheactualknowledgeofanyof

k."Bodilyinjury"toamasterormemberofthe yourpartners(ifyouareapartnership),your crewofanyvessel; "executiveofficers"(ifyouareanorganization

I.Finesorpenaltiesimposedforviolationof otherthanapartnership,jointventureorlim- federalorstatelaw; itedliabilitycompany),yourmembersor

m. managers(ifyouareajointventureorlimitedDamagespayableundertheMigrantand liabilitycompany)oryourtrustees(ifyouareSeasonalAgriculturalWorkerProtectionAct atrust); (29USCSections1801-1872)andunderany otherfederallawawardingdamagesforviola-

d.AnyobligationimposedbyaWorkersCom- tionofthoselawsorregulationsissuedthere- pensation,occupationaldisease,unemploy- under,andanyamendmentstothoselaws. mentcompensation,ordisabilitybenefitslaw, 5.SupplementaryPayments oranysimilarlaw;

e."Bodilyinjury"intentionallycausedoraggra-Wewillpaywithrespecttoanyclaimweinvestivatedbyyou; gateorsettle,orany"suit"againstaninsuredwe defend:

a.b. Reasonableexpensesincurredatourre-Coveragedoesnotapplyto"bodilyinjury" quest,butnotlossofearnings; thatoccurredbeforeyouacquiredorformed theorganization.

b.Premiumsforbondstoreleaseattachments andforappealbondsinbondamountsuptoNopersonororganizationisaninsuredwith thelimitofourliabilityunderthisinsurance; respecttotheconductofanycurrentorpastpartnership,jointventureorlimitedliabilitycompany

c.Litigationcoststaxedagainstyou; thatisnotshownasaNamedInsuredintheDec-

d.Interestonajudgmentasrequiredbylawun- larationsoftheCoverageParttowhichthisen- tilweoffertheamountdueunderthisinsur- dorsementisattached. ance;and

e.Expensesweincur.

SECTIONIll–LIMITSOFINSURANCE

1.TheLimitsofInsuranceshownintheSchedule ThesepaymentswillnotreducetheLimitsof aboveandthefollowingrulesfixthemostwewill Insurance. payregardlessofthenumberof:

SECTIONII–WHOISANINSURED

1.IfyouaredesignatedintheDeclarationsofthe

a.Insureds;

b.Claimsmadeor"suits"brought;or CoverageParttowhichthisendorsementisat-

c.Personsororganizationsmakingclaimsor tachedas: bringing"suits".

a.Anindividual,youandyourspouseareinsur-

2.TheBodilyInjurybyAccident–EachAccident eds,butonlywithrespecttotheconductofa limitisthemostwewillpayforalldamagesbe- businessofwhichyouarethesoleowner. causeof"bodilyinjury"tooneormore"employ-

b.Apartnershiporjointventure,youareanin- ees"inanyoneaccident.Adiseaseisnot"bodily sured.Yourmembers,yourpartners,and injury"byaccidentunlessitresultsdirectlyfrom theirspousesarealsoinsureds,butonlywith "bodilyinjury"byaccident. respecttotheconductofyourbusiness.

3.TheBodilyInjurybyDisease–Aggregatelimitis

c.Alimitedliabilitycompany,youareanin- themostwewillpayforalldamagesbecauseof sured.Yourmembersarealsoinsureds,but "bodilyinjury"bydisease,regardlessofthenum- onlywithrespecttotheconductofyourbusi- berof"employees"whosustain"bodilyinjury"by ness.Yourmanagersareinsureds,butonly disease; withrespecttotheirdutiesasyourmanagers.

4.TheBodilyInjurybyDisease–EachEmployee

d.Anorganizationotherthanapartnershipor limitisthemostwewillpayforalldamagesbe- jointventureorlimitedliabilitycompany,you causeof"bodilyinjury"bydiseasetoanyone areaninsured.Your"executiveofficers"and 3. "employee",subjecttoabove. directorsareinsureds,butonlywithrespect

3.4. Underpartsandabove,"bodilyinjury"bydistotheirdutiesasyourofficersordirectors.easedoesnotincludediseasethatresultsdirectly Yourstockholdersarealsoinsureds,butonlyfrom"bodilyinjury"byaccident. withrespecttotheirliabilityasstockholders.

Thelimitsofthisinsuranceapplyseparatelytoeach

e.Atrust,youareaninsured.Yourtrusteesareconsecutiveannualperiodandtoanyremaining alsoinsureds,butonlywithrespecttotheirperiodoflessthan12months,startingwiththebegindutiesastrustees. ningoftheendorsementperiod,unlesstheendorse-

2.Anyorganizationyounewlyacquireorform,othermentperiodisextendedafterissuanceforanaddithanapartnership,jointventureorlimitedliabilitytionalperiodoflessthan12months.Inthatcase,the company,andoverwhichyoumaintainownershipadditionalperiodwillbedeemedpartofthelast ormajorityinterest,willqualifyasaNamedIn-precedingperiodforpurposesofdeterminingthe suredifthereisnoothersimilarinsuranceavail-LimitsofInsurance. abletothatorganization.However:

a.Coverageunderthisprovisionisaffordedonly

SECTIONIV–DEFINITIONS

1."BodilyInjury"meansbodilyinjury,sicknessor untilthe90thdayafteryouacquireorform diseasesustainedbyaperson,includingdeath theorganization,ortheendoftheendorse- resultingfromanyoftheseatanytime. mentperiod,whicheverisearlier;

2.a. "Employee"includesa"leasedworker"."Em-Anarbitrationproceedinginwhichsuchdamployee"doesnotincludea"temporaryworker". agesareclaimedandtowhichyoumust submitordosubmitwithourconsent;or

3."Executiveofficer"meansapersonholdinganyof

b. theofficerpositionscreatedbyyourcharter,con-Anyotheralternativedisputeresolutionprostitution,by-lawsoranyothersimilargoverningceedinginwhichsuchdamagesareclaimed document.andtowhichyousubmitwithourconsent.

4.6. "Leasedworker"meansapersonleasedtoyou"Temporaryworker"meansapersonwhois byalaborleasingfirmunderanagreementbe-furnishedtoyoutosubstituteforapermanent tweenyouandthelaborleasingfirm,toperform"employee"onleaveortomeetseasonalorshorttermworkloadconditions. dutiesrelatedtotheconductofyourbusiness. "Leasedworker"doesnotincludea"temporary 7."WorkersCompensationLaws"meansthework- worker". ersorworkmen'scompensationlawandoccupa-

5."Suit"meansacivilproceedinginwhichdamagestionaldiseaselawofeachstateorterritory.Itinbecauseof"bodilyinjury"towhichthisinsurancecludesanyamendmentstothatlawwhicharein appliesarealleged."Suit"includes: effectduringtheendorsementperiod.Itdoesnot includetheprovisionsofanylawthatprovides non-occupationaldisabilitybenefits.

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

BUSINESS AUTO EXTENSION ENDORSEMENT

This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM

GENERAL DESCRIPTION OF COVERAGE This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general coverage description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered.

A. BROAD FORM NAMED INSURED USE INCREASED LIMIT

B. BLANKET ADDITIONAL INSURED

H. HIRED AUTO PHYSICAL DAMAGE LOSS OF

I. PHYSICAL DAMAGE TRANSPORTATION

C. EMPLOYEE HIRED AUTO EXPENSES INCREASED LIMIT

D. EMPLOYEES AS INSURED

J. PERSONAL PROPERTY

E. SUPPLEMENTARY PAYMENTS INCREASED K. AIRBAGS LIMITS

L. NOTICE AND KNOWLEDGE OF ACCIDENT OR

F. HIRED AUTO LIMITED WORLDWIDE COV- LOSS ERAGE INDEMNITY BASIS

G. WAIVER OF DEDUCTIBLE GLASS

PROVISIONS

M. BLANKET WAIVER OF SUBROGATION

N. UNINTENTIONAL ERRORS OR OMISSIONS

A. BROAD FORM NAMED INSURED person or organization qualifies as an "insured"

B.

this insurance applies and only to the extent that

The following is added to Paragraph A.1., Who Is under the Who Is An Insured provision contained An Insured, of SECTION II COVERED AUTOS in Section II. LIABILITY COVERAGE:

Any organization you newly acquire or form dur-

C. EMPLOYEE HIRED AUTO

1. The following is added to Paragraph A.1., ing the policy period over which you maintain Who Is An Insured, of SECTION II COV- 50% or more ownership interest and that is not ERED AUTOS LIABILITY COVERAGE: separately insured for Business Auto Coverage.

An "employee" of yours is an "insured" while Coverage under this provision is afforded only unoperating an "auto" hired or rented under a til the 180th day after you acquire or form the orcontract or agreement in an "employee's" ganization or the end of the policy period, whichname, with your permission, while performing ever is earlier. duties related to the conduct of your busi-

BLANKET ADDITIONAL INSURED

The following is added to Paragraph c. in A.1.,

ness.

2. The following replaces Paragraph b. in B.5., Who Is An Insured, of SECTION II COVERED Other Insurance, of SECTION IV BUSINESS AUTO CONDITIONS: AUTOS LIABILITY COVERAGE:

b. For Hired Auto Physical Damage Cover-

Any person or organization who is required under age, the following are deemed to be cov- a written contract or agreement between you and ered "autos" you own: that person or organization, that is signed and

(1) Any covered "auto" you lease, hire, executed by you before the "bodily injury" or rent or borrow; and "property damage" occurs and that is in effect during the policy period, to be named as an addi-

(2) Any covered "auto" hired or rented by tional insured is an "insured" for Covered Autos your "employee" under a contract in Liability Coverage, but only for damages to which an "employee's" name, with your

permission, while performing duties

(a) With respect to any claim made or "suit" related to the conduct of your busi- brought outside the United States of America, the territories and possessions ness. of the United States of America, Puerto

However, any "auto" that is leased, hired, Rico and Canada: rented or borrowed with a driver is not a covered "auto".

D. EMPLOYEES AS INSURED

(i) You must arrange to defend the "insured" against, and investigate or set-

tle any such claim or "suit" and keep

The following is added to Paragraph A.1., Who Is us advised of all proceedings and acAn Insured, of SECTION II COVERED AUTOS tions. LIABILITY COVERAGE:

(ii) Neither you nor any other involved

Any "employee" of yours is an "insured" while us- "insured" will make any settlement ing a covered "auto" you don't own, hire or borrow without our consent. in your business or your personal affairs.

(iii) We may, at our discretion, participate

E. SUPPLEMENTARY PAYMENTS INCREASED in defending the "insured" against, or LIMITS in the settlement of, any claim or

1. The following replaces Paragraph A.2.a.(2), "suit". of SECTION II COVERED AUTOS LIABIL-

2. The following replaces Paragraph A.2.a.(4),

(iv) We will reimburse the "insured" for ITY COVERAGE: sums that the "insured" legally must (2) Up to $3,000 for cost of bail bonds (in- pay as damages because of "bodily cluding bonds for related traffic law viola- injury" or "property damage" to which tions) required because of an "accident" this insurance applies, that the "inwe cover. We do not have to furnish sured" pays with our consent, but only up to the limit described in Para- these bonds. graph C., Limits Of Insurance, of

SECTION II COVERED AUTOS of SECTION II COVERED AUTOS LIABILLIABILITY COVERAGE. ITY COVERAGE:

(v) We will reimburse the "insured" for (4) All reasonable expenses incurred by the the reasonable expenses incurred "insured" at our request, including actual with our consent for your investiga- loss of earnings up to $500 a day betion of such claims and your defense cause of time off from work. of the "insured" against any such

F. HIRED AUTO LIMITED WORLDWIDE COV- "suit", but only up to and included ERAGE INDEMNITY BASIS within the limit described in Para-

The following replaces Subparagraph (5) in Para- graph C., Limits Of Insurance, of graph B.7., Policy Period, Coverage Territory,

SECTION II COVERED AUTOS of SECTION IV BUSINESS AUTO CONDI- LIABILITY COVERAGE, and not in addition to such limit. Our duty to TIONS: make such payments ends when we (5) Anywhere in the world, except any country or have used up the applicable limit of jurisdiction while any trade sanction, eminsurance in payments for damages, bargo, or similar regulation imposed by the settlements or defense expenses. United States of America applies to and prohibits the transaction of business with or

(b) This insurance is excess over any valid within such country or jurisdiction, for Cov- and collectible other insurance available ered Autos Liability Coverage for any covered to the "insured" whether primary, excess, contingent or on any other basis. "auto" that you lease, hire, rent or borrow without a driver for a period of 30 days or less

(c) This insurance is not a substitute for reand that is not an "auto" you lease, hire, rent quired or compulsory insurance in any or borrow from any of your "employees", country outside the United States, its terpartners (if you are a partnership), members ritories and possessions, Puerto Rico and (if you are a limited liability company) or Canada. members of their households.

Page 2 of 4

(2) In or on your covered "auto". You agree to maintain all required or compulsory insurance in any such coun- This coverage applies only in the event of a total try up to the minimum limits required by theft of your covered "auto". local law. Your failure to comply with No deductibles apply to this Personal Property compulsory insurance requirements will coverage. not invalidate the coverage afforded by K. AIRBAGS this policy, but we will only be liable to the same extent we would have been liable

The following is added to Paragraph B.3., Excluhad you complied with the compulsory in- sions, of SECTION III PHYSICAL DAMAGE surance requirements. COVERAGE:

Exclusion 3.a. does not apply to "loss" to one or (d) It is understood that we are not an admitmore airbags in a covered "auto" you own that in- ted or authorized insurer outside the flate due to a cause other than a cause of "loss" United States of America, its territories set forth in Paragraphs A.1.b. and A.1.c., but and possessions, Puerto Rico and Canonly: ada. We assume no responsibility for the furnishing of certificates of insurance, or

a. If that "auto" is a covered "auto" for Comprefor compliance in any way with the laws hensive Coverage under this policy; of other countries relating to insurance.

G. WAIVER OF DEDUCTIBLE GLASS

b. The airbags are not covered under any warranty; and

c. The airbags were not intentionally inflated.

The following is added to Paragraph D., Deductible, of SECTION III PHYSICAL DAMAGE We will pay up to a maximum of $1,000 for any COVERAGE: one "loss".

No deductible for a covered "auto" will apply to

L. NOTICE AND KNOWLEDGE OF ACCIDENT OR glass damage if the glass is repaired rather than LOSS replaced.

The following is added to Paragraph A.2.a., of

H. HIRED AUTO PHYSICAL DAMAGE LOSS OF SECTION IV BUSINESS AUTO CONDITIONS: USE INCREASED LIMIT

Your duty to give us or our authorized representative prompt notice of the "accident" or "loss" ap-

The following replaces the last sentence of Paraplies only when the "accident" or "loss" is known graph A.4.b., Loss Of Use Expenses, of SECto: TION III PHYSICAL DAMAGE COVERAGE:

(a) You (if you are an individual); However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of

(b) A partner (if you are a partnership); $750 for any one "accident".

(c) A member (if you are a limited liability com-

I. PHYSICAL DAMAGE TRANSPORTATION pany); EXPENSES INCREASED LIMIT

(d) An executive officer, director or insurance manager (if you are a corporation or other or-

The following replaces the first sentence in Paraganization); or graph A.4.a., Transportation Expenses, of SECTION III PHYSICAL DAMAGE COVER-

(e) Any "employee" authorized by you to give noAGE: tice of the "accident" or "loss".

We will pay up to $50 per day to a maximum of M. BLANKET WAIVER OF SUBROGATION

$1,500 for temporary transportation expense in-

J. PERSONAL PROPERTY

The following replaces Paragraph A.5., Transfer curred by you because of the total theft of a cov- Of Rights Of Recovery Against Others To Us, ered "auto" of the private passenger type. of SECTION IV BUSINESS AUTO CONDITIONS:

The following is added to Paragraph A.4., CoverOthers To Us age Extensions, of SECTION III PHYSICAL DAMAGE COVERAGE:

5. Transfer Of Rights Of Recovery Against

We waive any right of recovery we may have against any person or organization to the ex- Personal Property tent required of you by a written contract

We will pay up to $400 for "loss" to wearing ap- signed and executed prior to any "accident" parel and other personal property which is: or "loss", provided that the "accident" or "loss" arises out of operations contemplated by (1) Owned by an "insured"; and

such contract. The waiver applies only to the The unintentional omission of, or unintentional person or organization designated in such error in, any information given by you shall not contract. prejudice your rights under this insurance. How-

N. UNINTENTIONAL ERRORS OR OMISSIONS ever this provision does not affect our right to collect additional premium or exercise our right of The following is added to Paragraph B.2., Concancellation or non-renewal. cealment, Misrepresentation, Or Fraud, of SECTION IV BUSINESS AUTO CONDITIONS:

BUSINESSAUTOCOVERAGEFORM

Variousprovisionsinthispolicyrestrictcoverage. Readtheentirepolicycarefullytodeterminerights, dutiesandwhatisandisnotcovered.

Throughoutthispolicythewords"you"and"your"refertotheNamedInsuredshownintheDeclarations. Thewords"we","us"and"our"refertothecompany providingthisinsurance.

Otherwordsandphrasesthatappearinquotation markshavespecialmeaning.RefertoSectionV–Definitions.

SECTIONI–COVEREDAUTOS

ItemTwooftheDeclarationsshowsthe"autos"that arecovered"autos"foreachofyourcoverages.The followingnumericalsymbolsdescribethe"autos"that maybecovered"autos".Thesymbolsenterednextto acoverageontheDeclarationsdesignatetheonly "autos"thatarecovered"autos".

A.DescriptionOfCoveredAutoDesignation Symbols

Onlythose"autos"youown(andforCoveredAutosLiabilityCoverageany "trailers"youdon'townwhileattachedtopowerunitsyouown).Thisincludes those"autos"youacquireownershipofafterthepolicybegins.

Onlytheprivatepassenger"autos"youown.Thisincludesthoseprivate passenger"autos"youacquireownershipofafterthepolicybegins.

Onlythose"autos"youownthatarenotoftheprivatepassengertype(andfor CoveredAutosLiabilityCoverageany"trailers"youdon'townwhileattachedto powerunitsyouown).Thisincludesthose"autos"notoftheprivatepassenger typeyouacquireownershipofafterthepolicybegins.

Onlythose"autos"youownthatarerequiredtohaveno-faultbenefitsinthestate wheretheyarelicensedorprincipallygaraged.Thisincludesthose"autos"you acquireownershipofafterthepolicybeginsprovidedtheyarerequiredtohavenofaultbenefitsinthestatewheretheyarelicensedorprincipallygaraged.

Onlythose"autos"youownthatbecauseofthelawinthestatewheretheyare licensedorprincipallygaragedarerequiredtohaveandcannotrejectUninsured MotoristsCoverage.Thisincludesthose"autos"youacquireownershipofafterthe policybeginsprovidedtheyaresubjecttothesamestateuninsuredmotorists requirement.

Onlythose"autos"describedinItemThreeoftheDeclarationsforwhicha premiumchargeisshown(andforCoveredAutosLiabilityCoverageany"trailers" youdon'townwhileattachedtoanypowerunitdescribedinItemThree).

Onlythose"autos"youlease,hire,rentorborrow.Thisdoesnotincludeany"auto" youlease,hire,rentorborrowfromanyofyour"employees",partners(ifyouarea partnership),members(ifyouarealimitedliabilitycompany)ormembersoftheir households.

Onlythose"autos"youdonotown,lease,hire,rentorborrowthatareusedin connectionwithyourbusiness.Thisincludes"autos"ownedbyyour"employees", partners(ifyouareapartnership),members(ifyouarealimitedliabilitycompany) ormembersoftheirhouseholdsbutonlywhileusedinyourbusinessoryour personalaffairs.

19 MobileEquipmentSubjectTo CompulsoryOr Financial

Responsibility

OrOtherMotor VehicleInsuranceLawOnly

Onlythose"autos"thatarelandvehiclesandthatwouldqualifyunderthedefinition of"mobileequipment"underthispolicyiftheywerenotsubjecttoacompulsoryor financialresponsibilitylaworothermotorvehicleinsurancelawwheretheyare licensedorprincipallygaraged.

B.OwnedAutosYouAcquireAfterThePolicy Begins

1.IfSymbols1,2,3,4,5,6or19areentered nexttoacoverageinItemTwooftheDeclarations,thenyouhavecoveragefor"autos" thatyouacquireofthetypedescribedforthe remainderofthepolicyperiod.

2.But,ifSymbol7isenterednexttoacoverage inItemTwooftheDeclarations,an"auto"you acquirewillbeacovered"auto"forthatcoverageonlyif:

a.Wealreadycoverall"autos"thatyouown forthatcoverageoritreplacesan"auto" youpreviouslyownedthathadthatcoverage;and

b.Youtelluswithin30daysafteryouacquireitthatyouwantustocoveritforthat coverage.

C.CertainTrailers,MobileEquipmentAndTemporarySubstituteAutos

IfCoveredAutosLiabilityCoverageisprovidedby thisCoverageForm,thefollowingtypesofvehiclesarealsocovered"autos"forCoveredAutos LiabilityCoverage:

1."Trailers"withaloadcapacityof2,000 poundsorlessdesignedprimarilyfortravel onpublicroads.

2."Mobileequipment"whilebeingcarriedor towedbyacovered"auto".

3.Any"auto"youdonotownwhileusedwith thepermissionofitsownerasatemporary substituteforacovered"auto"youownthatis outofservicebecauseofits:

a.Breakdown;

b.Repair;

c.Servicing;

d."Loss";or

e.Destruction.

SECTIONII–COVEREDAUTOSLIABILITYCOVERAGE

A.Coverage

Wewillpayallsumsan"insured"legallymustpay asdamagesbecauseof"bodilyinjury"or"propertydamage"towhichthisinsuranceapplies, causedbyan"accident"andresultingfromthe ownership,maintenanceoruseofacovered "auto".

Wewillalsopayallsumsan"insured"legally mustpayasa"coveredpollutioncostorexpense" towhichthisinsuranceapplies,causedbyan "accident"andresultingfromtheownership, maintenanceoruseofcovered"autos".However, wewillonlypayforthe"coveredpollutioncostor expense"ifthereiseither"bodilyinjury"or"propertydamage"towhichthisinsuranceappliesthat iscausedbythesame"accident".

Wehavetherightanddutytodefendany"insured"againsta"suit"askingforsuchdamages ora"coveredpollutioncostorexpense".However,wehavenodutytodefendany"insured" againsta"suit"seekingdamagesfor"bodilyinjury"or"propertydamage"ora"coveredpollution costorexpense"towhichthisinsurancedoesnot apply.Wemayinvestigateandsettleanyclaimor "suit"asweconsiderappropriate.OurdutytodefendorsettleendswhentheCoveredAutosLiabilityCoverageLimitofInsurancehasbeenexhaustedbypaymentofjudgmentsorsettlements.

1.WhoIsAnInsured

Thefollowingare"insureds":

a.Youforanycovered"auto".

b.Anyoneelsewhileusingwithyourpermissionacovered"auto"youown,hireor borrowexcept:

(1)Theowneroranyoneelsefrom whomyouhireorborrowacovered "auto".

Thisexceptiondoesnotapplyifthe covered"auto"isa"trailer"connected toacovered"auto"youown.

(2)Your"employee"ifthecovered"auto" isownedbythat"employee"ora memberofhisorherhousehold.

(3)Someoneusingacovered"auto" whileheorsheisworkinginabusinessofselling,servicing,repairing, parkingorstoring"autos"unlessthat businessisyours.

(4)Anyoneotherthanyour"employees", partners(ifyouareapartnership), members(ifyouarealimitedliability company)oralesseeorborroweror anyoftheir"employees",whilemovingpropertytoorfromacovered "auto".

(5)Apartner(ifyouareapartnership)or amember(ifyouarealimitedliability company)foracovered"auto"owned byhimorheroramemberofhisor herhousehold.

c.Anyoneliablefortheconductofan"insured"describedabovebutonlytothe extentofthatliability.

2.CoverageExtensions

a.SupplementaryPayments

Wewillpayforthe"insured":

(1)Allexpensesweincur.

(2)Upto$2,000forcostofbailbonds (includingbondsforrelatedtrafficlaw violations)requiredbecauseofan "accident"wecover.Wedonothave tofurnishthesebonds.

(3)Thecostofbondstoreleaseattachmentsinany"suit"againstthe"insured"wedefend,butonlyforbond amountswithinourLimitofInsurance.

(4)Allreasonableexpensesincurredby the"insured"atourrequest,including actuallossofearningsupto$250a daybecauseoftimeofffromwork.

(5)Allcourtcoststaxedagainstthe"insured"inany"suit"againstthe"insured"wedefend.However,these paymentsdonotincludeattorneys'feesorattorneys'expenses taxedagainstthe"insured".

(6)Allinterestonthefullamountofany judgmentthataccruesafterentryof thejudgmentinany"suit"againstthe "insured"wedefend,butourdutyto

payinterestendswhenwehavepaid, offeredtopayordepositedincourt thepartofthejudgmentthatiswithin ourLimitofInsurance.

ThesepaymentswillnotreducetheLimit ofInsurance.

b.Out-of-stateCoverageExtensions

Whileacovered"auto"isawayfromthe statewhereitislicensed,wewill:

(1)IncreasetheLimitofInsurancefor CoveredAutosLiabilityCoverageto meetthelimitsspecifiedbyacompulsoryorfinancialresponsibilitylaw ofthejurisdictionwherethecovered "auto"isbeingused.Thisextension doesnotapplytothelimitorlimits specifiedbyanylawgoverningmotor carriersofpassengersorproperty.

(2)Providetheminimumamountsand typesofothercoverages,suchasnofault,requiredofout-of-statevehicles bythejurisdictionwherethecovered "auto"isbeingused.

Wewillnotpayanyonemorethanonce forthesameelementsoflossbecauseof theseextensions.

B.Exclusions

Thisinsurancedoesnotapplytoanyofthefollowing:

1.ExpectedOrIntendedInjury

"Bodilyinjury"or"propertydamage"expected orintendedfromthestandpointofthe"insured".

2.Contractual

Liabilityassumedunderanycontractor agreement.

Butthisexclusiondoesnotapplytoliability fordamages:

a.Assumedinacontractoragreementthat isan"insuredcontract",providedthe "bodilyinjury"or"propertydamage"occurssubsequenttotheexecutionofthe contractoragreement;or

b.Thatthe"insured"wouldhaveintheabsenceofthecontractoragreement.

3.Workers'Compensation

Anyobligationforwhichthe"insured"orthe "insured's"insurermaybeheldliableunder anyworkers'compensation,disabilitybenefits

orunemploymentcompensationlaworany similarlaw.

4.EmployeeIndemnificationAndEmployer's Liability

"Bodilyinjury"to:

a.An"employee"ofthe"insured"arisingout ofandinthecourseof:

(1)Employmentbythe"insured";or

(2)Performingthedutiesrelatedtothe conductofthe"insured's"business; or

b.Thespouse,child,parent,brotherorsisterofthat"employee"asaconsequence ofParagrapha.above.

Thisexclusionapplies:

(1)Whetherthe"insured"maybeliable asanemployerorinanyothercapacity;and

(2)Toanyobligationtosharedamages withorrepaysomeoneelsewho mustpaydamagesbecauseoftheinjury.

Butthisexclusiondoesnotapplyto"bodilyinjury"todomestic"employees"notentitledto workers'compensationbenefitsortoliability assumedbythe"insured"underan"insured contract".ForthepurposesoftheCoverage Form,adomestic"employee"isapersonengagedinhouseholdordomesticworkperformedprincipallyinconnectionwitharesidencepremises.

5.FellowEmployee "Bodilyinjury"to:

a.Anyfellow"employee"ofthe"insured" arisingoutofandinthecourseofthefellow"employee's"employmentorwhile performingdutiesrelatedtotheconduct ofyourbusiness;or

b.Thespouse,child,parent,brotherorsisterofthatfellow"employee"asaconsequenceofParagrapha.above.

6.Care,CustodyOrControl

"Propertydamage"toor"coveredpollution costorexpense"involvingpropertyownedor transportedbythe"insured"orinthe"insured's"care,custodyorcontrol.Butthisexclusiondoesnotapplytoliabilityassumed underasidetrackagreement.

7.HandlingOfProperty

"Bodilyinjury"or"propertydamage"resulting fromthehandlingofproperty:

a.Beforeitismovedfromtheplacewhereit isacceptedbythe"insured"formovementintoorontothecovered"auto";or

b.Afteritismovedfromthecovered"auto" totheplacewhereitisfinallydeliveredby the"insured".

8.MovementOfPropertyByMechanicalDevice

"Bodilyinjury"or"propertydamage"resulting fromthemovementofpropertybyamechanicaldevice(otherthanahandtruck) unlessthedeviceisattachedtothecovered "auto".

9.Operations

"Bodilyinjury"or"propertydamage"arising outoftheoperationof:

a.AnyequipmentlistedinParagraphs6.b. and6.c.ofthedefinitionof"mobile equipment";or

b.Machineryorequipmentthatison,attachedtoorpartofalandvehiclethat wouldqualifyunderthedefinitionof"mobileequipment"ifitwerenotsubjecttoa compulsoryorfinancialresponsibilitylaw orothermotorvehicleinsurancelaw whereitislicensedorprincipallygaraged.

10.CompletedOperations

"Bodilyinjury"or"propertydamage"arising outofyourworkafterthatworkhasbeen completedorabandoned.

Inthisexclusion,yourworkmeans:

a.Workoroperationsperformedbyyouor onyourbehalf;and

b.Materials,partsorequipmentfurnishedin connectionwithsuchworkoroperations.

Yourworkincludeswarrantiesorrepresentationsmadeatanytimewithrespecttothefitness,quality,durabilityorperformanceofany oftheitemsincludedinParagrapha.orb. above.

Yourworkwillbedeemedcompletedatthe earliestofthefollowingtimes:

(1)Whenalloftheworkcalledforinyour contracthasbeencompleted;

(2)Whenalloftheworktobedoneat thesitehasbeencompletedifyour

contractcallsforworkatmorethan onesite;or

(3)Whenthatpartoftheworkdoneata jobsitehasbeenputtoitsintended usebyanypersonororganization otherthananothercontractororsubcontractorworkingonthesameproject.

Workthatmayneedservice,maintenance, correction,repairorreplacement,butwhichis otherwisecomplete,willbetreatedascompleted.

11.Pollution

"Bodilyinjury"or"propertydamage"arising outoftheactual,allegedorthreateneddischarge,dispersal,seepage,migration,releaseorescapeof"pollutants":

a.Thatare,orthatarecontainedinany propertythatis:

(1)Beingtransportedortowedby,handledorhandledformovementinto, ontoorfromthecovered"auto";

(2)Otherwiseinthecourseoftransitby oronbehalfofthe"insured";or

(3)Beingstored,disposedof,treatedor processedinoruponthecovered "auto";

b.Beforethe"pollutants"oranypropertyin whichthe"pollutants"arecontainedare movedfromtheplacewheretheyareacceptedbythe"insured"formovementinto orontothecovered"auto";or

c.Afterthe"pollutants"oranypropertyin whichthe"pollutants"arecontainedare movedfromthecovered"auto"tothe placewheretheyarefinallydelivered, disposedoforabandonedbythe"insured".

Paragrapha.abovedoesnotapplytofuels, lubricants,fluids,exhaustgasesorothersimilar"pollutants"thatareneededfororresult fromthenormalelectrical,hydraulicormechanicalfunctioningofthecovered"auto"or itspartsif:

(1)The"pollutants"escape,seep,migrateoraredischarged,dispersedor releaseddirectlyfroman"auto"part designedbyitsmanufacturertohold, store,receiveordisposeofsuch"pollutants";and

(2)The"bodilyinjury","propertydamage"or"coveredpollutioncostorexpense"doesnotariseoutoftheoperationofanyequipmentlistedin Paragraphs6.b.and6.c.ofthedefinitionof"mobileequipment".

Paragraphsb.andc.aboveofthisexclusion donotapplyto"accidents"thatoccuraway frompremisesownedbyorrentedtoan"insured"withrespectto"pollutants"notinor uponacovered"auto"if:

(a)The"pollutants"oranyproperty inwhichthe"pollutants"arecontainedareupset,overturnedor damagedasaresultofthemaintenanceoruseofacovered "auto";and

(b)Thedischarge,dispersal,seepage,migration,releaseorescape ofthe"pollutants"iscauseddirectlybysuchupset,overturnor damage.

12.War

"Bodilyinjury"or"propertydamage"arising directlyorindirectlyoutof:

a.War,includingundeclaredorcivilwar;

b.Warlikeactionbyamilitaryforce,includingactioninhinderingordefending againstanactualorexpectedattack,by anygovernment,sovereignorotherauthorityusingmilitarypersonnelorother agents;or

c.Insurrection,rebellion,revolution, usurpedpoweroractiontakenbygovernmentalauthorityinhinderingordefendingagainstanyofthese.

13.Racing

Covered"autos"whileusedinanyprofessionalororganizedracingordemolitioncontestorstuntingactivity,orwhilepracticingfor suchcontestoractivity.Thisinsurancealso doesnotapplywhilethatcovered"auto"is beingpreparedforsuchacontestoractivity.

C.LimitOfInsurance

Regardlessofthenumberofcovered"autos", "insureds",premiumspaid,claimsmadeorvehiclesinvolvedinthe"accident",themostwewill payforthetotalofalldamagesand"coveredpollutioncostorexpense"combinedresultingfrom anyone"accident"istheLimitOfInsurancefor CoveredAutosLiabilityCoverageshowninthe Declarations.

All"bodilyinjury","propertydamage"and"coveredpollutioncostorexpense"resultingfrom continuousorrepeatedexposuretosubstantially thesameconditionswillbeconsideredasresultingfromone"accident".

Noonewillbeentitledtoreceiveduplicatepaymentsforthesameelementsof"loss"underthis CoverageFormandanyMedicalPaymentsCoverageendorsement,UninsuredMotoristsCoverageendorsementorUnderinsuredMotorists CoverageendorsementattachedtothisCoverage Part.

SECTIONIII–PHYSICALDAMAGECOVERAGE

A.Coverage

1.Wewillpayfor"loss"toacovered"auto"or itsequipmentunder:

a.ComprehensiveCoverage

Fromanycauseexcept:

(1)Thecovered"auto's"collisionwith anotherobject;or

(2)Thecovered"auto's"overturn.

b.SpecifiedCausesOfLossCoverage

Causedby:

(1)Fire,lightningorexplosion;

(2)Theft;

(3)Windstorm,hailorearthquake;

(4)Flood;

(5)Mischieforvandalism;or

(6)Thesinking,burning,collisionorderailmentofanyconveyancetransportingthecovered"auto".

c.CollisionCoverage

Causedby:

(1)Thecovered"auto's"collisionwith anotherobject;or

(2)Thecovered"auto's"overturn.

2.Towing

WewillpayuptothelimitshownintheDeclarationsfortowingandlaborcostsincurred eachtimeacovered"auto"oftheprivate passengertypeisdisabled.However,thelabormustbeperformedattheplaceofdisablement.

3.GlassBreakage–HittingABirdOrAnimal –FallingObjectsOrMissiles

IfyoucarryComprehensiveCoverageforthe damagedcovered"auto",wewillpayforthe followingunderComprehensiveCoverage:

a.Glassbreakage;

b."Loss"causedbyhittingabirdoranimal; and

c."Loss"causedbyfallingobjectsormissiles.

However,youhavetheoptionofhavingglass breakagecausedbyacovered"auto's"collisionoroverturnconsidereda"loss"under CollisionCoverage.

4.CoverageExtensions

a.TransportationExpenses

Wewillpayupto$20perday,toamaximumof$600,fortemporarytransportationexpenseincurredbyyoubecauseof thetotaltheftofacovered"auto"ofthe privatepassengertype.Wewillpayonly forthosecovered"autos"forwhichyou carryeitherComprehensiveorSpecified CausesOfLossCoverage.Wewillpay fortemporarytransportationexpensesincurredduringtheperiodbeginning48 hoursafterthetheftandending,regardlessofthepolicy'sexpiration,whenthe covered"auto"isreturnedtouseorwe payforits"loss".

b.LossOfUseExpenses

ForHiredAutoPhysicalDamage,wewill payexpensesforwhichan"insured"becomeslegallyresponsibletopayforloss ofuseofavehiclerentedorhiredwithout adriverunderawrittenrentalcontractor agreement.Wewillpayforlossofuse expensesifcausedby:

(1)OtherthancollisiononlyiftheDeclarationsindicatesthatComprehensive Coverageisprovidedforanycovered "auto";

(2)SpecifiedCausesOfLossonlyifthe DeclarationsindicatesthatSpecified CausesOfLossCoverageisprovidedforanycovered"auto";or

(3)CollisiononlyiftheDeclarationsindicatesthatCollisionCoverageisprovidedforanycovered"auto".

However,themostwewillpayforany expensesforlossofuseis$20perday, toamaximumof$600.

B.Exclusions

1.Wewillnotpayfor"loss"causedbyorresultingfromanyofthefollowing.Such"loss"is excludedregardlessofanyothercauseor

eventthatcontributesconcurrentlyorinany sequencetothe"loss".

a.NuclearHazard

(1)Theexplosionofanyweaponemployingatomicfissionorfusion;or

(2)Nuclearreactionorradiation,orradioactivecontamination,however caused.

b.WarOrMilitaryAction

(1)War,includingundeclaredorcivil war;

(2)Warlikeactionbyamilitaryforce,includingactioninhinderingordefendingagainstanactualorexpectedattack,byanygovernment,sovereign orotherauthorityusingmilitarypersonnelorotheragents;or

(3)Insurrection,rebellion,revolution, usurpedpoweroractiontakenby governmentalauthorityinhindering ordefendingagainstanyofthese.

2.Wewillnotpayfor"loss"toanycovered "auto"whileusedinanyprofessionalororganizedracingordemolitioncontestorstuntingactivity,orwhilepracticingforsuchcontestoractivity.Wewillalsonotpayfor"loss" toanycovered"auto"whilethatcovered "auto"isbeingpreparedforsuchacontestor activity.

3.Wewillnotpayfor"loss"dueandconfinedto:

a.Wearandtear,freezing,mechanicalor electricalbreakdown.

b.Blowouts,puncturesorotherroaddamagetotires.

Thisexclusiondoesnotapplytosuch"loss" resultingfromthetotaltheftofacovered "auto".

4.Wewillnotpayfor"loss"toanyofthefollowing:

a.Tapes,records,discsorothersimilaraudio,visualordataelectronicdevicesdesignedforusewithaudio,visualordata electronicequipment.

b.Anydevicedesignedorusedtodetect speed-measuringequipment,suchasradarorlaserdetectors,andanyjamming apparatusintendedtoeludeordisrupt speed-measuringequipment.

c.Anyelectronicequipment,withoutregard towhetherthisequipmentispermanently

installed,thatreproduces,receivesor transmitsaudio,visualordatasignals.

d.Anyaccessoriesusedwiththeelectronic equipmentdescribedinParagraphc. above.

5.Exclusions4.c.and4.d.donotapplyto equipmentdesignedtobeoperatedsolelyby useofthepowerfromthe"auto's"electrical systemthat,atthetimeof"loss",is:

a.Permanentlyinstalledinoruponthecovered"auto";

b.Removablefromahousingunitwhichis permanentlyinstalledinoruponthecovered"auto";

c.Anintegralpartofthesameunithousing anyelectronicequipmentdescribedin Paragraphsa.andb.above;or

d.Necessaryforthenormaloperationofthe covered"auto"orthemonitoringofthe covered"auto's"operatingsystem.

6.Wewillnotpayfor"loss"toacovered"auto" dueto"diminutioninvalue".

C.LimitsOfInsurance

1.Themostwewillpayfor:

a."Loss"toanyonecovered"auto"isthe lesserof:

(1)Theactualcashvalueofthedamagedorstolenpropertyasofthetime ofthe"loss";or

(2)Thecostofrepairingorreplacingthe damagedorstolenpropertywith otherpropertyoflikekindandquality.

b.Allelectronicequipmentthatreproduces, receivesortransmitsaudio,visualordata signalsinanyone"loss"is$1,000,if,at thetimeof"loss",suchelectronicequipmentis:

(1)Permanentlyinstalledinoruponthe covered"auto"inahousing,opening orotherlocationthatisnotnormally usedbythe"auto"manufacturerfor theinstallationofsuchequipment;

(2)Removablefromapermanentlyinstalledhousingunitasdescribedin Paragraphb.(1)above;or

(3)Anintegralpartofsuchequipmentas describedinParagraphsb.(1)and b.(2)above.

2.Anadjustmentfordepreciationandphysical conditionwillbemadeindeterminingactual cashvalueintheeventofatotal"loss".

3.Ifarepairorreplacementresultsinbetter thanlikekindorquality,wewillnotpayforthe amountofthebetterment.

D.Deductible

Foreachcovered"auto",ourobligationtopayfor, repair,returnorreplacedamagedorstolenpropertywillbereducedbytheapplicabledeductible shownintheDeclarations.AnyComprehensive CoveragedeductibleshownintheDeclarations doesnotapplyto"loss"causedbyfireorlightning.

SECTIONIV–BUSINESSAUTOCONDITIONS

Thefollowingconditionsapplyinadditiontothe CommonPolicyConditions:

A.LossConditions

1.AppraisalForPhysicalDamageLoss

Ifyouandwedisagreeontheamountof "loss",eithermaydemandanappraisalofthe "loss".Inthisevent,eachpartywillselecta competentappraiser.Thetwoappraiserswill selectacompetentandimpartialumpire.The appraiserswillstateseparatelytheactual cashvalueandamountof"loss".Iftheyfailto agree,theywillsubmittheirdifferencestothe umpire.Adecisionagreedtobyanytwowill bebinding.Eachpartywill:

a.Payitschosenappraiser;and

b.Beartheotherexpensesoftheappraisal andumpireequally.

Ifwesubmittoanappraisal,wewillstillretain ourrighttodenytheclaim.

2.DutiesInTheEventOfAccident,Claim, SuitOrLoss

Wehavenodutytoprovidecoverageunder thispolicyunlesstherehasbeenfullcompliancewiththefollowingduties:

a.Intheeventof"accident",claim,"suit"or "loss",youmustgiveusorourauthorized representativepromptnoticeofthe"accident"or"loss".Include:

(1)How,whenandwherethe"accident" or"loss"occurred;

(2)The"insured's"nameandaddress; and

(3)Totheextentpossible,thenames andaddressesofanyinjuredpersons andwitnesses.

b.Additionally,youandanyotherinvolved "insured"must:

(1)Assumenoobligation,makenopaymentorincurnoexpensewithoutour consent,exceptatthe"insured's" owncost.

(2)Immediatelysenduscopiesofany request,demand,order,notice, summonsorlegalpaperreceived concerningtheclaimor"suit".

(3)Cooperatewithusintheinvestigation orsettlementoftheclaimordefense againstthe"suit".

(4)Authorizeustoobtainmedicalrecordsorotherpertinentinformation.

(5)Submittoexamination,atourexpense,byphysiciansofourchoice, asoftenaswereasonablyrequire.

c.Ifthereis"loss"toacovered"auto"orits equipment,youmustalsodothefollowing:

(1)Promptlynotifythepoliceifthecovered"auto"oranyofitsequipmentis stolen.

(2)Takeallreasonablestepstoprotect thecovered"auto"fromfurtherdamage.Alsokeeparecordofyourexpensesforconsiderationinthesettlementoftheclaim.

(3)Permitustoinspectthecovered "auto"andrecordsprovingthe"loss" beforeitsrepairordisposition.

(4)Agreetoexaminationsunderoathat ourrequestandgiveusasigned statementofyouranswers.

3.LegalActionAgainstUs

Noonemaybringalegalactionagainstus underthisCoverageFormuntil:

a.Therehasbeenfullcompliancewithall thetermsofthisCoverageForm;and

b.UnderCoveredAutosLiabilityCoverage, weagreeinwritingthatthe"insured"has anobligationtopayoruntiltheamountof thatobligationhasfinallybeendeterminedbyjudgmentaftertrial.Noonehas therightunderthispolicytobringusinto anactiontodeterminethe"insured's"liability.

4.LossPayment–PhysicalDamageCoverages

Atouroption,wemay:

a.Payfor,repairorreplacedamagedorstolenproperty;

b.Returnthestolenproperty,atourexpense.Wewillpayforanydamagethat resultstothe"auto"fromthetheft;or

c.Takealloranypartofthedamagedor stolenpropertyatanagreedorappraised value.

Ifwepayforthe"loss",ourpaymentwillincludetheapplicablesalestaxforthedamagedorstolenproperty.

5.TransferOfRightsOfRecoveryAgainst OthersToUs

Ifanypersonororganizationtoorforwhom wemakepaymentunderthisCoverageForm hasrightstorecoverdamagesfromanother, thoserightsaretransferredtous.Thatperson ororganizationmustdoeverythingnecessary tosecureourrightsandmustdonothingafter "accident"or"loss"toimpairthem.

B.GeneralConditions

1.Bankruptcy

Bankruptcyorinsolvencyofthe"insured"or the"insured's"estatewillnotrelieveusofany obligationsunderthisCoverageForm.

2.Concealment,MisrepresentationOrFraud

ThisCoverageFormisvoidinanycaseof fraudbyyouatanytimeasitrelatestothis CoverageForm.Itisalsovoidifyouorany other"insured",atanytime,intentionallyconcealsormisrepresentsamaterialfactconcerning:

a.ThisCoverageForm;

b.Thecovered"auto";

c.Yourinterestinthecovered"auto";or

d.AclaimunderthisCoverageForm.

3.Liberalization

IfwerevisethisCoverageFormtoprovide morecoveragewithoutadditionalpremium charge,yourpolicywillautomaticallyprovide theadditionalcoverageasofthedaytherevisioniseffectiveinyourstate.

4.NoBenefitToBailee–PhysicalDamage Coverages

Wewillnotrecognizeanyassignmentor grantanycoverageforthebenefitofanyper-

sonororganizationholding,storingortransportingpropertyforafeeregardlessofany otherprovisionofthisCoverageForm.

5.OtherInsurance

a.Foranycovered"auto"youown,this CoverageFormprovidesprimaryinsurance.Foranycovered"auto"youdon't own,theinsuranceprovidedbythisCoverageFormisexcessoveranyothercollectibleinsurance.However,whileacovered"auto"whichisa"trailer"isconnectedtoanothervehicle,theCovered AutosLiabilityCoveragethisCoverage Formprovidesforthe"trailer"is:

(1)Excesswhileitisconnectedtoamotorvehicleyoudonotown;or

(2)Primarywhileitisconnectedtoa covered"auto"youown.

b.ForHiredAutoPhysicalDamageCoverage,anycovered"auto"youlease,hire, rentorborrowisdeemedtobeacovered "auto"youown.However,any"auto"that isleased,hired,rentedorborrowedwith adriverisnotacovered"auto".

c.RegardlessoftheprovisionsofParagrapha.above,thisCoverageForm's CoveredAutosLiabilityCoverageisprimaryforanyliabilityassumedunderan "insuredcontract".

d.WhenthisCoverageFormandanyother CoverageFormorpolicycoversonthe samebasis,eitherexcessorprimary,we willpayonlyourshare.Ourshareisthe proportionthattheLimitofInsuranceof ourCoverageFormbearstothetotalof thelimitsofalltheCoverageFormsand policiescoveringonthesamebasis.

6.PremiumAudit

a.TheestimatedpremiumforthisCoverage Formisbasedontheexposuresyoutold usyouwouldhavewhenthispolicybegan.Wewillcomputethefinalpremium duewhenwedetermineyouractualexposures.Theestimatedtotalpremiumwill becreditedagainstthefinalpremiumdue andthefirstNamedInsuredwillbebilled forthebalance,ifany.Theduedatefor thefinalpremiumorretrospectivepremiumisthedateshownastheduedate onthebill.Iftheestimatedtotalpremium exceedsthefinalpremiumdue,thefirst NamedInsuredwillgetarefund.

b.Ifthispolicyisissuedformorethanone year,thepremiumforthisCoverageForm willbecomputedannuallybasedonour ratesorpremiumsineffectatthebeginningofeachyearofthepolicy.

7.PolicyPeriod,CoverageTerritory

UnderthisCoverageForm,wecover"accidents"and"losses"occurring:

a.Duringthepolicyperiodshowninthe Declarations;and

b.Withinthecoverageterritory.

Thecoverageterritoryis:

(1)TheUnitedStatesofAmerica;

(2)Theterritoriesandpossessionsofthe UnitedStatesofAmerica;

(3)PuertoRico;

(4)Canada;and

(5)Anywhereintheworldifacovered "auto"oftheprivatepassengertype isleased,hired,rentedorborrowed withoutadriverforaperiodof30 daysorless, providedthatthe"insured's"responsibilityto paydamagesisdeterminedina"suit"onthe merits,intheUnitedStatesofAmerica,the territoriesandpossessionsoftheUnited StatesofAmerica,PuertoRicoorCanada,or inasettlementweagreeto.

Wealsocover"loss"to,or"accidents"involving,acovered"auto"whilebeingtransported betweenanyoftheseplaces.

8.TwoOrMoreCoverageFormsOrPolicies IssuedByUs

IfthisCoverageFormandanyotherCoverageFormorpolicyissuedtoyoubyusorany companyaffiliatedwithusappliestothe same"accident",theaggregatemaximum LimitofInsuranceunderalltheCoverage Formsorpoliciesshallnotexceedthehighest applicableLimitofInsuranceunderanyone CoverageFormorpolicy.Thisconditiondoes notapplytoanyCoverageFormorpolicyissuedbyusoranaffiliatedcompanyspecificallytoapplyasexcessinsuranceoverthis CoverageForm.

SECTIONV–DEFINITIONS

A."Accident"includescontinuousorrepeatedexposuretothesameconditionsresultingin"bodilyinjury"or"propertydamage".

B."Auto"means:

1.Alandmotorvehicle,"trailer"orsemitrailer designedfortravelonpublicroads;or

2.Anyotherlandvehiclethatissubjecttoa compulsoryorfinancialresponsibilitylawor othermotorvehicleinsurancelawwhereitis licensedorprincipallygaraged.

However,"auto"doesnotinclude"mobileequipment".

C."Bodilyinjury"meansbodilyinjury,sicknessor diseasesustainedbyaperson,includingdeath resultingfromanyofthese.

D."Coveredpollutioncostorexpense"meansany costorexpensearisingoutof:

1.Anyrequest,demand,orderorstatutoryor regulatoryrequirementthatany"insured"or otherstestfor,monitor,cleanup,remove, contain,treat,detoxifyorneutralize,orinany wayrespondto,orassesstheeffectsof,"pollutants";or

2.Anyclaimor"suit"byoronbehalfofagovernmentalauthorityfordamagesbecauseof testingfor,monitoring,cleaningup,removing, containing,treating,detoxifyingorneutralizing,orinanywayrespondingto,orassessing theeffectsof,"pollutants".

"Coveredpollutioncostorexpense"doesnotincludeanycostorexpensearisingoutoftheactual,allegedorthreateneddischarge,dispersal, seepage,migration,releaseorescapeof"pollutants":

a.Thatare,orthatarecontainedinany propertythatis:

(1)Beingtransportedortowedby,handledorhandledformovementinto, ontoorfromthecovered"auto";

(2)Otherwiseinthecourseoftransitby oronbehalfofthe"insured";or

(3)Beingstored,disposedof,treatedor processedinoruponthecovered "auto";

b.Beforethe"pollutants"oranypropertyin whichthe"pollutants"arecontainedare movedfromtheplacewheretheyareacceptedbythe"insured"formovementinto orontothecovered"auto";or

c.Afterthe"pollutants"oranypropertyin whichthe"pollutants"arecontainedare movedfromthecovered"auto"tothe placewheretheyarefinallydelivered, disposedoforabandonedbythe"insured".

Paragrapha.abovedoesnotapplytofuels, lubricants,fluids,exhaustgasesorothersimilar"pollutants"thatareneededfororresult fromthenormalelectrical,hydraulicormechanicalfunctioningofthecovered"auto"or itsparts,if:

(1)The"pollutants"escape,seep,migrateoraredischarged,dispersedor releaseddirectlyfroman"auto"part designedbyitsmanufacturertohold, store,receiveordisposeofsuch"pollutants";and

(2)The"bodilyinjury","propertydamage"or"coveredpollutioncostorexpense"doesnotariseoutoftheoperationofanyequipmentlistedin Paragraph6.b.or6.c.ofthedefinitionof"mobileequipment".

Paragraphsb.andc.abovedonotapplyto "accidents"thatoccurawayfrompremises ownedbyorrentedtoan"insured"withrespectto"pollutants"notinoruponacovered "auto"if:

(a)The"pollutants"oranyproperty inwhichthe"pollutants"arecontainedareupset,overturnedor damagedasaresultofthemaintenanceoruseofacovered "auto";and

(b)Thedischarge,dispersal,seepage,migration,releaseorescape ofthe"pollutants"iscauseddirectlybysuchupset,overturnor damage.

E."Diminutioninvalue"meanstheactualorperceivedlossinmarketvalueorresalevaluewhich resultsfromadirectandaccidental"loss".

F."Employee"includesa"leasedworker"."Employee"doesnotincludea"temporaryworker".

G."Insured"meansanypersonororganizationqualifyingasaninsuredintheWhoIsAnInsuredprovisionoftheapplicablecoverage.ExceptwithrespecttotheLimitofInsurance,thecoverageaffordedappliesseparatelytoeachinsuredwhois seekingcoverageoragainstwhomaclaimor "suit"isbrought.

H."Insuredcontract"means:

1.Aleaseofpremises;

2.Asidetrackagreement;

3.Anyeasementorlicenseagreement,except inconnectionwithconstructionordemolition operationsonorwithin50feetofarailroad;

4.Anobligation,asrequiredbyordinance,toindemnifyamunicipality,exceptinconnection withworkforamunicipality;

5.Thatpartofanyothercontractoragreement pertainingtoyourbusiness(includinganindemnificationofamunicipalityinconnection withworkperformedforamunicipality)under whichyouassumethetortliabilityofanother topayfor"bodilyinjury"or"propertydamage" toathirdpartyororganization.Tortliability meansaliabilitythatwouldbeimposedby lawintheabsenceofanycontractoragreement;or

6.Thatpartofanycontractoragreemententeredinto,aspartofyourbusiness,pertaining totherentalorlease,byyouoranyofyour "employees",ofany"auto".However,such contractoragreementshallnotbeconsidered an"insuredcontract"totheextentthatitobligatesyouoranyofyour"employees"topay for"propertydamage"toany"auto"rentedor leasedbyyouoranyofyour"employees".

An"insuredcontract"doesnotincludethatpartof anycontractoragreement:

a.Thatindemnifiesarailroadfor"bodilyinjury"or"propertydamage"arisingoutof constructionordemolitionoperations, within50feetofanyrailroadpropertyand affectinganyrailroadbridgeortrestle, tracks,roadbeds,tunnel,underpassor crossing;

b.Thatpertainstotheloan,leaseorrental ofan"auto"toyouoranyofyour"employees",ifthe"auto"isloaned,leasedor rentedwithadriver;or

c.Thatholdsapersonororganizationengagedinthebusinessoftransporting propertyby"auto"forhireharmlessfor youruseofacovered"auto"overaroute orterritorythatpersonororganizationis authorizedtoservebypublicauthority.

I."Leasedworker"meansapersonleasedtoyou byalaborleasingfirmunderanagreementbetweenyouandthelaborleasingfirmtoperform dutiesrelatedtotheconductofyourbusiness. "Leasedworker"doesnotincludea"temporary worker".

J."Loss"meansdirectandaccidentallossordamage.

K."Mobileequipment"meansanyofthefollowing typesoflandvehicles,includinganyattached machineryorequipment:

1.Bulldozers,farmmachinery,forkliftsandother vehiclesdesignedforuseprincipallyoffpublic roads;

2.Vehiclesmaintainedforusesolelyonornext topremisesyouownorrent;

3.Vehiclesthattraveloncrawlertreads;

4.Vehicles,whetherself-propelledornot,maintainedprimarilytoprovidemobilitytopermanentlymounted:

a.Powercranes,shovels,loaders,diggers ordrills;or

b.Roadconstructionorresurfacingequipmentsuchasgraders,scrapersorrollers;

5.VehiclesnotdescribedinParagraph1.,2.,3. or4.abovethatarenotself-propelledandare maintainedprimarilytoprovidemobilityto permanentlyattachedequipmentofthefollowingtypes:

a.Aircompressors,pumpsandgenerators, includingspraying,welding,building cleaning,geophysicalexploration,lighting andwell-servicingequipment;or

b.Cherrypickersandsimilardevicesused toraiseorlowerworkers;or

6.VehiclesnotdescribedinParagraph1.,2.,3. or4.abovemaintainedprimarilyforpurposes otherthanthetransportationofpersonsor cargo.However,self-propelledvehicleswith thefollowingtypesofpermanentlyattached equipmentarenot"mobileequipment"butwill beconsidered"autos":

a.Equipmentdesignedprimarilyfor:

(1)Snowremoval;

(2)Roadmaintenance,butnotconstructionorresurfacing;or

(3)Streetcleaning;

b.Cherrypickersandsimilardevices mountedonautomobileortruckchassis andusedtoraiseorlowerworkers;and

c.Aircompressors,pumpsandgenerators, includingspraying,welding,building cleaning,geophysicalexploration,lighting orwell-servicingequipment.

However,"mobileequipment"doesnotinclude landvehiclesthataresubjecttoacompulsoryor financialresponsibilitylaworothermotorvehicle insurancelawwhereitislicensedorprincipally garaged.Landvehiclessubjecttoacompulsory orfinancialresponsibilitylaworothermotorvehicleinsurancelawareconsidered"autos".

L."Pollutants"meansanysolid,liquid,gaseousor thermalirritantorcontaminant,includingsmoke, vapor,soot,fumes,acids,alkalis,chemicalsand waste.Wasteincludesmaterialstoberecycled, reconditionedorreclaimed.

M."Propertydamage"meansdamagetoorlossof useoftangibleproperty.

N."Suit"meansacivilproceedinginwhich:

1.Damagesbecauseof"bodilyinjury"or"propertydamage";or

2.A"coveredpollutioncostorexpense"; towhichthisinsuranceapplies,arealleged.

"Suit"includes:

a.Anarbitrationproceedinginwhichsuch damagesor"coveredpollutioncostsor expenses"areclaimedandtowhichthe "insured"mustsubmitordoessubmitwith ourconsent;or

b.Anyotheralternativedisputeresolution proceedinginwhichsuchdamagesor "coveredpollutioncostsorexpenses"are claimedandtowhichtheinsuredsubmits withourconsent.

O."Temporaryworker"meansapersonwhoisfurnishedtoyoutosubstituteforapermanent"employee"onleaveortomeetseasonalorshorttermworkloadconditions.

P."Trailer"includessemitrailer.

Thi e dorseme t m d fie i surance prov ded under he f l o ing:

s n n o i s n i t o l w

BUS NE S A TO OV RAGE F RM I S U C E O

P O ISION

2. R V S The fol o ing i added to Paragraph l w s B.5., Other In u ance s r of SE TION IV BU IN S AUT C S E S O

1. The fol owing is a ded to Pa agrap l d r h c. in A.1., COND T ON I I S: Wh Is An Insured o , of SE TION Il COVERED C

AU OS LIAB LIT CO E AGE T I Y V R : Re ardle s o the prov sions o pa ag aph g s f i f r r a. and pa ag aph r r d. of this part 5. O her Insurance t , this Thi i cludes any pe son or organization who yo s n r u i suran e i prim ry to and non-contri utory wit n c s a b h are requi ed under a writ en co tra t o r t n c r appl cable othe in urance under which an i r s ag ee ent, that is signed by y u be o e the r m o f r addi ional insured person o organiza ion is a t r t "bodi y inju y or "property dam ge o curs and l r " a " c name i sured when a writ en co tra t o d n t n c r that i i e fe t during the poli y period, to nam s n f c c e ag ee ent with you, tha i signed by you be ore r m t s f a an addit onal i sured fo Cov red Auto s i n r e s the "bodily inj ry or "property dama e" o curs u " g c Lia il ty Cov rage, but only fo dam ges to whi h b i e r a c and that i in e fe t duri g the poli y perio , s f c n c d th s insuran e applie and only to the ex ent o i c s t f re ui e thi insuran e to be prim ry and non- q r s s c a that person s or o ganiza io 's l abi i y fo the ' r t n i l t r contributory. conduct o anothe "in ured". f r s

DESIGNATED PROJECT(S) GENERAL AGGREGATE LIMIT

This endorsement i ies insurance pro ided under t fol mod f v he lowing:

COMMERC GENERAL L ITY VERA A IAL IABIL CO GE P RT

SCHEDULE

Designated Project

A.

3.

Any payments made under l ly obligated to pay as damages caused by "occur- for da or under for mages COVERAGE C. rences" under , and med e shall reduce the Desi COVERAGE A. (SECT I ION ) ical xpenses gfor al med e s caused by accidents un- nated Projec General Aggregate L m for l ical xpense t i it der , which can be that designated "project". Such payments COVERAGE C (SEC I I) T ON attr only to operations at a single desig- shall not reduce the General Aggregate Lim ibuted it nated "project shown in the Schedule abo e: " v shown in the Declarat nor shall they re- ions duce any other Designated Pro General ject

COVERAGE A. For al sums which the insured becomes legal

1. A separate Designated Project General Ag- Aggregate Li it fo any other designated m r gregate Li it app designated "pro- m lies to each "project" n in the dule abo e. show Sche v ject" and that l m is equal to the amount of , i it the General Aggregate Li t shown in the

The l m shown in the Declarations for mi i its 4. Each Declarat unless separate ions, Designated Occurrence, Damage T Premises Re o nted Project General Ag T Yo and Me Expe gregate(s) o u dical nse are sche continue to duled above apply. Howe instead o be subject to ver, f ing the General Aggregate Li t shown in the mi

2. The Designated Project General Aggregate Declarat such li its will be subject to the ions, m Li it is the most we will pay for the sum o al m f l applicab Designated Project General Ag- le damages under , except COVERAGE A. gregate Limit. damages because of "bodil in " or "prop- y jury erty damage inc in the "products- For al sums which the insured becomes legal " luded l ly B. comp operations hazard , and for med obligated to pay as damages caused by "occur- leted " ical expenses under , regar rences" under , and COVERAGE C

COVERAGE A. (SECT I d- ION ) less of the o number f: for al med e s caused by accidents un- l ical xpense der , which cannot COVERAGE C. (SEC ON I) TI a. Insureds; be attribu only to operations at a sing desi ted le g- b. Clai made or "suits" brought; or ms nated "project shown in the Schedule abo e: " v c. Persons or organizations m ing cla ms ak i or bringing "suits".

1.

COVERAGE A. Any payments made under

v ded, any pa ments for da because of i y mages for da or under for "bodily injury or "property damage" inc in mages " luded

COVERAGE C. med e shall reduce the amount the "products-comp o erat hazard" will ical xpenses leted p ions a ilab under the General Aggregate Lim reduce the Products Comp Operat Ag- va le it - leted ions or the Products Completed Operat Ag- gregate Li t, and not reduce the General Aggre- - ions mi gregate Li it ver is applic b m , whiche a le; and gate Li it nor the Designated Pro General m ject Aggregate Limit.

2. Such payments shall not reduce any Designated Projec General Aggregate L m t i it

C. 2. SEC ION I LI T OF Part of T II MI S

INSURANCE

E. Defi i-

For the purposes of this endorsement the n tio Sectio ns n is amended by the addit of the ion

fo lowing def it l in ion: is deleted and rep fo laced by the llowing: "Projec " means an area away fro pre ises t m m

2. The General Aggregate Li i is the most we m t owned by or rented to you at which you are per- will for o : pay the sum f for ing oper t pursuant to a contract or m a ions

a. Coverage B Damages under ; and agreement. For the purposes of deter ing the min

b. Damages f m "occurrences" under applicab aggregate li t o insurance, each ro le mi f

COVERAGE A (SECT I) ION and for al "project" that includes prem in l i the l ises vo v ng med e caused by accidents same or connecting lots, or prem whose con- ical xpenses ises under which nection is interrupted only by a street, roadway,

COVERAGE C ( T I) SEC ION cannot be attr buted only to operat at waterway or right of way of a railroad shall be i ions -considered a single "project". a single designated "project" shown in the SCHEDULE abo e. v

F. SEC ION I LIM T OF The pro ons of visi T II I S

D. INSURANCE W co erage for liab li arising out o the not otherwise modi ied by this en- hen v i ty f f dorsement shall to apply continue as stipulated. "products-comple operations hazard is pro- ted "

BLANKET ADDITIONAL INSURED

(Incl des Products-Completed Operations If Required By Cont u ract)

Thi e dorseme t m d fie i surance prov ded under he f l o ing: s n n o i s n i t o l w

COMM RCI L G NERAL IAB LI Y COVERA E PART E A E L I T G

P O ISION R V S (1) Any "bodily injury", "property dam ge" o a r "pe sonal injury arising out o the prov di g, r " f i n

The fol owing i added to l s SE TI N II WHO IS AN C O or fa l re to prov de, any pro e sional i u i f s INSURED : arch te tural engineer ng o surv ying i c , i r e

Any person o o gan zat on that yo agree in a r r i i u se v ce , ncl ding: r i s i u writ en con ract or agreem nt to in lude a an t t e c s addi ional i sured o thi Cov rage Part i a t n n s e s n

(a) The preparin , approv ng, or fa li g to g i i n i sured, ut only n b : prepa e or approv , ma s, shop r e p drawi gs, opin on , reports, surv y , n i s e s a. Wi h re pe t to l abi ity fo "bodily injury o t s c i l r " r fi l orders or change orders, or the e d "prope ty dam ge that o curs, or fo "perso al r a " c r n

prepa i g, approv ng, or fa l n to r n i i i g i ju y ca sed by an o fe se that is comm tted n r " u f n i , prepa e or app ov , drawings and r r e subsequent to the signing of that contract or ag ee ent and while tha pa t o the contra t o r m t r f c r spe i i a io s; and c f c t n ag ee ent s in e fe t; and r m i f c

(b) Su erv so y, in pe t on, archi ect ral o p i r s c i t u r

b. If a d only to the ex ent that such injury o , n t , r engineerin a t v t e . g c i i i s dama e is ca sed by a ts o om ssio s o yo o g u c r i n f u r

(2) Any "bodi y inju y or "prope ty dam ge l r " r a " y ur subco tra tor in the perfo m nce o "y u o n c r a f o r caused by "y ur work an in luded in the o " d c work to which the wri ten cont a t or agreemen " t r c t "produ ts-com leted o erat on hazard c p p i s " appl e . Such person or organiza ion doe no i s t s t

un ess the wri ten cont a t o ag ee ent l t r c r r m qual fy a an ad itional in ured with re pect to i s d s s the independent a t o om ssions o such spe i i a ly requi es c s r i f c f c l r y u to prov de such o i pe son or organization r cov rage fo that addi ional in ured durin e r t s g the oli y pe iod. p c r

The i surance prov ded to such ad it onal insured is n i d i subje t o he o lo ing p ov sions: c t t f l w r i

c. The ad itional insured m st com ly with the d u p

a. If the Lim t o In uran e o thi Cov rage Part fo lowi g dutie i s f s c f s e l n s: shown in the De laratio s ex eed the m nim m c n c i u

(1) Giv us wri ten no i e as soon a pra tica le e t t c s c b l m t requi ed by the written co tra t o i i s r n c r

o an "o cur en e o an o fe se whi h m y f c r c " r f n c a ag ee ent, the i surance prov ded to the r m n i re ult i a clai To t e ex en possible such s n m h t t , addi ional insured wil be lim ted to such t l i no ice should in l de: t c u m nim m required lim ts. Fo the purpo e o i u i r s s f de erm nin whether thi lim tatio applie , the t i g s i n s

(a) How, when an where the "o cur en e d c r c " m nim m im t requi ed by the wri ten co tra t o i u l i s r t n c r or o fe se too pla e; f n k c ag ee ent will be co sidered to include the r m n

(b) The nam s and addre se o any inj red e s s f u m nim m lim ts o any Umb el a o Ex ess i u i f r l r c pe sons an witne s e ; and r d s s l ab l ty cov rage requi ed fo the addi ional i i i e r r t i sured by that writ en cont a t o agreem nt. n t r c r e

(c) The nature and lo ation o any inj ry o c f u r Thi prov sion will not increa e the lim t o s i s i s f dama e ari ing out o the "o cur en e g s f c r c " i suran e de cribed in Se tio n c s c n III Lim t Of i s or o fe se. f n Insurance.

b. The insurance prov ded to such addi ional i t the ad it onal nsured d i i : i sured does not ap ly o: n p t

(2) If a cla m is ma e or "sui " i brought agai st i d t s n

(a) Im e ia ely re ord the spe i i s o the m d t c c f c f

cla m or "sui " to any prov der i " d c e i t i o othe f r

(4) Te der the de ense and i dem i y o any n f n n t f cla m or "suit an the date re eiv d; and

(b) No i y us a soo a practi able and see t f s n s c

i suran e which woul cov r such addi ional n c d e t

i sured fo a lo s we cov r. Howev r, this n r s e e to it that we re eiv wri ten noti e o the c e t c f

condi ion doe not a f ct whethe the t s f e r cla m or "suit a soon a pra ti able i " s s c c

i suran e prov ded to such addi io al n c i t n

(3) Im e ia ely send us cop es o all legal m d t i f i sured i prima y to ot er insurance n s r h pape s receiv d in conne t on with the clai r e c i m

av ila le to such addi ional insured whi h a b t c or "sui ", coopera e wit us in the t t h

cov r that person or organi ation a a e s z s i v stigat on o se tlem nt o the claim o n e i r t e f r

name i sured a de cribed i Paragraph d n s s n 4. , de e se against the "sui ", and o herwise f n t t

Ot e In uran e o Se tion h r s c , f c IV Com e cial m r com ly wit all pol cy o ditio s. p h i c n n

Ge eral Liabil ty ondit on n i C i s

XTEND ENDORSEMENT FOR CONTRACTORS

Thi e dorseme t m d fie i surance prov ded under he f l o ing: s n n o i s n i t o l w COMM RCI L G NERAL IAB LI Y COVERAG PA T E A E L I T E R

GE ERAL D SCRIP ION O CO ERAGE N E T F V Thi endorsem nt broadens cov rage. Howev r cov rage fo any s e e e , e r i ju y, dama e o me i al ex ense descri ed in any o the prov n r g r d c p s b f i ion o th s e dorseme t may b s s f i n n e ex luded or c l m ted by anothe endorsem n to this Cov rage Pa t, and the e c i i r e t e r s ov rage broadening prov sions do no ap ly to e i t p the ex en tha cov rage is ex l ded or lim ted by such an en t t t e c u i dorsem n The fo lo ing li ti g i a g e t l w s n s eneral cov rage de cript on only Read al the prov sions o thi endors e s i l i f s em nt and the re t o y ur pol cy ca e ull e s f o i r f y to de erm ne r gh s, dut es, and wha i and s not cov red.

t i i t i t s i e

A. Wh I An Insured Unnam d Subsid arie o s e i s

B. Bla ket Addit onal Insured Gov rnme tal n i e n

C. In i ental Med cal Mal racti e c d i p c

D. Bla ket Wa v r f Sub ogation n i e O r En it e Pe m t Or Au ho iza ions Re ati g To t i s r i s t r t l n

E. Co tra tua Liab l ty Rai road n c l i i l s Ope atio s r n

F. Da a e To Prem se Ren ed o You m g i s t T

P O ISION

A. WH IS AN INSU ED UNNAMED O R

a. R V S An o ganizat on o he than a pa tnership, jo nt r i t r r i v nture or l m ted liab l ty company; or e i i i i

b. A trust; SUBSIDIARIES

The fol owing is ad ed to l d SE TION II WHO IS C a indi a ed in i s nam o the docum n s tha s c t t e r e t t AN INSURED : gov rn it stru ture. e s c

Any o yo r sub idiar e , o her than a pa tnershi , f u s i s t r p B B ANKET ADD TIONA INSURED . L I L jo n v nture o lim ted liabil ty com any, that i i t e r i i p s GO E N ENT L EN IT ES P RMIT O V R M A T I E S R no shown as a Nam d Insured in the t e AU H R ZA I N R L TI G T O E AT O S T

De la ation i a am d In ured f: c r s s N e s i

a. Yo are the so e owner o , o ma ntai an u l f r i n

The fol owing is ad ed to l d SE TION II WHO IS C

AN INSURED : ownership intere t o mo e than 50% in, such s f r

Any gov r men al enti y tha ha issued a perm t e n t t t s i subsidia y on the fi st day o the pol cy perio ; r r f i d or authoriza ion wit re pe t to ope ations t h s c r and pe fo med by yo or on your behal and that you r r u f b. Su h subsidiary i not an in ured unde c s s r are required by any o dinance, law, buil ing code r d si ila o her n urance. m r t i s or written cont act or agreeme t to incl de a an r n u s

No such subsidiary i a insured fo "bodily inju y s n r r " addi ional i sured on thi Cov rage Pa t is a t n s e r n or "property dama e" tha o curred, o "perso al i sured, but only wi h re p g t c r n n t s e t to liabi i y fo "bodily c l t r i ju y", "prope ty dam ge" or "perso al and n r r a n and a v rt sing i ju y" caused by an o fe se d e i n r f n adv rti ing inj ry" ari ing ou o uch operatio s. e s u s t f s n com i ted: m t

a. Be o e you ma ntai ed an ownership intere t f r i n s en ity doe not apply o: t s t o mo e than 50% i such ub idiary; or f r n s s

The in uran e prov ded to such gov r men al s c i e n t

a. Any "bodi y inju y , "property dama e o l r " g " r

b. Af e the date, i any duri g the poli y perio t r f , n c d "pe sonal and adv rti ing injury" a i ing o t o r e s r s u f that yo no longer ma ntain a ownershi u i n p operatio s perfo m d fo the gov r men al n r e r e n t i tere t o ore han 50% n such subsi ia y. n s f m t i d r en ity or t ; Fo purpose o Pa agraph r s f r 1. o Se tion f c II Who

b. Any "bodily inj ry or "property dam ge u " a "

Is An Insured, ea h such subsidiary wil be c l i clu ed in the "products-co ple ed n d m t deem d to e de ignated in the Declarat on a : e b s i s s operatio s hazard". n

3 16 02 9 D 1

C. IN IDEN AL ED CAL ALPRACTI E C T M I M C

1. The fo lo i g repla e Pa agraph l w n c s r b. o the f de i i ion o "o cur en e in the f n t f c r c "

D FIN TION E I S Section:

b. An a t o om ssio com i ted i prov din c r i n m t n i g

pharma eut cal co m t ed by o wi h the c i s m i t , r t

k owledge o co sent o , the n ured n r n f i s .

5. The fol owing i a ded to the l s d D FIN TION E I S

Se tio : c n

"In i ental m d cal se v ce " m a s: c d e i r i s e n or fa l ng to prov de "incidental me ica i i i d l

a. Med cal surgi al dental laborato y, x ray i , c , , rse v ce ", fi st a d o "Good Sam r tan r i s r i r a i or nur ing se v ce or treatm n , adv ce o s r i e t i r se v ce " to a person, unle s yo are i r i s s u n

i struction o the related fur i hi g o n , r n s n f the busine s or o cupat on o prov din s c i f i g

fo d or bev rages; or o e pro e sional hea th a e se v ce . f s l c r r i s

2. The fo lowi g rep a es the la t paragraph o l n l c s f m d cal dental o surgi al supplie o e i , , r c s r Pa ag aph r r 2.a.(1) of SECTI N II WHO IS O

AN INSURED :

b. The furni hing o di pensing o dru s o s r s f g r

appl a ce i n s

6. The fol o ing i added to Parag aph l w s r 4.b. , Unle s yo a e in the business or o cupatio s u r c n

Ex ess In urance c s , of SE TION IV C o prov di g pro e sional healt ca e se v ce , f i n f s h r r i s Pa ag aphs r r (1) a) ( , (b) , (c) and (d) abov do e

CO MERCIAL GENE AL LIABI IT M R L Y

COND T ON I I S not apply to : "bodily injury" arising out of prov din o ai ing o rov de: i g r f l t p i

Thi i surance i ex e s ov r any v li an s n s c s e a d d (a) "In i ental me ica se v ce " by any o c d d l r i s f

col e ti le othe in urance whether prim ry, l c b r s , a y ur "em loyee " who is a nu se, nurse o p s r ex e s, conti gent o on any other ba is, that c s n r s a sistant, em rgen y me i al techni ia s e c d c c n

i av ilab e to any o your "em loy es" fo s a l f p e r or arame ic; or p d "bo ily injury that ari e ou o prov ding o d " s s t f i r

fa l n to prov de "i cidental medi al serv ce " i i g i n c i s

(b) F rst ai or "Good Sama itan se v ce " by i d r r i s a y o y u "em loyee " o " to any perso to the ex ent not n f o r p s r n t subje t to c volunteer

Pa ag aph r r 2.a.(1) o Se t on f c i II Who Is An workers", other than an employed or v lunteer do tor. Any such "em loyee " o c p s

Insured. or "v lu teer wo kers" prov ding o fa l ng o n r i r i i D B ANKET WAIVER O SUB O ATION . L F R G to prov de fi st aid or "Good Sama i an i r r t

The fo lowing is a ded to Paragraph l d 8. , Transfer se v ce " during thei work hou s fo you r i s r r r

O Righ s O Reco ery Agai st O hers To Us f t f v n t , wil be deem d to be a t ng wi hin the l e c i t of SE TION IV CO MERCIAL GENERAL C M sco e o thei em loym nt by yo o p f r p e u r pe fo m n dutie rela ed to the co du t r r i g s t n c L ABI I Y CO D T ON I L T N I I S : o yo r busine s. f u s

If the insured has a ree in a cont act o g d r r

3. The fo lo i g repla e the la t se tence o l w n c s s n f ag ee ent to waiv that i sured' righ o r m e n s t f Pa ag aph r r 5. of SE TION III LIMITS O C F re ov ry against any person o o gan zat on, we c e r r i i

INSU AN E R C : waiv our right o e ov ry again t uch pe son o e f r c e s s r r organi ation, but only fo pay ents we ma e z r m k Fo the purpo e o dete m nin the r s s f r i g be ause o : c f appl cable Ea h Occurrence Lim t, al related i c i l a t or om ssions com i ted i prov di g o c s i m t n i n r a. "Bo ily i ju y" o "property dam ge" that d n r r a fa l n to prov de "inci ental me ica i i g i d d l o curs; o c r se v ce ", fi st a d o "Good Sam r tan r i s r i r a i

b. "Pe so al and adv rti ing inj ry" ca sed by r n e s u u se v ce " to any one perso wil be deeme to r i s n l d an o fe se hat i com it ed f n t s m t ; be one "occurrence".

4. The fo lowi g ex lu ion i added to subsequent to the ex cution o the l n c s s e f cont a t o r c r Pa ag aph r r 2. , Exclusions , of SE TION I C ag ee ent. r m CO ERAGES CO ERAGE A BODI Y V V L

E. CON RACTUAL IABILIT RAIL OAD T L Y R S

INJU Y AND P OP RT DAMAGE R R E Y

L ABI I Y I L T :

1. The fol o ing repla e Pa agraph l w c s r c. o the f de i i ion o "insured cont act" i the f n t f r n Sa e O Ph rmaceu icals l f a t D FIN TION E I S Section: "Bo ily inju y or "property dama e" ari ing d r " g s ou o the v ola ion o a penal stat te o t f i t f u r

c. Any ea em nt or l cense agreem nt; s e i e ordi ance rela i g to the sale o n t n f

Pa e 2 o 3 g f © 2017 The T avelers Indemnit Company. All rights r y reserved. CG 3 16 02 9 D 1 Includes copyrighted material of nsurance Services Of ice I f , Inc., with its permission.

2. Pa ag aph r r f.(1) o the de init o o "i sured f f i n f n a. Any prem se whi e rented to yo o i s l u r cont a t i the r c " n D FIN TION E I S Se tion is tem ora i y o cupied by you wi h pe m ssion c p r l c t r i de eted. o he owne ; or l f t r

F DAMAGE TO P EMISE EN ED TO YOU b . R S R T . The co tent o any premi e whi e such n s f s s l prem se i rented to yo , i y u rent such i s s u f o The fol owing repla e the de i ition o "prem se l c s f n f i s prem se fo a period o sev n or fewe i s r f e r dama e in he g " t DEF NIT ONS I I Se tion c : conse utiv day c e s "Pre i e dama e m a s "property dama e" to: m s s g " e n g

3 16 02 9 D 1

COMMERCIA GENERA LIA ILITY COVERA E FORM L L B G

Va i u pro i i n in thi po i y re tri t co e a e Re d

r o s v s o s s l c s c v r g a

(1) The "bo i y in ur " o "pro e ty da a e i d l j y r p r m g " s th e t re po i y ca e ul y to de e m n ri ht , dut e a d

ca se by

e n i l c r f l t r i e g s i s n u d a "o cur e ce th t n c r n " a t k s pl ce a e a wha s a d s no co e e . i he "co e a e t rri o y ; t i n i t v r d n t v r g e t r "

Thro g o t th s po i y th wo ds "y u a d "y ur" re e u h u i l c e r o " n o f r

(2) The "bo i y in u y o "pro e ty da a e d l j r " r p r m g " to th Na e Insure sho n i the De l ra i ns, a d

o cur d ri g e m d d w n c a t o n

a y o he pe so o o g n z t o qua i y ng a a Na e n t r r n r r a i a i n l f i s m d

In ure und r thi po i y The wo ds "we , "us" a d s d e s l c . r " n

c s u n t e p l cy pe i d; a d h o i r o n

(3) Pri r to th po i y pe i d, no in ure l ste o e l c r o s d i d

un e Pa a ra h d r r g p 1. o Se t o f c i n II Who Is "o r re e o t e co pa y p o i i g hi i sura ce u " f r t h m n r v d n t s n n

An In ure a d no "e pl y e a t o i e s d n m o e " u h r z d

The wo d "i sure " m a s a y pe so o o ga i a i n by y u to r n d e n n r n r r n z t o o gi e o re e v no i e o v r c i e t c f an

qu l fy ng a such unde Se t o a i i s r c i n II Who Is An "o curre ce o cl i kn w tha the "bo i y c n " r a m e t d l

I sure i j r " o "pro e ty da a e ha o cur e , n d n u y r p r m g " d c r d

Ot e wo ds a d phr se tha a p a in quo a i n h r r n a s t p e r t t o

i who e o in pa t If such a li te i sure n l r r s d n d

o a t o i e "e pl y e k e , pri r to the r u h r z d m o e " n w o m rk ha e spe i l m a i g. Re e to Se ti n a s v c a e n n f r c o V

po i y pe i d th t the "bo i y i j ry o l c r o , a d l n u " r

De i i i ns. f n t o "pro e ty da a e o cur e , th n a y p r m g " c r d e n

SE TI N I CO ERA E C O V G S

CO ERA E A B D L IN U Y A D P O E TY V G O I Y J R N R P R

D MAGE L A I IT A I B L Y

1. I su i g A reem n n r n g e t

a. We wi l pa th se sum tha th i sure l y o s t e n d

b co e le a l o l ga e to pa a da a e e m s g l y b i t d y s m g s

b ca se o "bo i y i j ry o "pro e ty da a e e u f d l n u " r p r m g "

to whi h th s in ura ce a p i s. We wi l ha e c i s n p l e l v

co ti u t o , cha g o re um ti n o such n n a i n n e r s p o f

"bo i y in ur " o "pro e ty da a e du i g d l j y r p r m g " r n

o a t r th po i y pe i d wi l be de m d to r f e e l c r o l e e

ha e be n no n pri r t h p l cy pe i d v e k w o o t e o i r o

c. "Bo i y i j ry o "pro e ty da a e whi h d l n u " r p r m g " c

o cur duri g th po i y pe i d a d wa no , c s n e l c r o n s t

pri r to the po i y pe i d kn w to ha e o l c r o , o n v

o curre by a y i sure l ste n e a a ra h

c d n n d i d u d r P r g p

1. o Se t o f c i n II Who Is An Insure o a y d r n th rig t a d du y to de e d the i sure a a nst e h n t f n n d g i

"e pl y e a t o i e by y u to gi e o re e v m o e " u h r z d o v r c i e a y "sui " se k n th se da a e . Ho e e , n t e i g o m g s w v r

no i e o a "o cur e ce o cl i , n l d s a y t c f n c r n " r a m i c u e n we wi l ha e no dut to de e d the i sure l v y f n n d

co ti u t o , cha g o re um t o o tha n n a i n n e r s p i n f t a a nst a y "sui " se k n da a e fo "bo i y g i n t e i g m g s r d l

"bo i y i j ry o "pro e ty da a e a t r th d l n u " r p r m g " f e e i j ry o "pro e ty da a e to whi h thi n u " r p r m g " c s

e d f he po i y p ri d. n o t l c e o i sura ce do s no a p y We m y a o r n n e t p l a , t u

di cre i n, in e t ga e a y " wi l be s t o v s i t n l o cur e ce c r n " d.

se t e a y cl i r "sui " th t a e ul Bu : t l n a m o t a m y r s t t

"Bo i y i j ry o "pro e ty da a e d l n u " r p r m g " and

(1) The a o n we wil pa fo da a e is m u t l y r m g s

de m d to ha e be n kn wn to ha e o curr d e e v e o v c e

a the e rl e t ti e whe a y in ure l ste t a i s m n n s d i d

un e Pa a ra h d r r g p 1. o Se ti n f c o II Who Is An l m te a de cri e i Se t o i i d s s b d n c i n III Li i s m t

Of I sur n e nd n a c ; a

(2) Our right and duty to defend end when we ha e use up th a p i a l li i o v d e p l c b e m t f

In ure o a y "e pl y e a t o i e by y u to s d r n m o e " u h r z d o

gi e o re e v no i e o a "o cur e ce o v r c i e t c f n c r n " r

cl i : a m

(1) Re o t a l o a y pa t o the "bo i y p r s l , r n r , f d l i sur n e i the pa m nt o j d m n s o n a c n y e f u g e t r

i j ry o "pro e ty da a e to us o a y n u " r p r m g " r n se tl m n s und r Co e a e t e e t e v r g s A or B or o h r i sure ; t e n r m d ca x e se un e o e a e e i l e p n s d r C v r g C .

No o he o l g t o o l a i i y to pa sum o t r b i a i n r i b l t y s r

(2) Re e v s a wri t n o v rb l de a d o c i e t e r e a m n r

cl i fo da a e be a se o the "bo i y a m r m g s c u f d l pe f r a t o se v ce i co e e unl ss r o m c s r r i s s v r d e i j ry o "pro e t a a e ; r n u " r p r y d m g " o e pl ci l pro i e fo und r Sup l m n a y x i t y v d d r e p e e t r

(3) Payments. Be o e a a e by a y o he m a s tha c m s w r n t r e n t "bo i y in ur " o "pro e ty da a e ha d l j y r p r m g " s

b. Thi in ura ce a p i s to "bo i y i j ry a d s s n p l e d l n u " n

o curre o a be un t ccur c d r h s g o o "pro e ty d m ge o l f p r a a " n y i :

e. Da a e be a se o "bo i y i j ry i cl de

m g s c u f d l n u " n u

(3) An sta u e o di a ce o e u a i n e a i g y t t , r n n r r g l t o r l t n da a e cla m d by a y pe so r rga i a i n to the sa e gi t, di m g s i e n r n o o n z t o l , f str bu i n o us i t o r e of fo ca e l ss o se v ce o de th re ul i g a a co o i r r , o f r i s r a s t n t l h l c e e a e b v r g s

a y t m ro he "bo i y i j r ". n i e f m t d l n u y

Thi e cl sio a p i s o l i y u a e in the s x u n p l e n y f o r

2. Ex l si n c u o s bu i e s o m n f ct r ng di tri u i g se l n , s n s f a u a u i , s b t n , l i g

Thi i sura ce d e no p l o s n n o s t a p y t :

a. Ex ec ed O I te d d I j ry p t r n n e n u

"Bo i y i j ry o "pro e ty d m ge e pe te o

se v ng o furn shi g a co o i be e a e F r r i r i n l h l c v r g s o

th pur o e o thi e cl sio , pe m t i g a e p s s f s x u n r i t n

pe so to bri g a co o i be e a e o y ur r n n l h l c v r g s n o

pre i e , fo co sum ti

d l n u " r p r a a " x c d r m s s r n p o o y u pre n n o r m se , i s

i t nd d fro th sta d o n o th i sure

whe he o no n e e m e n p i t f e n d

t r r t a fe is cha g d o a li e se e r e r c n is

Thi e cl sio do s no a pl to "bo i y in u y re u re fo such s x u n e t p y d l j r " q i d r a ti i y is no by it e f c v t , t s l

o "pro e ty da a e re ul i g fro the use o

co si e e th bu i r p r m g " s t n m f n d r d e s ne s o se l n , s s f l i g e v n o r i g r

re so a l f rce t p o e t pe so s o p o e t . fu ni hi g l o o i a n b e o o r t c r n r r p r y r s n a c h l c be e a e . v r g s

b Co trac u l L ab l t d Wo ke s' Co p n a i n An i il r L w n t a i i i y r r m e s t o d S m a a s

"Bo i y i j ry o "pro e ty da a e fo whi h

d l n u " r p r m g " r c y b i a i n f i sure un e a n d d r wo k r ' r e s

th i sure is o l ga e to pa da a e by

An o l g t o o the

co p nsa i n di a i e n d b i t d y m g s m e t o , s b l t be e i s or i y n f t

re so o th a sum t o o l a i i y i a un m l y e t co pe a n f e s p i n f i b l t n e p o m n m n a i n l w o a s t o a r n sim l r y i a

co tr ct o a r e e t. Thi e cl sio do s no l w. n a r g e m n s x u n e t a

a pl o l a i i y f r a a e : p y t i b l t o d m g s

e. Em l yer's i b l t p o L a i i y

(1) Tha t e i sure o l a e i t e a se ce t h n d w u d h v n h b n "Bo i y i j r " to d l n u y : o h co t a t o gr e e t; o f t e n r c r a e m n r

(2) Assum d in a co tr ct o a re m nt th t i e n a r g e e a s

(1) An "e pl y e o the i sure a i in o t o m o e " f n d r s g u f

a d n th co r e o : n i e u s f a "i sure co t a t , pro i e th t th n n d n r c " v d d a e

"bo i y in u y o "pro e ty da a e o cur d l j r " r p r m g " c s

subse u n to t e e e ut o o t e co t a t q e t h x c i n f h n r c

(a) Em l y e t y th i sure ; o p o m n b e n d r

(b) Pe f r i g dut e re a e to the r o m n i s l t d

o a r e e t. So e y fo th purp se o co du t f he i sure 's r g e m n l l r e o s f n c o t n d b sin ss; o u e r

l a i i y a sum d in a "i sure co t a t", i b l t s e n n d n r c

re so a l a t rne s' fe s a d ne e sa y a n b e t o y e n c s r

l t g ti n e p nse i curr d by o f r a ty i i a o x e s n e r o a p r

(2) The spo se chi d pa e t bro h r o siste u , l , r n , t e r r

o tha "e pl y e a a co se ue ce o f t m o e " s n q n f

Pa a r p r g a h (1) a o e b v o h r th n a i sure wi l be de m d to be t e a n n d l e e

Thi e cl si n a pl e whe he th in ure m y s x u o p i s t r e s d a da a e be a se o "bo i y i j ry o m g s c u f d l n u " r

be l a l s a e p o e r n ny o he a a i y i b e a n m l y r o i a t r c p c t "pro e ty d m g ", ro i e th t p r a a e p v d d a :

(a)

Li b l t to such pa ty fo , o fo the a i i y r r r r

a d t a y o l ga i n to sha e da a e wi h o n o n b i t o r m g s t r

re a so e ne e se who m st pa da a e p y m o l u y m g s co t o , th t pa t ' de e se ha a so s f a r y s f n s l

be a se o he i j r c u f t n u y be n a sum d in the sa e "i sure e s e m n d

Thi e cl si n do s no a p y to l a i i y s x u o e t p l i b l t co tr ct"; nd n a a

(b) Su h a t r e s' fe s a d l t g t o c t o n y e n i i a i n

e pe se a e fo de e se o th t pa t x n s r r f n f a r y

a sum d by the i sure un e a "i sure s e n d d r n n d

co tr ct n a "

f. P l u i n o l t o a a nst a ci i o a t rn t v di put g i v l r l e a i e s e

(1) "Bo i y in u y o "pro e ty da a e a i i g d l j r " r p r m g " r s n re o ut o pro e d ng in whi h s l i n c e i c

o t o the a t a , a l g d o th e te e u f c u l l e e r r a n d da a e to whi h th s in ura ce m g s c i s n

di cha ge di pe sa , se p g , m gr t o , s r , s r l e a e i a i n a pl e a e a l ge p i s r l e d

c. L q o i b l t i u r L a i i y

"Bo i y i j ry o "pr p rt da a e fo whi h d l n u " r o e y m g " r c

re e se o e ca e o "po l t n s": l a r s p f l u a t

(a) At o fro a y pre i e , sit o r m n m s s e r

l ca i n whi h i o wa a a y ti e o t o c s r s t n m a y i sure a e h l i b e b e so o : n n d m y b e d l a l y r a n f

(1) Ca si g o co t i ut n to the i t x ca i n u n r n r b i g n o i t o

o ne o o cupi d by o re t d o w d r c e , r n e r

l a e to a y i sure . Ho e e , th s o n d , n n d w v r i o n e so ; f a y p r n subp ra ra h o s n t pp y t : a g p d e o a l o

(2) The furn shi g o a co o i be e a e to a i n f l h l c v r g s

(i) "Bo i y in u y i susta n d wit i a d l j r " f i e h n pe so und r the l g l dri k ng a e o r n e e a n i g r

bu l i g a d ca se by sm k , i d n n u d o e u de he i f u n e o l o o ; o n r t n l e c f a c h l r

fu e , v po o so t pro uce by m s a r r o d d o o i i a i g fro e u pm n th t r r g n t n m q i e t a

i use to he t co l o de u i i y

th bu l i g o pro u e by o

to pe f rm th no m l e e tri

s d a , o r h m d f r o e r a l c cal,

hy ra l c o m cha i a fun ti n e i d n , r d c d r d u i r e n c l c o s

o i i a i g fro e u pm n tha is r g n t n m q i e t t

use to he t wa e fo pe so a d a t r r r n l

use by th bui di g s o cup n s o e l n ' c a t r

th i u sts; e r g e

ne e sa y fo th o e a i n o c s r r e p r t o f

"m bi e e ui m n " o it pa t , if o l q p e t r s r s

such fue s, l b i a t o o h r l u r c n s r t e

o e a i g fl i s e ca e fro a p r t n u d s p m

v hi l pa t de i n d to ho d, sto e e c e r s g e l r (ii) "Bo i y i j ry o "pro e ty d l n u " r p r

da a e fo whi h y u m y be m g " r c o a

he d li b e if y u a e a co tr ct r l a l , o r n a o

a d the o ne o le se o such n w r r s e f

o re e v the Thi e ce ti n r c i e m s x p o

do s no a pl if the "bo i y i j ry e t p y d l n u "

o "pro e ty da a e a i e o t o r p r m g " r s s u f

th in e ti n l di cha ge di pe sa e t n o a s r , s r l pre i e , sit o l ca i n ha be n m s s e r o t o s e

o r l a e o the fue s, l b i a t r e e s f l u r c n s a de to y ur po i y a a d d o l c s n

o o h r o e a i g fl i s, o i such r t e p r t n u d r f additional insured with respect to

y ur o g i g o e a i ns pe fo m d

fu l , lu ri a t o o he o o n o n p r t o r r e e s b c n s r t r p r t n e a i g

fo th t a d t o a i sure a tha fl i s a e bro gh o o r a d i i n l n d t t u d r u t n r to the pre i e , sit o l ca i n a d such m s s e r o t o n pre i e , sit o l ca i n wit the m s s e r o t o h pre i e , sit o l ca i n is no m s s e r o t o t

a d ne e wa o n d o o cupi d n v r s w e r c e

i t nt th t th y be di cha g d, n e a e s r e

di pe se o re e se a pa t o s r d r l a d s r f

by o re te o l a e to a y , r n d r o n d , n th o e a i n be ng pe fo m d by e p r t o s i r r e

i sure , o he tha tha a d t o a n d t r n t d i i n l

such in ure , co t a to or s d n r c r

i sure ; o n d r subco t a to ; n r c r

(iii) "Bo i y i j ry o "pro e ty d l n u " r p r

da a e a i i g o t o he t, m g " r s n u f a

sm k o fu e fro a "ho ti e o e r m s m s l

fi e ; r "

(b) At o fro a y pre i e , sit o r m n m s s e r

l ca i n whi h i o wa a a y ti e o t o c s r s t n m

use by o fo a y i sure o o h rs f r d r r n n d r t e o

(ii) "Bo i y inj ry o "pro e ty d l u " r p r

da a e susta n d wit i a m g " i e h n

bu l i g a d ca se by th re e se i d n n u d e l a

o ga e , fum s o v po s fro f s s e r a r m

m te i l bro g t in o th t bu l i g a r a s u h t a i d n

i o n cti n wi h pe a i ns be n n c n e o t o r t o i g

pe f r e by y u o o y u e a f r o m d o r n o r b h l

th ha dl ng sto a e dispo a , e n i , r g , s l by a co tr ct r r subco t a to ; o n a o o n r c r r

pro e sin r re tm n o w ste c s g o t a e t f a ;

(iii) "Bo i y inj ry o "pro e ty d l u " r p r (c) If such "po l t n s" a e o we e a a y l u a t r r r t n

da a e a i i g o t o he t m g " r s n u f a , ti e tra spo t d, ha d e , sto e , m n r e n l d r d

sm k o fu e fro a "ho ti e o e r m s m s l tr a e , di po e o , o pro e se a e t d s s d f r c s d s

fi e ; r r " o wa te by o o : s r f r

(i) An nsure ; o y i d r

(e) At o fro a y pre i e , sit o r m n m s s e r

l ca i n o whi h a y in ure o a y o t o n c n s d r n (ii) An pe so o o g n z t o fo y r n r r a i a i n r

co tr ct rs o subco t a t r wo k ng n a o r n r c o s r i who y u m y be le a l m o a g l y

di e t y o i di e t y o a y i sure ' r c l r n r c l n n n d s re po si l ; s n b e

be a f a e o we e a a y ti e h l r r r t n m

(d) At o fro a y pre i e , sit o r m n m s s e r pe fo m ng o e a i n to te t fo , r r i p r t o s s r

l ca i n o whi h a y in ure o a y o t o n c n s d r n m ni o , cl a up, re o e co t i , o t r e n m v , n a n co tr ct rs o subco t a t r wo k ng n a o r n r c o s r i tr a , de o i y o ne tr l z , o in a y e t t x f r u a i e r n di e t y o i di e t y o a y i sure 's r c l r n r c l n n n d wa re po d to o a se s th e fe ts y s n , r s s e f c be a f a e pe fo m ng o e a i n if the h l r r r i p r t o s o , "po l t n s". f l u a t "po l t n s" a e bro gh o o to the l u a t r u t n r

(2) An l ss, co t o e p n e a i in o t o y o s r x e s r s g u f pre i e , si e o l ca i n i co n ct o m s s t r o t o n n e i n any: wi h such o e a i n by such in ure , t p r t o s s d co tr ct r o sub o tr ct r. Ho e e , n a o r c n a o w v r (a) Re ue t, de a d o de o sta ut ry o q s m n , r r r t o r th s subp ra ra h o s n t pp y t : i a g p d e o a l o re u a o y re ui e e t t a a y in ure g l t r q r m n h t n s d (i) "Bo i y inj ry o "pro e ty d l u " r p r o o he s te t fo , m ni o , cle n up, r t r s r o t r a

da a e a i i g o t o the e ca e m g " r s n u f s p r m v , co t i , tre t de o i y o e o e n a n a , t x f r

o fue s, lub i a t o ot e f l r c n s r h r

o e a i g fl i s whi h a e ne d d p r t n u d c r e e

ne t a i e o in a y wa re po d to o u r l z , r n y s n , r

a se s t e e fe t o , "po l t n s"; r s s h f c s f l u a t o

(b) Cl i o sui by o o be a f o a y a m r t r n h l f n

(b) The o e a i n o a y o the m chi e y p r t o f n f a n r

go e nm n a a t o i y o a y o he o e ui m n l ste in Pa a

v r e t l u h r t r n t r r q p e t i d r graph f.(2)

pe so o o ga i a i n b ca se o o r n r r n z t o e u f r f.(3) o the de i i i n o "m bi e f f n t o f o l

te ti g fo , m n t r ng cl a i g up, e ui m n "; r s n r o i o i , e n n q p e t o

re o i g, con a ni g, tre t ng m v n t i n a i ,

d to i y ng o ne t a i i g, o i a y e x f i r u r l z n r n n

wa re po di g to o a se sin the y s n n , r s s g

e fe t o , "po l t n s". f c s f l u a t

g Ai craft u o O at rcra t

(6) An a r ra t t a s: i c f h t i

(a) Cha t re i h a pi o o a y i sure ; r e d w t l t t n n d

(b) No w e y a y i sure ; a d t o n d b n n d n

(c) . r , A t r W e f No be n use to ca r a y pe so o t i g d r y n r n r

"Bo i y in u y o "pro e t da a e a i i g o t d l j r " r p r y m g " r s n u

pro e ty f r ha g p r o a c r e

o th o n r hi , m i t na ce use or f e w e s p a n e n , h Mob l q ip e t . i e E u m n

e tr stm nt to o he s o a y a r ra t "a t " o n u e t r f n i c f , u o r

"Bo i y in u y o "pro e ty da a e a i i g o t d l j r " r p r m g " r s n u

w te cra t o n d o o e a e by o re t d o a r f w e r p r t d r n e r of:

l a e to a y in ure Use in l d s o e a i n o n d n s d c u e p r t o

a d "l a i g r n o d n ". n o d n o u l a i g by a "a t " o ne o o e a e by o n u o w d r p r t d r

(1) The tra spo t t o o "m bi e e u pm n " n r a i n f o l q i e t

Thi e cl si n a p i s e e if the cla m s x u o p l e v n i s re t d r l a e o a y i sure ; o n e o o n d t n n d r

a a nst a y i sure a l g ne l g nce o o h r g i n n d l e e g i e r t e

(2) The use o "m bi e e ui m nt i , o whi e f o l q p e " n r l wro g o n i th supe v sio , hir ng n d i g n e r i n i , i pra ti e fo , o whi e be ng pre a e fo , n c c r r l i p r d r

th t in ure , if th "o cur e ce whi h ca se a s d e c r n " c u d

e pl y e t tr i i g o m ni o i g o o he s by m o m n , a n n r o t r n f t r a y pre rr n e ra i g, spe d, de o i i n, n a a g d c n e m l t o

o stun i g a t v ty r t n c i i . th "bo i y i j ry o "pro e ty d m ge i v l e e d l n u " r p r a a " n o v d

th o ne shi , m i t na ce use o e w r p a n e n , r i. War

e t ust e t to o he s o a y a r ra t "a t " o n r m n t r f n i c f , u o r

"Bo i y in u y o "pro e ty da a e a i i g o t d l j r " r p r m g " r s n u

wa e cra t tha is o ne o o e a e by o t r f t w d r p r t d r of:

re t d r o n d o a y i sure n e o l a e t n n d

Thi e cl sio o s no a pl t : s x u n d e t p y o

(1) Wa , i cl di g u d cl r d o ci i a ; r n u n n e a e r v l w r

(2) Wa l k a t o by a m l ta y fo ce in l d ng r i e c i n i i r r , c u i

(1) A wa e cra t whi e a ho e o pre i e y u t r f l s r n m s s o a t o i hi d ri g o de e d ng a a n t a c i n n n e n r f n i g i s n

o n r e t w o r n ;

a t a o e pe t d a t ck by a y c u l r x c e t a , n

(2) A a e cra t y u o n t o n ha s: go e n e t so e e gn o w t r f o d o w t t i v r m n , v r i r o he a t o i t r u h r ty

(a) 50 fe t o g o l ss; nd e l n r e a

usin i i a y pe so n l o t e ge t ; o g m l t r r n e r o h r a n s r

(3) In urr ct o , re e l o , re o ut o , usurp d s e i n b l i n v l i n e (b) No be n use to ca r a y pe so o t i g d r y n r n r

po e , o a ti n ta e by go e n e t l w r r c o k n v r m n a pro e ty f r ha g ; p r o a c r e

a t o i y in hi d ri g o de e d ng a a nst u h r t n e n r f n i g i

(3) Pa k n a "a t " o , o o the wa s ne t r i g n u o n r n y x a y o he e n f t s to pre i e y u o n o re t, pro i e the , m s s o w r n v d d

j. D m g o P o erty a a e T r p "a t " i no o n d by o re t d o l a e u o s t w e r n e r o n d to y u r he i sure ; "Pro e ty d m ge to o o t n d p r a a " : (4) Li b l t a sum d unde a y "i sure a i i y s e r n n d (1) Pro e ty y u o n, re t, o o cup , p r o w n r c y co tr ct fo he o ne shi , m i t na ce o i cl di g a y co ts o e n a " r t w r p a n e n r n u n n s r x e se i cu re p n s n r d

use o a r ra t o a e cra t by y u, o a y o he pe so , o g ni a i f i c f r w t r f ; o r n t r r n r a z t o o n r

e t t , fo re a r, re l ce e t n i y r p i p a m n , (5) "Bo i y in u y o "pro e ty da a e a i i g d l j r " r p r m g " r s n e ha ce e t, re to a i n o m i t na ce n n m n s r t o r a n e n o t o : u f o such pro e t fo a y re so , in l d ng f p r y r n a n c u i (a) The op ra i n o m chi e y or e t o f a n r pre e ti n o i j ry to a pe so o da a e v n o f n u r n r m g e ui m n th t i a t ch d to o pa t q p e t a s t a e , r r to a o he 's p o e t ; n t r r p r y o , a la d v hi l th t wo l qua i y a f n e c e a u d l f s

(2) Pre i e y u sel , gi e a a o a a d n if m s s o l v w y r b n o , "m bi e e u pm n " un e th d fi i i n o l q i e t d r e e n t o th "pro e ty da a e a i e o t o a y e p r m g " r s s u f n o "m bi e e ui m nt i such la d f o l q p e " f n pa t o h se pr m se ; r f t o e i s v hi l we e no subj ct to a e c e r t e

co p l o y o fi a ci l re po si i i y m u s r r n n a s n b l t

l w, o o he m t r v h cl in ura ce a r t r o o e i e s n

l w, whe e i is li e se o pri ci a l a r t c n d r n p l y

(3) Pro e ty l a e o y u; p r o n d t o

(4) Pe so a pro e t i th ca e custo y o r n l p r y n e r , d r

co tr l o t e i sure ; n o f h n d ga a e ; r r g d o

(5) Tha pa t cul r pa t o re l pro e t o a ci e t l phy ica in u y

t r i a r f a p r y n

c d n a s l j r to "y ur pro u t" o d c or whi h y u o a y co tr ct rs o "y ur wo k a t r it ha be n put c o r n n a o r

subco t a t r wo k n di e t y o i d re tl

o r " f e s e to it in e de s t n d

use n r c o s r i g r c l r n i c y .

o y u be a f a e pe f rm n o e a i ns, if

n o r h l r r o i g p r t o

th "pro e ty da a e a i e o t o tho e e p r m g " r s s u f s

o e a i n ; r p r t o s o

n Rec l O ro u ts W rk r mp i ed . a l f P d c , o O I a r

P o erty r p

Da a e cl i e fo a y l ss, co t o e pe se m g s a m d r n o s r x n

(6) Tha pa ti ul r pa t o a y pro e t tha t r c a r f n p r y t i cu re by y u o o h r fo th l ss o use n r d o r t e s r e o f ,

m st be re to e , re a re o re l ce u s r d p i d r p a d wi hd a a , re a l i spe t o , re a r t r w l c l , n c i n p i ,

b ca se "y ur wo k wa i co re t y e u o r " s n r c l

re l ce e t a j stm nt re o a o di po a p a m n , d u e , m v l r s s l

pe fo m d o i r r e n t of:

(1) "Y u ro uct"; o r p d Pa a r p s r g a h (1) , (3) and (4) o th s e cl si n do f i x u o

no a p y to "pre i e da a e A se a a e

t p l m s s m g " p r t

l m t o i sura ce a p i s to "pre i e da a e i i f n n p l e m s s m g "

(2) "Y u o k ; r o r w r " o

(3) "Im a re p o e t "; p i d r p r y a de crib d in Pa a r p s s e r g a h 6. o Se ti n f c o III

Li i s O nsura ce m t f I n

Pa a ra h r g p (2) o h s e cl sio o s no a pl i f t i x u n d e t p y f

i such pro u t, wo k o pro e t is wit dra n f d c r , r p r y h w

o re a l d fro th m rk t o fro use by a y r c l e m e a e r m n

pe so o o g n z t o be a se o a k o n o r n r r a i a i n c u f n w r th pre i e a e "y ur wo k a d we e ne e e m s s r o r " n r v r

o cup e , re t d r e d fo e t l by y u

c i d n e o h l r r n a o .

Pa a r p s r g a h (3) , (4) , (5) and (6) o th s f i

e cl sio do no a pl to li b l t a sum d x u n t p y a i i y s e

suspe te de e t de i i ncy in de u cy o c d f c , f c e , a q a r

da g ro s co di i n i t n e u n t o n i

o P rso a n d erti i g I ju y e n l A d A v s n n r

"Bo i y in u y a i i g o t o "pe so a a d d l j r " r s n u f r n l n un e sid tr ck a re m nt d r a e a g e e

Pa a ra h r g p (6) o th s e cl sio do s no a pl f i x u n e t p y

a v rt si g i j ry . d e i n n u "

p El c ro i a a . e t n c D t to "pro e ty da a e i cl de in th "pro uct - p r m g " n u d e d s

co p e e p ra i n h z r ". m l t d o e t o s a a d

"Pro e ty da a e to "y ur pr d ct a i i g o t p r m g " o o u " r s n u

o t o ny p rt o i . f i r a a f t

l. D m g o Yo r Wo k a a e T u r

Da a e a i i g o t o th lo s o , lo s o use

m g s r s n u f e s f s f

o , da a e to co ru t o o , i a i i y to a ce s, f m g , r p i n f n b l t c s k. D m g o Yo r P o u t a a e T u r d c

o i a i i y t a i u a e "e e t o i d t ". r n b l t o m n p l t l c r n c a a

Ho e e , thi e cl si n do s no a p y to w v r s x u o e t p l

l a i i y fo a a e b ca se o "bo i y i j r ". i b l t r d m g s e u f d l n u y

"Pro e ty d " p r q U so i i e o m n ca i n . n l c t d C m u i t o a a e to y ur wo k a i i g o t o m g " o r " r s n u f

i o a y pa t o it a d i cl d d i he "pro uct - t r n r f n n u e n t d s

co p e e p ra i n h z r ". m l t d o e t o s a a d

Thi e cl si n do s no a pl if th da a e s x u o e t p y e m g d

"Bo i y in u y o "pro e ty da a e a i i g o t d l j r " r p r m g " r s n u

o a y a tu l o a l g d v o a i n o a y l w tha f n c a r l e e i l t o f n a t

re tri ts o pro i i s the se d ng tr n m t i g s c r h b t n i , a s i t n wo k o th wo k o t o whi h th da a e r r e r u f c e m g

a i e wa pe fo m d o y ur be a f by a r s s s r r e n o h l

o d stri ut n f "un o i i e co m ni a i n". r i b i g o s l c t d m u c t o

r. Acc s O Di c o u e O Con id n i l O e s r s l s r f f e t a r subco tr cto n a r

m. D m g o I p i ed P o erty O P o erty a a e T m a r r p r r p

N t h sic l y In u ed o P y a l j r

"Pro e ty da a e to "i p i e pro e t " o p r m g " m a r d p r y r

pro e ty th t ha no be n ph si a l in u e , p r a s t e y c l y j r d

P rso a n o m ti n e n l I f r a o

"Bo i y in u y o "pro e ty da a e a i i g o t d l j r " r p r m g " r s n u

o a y a ce s to o di cl sure o a y pe so ' f n c s r s o f n r n s

o o g ni a i n' co f de ti l or pe so a r r a z t o s n i n a r n l

i f rm t o . n o a i n a i i g o t o : r s n u f

(1) A de e t de i i n y in d qu cy or f c , f c e c , a e a

s. Asb st s e o

(1) "Bo i y in u y o "pro e ty da a e a i i g d l j r " r p r m g " r s n da g ro s co di i n in "y ur pro uct o n e u n t o o d " r

o t o th a t a o a l g d pre e ce o u f e c u l r l e e s n r "y ur o k ; r o w r " o

a t a , a l ge o th e t ne di pe sa o c u l l e d r r a e d s r l f (2) A de a o fa l r by y u o a y n a t ng l y r i u e o r n o e c i

a be to , a be to fi e s o pro u ts s s s s s s b r r d c o y ur be a f to pe fo m a co t a t o n o h l r r n r c r

co ta n n a be to , pro i e th t the n i i g s s s v d d a a re m nt i cco d nce w t t t rm g e e n a r a i h i s e s

Thi e cl si n do s no a pl to the l ss o se s x u o e t p y o f u

"bo i y i j ry o "pro e ty da a e i d l n u " r p r m g " s

ca se o co t i ut d to by the ha a d us u d r n r b e z r o o o h r pro e t a i in o t o sudd n a d f t e p r y r s g u f e n

pro e ti s o sbe to p r e f a s s

(2) "Bo i y in u y o "pro e ty da a e a i i g

e pl y e t- e a e pra t d l j r " r p r m g " r s n

o t o th a t a o a l g d pre e ce o

m o m n r l t d c i e de cri e c s s b d in

Pa a r p u f e c u l r l e e s n r r g a h (a) , (b) , or (c) a o e i d re te b v s i c d

a t a , a l ge o th e t ne di pe sa o c u l l e d r r a e d s r l f

a y so i , li ui , ga e us o th r a ir i a t n l d q d s o r e m l r t n

o co t m na t, i cl di g sm k , v po s, r n a i n n u n o e a r

so t fu e , a i s, a k l s, che i a s a d o , m s c d l a i m c l n

wa te a d th t a e pa t o a y cl i o s , n a r r f n a m r

Thi e cl si n a pl e whe he th in ure m y s x u o p i s t r e s d a

be l a l s a e p o e r n ny o he a a i y i b e a n m l y r o i a t r c p c t

a d t a y o l ga i n to sha e da a e wit o n o n b i t o r m g s h r

re a so e ne e se who m st pa da a e p y m o l u y m g s

be a se o he "bo i y i j r ". c u f t d l n u y

"sui " whi h a so a l ge a y "bo i y i j ry

t c l l e s n d l n u "

o "pro e ty da a e de cri e in r p r m g " s b d

Pa a r p r g a h (1) a o e b v

Ex l si ns c u o c. th o g r u h n. do no a p y to "pre i e t p l m s s

da a e A se a a e li i o i sura ce a p i s to m g " p r t m t f n n p l e

"pre i e da a e a de cri e in Pa a r p m s s m g " s s b d r g a h 6. of

Se ti n c o III Li i s O nsur n e m t f I a c (3) An l ss, co t o e p nse a i in o t o y o s r x e r s g u f

any:

(a) Re ue t, de a d o de o sta ut ry o q s m n , r r r t o r

CO ERA E B P RSO A A D AD ERT SI G V G E N L N V I N

IN U Y L AB L T J R I I I Y

1. In u in g e m n s r g A r e e t re u a o y re ui e e t tha a y i sure g l t r q r m n t n n d

o o he s te t fo , m ni o , cle n up, r t r s r o t r a

re o e co t i , tre t de o i y o m v , n a n a , t x f r

a. We wi l pa th se sum tha th i sure l y o s t e n d

be o e le a l o l ga e to pa a da a e c m s g l y b i t d y s m g s

ne t a i e o i a y wa re po d to o u r l z , r n n y s n , r be a se o "pe so a a d a v rt si g in ur " to c u f r n l n d e i n j y

a se s the e f ct o , a be to , s s f e s f s s s

a be to fi e s o pro uct co t i i g s s s b r r d s n a n n

a be to ; r s s s o

whi h th s i sura ce a pl e . We wi l ha e the c i n n p i s l v

ri ht a d du y to de e d t e i sure a a nst a y g n t f n h n d g i n

"sui " se k n th se da a e Ho e e , we wi l t e i g o m g s w v r l

ha e no dut to de e d the in ure a a n t a y v y f n s d g i s n (b) Cl i o sui by o o be a f o a y a m r t r n h l f n

go e n e t l a t o i y o a y o h r v r m n a u h r t r n t e

pe so o o ga i a i n be a se o r n r r n z t o c u f

"sui " se k n da a e fo "pe so a a d t e i g m g s r r n l n

a v rt si g in ur " to whi h thi i sura ce do s d e i n j y c s n n e

no a p y We m y at o r di cre i n t p l a , u s t o , te ti g fo , m n t r ng cl a i g up, s n r o i o i , e n n i v sti a e a y o fe se a d se t e a y cla m o n e g t n f n n t l n i r re o i g, con a ni g, tre t ng m v n t i n a i ,

"sui " th t a e ul . Bu : t a m y r s t t de o i y ng o ne t a i i g o in a y t x f i r u r l z n , r n wa re po di g to o a se sin the y s n n , r s s g

(1) The a o n we wil pa fo da a e is m u t l y r m g s e fe t o , a be to , a be to fi e s o l m te a de cri e i f c s f s s s s s s b r r i i d s s b d n Se t o c i n III Li i s m t pro uct co t i i g a be to

Of I sura ce a d d s n a n n s s s n n ; n

t. Em l ymen -Rel te ra ti es p o t a d P c c

(2) Ou rig t a d dut to de e d e d whe we r h n y f n n n ha e use up th a p i a l li i o v d e p l c b e m t f "Bo i y i j r " to d l n u y :

(1) A e so ri in ut o ny p r n a s g o f a :

i sur n e i the pa m nt o j d m n s o n a c n y e f u g e t r

se tl m n s und r Co e a e t e e t e v r g s A or B or (a) Re usa o e p o h t e so ; f l t m l y t a p r n

(b) Te m na i n o tha pe so 's r i t o f t r n

m di a x e se un e o e a e e c l e p n s d r C v r g C

No o he o l g t o o l a i i y to pa sum o t r b i a i n r i b l t y s r e pl y e t r m o m n ; o

(c) Em l y e t re a e pra t ce po i y p o m n - l t d c i , l c ,

pe f r a t o se v ce i co e e unl ss r o m c s r r i s s v r d e

e pl ci l pro i e fo un e Su p e e t ry x i t y v d d r d r p l m n a a t o o i si n, such a co rci n, c r m s o s e o

Pa m nt y e s de o i n, e a u ti n re ssi nm n , m t o v l a o , a g e t

b. Thi i sura ce a pl e to "pe so a a d s n n p i s r n l n di cip i e fa l re to pro o e o s l n , i u m t r

a v rti i g in ur " ca se by a o fe se a i i g d e s n j y u d n f n r s n a v nce ha a sm n , hum l a i n d a , r s e t i i t o ,

o t o y u bu i e s but o l i th o f nse wa u f o r s n s n y f e f e s di crim na i n, li e , sl nd r v o a i n s i t o b l a e , i l t o

co m t e in th "co e a e te r t r " du i g th m i t d e v r g r i o y r n e o th pe so 's rig t o pri a y f e r n h f v c ,

po i y p ri d. l c e o m l ci us pro e ut o o fa se a re t, a i o s c i n r l r s

de e t o o i p i o m n a p i d t o t n i n r m r s n e t p l e o r 2 Ex l si n . c u o s di e t d a tha pe so , re a dl ss o r c e t t r n g r e f

Thi i sura ce d e no p l o s n n o s t a p y t : whe he such pra ti e po i y a t o t r c c , l c , c r

a. Kn w n i l t o f i h s f n th r o i g V o a i n O R g t O A o e o i si n o curs, i a p i d o is m s o c s p l e r co m t e be o e duri g o a t r the m i t d f r , n r f e "Pe so a a d a v rt sin in ur " ca se by o r n l n d e i g j y u d r ti e o t a e so 's e p o m nt r m f h t p r n m l y e ; o a th di e ti n o the i sure wi h the t e r c o f n d t (2) The spo se chi d pa e t bro h r o siste u , l , r n , t e r r k o l d e th t the a t wo l v o a e the rig t n w e g a c u d i l t h s o tha pe so a a co se u nce o "bo i y f t r n s n q e f d l o a o h r a d wo l i f i t "pe so a a d f n t e n u d n l c r n l n i j ry to tha pe so a who a y o the n u " t r n t m n f a v rt si g i j r ". d e i n n u y

Thi e cl si n do s no a pl to "pe so a

s x u o e t p y r n l g i v l r l e n t v di put t r a i e s e

a a nst a ci i o a

re o u i n pro e di g i n u " u d y m l c o s r s c i n

i j ry ca se b a i i u p o e ut o

b Mate ia u l s ed Wi h Kn w ed e O . r l P b i h t o l g f

F l i y a s t

"Pe so a a d a v rt sin in u y a i i g o t o r n l n d e i g j r " r s n u f

o a o wri te pu l ca i n i cl di g pub i a i n

s l t o c e n n which

da a e to whi h th s in ura ce m g s c i s n

a pl e a e a l ge . p i s r l e d

f. B ea h O o trac r c f C n t

"Adv rt sin

r l r t n b i t o , n u n l c t o e i g i j ry a i i g o t o n u " r s n u f a bre ch o a f

by e e tro i m a s, o a e i l f do e by o t co tr ct l c n c e n f m t r a , i n r a n a

th di e ti n o th i sure wi h kno l d e o e r c o f e n d t w e g f

i s f l i y t a s t

c. Mate ia u l s ed O s d P i r T o i y r l P b i h r U e r o o P l c

g Q a it O erfo m n e f o d F i u e . u l y r P r a c O G o s a l r

To Co fo m To S at m n s n r t e e t

"Adv rt sin in ur " a i i g o t o th fa l re o e i g j y r s n u f e i u f

Period go ds, pro uct o se v ce to co fo m wi h o d s r r i s n r t

(1) "Pe so a a d a v rt sin n u y a i i g o t a y sta e e t o qua r n l n d e i g i j r " r s n u n t m n f l t o pe fo i y r r rm n e m de a c a

o o a o wri t n pu l ca i n in l d n i o r "a v rt se e f r l r t e b i t o , c u i g n y u d e i m nt"

pu l ca i n by e e t o i m a s, o m t ri l b i t o l c r n c e n f a e a

who e fi st pu l ca i n to k pl ce be o e s r b i t o o a f r

(2)

h Wro g D s ri ti n O ric s . n e c p o f P e

"Adv rt sin in u y a i i g o t o the wro g e i g j r " r s n u f n th b gi ni g o t e p l cy pe i d r e e n n f h o i r o ; o

"Ad e t si g i j ry a i i g ou of v r i n n u " r s n t

i f i ge e t o co y i ht "ti l " o "sl g n" n r n m n f p r g , t e r o a

de cri t o o the pri e o go ds, pro uct o s p i n f c f o d s r

se v ce sta e n y ur "a v rt se e t r i s t d i o d e i m n "

i.

In el ec u l P op rty t l t a r e i y ur "a v rt se e t who e fi st n o d e i m n " s r

i f i ge e t i y ur "a v rt se e t wa

"Pe so a a d a v rt sin n r n m n n o d e i m n " s r n l n d e i g in u y a i i g o t j r " r s n u of co m t e be o e the be i n n o the a y a t a o a l g d i f m i t d f r g n i g f n c u l r l e e n ri ge e t o v o a n m n r i l t o o i n f

po i y p r o a y o th fo l wi g ri h s o la s, o a y l c e i d n f e l o n g t r w r n o h r t e

"pe so a a d a v rt si g in ur " a l ge i a y r n l n d e i n j y l e d n n d Crim n l Act . i a s

"Pe so a nd a v rt si g i j ry a i i g o t o a r n l a d e i n n u " r s n u f

cri i a a t co m t e by o a the di e ti n o m n l c m i t d r t r c o f

cl i o "sui " th t a so a l ge a y such a m r t a l l e s n

i f i ge e t r i l t o : n r n m n o v o a i n

(1) Co y i h ; p r g t th i sure e n d

(2) Pa e t t n ; e. Co trac u l L ab l t n t a i i i y

"Pe so a a d a v rt sin in ur " fo whi h the r n l n d e i g j y r c

i sure ha a sum d l a i i y in a co t a t o n d s s e i b l t n r c r

a re m nt Thi e cl sio do s no a pl to g e e . s x u n e t p y

l a i i y f r a a e : i b l t o d m g s

(1) Tha the i sure o l a e i h a se ce t n d w u d h v n t e b n

(3) Tra e d e s; d r s

(4) Tra e n m ; d a e

(5) Tra e a k d m r ;

(6) Tra e se re ; o d c t r

(7) Ot e n e l ctu l p o e t i h s o a s. h r i t l e a r p r y r g t r l w o h co t a t o gr e e t r f t e n r c r a e m n ; o

Thi e cl sio d e no p l o s x u n o s t a p y t : (2) Be a se o "pe so a in u y a sum d by c u f r n l j r " s e y u in a co t a t o a re m nt th t i a o n r c r g e e a s n

(1) "Ad e t si g i j ry a i i g o t o a y a tu l v r i n n u " r s n u f n c a "i sure co tr ct , pro i e th t the n d n a " v d d a o a l g d i fri g m n o v o a i n o r l e e n n e e t r i l t o f "pe so a in u y i ca se by a o f n e r n l j r " s u d n f e s

a o h r's co y i h , "ti l " o "sl g n" i n t e p r g t t e r o a n co m t e sub e ue t to th e e ut o o m i t d s q n e x c i n f

y ur "a v rt se e t ; r o d e i m n " o th co t a t o a re m n So e y fo the e n r c r g e e t l l r

(2) An o h r "pe so a a d a v rt sin in u y y t e r n l n d e i g j r " pu po e o li b l ty a sum d by y u i a r s s f a i i s e o n n

a l ge in a y cla m o "sui " th t a so l e d n i r t a l "i sure co t a t , re so a l a t r e s' n d n r c " a n b e t o n y

a l ge a y such i f i ge e t o v o a i n l e s n n r n m n r i l t o fe s a d ne e sa y l t ga i n e pe se e n c s r i i t o x n s

o a o h r' co y i ht "ti l " o "sl g n" i f n t e s p r g , t e r o a n i cu re by o fo a pa ty o he th n a n r d r r r t r a n y ur "a v rt se e t . o d e i m n " i sure wi l be de m d to be da a e n d l e e m g s

be a se o "pe so a i j ry , ro i e h t: c u f r n l n u " p v d d t a

j.

In u ed I ed a n n e ne ype

s r s n M i A d I t r t T

B si e s s u n s e (a) Li b l t to such pa t fo , o fo th a i i y r y r r r e co t o , th t pa t ' de e se ha a so s f a r y s f n s l

"Pe so a a d a v rt si g in ur " ca se by a r n l n d e i n j y u d n be n a sum d by y u in th sa e e s e o e m o fe se co m t e by a i sure who e f n m i t d n n d s

"i sure o t a t ; nd n d c n r c " a

(b) Su h a t r e s' fe s a d l t g t o c t o n y e n i i a i n

bu i e s i : s n s s

(1) Ad e t si g "b o d a ti g" o pu l shi g; v r i n , r a c s n r b i n e pe se a e fo de e se o th t pa t x n s r r f n f a r y

(2) De ig i g o de e m n n con e t o

ne tr l z n , o i a y wa e

s n n r t r i i g t n f u a i i g r n n y r spo di g o n n t , or we sit s f r o he s; r a se si g th e fe ts o , "po l t n s". b e o t r o s s n e f c f l u a t

(3) An In e n t se rch, a ce s, co t nt o t r e a c s n e r o War .

se v ce p o i e . r i r v d r

Ho e e , thi e cl si n do s no a p y to w v r s x u o e t p l

Pa a ra h r g p s a.(1) , (2) and (3) o th d fi i i n f f e e n t o o

"pe so a i j ry r n l n u "

F r t e p rp se o h s e cl sio : o h u o s f t i x u n

(1) Cre t n a d pro uci g co re po de ce

"Pe so a nd a v rt si g i j ry a i i g o t o : r n l a d e i n n u " r s n u f

(1) Wa , i cl d n n e l re r i i w r r n u i g u d c a d o c v l a ;

(2) Wa l k a t o by a m l ta y fo ce in l d ng r i e c i n i i r r , c u i

a t o i hi d ri g o de e d ng a a n t a

c i n n n e n r f n i g i s n

a t a o e pe t d a t ck by a y

c u l r x c e t a , n

go e nm nt so e e gn o o a i g n d n r s n n v r e , v r i r t e a t o i y h r u h r t

wri t n in the co d ct o y u busin ss, usin i i a y pe so n l t e n u f o r e g m l t r r n e o t e ge t ; o r o h r a n s r

bu l t ns, fi a ci l o a n a re o t , o l e i n n a r n u l p r s r

ne sle te s a o t y u go ds, pro u ts o w t r b u o r o d c r

se v ce wil no be co si e e the r i s l t n d r d

bu i e s o u l shi g; a d s n s f p b i n n

(2) The pl ci g o fra e , bo d rs o l n s, o a n f m s r e r i k r

a v rt sin , fo y u o o he s a y he e o d e i g r o r t r n w r n

(3) In urre t o , re e l o , re o ut o , usurp d s c i n b l i n v l i n e

po e , o a ti n ta e by go e n e t l w r r c o k n v r m n a

a th ri y i hi d r ng o de e di g a a nst u o t n n e i r f n n g i

a y o he e n f t s

p U so i i e o m n ca i n . n l c t d C m u i t o

"Pe so a a d a v rt sin in u y a i i g o t o r n l n d e i g j r " r s n u f th Int rn t wi l no , by i se f, be co si e e e e e l t t l n d r d

a y a tu l o a l ge v o a i n o a y l w th t n c a r l e d i l t o f n a a th bu i e s o a v rt si g "bro dca ti g e s n s f d e i n , a s n "

re tri ts o pro i i s the se d ng tr n m t i g s c r h b t n i , a s i t n o pu l shi g. r b i n

k. El c ro i h t oo s O u le i B ard e t n c C a r m r B l t n o s

"Pe so a a d a v rt sin in u y a i i g o t o r n l n d e i g j r " r s n u f

a e e tro i cha r o o bul e i bo rd the n l c n c t o m r l t n a

i sure ho ts o o ns, o o e whi h the n d s r w r v r c

o d stri ut n f "un o i i e co m ni a i n". r i b i g o s l c t d m u c t o

q Acc s O Di c o u e O Con id n i l O . e s r s l s r f f e t a r

P rso a n o m ti n e n l I f r a o

"Pe so a a d a v rt sin in u y a i i g o t o r n l n d e i g j r " r s n u f

a y a ce s to o di cl sure o a y pe so ' o n c s r s o f n r n s r i sure x rci e co t o . n d e e s s n r l

l. U au h rized U e f n th r's a e O n t o s O A o e N m r

o ga i a i n' co fi e t a o pe so a r n z t o s n d n i l r r n l

i f rm t o n o a i n

P o u t r d c r. Asb st s e o

"Pe so a a d a v rt sin in u y a i i g o t o r n l n d e i g j r " r s n u f

th una t o i e use o a o he 's na e o e u h r z d f n t r m r

(1) "Pe so a a d a v rt sin n u y a i i g o t r n l n d e i g i j r " r s n u

o the a tu l o a l ge pre e ce o a t a , f c a r l e d s n r c u l pro uct in y ur - a l a d e s, o a n n m o d o e m i d r s d m i a e r

m ta a , o a y o he sim l r ta ti s to m sl a e t g r n t r i a c c i e d

a o h r s p t nt a usto e s. n t e ' o e i l c m r

a l ge r hre t n d i pe sa o a be to , l e d o t a e e d s r l f s s s

a be to fi e s o pro u ts co t i i g s s s b r r d c n a n n

a be to , pro i e th t th "pe so a a d s s s v d d a e r n l n

m. P l u i n o l t o a v rt sin in ur " i ca se o co tr bu e d e i g j y s u d r n i t d

"Pe so a a d a v rt sin in u y a i i g o t o r n l n d e i g j r " r s n u f

to by t e h z rd us pro e ti s o sbe to h a a o p r e f a s s

(2) "Pe so a a d a v rt sin n u y a i i g o t r n l n d e i g i j r " r s n u th a tu l a l ge o th e te e di cha g , e c a , l e d r r a n d s r e

o the a tu l o a l ge pre e ce o a t a , f c a r l e d s n r c u l di pe sa , se pa e m gra i n, re e se o s r l e g , i t o l a r

a l ge o th e t ne di pe sa o a y so i , l e d r r a e d s r l f n l d e ca e o "po l t n s" a ny t m s p f l u a t t a i e

l q i , ga e us o th rm l ir i a t o i u d s o r e a r t n r n P l u i n Rel t d . o l t o - a e

co ta i a t i cl di g sm k , v po s, n m n n , n u n o e a r

An o s, o t o x e se a i in ut o ny y l s c s r e p n r s g o f a : so t fu e , a i s, a k l s, che i a s a d o , m s c d l a i m c l n

(1) Re ue t, de a d o de o sta ut ry o q s m n , r r r t o r

wa te a d th t a e pa t o a y cl i o s , n a r r f n a m r

"sui " whi h a so a l ge a y "pe so a a d t c l l e s n r n l n re u a o y re u re e t th t a y in ure o g l t r q i m n a n s d r

a v rt sin in u y de cri e i Pa a r ph d e i g j r " s b d n r g a o h r te t fo , m n t r cl a up re o e t e s s r o i o , e n , m v , (1) a o e b v co ta n tre t de o i y o ne t a i e o in n i , a , t x f r u r l z , r

(3) An l ss, co t o e p n e a i in o t o y o s r x e s r s g u f any way respond to, or assess the effects o , "po l t n s"; r a y f l u a t o n :

(2) Cl i o sui by o o be a f o a y a m r t r n h l f n (a) Re ue t, de a d o de o sta ut ry o q s m n , r r r t o r re u a o y re ui e e t tha a y i sure g l t r q r m n t n n d governmental authority or any other person o o g n z ti n be a se o te ti g fo , o o he s te t fo , m r r a i a o c u f s n r r t r s r o i o , cle n up, n t r a m ni o i g, cl a i g up, re o i g re o e co t i , tre t de o o t r n e n n m v n , m v , n a n a , t x fy o i r co ta n n , tre t ng de o i y ng or ne t a i e o i a y wa re po n i i g a i , t x f i u r l z , r n n y s nd to o , r

a se s the e f ct o , a be to , s s f e s f s s s

a be to fi e s o pro uct co t i i g s s s b r r d s n a n n

(3) Be a se o y u pe a i ns; c u f o r o r t o

pro i e ha : v d d t t a be to ; r s s s o

(b) Cl i o sui by o o be a f o a y a m r t r n h l f n

(a) The a ci e t ta e pl ce in th "co e a e c d n k s a e v r g

te r t r " a d uri g t e p l cy pe i d r i o y n d n h o i r o ;

go e n e t l a t o i y o a y o h r

v r m n a u h r t r n t e

pe so o o ga i a i n be a se o r n r r n z t o c u f

(b) The e pe se a e i cu re a d re o t d to x n s r n r d n p r e

us wit i o e y a o the da e o the h n n e r f t f te ti g fo , m n t r ng cl a i g up, s n r o i o i , e n n

a ci e t n c d n ; a d re o i g, con a ni g tre t ng m v n t i n , a i ,

de o i y ng o ne t a i i g o in a y t x f i r u r l z n , r n

wa re po di g to o a se sin the

(c) The in ur d pe so subm t to e a i a i n j e r n i s x m n t o ,

a o r e pe se by phy i i n y s n n , r s s g t u x n , s c a s o o r ho ce f u c i

e fe t o , a be to , a be to fi e s o a o t n s we re so a l f c s f s s s s s s b r r s f e a a n b y re ui e q r

pro uct co t i i g a be to . d s n a n n s s s

s. Em l ymen -Rel t d P act c s p o t a e r i e

b. We wi l m k th se pa m nt re a d e s o l a e e y e s g r l s f

fa l The e pa m nt wi l no e ce d the u t s y e s l t x e

a pl ca l li i o i sura ce We wi l pa p i b e m t f n n l y "Pe so a n ur " to r n l i j y :

(1) A e so ri in ut o ny p r n a s g o f a :

re so a l x e se f r: a n b e e p n s o

(1) F rst a d a m ni te e a the ti e o a i i d i s r d t m f n

(a) Re u a o e p o ha p rso ; f s l t m l y t t e n a ci e t c d n ;

(b) Te m na i n o tha pe so 's r i t o f t r n

(2) Ne e sa y m d ca , surgi a , X-ra a d c s r e i l c l y n e pl y e t r m o m n ; o de t l se v ce , in l d n pro the i n a r i s c u i g s t c

(c) Em l y e t re a e pra t ce po i y de i e ; n p o m n - l t d c i , l c , v c s a d a t o o i si n, such a co rci n, c r m s o s e o

(3) Ne e sa y a b l n e ho pi a , c s r m u a c , s t l de o i n, e a u ti n re ssi n e t m t o v l a o , a g m n , pro e si n l nu si g a d un r l se v ce f s o a r n n f e a r i s di cip i e fa l re to pro o e or s l n , i u m t

2. Ex l si n c u o s a v nce ha a sm n , hum l a i n d a , r s e t i i t o ,

We wi l n t a e pe se fo "bo i y i j r ": l o p y x n s r d l n u y di crim na i n, li e , sl nd r v o a i n s i t o b l a e , i l t o o th pe so 's rig t o pri a y f e r n h f v c , a.

m l ci us pro e ut o o fa se a re t, a i o s c i n r l r s

de e t o o i p i o m n a p i d t o t n i n r m r s n e t p l e o r

An I su ed y n r

To a y i sure , x e t "v l n e r o k rs". n n d e c p o u t e w r e

b H red P rso i e n di e t d a tha pe so , re a d e s o r c e t t r n g r l s f

whe he such pra ti e po i y a t o t r c c , l c , c r

To a pe so hi e to do wo k fo o o be a f o r n r d r r r n h l f

o i si n o curs, i a p i d o is m s o c s p l e r a y i sure r t na t f ny i sure . n n d o a e n o a n d

co m t e be o e duri g o a t r the m i t d f r , n r f e

c.

In u y O N rma l O c p ed P em s s j r n o l y c u i r i e ti e o t a e so 's e p o m nt r m f h t p r n m l y e ; o

(2) The spo se chi d pa e t bro h r o siste u , l , r n , t e r r

o th t pe so a a co se u nce o f a r n s n q e f

"pe so a i j ry to th t pe so a who r n l n u " a r n t m

a y o the e pl y e t re a e pra ti e n f m o m n - l t d c c s

To a pe so in u e o th t pa t o pre i e r n j r d n a r f m s s

y u o n o re t tha th pe so no m l y o w r n t e r n r a l

o cupi s. c e

d Wo ke s' Co p n a i n An i il r L w . r r m e s t o d S m a a s

To a pe so , whe he o no a "e pl y e o r n t r r t n m o e " f de cri e in Pa a ra h s b d r g p (a) , (b) , or (c)

a y i sure , i be e i s f r t e "bo i y i j r " a e n n d f n f t o h d l n u y r above is directed.

Thi e cl si n a pl e w e he th in ure m y s x u o p i s h t r e s d a

be l a l s a e p o e r n ny o he a a i y i b e a n m l y r o i a t r c p c t

a d t a y o l ga i n to sha e da a e wi h o n o n b i t o r m g s t r

pa a l o m st be pro i e und r a wo k r ' y b e r u v d d e r e s

co p nsa i n o di a i i y be e i s la o a m e t o r s b l t n f t w r

si i a a m l r l w

e. Ath et c c i iti s l i s A t v e repay someone else who must pay damages

be a se o he "pe so a nj ry c u f t r n l i u "

To a pe so i j re whi e pra t ci g in tr ct ng r n n u d l c i n , s u i

CO ERA E C V G o pa t ci a i g i a y phy ica e e ci e o r r i p t n n n s l x r s s r MED CAL P YMEN S I A T

1. In u in g e m n s r g A r e e t

a. We wi l pa m d ca e pe se a de cri e l y e i l x n s s s b d

ga e , po t , o a h e i co te ts. m s s r s r t l t c n s

f. P o u ts-Co p e ed O era i n a ard r d c m l t p t o s H z

In l d d wi hi the "pro uct -co p e e c u e t n d s m l t d be o o "bo i y i j r " ca se b n cci e t l w f r d l n u y u d y a a d n : o e a i n h z r ". p r t o s a a d

(1) On p e i e y u o n r e t r m s s o w o r n ;

g Co erag x l s o s . v e A E c u i n (2) On wa s ne t to pre i e y u o n o re t y x m s s o w r n ; or

Ex l de u d r o e a e c u d n e C v r g A

SU P EMEN ARY P YMEN S P L T A T

1. We wi l pa , wi h re pe t to a y cl i we l y t s c n a m

i v st ga e o se tl , o a y "sui " a a nst n i sure n e i t r t e r n t g i a n d

a sum d by th in ure in th sa e "i sure

s e e s d e m n d

co tr ct ; n a "

d. The a l ga i ns i th "sui " a d t e i f r a i n l e t o n e t n h n o m t o

we k o a o t th "o cur e ce o o f n e a e n w b u e c r n " r f e s r we d fe d e n :

a. A l e pe se we i cur l x n s n

b. Up to $2 50 fo th co t o ba l bo ds re u re , 0 r e s f i n q i d

b ca se o a ci e ts o tra f c l w v o a i n e u f c d n r f i a i l t o s

a i i g o t o the use o a y v hi l to whi h r s n u f f n e c e c

th Bo i y Inj ry Li b l t Co e a e a p i s. We e d l u a i i y v r g p l e

do no h v t u ni h h se bo ds. t a e o f r s t e n

such th t no co fl ct a p a s to e i t be we n a n i p e r x s t e

th i t re ts o the i sure a d the i t re ts o e n e s f n d n n e s f

th i de n t e e n m i e ;

e. The in e n t e a d the i sure a k us to d m i e n n d s

co du t a d co t o th de e se o tha n c n n r l e f n f t

i d m i e a a n t such "sui " a d a re tha n e n t e g i s t n g e t

we ca a si n th sa e co n e to de e d th n s g e m u s l f n e

c. The co t o bo ds to re e se a ta hm n s, but s f n l a t c e t it f. only for bond amounts within the applicable lim

o i sura ce We do no ha e to furn sh th se f n n t v i e

i sure nd th i d m i e ; nd n d a e n e n t e a

The i d m i e : n e n t e

(1) Ag e s i w i i g o r e n r t n t : bonds

(a) Co p r t wi h us in th in e ti a i n, o e a e t e v s g t o

d. Al re so a l e pe se in urre by the l a n b e x n s c d se t e e t o d fe se o h "sui "; t l m n r e n f t e t i sure a o r re ue t to a sist us in the n d t u q s s

(b) Im e i t l se d us co i s o a y m d a e y n p e f n i v st ga i n o de e se o th cl i o "sui ", n e i t o r f n f e a m r t

d m nd , no i e , sum o se o e a e a s t c s m n s r l g l i cl di g a t a l ss o e rn n s up to $5 0 a n u n c u l o f a i g 0 pa e s re e v d in co ne t o wi h the p r c i e n c i n t da e a se o t m ff fro o k y b c u f i e o m w r . "suit";

e. Al co rt co ts ta e a a nst th i sure in the l u s x d g i e n d

(c) No i y an o h r insure who e t f y t e r s "sui ". Ho e e , th se pa m nt do no in l d t w v r e y e s t c u e

co e a e i a a l b e to th i de n t e v r g s v i a l e n m i e ; a t rne s' fe s o a t rn y ' e pe se ta e t o y e r t o e s x n s x d and a a nst h i sure g i t e n d

(d) Co p r t wi h us wi h re pe t to o e a e t t s c

f. Pre u g e t i t re t a a d d a a nst the co rdi a i g o he a pl ca j d m n n e s w r e g i o n t n t r p i b e i sura ce l n n i sure o tha pa t o th j d m n we pa If a a l bl o t n d n t r f e u g e t y v i a e t he i de n t e n n m i e ; a d

we m k a o f r to pa the a pl ca l li i o a e n f e y p i b e m t f

(2) Pro i e u w t ri t n ut o i a i n to v d s s i h w t e a h r z t o : i sura ce we wil no pa a y pre u g e t n n , l t y n j d m n

(a) Ob a n re o ds a d o h r i f r a i n t i c r n t e n o m t o i te e t ba e o tha pe i d o ti e a t r the n r s s d n t r o f m f e

re a e t h "sui "; nd l t d o t e t a offer

g. Al i t re t o the fu l a o n o a y ju g e t l n e s n l m u t f n d m n i d m i e n uch "sui ". n e n t e i s t th t a crue a t r e tr o th j d m n a d a c s f e n y f e u g e t n

(b) Co du t a d co t o th de e se o t e n c n n r l e f n f h

So lo g a th a o e co d t o s a e m t a t r e s' n s e b v n i i n r e , t o n y b fo e we ha e pa d, o f r d to pa , o e r v i f e e y r

fe s in urr d by us in th de e se o tha e c e e f n f t de o it d in co rt th pa t o th ju g e t tha p s e u e r f e d m n t

i de n t e ne e sa y l t ga i n e pe se in urre n m i e , c s r i i t o x n s c d i w t i h a pl ca l l m t o n ura ce s i h n t e p i b e i i f i s n .

The e pa m n s wi l no re u e the l m ts o s y e t l t d c i i f

by us a d ne e sa y l t g ti n e p nse in urre by n c s r i i a o x e s c d

th i d m i e a o r re u st wi l be pa d a e n e n t e t u q e l i s i sur n e n a c .

2. If we de e d a i sure a a nst a "sui " a d a f n n n d g i t n n

Su p e e t ry Pa m n s. No wi h ta d n the p l m n a y e t t t s n i g

pro i i n o Pa a ra h v s o s f r g p 2. . 2) b ( o Se t o f c i n I i d m i e o the in ure i a so na e a a pa t n e n t e f s d s l m d s r y

Co e a e Co e a e v r g s v r g A Bo i y Inj ry An d l u d to the "sui ", we wi l de e d tha i d m i e if a l o t l f n t n e n t e l f

Se ti n c o I Co e a e Co e a e v r g s v r g B Pe so a r n l

Pro e ty Da a e Li bi i y o Pa a ra h p r m g a l t r r g p 2.e. of th f l o i g o d t o s a e m t e o l w n c n i i n r e :

An Adv rt sin Inj ry Li bi i y such pa m nt wi l d e i g u a l t , y e s l a. The "sui " a a nst the i d m i e se k t g i n e n t e e s

no be de m d to be da a e fo "bo i y i j ry , t e e m g s r d l n u " da a e fo whi h the in ure ha a sum d m g s r c s d s s e

"pro e ty da a e o "pe so a in u y , a d wi l no p r m g " r r n l j r " n l t th l a i i y o th i d m i e in a co t a t o e i b l t f e n e n t e n r c r

re u e t e l m ts o n ura ce d c h i i f i s n a re m nt th t s a "i sure o t a t ; g e e a i n n d c n r c "

b. Thi i sura ce a pl e t uch l a i i y a sum d s n n p i s o s i b l t s e Ou o l g t o to de e d a in ure ' in e n t e r b i a i n f n n s d s d m i e by t e i sure ; h n d a d to pa fo a t rne s' fe s a d ne e sa y n y r t o y e n c s r

c. The o l ga i n to de e d o the co t o th b i t o f n , r s f e

l t g ti n e pe se a Sup l m n a y Pa m n s i i a o x n s s p e e t r y e t

e ds wh n n e : de e se o , tha i d m i e , ha a so be n f n f t n e n t e s l e

a. We ha e use up the a pl ca l l m t o

wo k rs" whi e pe fo m ng du

re a e to the co d ct o n a c e y e f u g e t l t d n u f your

v d p i b e i i f r e l r r i ties i sur n e in th pa m nt o j d m n s,

se t e e t o m d ca x e se ; r

bu i e s; t l m n s r e i l e p n s o s n s

b. The co d t o s se fo t a o e o the te m o n i i n t r h b v , r r s f

(b) To th spo se chi d pa e t, bro he o e u , l , r n t r r

th a r e e t de cri e i a a ra h e g e m n s b d n P r g p f. a o e b v , "v l n e r wo k r" a a co se u nce o u t e r e s n q e a e n o ge e r o l n r m t

SE TI N I WH S AN I SU ED C O I O I N R

1. If y u re d si n t d n th De l ra i ns a : o a e g a e i e c a t o s

a. An in i i ua , y u a d y u spo se a e d v d l o n o r u r

i sure s, but o l wit re pe t to the co du t n d n y h s c n c

o usin ss o hi h o re t e so e o n r. f a b e f w c y u a h l w e

b. A pa tn rshi o jo n v n ure y u a e a r e p r i t e t , o r n

i sure Y ur m m e s, y u pa t e s, a d n d o e b r o r r n r n

th i spo se a e a so in ure s, bu o l wi h e r u s r l s d t n y t

r spe t o t e co du t f o r u i e s. e c t h n c o y u b s n s

c. A li i e l a i i y co pa y y u a e a i sure m t d i b l t m n , o r n n d

Y u m m e s a e a so i sure s, bu o l wi h o r e b r r l n d t n y t

re pe t to th co d ct o y ur busin ss. Y u s c e n u f o e o r

m na e s a e i sure s, but o l wi h re pe t t a g r r n d n y t s c o

th i u i s a y ur a a e s. e r d t e s o m n g r

si te o tha co "e pl y e o s r f t - m o e " r

o a a r p f P r g a h (1)(a) a o e b v ;

(c) F r whi h th re i a y o l ga i n to o c e s n b i t o

sha e da a e wi h o re a so e ne r m g s t r p y m o

e se who m st pa da a e be a se l u y m g s c u

o the in ur de cri e in Pa a ra h f j y s b d r g p

(1)(a) or (b) a o e r b v ; o

(d) Ari i g o t o hi o he pro i i g o s n u f s r r v d n r

fa l ng to pro i e pro e sio a he l h i i v d f s n l a t

ca e se v ce r r i s

Unl ss y u a e in th busin ss o e o r e e r

o cup ti n o pro i i g pro e sio a he l h c a o f v d n f s n l a t

ca e se v ce , Pa a ra h r r i s r g p s (1)(a) , (b) , (c)

and (d) a o e do no a pl to "bo i y i j r " b v t p y d l n u y

a i i g o t o pro i i g o fa l n to pro i e r s n u f v d n r i i g v d

fi st a d o "Go d Sa a i a se v ce " by r i r o m r t n r i s

d. An o ga i a i n o he th n a pa t e shi , j i t r n z t o t r a r n r p o n a y o y ur "e pl y e " o "v l n e r n f o m o e s r o u t e

v nt r o l m te l a i i y co p ny y u a e a e u e r i i d i b l t m a , o r n wo k rs", o h r tha a e p o e o r e t e n n m l y d r

i sure Y u "e e u i e o fi e s" a d di e t rs n d o r x c t v f c r n r c o

a e in ure s, but o l wi h re pe t to th i r s d n y t s c e r

d ti s a y ur o fi e s o di e t rs. Y u u e s o f c r r r c o o r

v l n e r do t r. Any such "e pl y e " o o u t e c o m o e s r

"v l n e r wo k rs" pro i i g o fa l ng to o u t e r e v d n r i i

pro i e fi st a d o "Go d Sa a i a v d r i r o m r t n

st ck o d r a e a so i sure s, but o l wi h o h l e s r l n d n y t se v ce " du i g the r wo k ho rs fo y u r i s r n i r u r o re pe t o t e r l a i i y a sto k o d rs. s c t h i i b l t s c h l e

e. A tr st, y u a e a in ure Y u tru te s a e u o r n s d o r s e r

wi l be de m d to be a t n wi hi the l e e c i g t n

sco e o the r e pl y e t by y u o p f i m o m n o r

pe f r i g dut e re a e to the co d ct o r o m n i s l t d n u f a so in ure s, but o l wit re pe t to th i l s d n y h s c e r

y ur usin ss. o b e d ti s a t u te s. u e s r s e

2. Ea h f he fo l wi g i a so a i sure : c o t l o n s l n n d

a. Y ur "v l n e r wo k rs" o l whi e pe fo m ng o o u t e r e n y l r r i

(2) "Pro e ty d m ge to pr p rt : p r a a " o e y

(a) Own d, o cup e r se y e c i d o u d b ;

(b) Re t d to in the ca e custo y o n e , r , d r du i s re a e to the co du t o y ur busin ss, t e l t d n c f o e

co tr l o , o o e whi h phy ica n o f r v r c s l o y u "e pl y e ", o h r th n e t e y u r o r m o e s t e a i h r o r

co tr l i b i g e e ci e fo a y n o s e n x r s d r n "e e u i e o f ce s" (i y u a e a o ga i a i n x c t v f i r f o r n r n z t o

pu po e b ; r s y o h r tha a pa t e shi , j i t v n u e o l m t d t e n r n r p o n e t r r i i e

l a i i y co p ny o y u a a e s (i o re a i b l t m a ) r o r m n g r f y u a

l m te l a i i y co pa y , but o l fo a ts i i d i b l t m n ) n y r c

y u, a y o y u "e pl y e ", "v l n e r o n f o r m o e s o u t e

wo k rs", a y pa t e o m m e i o re r e n r n r r e b r ( f y u a wi hi the sco e o the r e p o m n by y u o t n p f i m l y e t o r a pa t e shi o jo n v n u e , o a y r n r p r i t e t r ) r n whi e pe f rm n du i s re a e to the co d ct l r o i g t e l t d n u

m m e (i y u a e a li i e l a i i y e b r f o r m t d i b l t o y ur busin ss. Ho e e , no e o th se f o e w v r n f e co pa y m n )

"e pl y e " o "v l n e r wo k rs" a e m o e s r o u t e r e r

b. An pe so (o he tha y ur "e pl y e o y r n t r n o m o e " r i sur d f r: n e s o

"v l n e r wo k r"), o a y o g n z t o , whi e o u t e r e r n r a i a i n l (1) "Bo i y i j r " o "pe so a n ur ": d l n u y r r n l i j y a t n s y u e l e ta e m na e c i g a o r r a s t a g r

(a) To y u, to y u pa t e s o e be s (i o o r r n r r m m r f

c.

An pe so o o g n z t o ha i g pro e y r n r r a i a i n v n p r y u a e a pa t e shi o j i t v n u e , o r r n r p r o n e t r )

to y u m m e s (if y u a e a li i e o r e b r o r m t d

te po a y custo y o y ur pro e ty if y u di , m r r d f o p r o e

bu nl : t o y l a i i y co p n ), to a co "e pl y e i b l t m a y - m o e "

(1) Wit re pe t to li b l t a i i g o t o the h s c a i i y r s n u f whi e in th co rse o hi o he l e u f s r r

m i t na ce o se o t a r p rt ; a d a n e n r u f h t p o e y n e pl y e t o pe fo m ng dut e m o m n r r r i i s re a e to the co du t o y u l t d n c f o r (2) Unt l y u l ga re r se t t v ha be n i o r e l p e n a i e s e bu i e s, o to y u o h r "v l n e r a po n e s n s r o r t e o u t e p i t d

d. Y u l g l re re e t t v if y u di , but o l o r e a p s n a i e o e n y

b. Ari e o t o th o n r hi , m i te a ce o s s u f e w e s p a n n n r wi h re pe t to duti s as such. Tha

use o t a a t o ny pre i e t s c e t f h t p r f a m s s l a e o y u. e s d t o re re e ta i e wi l ha e a l y u rig t a d p s n t v l v l o r h s n

m na e o l sso i sub e t to the fo l w ng a g r r e r s j c l o i

The i sura ce pro i e to such pre i e o ne , n n v d d m s s w r du i s un e hi Co e a e Pa t t e d r t s v r g r .

e. An pe so o o ga i a i n tha , wi h y u pro i io s: y r n r r n z t o t t o r v s n e pre s o im l e co se t, e t e use o is x s r p i d n n i h r s r

a. The l m ts o i sura ce pro i e to such i i f n n v d d re po sib e fo the use o a wa e cra t th t y u s n l r f t r f a o

pre i e o ne , m na e o le so wi l be the m s s w r a g r r s r l do no o n th t s: t w a i

m n m m l m t th t y u gre d o p o i e i he i i u i i s a o a e t r v d n t

(1) 50 fe t o g r e s; a d wri t n co t a t o a r e e t, o the l e l n o l s n t e n r c r g e m n r i i s m t

(2) No be ng use to ca ry a y pe so o t i d r n r n r pro e ty f r ha g p r o a c r e

3. An o g n z t o y u ne l a qu re o fo m o h r y r a i a i n o w y c i r r , t e

th n a pa t e shi , jo n v nt r o l m t d l a i i y a r n r p i t e u e r i i e i b l t

sho n i he De l ra i ns, hi he e a e l ss. w n t c a t o w c v r r e

b. The in ura ce pro i e to such pre i e s n v d d m s s o ne , m na e r e so o s no a pl t : w r a g r o l s r d e t p y o

(1) An "bo i y in u y o "pro e ty da a e y d l j r " r p r m g "

co p ny a d o whi h y u a e t e so e o n r o i th t o cur , o "pe m a , n f c o r h l w e r n a c s r rso a a d a v rti i n l n d e s ng

whi h y u m i t i a o ne shi in e e t o m r i j ry ca se by c o a n a n n w r p t r s f o e n u " u d a o fe se tha i n f n t s

th n 50 , wi l qu l fy a a Na e nsure f t e e i co m t e , ft r o a % l a i s m d I d i h r s m i t d a e y u e se to be c a t na t n a e n i

no o h r sim l r in ura ce a a l bl to tha th t re i e ; r t e i a s n v i a e t a p m s s o

o ga i a i n o e e : r n z t o H w v r

(2) St u tu a a te a i ns, ne co stru ti n o r c r l l r t o w n c o r

a. Co e a e und r thi pro i i n i a f rde o l de o i i n o e a i v r g e s v s o s f o d n y m l t o p r t o s pe fo m d n r r e by o o r n

un i th 180t da a t r y u a qu re o fo m th be a f o such p e i e o t l e h y f e o c i r r e h l f r m s s wn r, m na e r e a g r o

o ga i a i n o the e d o the po i y pe i d, l sso r n z t o r n f l c r o e r

whi he e s e rl e ; c v r i a i r

5. An pe so o o g n z t o th t is a e ui m nt y r n r r a i a i n a n q p e

b. Co e a e v r g A do s no a pl to "bo i y in u y o l sso nd t a o a e e t p y d l j r " r e r a h t y u h v gr e i w i t n co a e d n a r t e ntract "pro e ty da a e th t o curre be o e y u o a re m nt to in l d p r m g " a c d f r o r g e e c u e a a a d t o a s n d i i n l i sure o n d n

c. Co e a e v r g B do s no a p y to "pe so a a d e t p l r n l n

a q i e r f rm d he o ga i a i n nd th s Co e a e Pa t is a c u r d o o e t r n z t o ; a i v r g r n i sure , bu n d t o l wi h n y t re pe t to l a i i y fo "bo i y i j ry , "pro e ty s c i b l t r d l n u " p r

da a e , r "pe so a nd a v rt si g i j ry th t: m g " o r n l a d e i n n u " a a v rt sin i j ry a i i g o t o a o f n e d e i g n u " r s n u f n f e s

co m t e be o e y u a q i e o fo m d the m i t d f r o c u r d r r e

a. Is "bo i y i j ry o "pro e ty da a e th t d l n u " r p r m g " a

o ga i a i n o cur , o i "pe so a a d a v rt si g in u y r n z t o c s r s r n l n d e i n j r "

F r th pu po e o Pa a r p o e r s s f r g a h 1. o Se t o f c i n II

Who Is An In ure , e ch such o ga i a i n wi l be s d a r n z t o l

de m d o b e ig a e n t e De l ra i n a : e e t e d s n t d i h c a t o s s

a. An o g n z t o , o he tha a pa t e shi , jo n r a i a i n t r n r n r p i t

v nt r r i i e i bi i y co pa y r e u e o l m t d l a l t m n ; o

b. A trust;

ca se by a o fe se tha is co m t e , u d n f n t m i t d

subse u nt to the si n ng o tha co tr ct o q e g i f t n a r

a re m nt a d g e e ; n

b. Is ca se , in who e o i pa t, by y u a ts o u d l r n r o r c r

o i si n in the m i t n nce o e a i n o use m s o s a n e a , p r t o r

o e u pm n l a e to y u by such e u p e t f q i e t e s d o q i m n

lessor

The in ura ce pro i e t such qu p e t l sso s s n v d d o e i m n e r i a in i a e in it na e o the do um nt tha s d c t d s m r c e s t

subj ct to t e fo l wi g p o i i n : e h l o n r v s o s go e n i s str ct re v r t u u

4. An pe so o o g n z t o th t i a pre i e y r n r r a i a i n a s m s s

a. The l m ts o i sura ce pro i e to such i i f n n v d d

e ui m n e so w l e t e m n m m l m t t a q p e t l s r i l b h i i u i i s h t o ne , m n g r o l sso a d th t y u ha e a re d w r a a e r e r n a o v g e y u a r e to pro i e i the wri te co tr ct o o g e d v d n t n n a r i a wri t n co t a t o a re m nt to i cl d a a n t e n r c r g e e n u e s n a re m nt o the li i s sho n i th g e e , r m t w n e a di i n l in ure o th s Co e a e Pa t is a d t o a s d n i v r g r n

De l ra i ns, hi h v r a e l ss. c a t o w c e e r e i sure , but o l wit re pe t to li b l t fo "bo i y n d n y h s c a i i y r d l

b. The i sura ce pro i e to such e u p e t n n v d d q i m n i j ry , "pro e ty da a e o "pe so a a d n u " p r m g " r r n l n

l sso do s no a pl to a y "bo i y i j ry o e r e t p y n d l n u " r a v rt sin n ur " th t: d e i g i j y a "pro e ty da a e th t o curs, o "pe so a p r m g " a c r r n l

a. Is "bo i y i j ry o "pro e ty da a e th t a d a v rt sin in ur " ca d l n u " r p r m g " a n d e i g j y u e by a o fe se s d n f n th t i co m t e , a t r the e ui m nt l a e a s m i t d f e q p e e s occurs, or is "personal and advertising injury" e pi e x r s ca se by a o fe se tha is co m t e , u d n f n t m i t d subse u nt to the si n ng o tha co tr ct o q e g i f t n a r No pe so o o ga i a i n is a in ure wi h re pe t to r n r r n z t o n s d t s c a re m nt a d g e e ; n th co du t o a y curre t o pa t pa t e shi , jo n e n c f n n r s r n r p i t

v nt r o l m t d l a i i y co pa y tha is no sho n a

e u e r i i e i b l t m n t t w s

a. The a o n sho n fo th Da a e To m u t w r e m g a Na e In ure in the De l ra i n Thi pa a ra h

Pre i e Re t m d s d c a t o s s r g p m s s n e To Y u Li i i th d o m t n e do s no a pl to a y such pa t e shi , jo n v nt re o

De l ra e t p y n r n r p i t e u r c a t o s o hi Co e a e Pa i n f t s v r g rt o ; r l m te l a i i y co pa y tha o h rwi e qua i i s a a i i d i b l t m n t t e s l f e s n

b. $3 0 0 0 if no a o nt i sho n fo the 0 , 0 m u s w r i sure n e e t o n d u d r S c i n II Who I A nsure . s n I d

SE TI N I I L MIT F I S RAN E C O I I S O N U C

1. The Li i s o Insura ce sho n i th De l ra i ns m t f n w n e c a t o

Da a e To Pre i e Re t d To Y u Li i i m g m s s n e o m t n th De l ra i ns o h s Co e a e Pa t e c a t o f t i v r g r

7. Su j ct to Pa a r p b e r g a h 5. a o e the M d ca b v , e i l

Ex e se Li i i th m st we wil pa und r p n m t s e o l y e a d th rul s be o fi the m st we wi l pa n e e l w x o l y

Co e a e v r g C fo a l m di a e p nse be a se o r l e c l x e s c u f r ga d e s o he nu be f: e r l s f t m r o

a. In ure s; s d

b. Cl i s m de o "sui s" bro gh ; o a m a r t u t r

c. Pe so s o o ga i a i n m k ng cl i s o r n r r n z t o s a i a m r

"bo i y i j r " su ta n d y a y o e p rso . d l n u y s i e b n n e n

The Li i s o Insura ce o thi Co e a e Pa t a pl m t f n f s v r g r p y

se a a e y to e ch co se ut v a n a pe i d a d to a y p r t l a n c i e n u l r o n n

re a ni g pe i d o l ss th n 12 m nt s, sta t n wi h m i n r o f e a o h r i g t

th be i n n o the po i y pe i d sho n i the e g n i g f l c r o w n bri g ng "sui s". n i t

2. The Ge e a Agg e a e L m t s t e m st e wi l p y n r l r g t i i i h o w l a

De l ra i ns, un e s the po i y pe i d is e t nd d a t r c a t o l s l c r o x e e f e

i sua ce fo a a di i n l pe i d o le s th n 12 s n r n d t o a r o f s a fo he sum o : r t f

a. M di a x e se un e o e a e e c l e p n s d r C v r g C ;

b. Da a e unde Co e a e m g s r v r g A , e ce t da a e x p m g s

be a se o "bo i y i j ry o "pro e ty da a e c u f d l n u " r p r m g "

i cl d d in th "pro uct -co p e e o e a i ns n u e e d s m l t d p r t o

ha a d ; nd z r " a

c. Da a e u d r Co e a e m g s n e v r g B

m nt s. In th t ca e th a d t o a pe i d wi l be o h a s , e d i i n l r o l

de m d pa t o h l st re e i g e i d o urp se o e e r f t e a p c d n p r o f r p o s f

de e m n ng th L m ts o nsura ce t r i i e i i f I n

SE TI N I CO MERCIAL G N RAL L AB L TY C O V M E E I I I

CO D TI N N I O S

1. B n ru tcy a k p

Ba k up cy o i so v ncy o th i sure o o th n r t r n l e f e n d r f e

3. The Pro u ts-Co pl t d Ope a i ns Aggr g te d c m e e r t o e a i sure ' e ta e wi l no re i v us o o r o l ga i n n d s s t l t l e e f u b i t o s

Li i i th m st we wi l pa un e Co e a e m t s e o l y d r v r g A for un e hi Co e a e Pa t d r t s v r g r

da a e be a se o "bo i y in u y a d "pro e ty m g s c u f d l j r " n p r

da a e i cl de i the "pro uct -co p e e m g " n u d n d s m l t d

o e a i n h z rd . p r t o s a a "

4. Su j ct to Pa a r p b e r g a h 2. a o e th Pe so a And b v , e r n l

Ad e t si g In u y Li i is the m st we wi l pa v r i n j r m t o l y

2. D ti s In T e vent O cc rren e O f n e, u e h E f O u c , f e s

Cla m r S i i O u t

a. Y u m st se to i th t we a e no i i d a so n o u e t a r t f e s o

a pra ti a l o a "o cur e ce o a o f n e s c c b e f n c r n " r n f e s

whi h m y re ul i a cla m To the e t n c a s t n i x e t un e Co e a e d r v r g B fo the sum o a l da a e r f l m g s

be a se o a l "pe so a i j ry a d "a v rt sin c u f l r n l n u " n d e i g

po si l , no i e sho l n l d : s b e t c u d i c u e

(1) Ho , whe a d whe e the "o cur e ce o w n n r c r n " r i j ry susta n d y a y o e pe so r r a i a i n n u " i e b n n r n o o g n z t o

5. Su j ct to Pa a r p b e r g a h 2. or 3. a o e whi he e b v , c v r

o fe se t o l ce f n o k p a ;

(2) The na e a d a dr sse o a y in ur d m s n d e s f n j e a pl e , the Ea h Occurr n e Li i i th m st we p i s c e c m t s e o

pe so s a d i n sse ; nd r n n w t e s a wi l p y fo he sum o : l a r t f

a. Da a e u d r Co e a e m g s n e v r g A ; and da a e a i i g o t o th "o cur e ce o m g r s n u f e c r n " r

(3) The na ur a d l ca i n o a y i j ry o t e n o t o f n n u r

b. M di a x e se un e o e a e e c l e p n s d r C v r g C ; o fe se f n . be a se o a l "bo i y i j ry a d "pro e ty da a e c u f l d l n u " n p r m g "

a i i g o t o a y o e "o cur e ce r s n u f n n c r n "

F r the pur o e o de e m ni g the a pl ca l o p s s f t r i n p i b e

Ea h Occurr n e Li i , a l re a e a t o c e c m t l l t d c s r

b. If a cl i i m de o "sui " i bro g t a a nst a m s a r t s u h g i

a y i sure , y u u t: n n d o m s

(1) Im e i t l re o d th spe i i s o the m d a e y c r e c f c f

cl i r "sui " a d he da e r ce v d nd a m o t n t t e i e ; a o i si n co m t e i pro i i g o fa l ng to m s o s m i t d n v d n r i i

(2) No i y us a so n a pr ct ca l t f s o s a i b e pro i e fi st a d o "Go d Sa a i a se v ce " to v d r i r o m r t n r i s

a y o e pe so wi l be de m d to be o e n n r n l e e n

Y u m st se to i tha e r ce v ri t n o i e o u e t t w e i e w t e n t c "o cur e ce c r n " o h cl i o "sui " a so n a pra t ca l f t e a m r t s o s c i b e

6. Su j ct to Pa a r p b e r g a h 5. a o e th Da a e To b v , e m g

Pre i e Re t d To Y u Li i i the m st we wil m s s n e o m t s o l

c. Y u a d ny o he n o v d n ure m st: o n a t r i v l e i s d u

(1) Im e i t l se d us co i s o a y m d a e y n p e f n pa und r Co e a e y e v r g A fo da a e be a se o r m g s c u f de a d , no i e , sum o se o le a m n s t c s m n s r g l "pre i e da a e to a y o e pre i e . The m s s m g " n n m s s

pa e s re e v d in co ne ti n wit th p r c i e n c o h e

Da a e To Pre i e Re t d To Y u Li i w l e m g m s s n e o m t i l b : cl i r "sui "; a m o t

1 0 02 1 T 0 9

(2) Au h ri e us to o ta n re o d a d o h r

t o z b i c r s n t e

(iii) An e e u i e o f ce o di e to o x c t v f i r r r c r f

i f rm t o ; a y o h r r a i a i n r n o a i n n t e o g n z t o ; o

(3) Co p r t wi h us i th in e ti a i n o o e a e t n e v s g t o r

(iv) A ruste f ny t u t; t e o a r s

se t e e t o the cl i o de e se a a nst

t l m n f a m r f n g i

th "sui "; nd e t a

(4) Assi t us, upo o r re ue t, i the s n u q s n

e fo ce e t o a y ri h a a n t a y n r m n f n g t g i s n

pe so o o ga i a i n whi h m y be l a l r n r r n z t o c a i b e

to th i sure be a se o in u y o da a e e n d c u f j r r m g

th t is y u pa t e , jo n v n u e a o r r n r i t e t r

m m e , m na e o ru te ; r e b r a g r r t s e o

(b) An e p o e a t o i e by such y m l y e u h r z d

pa t e shi , j i t v n ure li i e r n r p o n e t , m t d

l a i i y co p ny trust or ot e i b l t m a , h r

o ga i a i n to gi e no i e o a r n z t o v t c f n

to wh ch hi i sura ce m y a so a p y i t s n n a l p l "o cur e ce o o fe se c r n " r f n .

d. No in ure wi l e ce t a th t in ure 's o n s d l , x p t a s d w

co t, v l nt ri y m k a pa m n , a sum a y s o u a l a e y e t s e n

o l g ti n o in ur a y e pe se o h r tha fo b i a o , r c n x n , t e n r

fi st i , wi h u o r o se t. r a d t o t u c n n

(3) No i e to us o such "o cur e ce o t c f c r n " r

o fe se wi l be de m d to be gi e a so n f n l e e v n s o

a pra ti a l i it is gi e i go d fa th a s c c b e f v n n o i s

so n a pra ti a l to y u wo k r ' o s c c b e o r r e s

co p nsa i n in ure Thi a p i s o l if m e t o s r s p l e n y e. The fo l wi g pro i io s a p y to Pa a ra h l o n v s n p l r g p a.

y u subse ue tl gi e no i e to us o the o q n y v t c f a o e bu o l fo pur o e o th in ura ce b v , t n y r p s s f e s n

pro i e un e t i Co e a e Pa t o y u o a y v d d d r h s v r g r t o r n

"o cur e ce o o fe se a so n a c r n " r f n s o s

pra t ca l a t r a y o th pe so s c i b e f e n f e r n i sure l ste i Pa a r p n d i d n r g a h 1. or 2. o Se ti n f c o II

de cri e in Pa a ra h s b d r g p e.(1) or (2) a o e b v Who I A nsure : s n I d

(1) No i e to us o such "o cur e ce o t c f c r n " r

o fe se m st be gi e a so n a f n u v n s o s

di co e s tha th "o cur e ce o o fe se s v r t e c r n " r f n

m y re ul in sum to whi h the in ura ce a s t s c s n

pro i e un e th s Co e a e Pa t m y v d d d r i v r g r a

pra t ca l o l a t r th "o cur e ce o c i b e n y f e e c r n " r apply

o fe se is k o n to y u (i y u a e a f n n w o f o r n

Ho e e , i thi po i y i cl de a e do se e t w v r f s l c n u s n n r m n i d v du l , a y o y u pa tn rs or n i i a ) n f o r r e

m m e s who i a in i i u l (if y u a e a e b r s n d v d a o r

pa t e shi o jo n v n ure , a y o y u r n r p r i t e t ) n f o r

th t pro i e li i e co e a e fo "bo i y i j ry a v d s m t d v r g r d l n u "

o "pro e ty da a e o po l ti n co ts a i i g r p r m g " r l u o s r s n

o t o a di cha ge re e se o e ca e o u f s r , l a r s p f m na e s who is a in i i u l (i y u a e a a g r n d v d a f o r

l m te li b l ty co p n ), a y o y u i i d a i i m a y n f o r

"e e u i e o f ce s" o di e to s (i y u a e x c t v f i r r r c r f o r

a o g n z t o o h r tha a pa t e shi , n r a i a i n t e n r n r p

j i t v nt re o li i e l a i i y co pa y , o n e u , r m t d i b l t m n )

a y o y ur tr ste s who is a i d v du l (if n f o u e n n i i a

"po l t n s" whi h co t i s a re ui e e t tha l u a t c n a n q r m n t

th di cha ge re e se o e ca e o "po l t n s" e s r , l a r s p f l u a t

m st be re o te to us wi h n a spe i i n m e u p r d t i c f c u b r

o da s a t r i s a ru t co m n e e t, th s f y f e t b p m e c m n i

Pa a r p r g a h e. do s n t a fe t t a e u re e t. e o f c h t r q i m n

3. L g l c i n Ag i s s e a A t o a n t U y u a e a trust) o a y "e pl y e o r r n m o e "

No pe so o o g n z t o ha a ri h und r th s r n r r a i a i n s g t e i a t o i e by y u to gi e no i e o a u h r z d o v t c f n

Co e a e P rt v r g a : "o cur e ce o o fe se c r n " r f n

a. To jo n us a a pa t o o h r i e bri g us i t i s r y r t e w s n n o (2) If y u a e a pa t e shi , jo n v n ure o r r n r p i t e t , a "sui " a ki g o d m ge f o n n ure ; o t s n f r a a s r m a i s d r l m te li b l ty co pa y o tru t, a d no e i i d a i i m n r s n n

b. To sue us o th s Co e a e Pa t unl ss a l o n i v r g r e l f o y ur pa t e s, jo n v nt r m m e s, f o r n r i t e u e e b r

i s t rm ha e be n u l co p i d i h t e s v e f l y m l e w t m na e s o t u te s a e i di i u l , o i e a g r r r s e r n v d a s n t c to us o such "o cur e ce o o f nse m st f c r n " r f e u

A pe so o o ga i a i n m y sue us to re o e o r n r r n z t o a c v r n be gi e a so n a pra ti a l o l a t r v n s o s c c b e n y f e a a r e se t e e t o o a fi a ju g e t a a nst n g e d t l m n r n n l d m n g i th "o cur e ce o o fe se i k o n y e c r n " r f n s n w b : a in ure ; but we wil no be li b e fo da a e n s d l t a l r m g s th t a e no pa a l und r th te m o th s a r t y b e e e r s f i (a) An nd v du l w o i : y i i i a h s

Co e a e Pa t o tha a e i e ce s o the v r g r r t r n x s f (i) A pa t e o m m e o a y r n r r e b r f n a pl ca l l m t o in ura ce An a r e se tl m n p i b e i i f s n g e d t e e t pa t e shi r o n e t r ; r n r p o j i t v n u e m a s a se tl m n a d e e se o i b l t ig e y e n t e e t n r l a f l a i i y s n d b us, the i sure , a d the cl i a t o th cla m n ' n d n a m n r e i a t s (ii) A m na e o a y l m te l a i i y a g r f n i i d i b l t l ga e r se ta i e e l r p e n t v . co p ny m a ;

4. O h r n u an e

If v l d a d co l cti l o h r i sura ce is a a l bl o a i n l e b e t e n n v i a e t

( i t e I s r c i ) Tha i in ura ce fo "pre i e t s s n r m s s da a e ; m g "

( i ) i i If th lo s a i e o t o the e s r s s u f th i sure fo a lo s we co e unde Co e a e e n d r s v r r v r g s A

m i t na ce o use o a rcra t a n e n r f i f , or B o th s Co e a e Pa t o r o l g t o s a e f i v r g r , u b i a i n r

"a t s" o wa e cra t to the e t nt u o r t r f x e l m te a de cri e i a a ra h i i d s s b d n P r g p s a. and b. below no subj ct to a y e cl sio i th s t e n x u n n i

As use a y he e in th s Co e a e Pa t o h r d n w r i v r g r , t e

Co e a e Pa t th t a pl e to v r g r a p i s i sura ce m a s in ura ce o th fun i g o n n e n s n , r e d n f

a rcra t "a t s" o w t rcra t i f , u o r a e f ; l sse , ha s p o i e y hr u h o o b ha f o : o s t t i r v d d b , t o g r n e l f

(i) An t e i sura ce co pa y o h r n n m n ;

(ii) Us o n f ur ff l a e n ura ce co pa i s, r a y o o a i i t d i s n m n e

e ce t whe th No cum l t o o Ea h x p n e n u a i n f c

Occurr n e Li i pro i io o Pa a ra h e c m t v s n f r g p 5. of

Se ti n c o III Li i s Of Insura ce o th No m t n r e n

cum l ti n o Pe so a a d Adv rt sin In ur u a o f r n l n e i g j y

Li i pro i io o Pa a ra h m t v s n f r g p 4. o Se ti n f c o III

(iv) Tha is in ura ce a a l bl to a t s n v i a e

pre i e ow e , m na e or m s s n r a g r

l sso th t qua i i s a a in ure e r a l f e s n s d

un e Pa a ra h d r r g p 4. o Se t o f c i n II

Who Is An Insure , e ce t whe d x p n

Pa a r p r g a h d. be o pp i s; r l w a l e o

(v) Tha is i sura ce a a l b e to a t n n v i a l n

e ui m n l sso th t qua i i s a q p e t e r a l f e s

Li i s o In ura ce a p i s be a se th m t f s n p l e c u e a in ure unde Pa a r p n s d r r g a h 5. of

Am n m n No Cum l t o Of Ea h e d e t n u a i n c

Occurr n e Li i Of Li bi i y And No e c m t a l t n

Se ti n c o II Who Is An Insured,

e ce t whe Pa a ra h x p n r g p d. below

Cum l t o Of Pe so a A d Ad e t si g Inj ry u a i n r n l n v r i n u a pl e p i s

Li i e do se e t i i cl de n th s po i y m t n r m n s n u d i i l c ; (b) An o the o h r i sura ce whe he y f t e n n , t r

(iii) An i k e e ti n gro p; o y r s r t n o u r

(iv) Any self-insurance method or program, in

pri a y e ce s, co t n e t o o a y m r , x s n i g n r n n

o h r ba is, tha i a a l bl to th t e s t s v i a e e

i sure whe the i sure is a n d n n d n which case the insured will be deemed to be

th p o i e f o h r i sura ce a di i n l i sure , o is a y o e r v d r o t e n n d t o a n d r n ther

Ot e in ura ce do s no in l d um re l h r s n e t c u e b l a

i sura ce o e ce s in ura ce th t wa bo g t n n , r x s s n , a s u h

spe i i a l to a p y in e ce s o th Li i s o c f c l y p l x s f e m t f

In ura ce sho n in the De l ra i ns o th s s n w c a t o f i

i sure tha do s no qu l fy a a n d t e t a i s

na e i sure , un e such o h r m d n d d r t e

i sura ce n n

(2) Whe th s i sura ce i e ce s, we wil n i n n s x s l

ha e no dut und r Co e a e v y e v r g s A or B to Co e a e P rt v r g a

As use a y he e in th s Co e a e Pa t o h r d n w r i v r g r , t e

de e d th i sure a a nst a y "sui " i a y f n e n d g i n t f n

o h r in ure ha a du y to de e d the t e s r s t f n i sure m a s a pro i e o o h r in ura ce As n r e n v d r f t e s n

i sure a a n t tha "sui ". If no o h r n d g i s t t t e use in Pa a ra h d r g p c. be o , in ure m a s a l w s r e n

i sure de e d , we wi l un e t k t o so n r f n s l d r a e o d , pro i e f n ura ce v d r o i s n .

bu we wi l b nt t e t h i sure ' ri h s t l e e i l d o t e n d s g t

a a nst l h se o h r nsur r g i a l t o t e i e s a. P i ary I su an e r m n r c

Thi insura ce is pri a y ex e t whe s n m r c p n

Pa a r p r g a h b. be o a pl e If th s i sura ce i l w p i s i n n s

(3) Whe thi in ura ce i e ce s o e o h r n s s n s x s v r t e

i sura ce we wi l pa o l o r sha e o the n n , l y n y u r f

a o nt o the lo s, i a y th t e ce d the m u f s f n , a x e s pri a y o r o l g ti n a e no a f cte un e s m r , u b i a o s r t f e d l s sum of:

a y o th o h r i sura ce is a so pri a y n f e t e n n l m r

(a) The to a a o nt tha a l such o h r t l m u t l t e The , we wi l sha e wi h a l t a o he n ura ce n l r t l h t t r i s n

i sur n e wo l pa fo th lo s i th n a c u d y r e s n e by t e m th d e cri e n Pa a r p h e o d s b d i r g a h c. be o , l w

a se ce o hi i sura ce n b n f t s n n ; a d e ce t h n a a ra h x p w e P r g p d. be o pp i s. l w a l e

(b) The to a o a l de u ti l a d se f t l f l d c b e n l - b Ex e s I s ran e . c s n u c i sure a o nt unde a l th t o h r n d m u s r l a t e

(1) Thi i sura ce i e ce s o e : s n n s x s v r

i sur n e n a c .

(4) We wi l sha e the re a n ng l ss, if a y l r m i i o n , (a) An o the o he in ura ce whe he y f t r s n , t r

wi h a y o he in ura ce th t i no t n t r s n a s t pri a y e ce s, co t n e t o o a y m r , x s n i g n r n n de cri e in thi Ex e s Insura ce s b d s c s n o h r b si : t e a s pro i i n a d wa no bo g t spe i i a l t v s o n s t u h c f c l y o (i) Tha is Fi e Ex e d d Co e a e t r , t n e v r g , a pl i e ce s o the Li i s o In ura ce p y n x s f m t f s n Bu l e ' Ri k In ta l t o Risk o i d r s s , s l a i n r sho n i th De l r t o s o thi Cov r g w n e c a a i n f s e a e si i a o e a e fo "y ur o k ; m l r c v r g r o w r " Part

c. Meth d O h rin

a. o f S a g

If a l o the o he i sura ce pe m t co t i ut o

l f t r n n r i s n r b i n by e u l sha e , w i l fo l w t i m t o l o q a r s e w l l o h s e h d a s .

e ua a o n s unt l it ha pa d it a pl ca l q l m u t i s i s p i b e

l m t o in ura ce o no e o th l ss re a ns, i i f s n r n f e o m i

The sta e e t in th De l ra i ns a e

t m n s e c a t o r

a cura e a d co p e e c t n m l t ;

b. Tho e sta e e ts a e ba e upo s t m n r s d n

Und r th s a pr a h e ch in ure co t i ut s re re e t ti n y u e i p o c a s r n r b e p s n a o s o a e to us; n m d a d

c. We ha e i sue th s po i y i re i n e up n v s d i l c n l a c o

y ur e re e ta i ns. o r p s n t o whi he e o e fi st. c v r c m s r

The uni te ti n l o i sio o , o uni t n i na e ro n n o a m s n f r n e t o l r r

If a y o th o h r i sura ce do s no pe m t n f e t e n n e t r i i , a y i f rm ti n pro i e by y u whi h we re i d n n n o a o v d d o c l e co tr bu i n by e u l sha e , we wi l co t i ut n i t o q a r s l n r b e

up n i issui g th s po i y wi l no pre u i e y u o n n i l c l t j d c o r

by l m t . Und r th s m t o , e ch i sure 's i i s e i e h d a n r ri ht unde th s in ura ce Ho e e , thi pro i i n g s r i s n . w v r s v s o sha e is ba e o the ra i o i s a p i a l i i r s d n t o f t p l c b e l m t do s no a f ct o r ri h to co l ct a di i n l e t f e u g t l e d t o a o in ura ce to th to a a pl ca l li i s o f s n e t l p i b e m t f pre i m o to e e ci e o r rig t o ca ce l t o o m u r x r s u h s f n l a i n r i sura ce o l nsure s. n n f a l i r no re e a i cco d nce w t pp i a l n ura ce n n w l n a r a i h a l c b e i s n

d P i a y And No -Co trib t ry In u an e If . r m r n n u o s r c l ws o e ul t o s. a r r g a i n

Req i ed B Wri te o trac u r y t n C n t

If y u spe i i a l a re i a wri t n co t a t o o c f c l y g e n t e n r c r

7. Se arat o f n u ed p i n O I s r s

Ex e t wi h re pe t to the Li i s o In ura ce a d c p t s c m t f s n , n

a re m nt tha the i sura ce a fo d d to a g e e t n n f r e n a y ri h s o du i s spe i i a l a sig e i th s n g t r t e c f c l y s n d n i

i sure un e hi Co e a e Pa t m st p l n n d d r t s v r g r u a p y o

Co e a e Pa t to the fi st Na e Insure , th s v r g r r m d d i

a pri a y ba i , o a pri a y a d no - m r s s r m r n n i sura ce a pl e : n n p i s

co tr bu o y ba is, th s i sura ce is pri a y to n i t r s i n n m r

a. As i e ch Na e In ure we e the o l f a m d s d r n y o h r in ura ce th t i a a l bl o such i sure t e s n a s v i a e t n d

Na e n ure ; nd m d I s d a whi h o e s such n ure a a n m d i sure , c c v r i s d s a e n d

b. Se a a e y to e ch in ure a a n t who cl i p r t l a s d g i s m a m a d we wil no sha e wi h th t o h r in ura ce n l t r t a t e s n ,

i m d o "sui " i b o g t s a e r t s r u h . pro i e ha : v d d t t

(1) The "bo i y i j ry o "pro e ty da a e fo d l n u " r p r m g " r

8. Tra sfe O i h s O e o ery Ag i s t ers n r f R g t f R c v a n t O h

To Us whi h co e a e i so gh o cur ; nd c v r g s u t c s a

(2) The "pe so a a d a v rt sin i j ry fo r n l n d e i g n u " r

If the i sure ha ri h s to re o e a l o pa t o a y n d s g t c v r l r r f n

pa m n we ha e m d unde thi Co e a e Pa t y e t v a e r s v r g r , whi h co e a e is so gh i ca se by a c v r g u t s u d n

th se ri ht a e tra sfe re t us. he i sure ust o g s r n r d o T n d m o fe se t a i co m t e ; f n h t s m i t d

do no h ng a te l ss to i p i th m At o r re u st, t i f r o m a r e . u q e subse u nt to the si n ng o tha co tr ct o q e g i f t n a r

th i sure wi l bri g "sui " o tra sfe tho e ri h s e n d l n t r n r s g t a re m nt by y u g e e o

5. P e i m Au i r m u d t

a. We wi l co p t a l p e i m f r h s Co e a e l m u e l r m u s o t i v r g

to us a d h l s e f rce t e n e p u n o h m

9. Wh n We D N t en w e o o R e

If we d ci e n t o r n w h s Co e a e P rt e wi l e d o t e e t i v r g a , w l Pa t i cco d nce w t ur u e a d a e . r n a r a i h o r l s n r t s

b. Pre i m sho n in th s Co e a e Pa t a m u w i v r g r s

m i o de i e to th fi st Na e In ure sho n in a l r l v r e r m d s d w

th De l ra i n wri te no i e o the no r n wa e c a t o s t n t c f n e e l a v nce pre i m i a de o i pr m um o l . A d a m u s p s t e i n y t

no l ss th n 0 da s be o e t e e pi a i n da e t e a 3 y f r h x r t o t . th clo e o e ch a d t pe i d we wi l co p t e s f a u i r o l m u e

If no i e is m i e , pro f o m i i g wi l be suffi i n t c a l d o f a l n l c e t th e rn d pre i m fo th t pe i d a d se d e a e m u r a r o n n pro f f o i e o o n t c no i e t th fi st Na e I sure The du da e t c o e r m d n d e t

SE TI N V D F N T O S C O E I I I N fo a di a d re ro pe ti e p e i m i t e d t r u t n t s c v r m u s s h a e

1. " shown as the due date on the bill. If the sum of Ad e t se e t" m a s a no i e th t s br a ca t o v r i m n e n t c a i o d s r pu l she to the ge e a pub i o spe i i m r b i d n r l l c r c f c a the advance and audit premiums paid for the ket po i y pe i d is gre te tha the e rn d l c r o a r n a e se m nt a o t y ur go ds, pro u ts o ser i e g e s b u o o d c r v c s fo th purp se o a t a ti g custo e s o r e o f t r c n m r r premium, we will return the excess to the first Na e nsure . supp rt r . o h p r o e o hi de i i i n m d I d o e s F r t e u p s s f t s f n t o :

c. The fi st Na e In ure m st k e re o d o r m d s d u e p c r s f a. No i e th t a e publ she i cl de m t r a t c s a r i d n u a e i l th in o m t o we ne d fo pre i m pl ce o the Int rn t o o e f r a i n e r m u a d n e e r n sim l r e e tr n c i a l c o i co p t ti n a d se d us co i s a such t m s m u a o , n n p e t i e m a s o co m ni a i n; a d e n f m u c t o n a we m y re u st. s a q e

b. Re a di g we sit s, o l tha pa t o a we si e g r n b e n y t r f b t

6. Rep es n ati n r e t o s th t is a o t y u go d , pro u ts o se v ce a b u o r o s d c r r i s fo th pur o e o a t a t ng custo e s o r e p s s f t r c i m r r By a ce ti g t i p l cy o gre : c p n h s o i , y u a e supp rt r i co si e e a a v rt se e t o e s s n d r d n d e i m n

2. "Ad e t si g i j ry : v r i n n u "

a. M a s in ur ca se by o e o m re o the e n j y u d n r o f

b. In by o wit a y o he e e t o i m a s o , r h n t r l c r n c e n f

co m n ca i n such a th In e n t, if tha m u i t o , s e t r e t

m te i l i p r f: a r a s a t o fo l wi g o fe se : l o n f n s

(1) Ora o writ e pub i a i n incl di g l r t n l c t o , u n

(1) Ra i o te e i i n pro r m i g be ng d o r l v s o g a m n i

tr n m t e ; a s i t d pu l ca i n by e e t o i m a s, o m t ri

l b i t o l c r n c e n f a e a i y ur "a v rt se e t th t sla d rs o n o d e i m n " a n e r

l b l a pe son or or a i a i n or i e s r g n z t o

di pa a e a pe so ' o o ga i a i n s s r g s r n s r r n z t o '

go ds, pro u ts o se v ce , pro i e tha o d c r r i s v d d t

th cla m i m d o he "sui " i b o g t by e i s a e r t t s r u h

a pe so o o g ni a i n h t cl i s to ha e r n r r a z t o t a a m v

be n sla d re o li e e , o tha cla m to e n e d r b l d r t i s

ha e ha it go ds, pro uct o se v ce v d s o d s r r i s

di pa a e ; s r g d

(2) Ora o writ e pub i a i n incl di g l r t n l c t o , u n

(2) Ot e en e ta n e t e uca i n l h r t r i m n , d t o a ,

i structi n l m si o ne s pro r m i g n o a , u c r w g a m n

be n ra sm t e ; o i g t n i t d r

(3) Ad e t si g tra sm t e wi h a y o such v r i n n i t d t n f

pro ra m n . g m i g

6. "Co e a e t rri o y m a s: v r g e t r " e n

a. The Uni e Sta e o Am ri a (i cl di g i s t d t s f e c n u n t

te r t r e a d po se si ns), Pue t Ri o a d r i o i s n s s o r o c n

Ca a a n d ; pu l ca i n by e e t o i m a s, o m t r a b i t o l c r n c e n f a e i l

i o r "a v rt se e t th t: n y u d e i m n " a

b. In e na i na wa e s o a rspa e but o l if the t r t o l t r r i c , n y

(a) Ap ro ri t s a pe so ' na e v i e p p a e r n s m , o c , i j ry o da a e o curs in th co rse o tra e n u r m g c e u f v l

ph t gr p r i e e s; o o o a h o l k n s r

o tra spo t t o be w e a y pl ce in l d d r n r a i n t e n n a s c u e

i Pa a r p n r g a h a. a o e r b v ; o (b) Unre so a l pl ce a pe so in a a n b y a s r n fa se l gh ; r l i t o

(3) In r ng m nt o co y i ht "ti l " o "sl g n" f i e e f p r g , t e r o a

i y u "a v rt se e t , pro i e tha th n o r d e i m n " v d d t e

c. Al o h r pa t o th wo l if th i j ry o l t e r s f e r d e n u r

da a e a i e o t o : m g r s s u f

(1) Go ds o pro uct m d o so d by y u in o r d s a e r l o cl i i m d o th "sui " i bro gh by a a m s a e r e t s u t th te ri o y de cri e i Pa a r p e r t r s b d n r g a h a. pe so o o ga i a i n tha cla m r n r r n z t o t i s a o e b v ; o ne shi o such co y i ht "ti l " o w r p f p r g , t e r

(2) The a ti i i s o a pe so who e ho e i i c v t e f r n s m s n "sl g n . o a "

b. In l d s "bo i y in ur " ca se by o e o m r c u e d l j y u d n r o e

th te ri o y de cri e i Pa a r p e r t r s b d n r g a h a.

a o e but i a a fo a sho t ti e o y ur b v , s w y r r m n o o the o f n e de crib d in Pa a ra h f f e s s s e r g p a.

bu i e s; r s n s o a o e b v

(3) "Pe so a a d a v rt sin i j ry o fe se r n l n d e i g n u " f n s

3. "Au o m a s: t " e n th t ta e pl ce th o g th In e ne o a k a r u h e t r t r

a. A l nd m t r v h cl , tra l r o se i r i e a o o e i e i e r m t a l r si i a l ct o i m a s o o m n ca i n m l r e e r n c e n f c m u i t o ; de i n d fo tra e o pub i ro ds, i cl di g s g e r v l n l c a n u n

pro i e the insure ' re po sib l ty to pa v d d d s s n i i y a y a t che a hi e y o qu pm n ; r n t a d m c n r r e i e t o

da a e is de e m n d in a "sui " o th m r t i m g s t r i e t n e e i s n

b. An o he la d v h cl th t is sub e t to a y t r n e i e a j c th te ri o y de cri e i Pa a r p e r t r s b d n r g a h a. a o e o i b v , r n a co p l o y o fi a ci l re po si i i y la , o m u s r r n n a s n b l t w r

se t e e t we a re o t l m n g e t o h r m to v hi l i sura ce l w, whe e i i t e o r e c e n n a r t s

7. "El ct o i da a m a s in o m t o , fa t o e r n c t " e n f r a i n c s r l ce se r ri ci a l a a e . i n d o p n p l y g r g d

Ho e e , "a t " do s no in l d "m bi e w v r u o e t c u e o l

pro ra s sto e a o o , cre te o use o , o g m r d s r n a d r d n r

tr n m t e to o fro co pu e so tw r (i cl d ng a s i t d r m m t r f a e n u i e ui m n ". q p e t

sy te s a d a p i a i ns so tw r ) ha d o fl p y s m n p l c t o f a e , r r o p

4. "Bo i y i j r " m a s: d l n u y e n di ks, CD-ROM , ta e , dri e , cel s, da a s s p s v s l t pro e sin de i e o a y o h r m di whi h a e c s g v c s r n t e e a c r a. Ph si a ha m i cl di g si kn ss o di e se y c l r , n u n c e r s a ,

use i h e e t o i a l co t o l d e ui m n d w t l c r n c l y n r l e q p e t susta n d y a pe so ; o i e b r n r

b. M nt l a g i h, i j ry o i l e s, o e o i n l e a n u s n u r l n s r m t o a

8. "Em l y e i cl de a "l a e wo k r". "Em l y e p o e " n u s e s d r e p o e " di tre s, re ul i g a a y ti e fro such s s s t n t n m m do s n t i cl d "te po a y wo k r e o n u e a m r r r e " ph si a h rm i k e s o di e se y c l a , s c n s r s a

9. "Ex cut v o f ce " m a s a pe so ho di g a y o e i e f i r e n r n l n n f

5. "Bro dca ti g m a s tra sm tt n a y a d o o a s n " e n n i i g n u i r th o fi e po it o s cre te by y u cha t r, e f c r s i n a d o r r e v sua a e i l fo ny p r o e i l m t r a r a u p s :

co sti u i n by a s o a y o h r sim l r go e n ng n t t o , l w r n t e i a v r i do um n . c e t a. By ra i o e e i io ; o d o r t l v s n r

10. "Go d Sa a i a se v ce " m a s a y e e g n y

tr ck , ro db d o m r t n r i s e n n m r e c

a s a e s, tu n l und r a s n e , e p s or m di a se v ce fo whi h no co p n a i n is

cro sin ; e c l r i s r c m e s t o s g

de a d d r e e v d m n e o r c i e

11. "Ho ti e fi e m a s a fi e whi h be o e

(2) Tha i d m i i s a a chi e t, e g ne r o t n e n f e n r t c n i e r

surv y r o i j ry o a a s l r " e n r c c m s e o f r n u r d m g ri in ut o : e a s g o f

un o tr l a l o bre k o t fro whe e i wa

c n o l b e r a s u m r t s

(a) Pre a i g a pr v ng o fa l n to p r n , p o i , r i i g i t nd d o b n e e t e pr pa e or ap r v , m p , sho e r p o e a s p

12. "Im a re pro e t " m a s ta g bl pro e t , o he dra i g , o i p i d p r y e n n i e p r y t r w n s p n o s, re o ts, surv i n p r eys, th n "y ur pro uct o "y ur wo k , tha ca n t be

fi l o d rs, cha g a o d " r o r " t n o e d r e n e o d rs o ra i gs r e r d w n

use r s l ss use u e a se a d pe i i a i ns; r d o i e f l b c u : n s c f c t o o

a. It i co po a e "y ur pro uct o "y ur wo k n r r t s o d " r o r "

(b) Gi i g di e t o s o i stru ti n , o v n r c i n r n c o s r th t is kn wn o th ug t to be de e t v , fa l ng to gi e th m if a o r o h f c i e i i v e , th t is the a de i i n , n de u te o a g ro s; o pri a y ca se o the in u y o f c e t i a q a r d n e u r m r u f j r r da a e m g ; or

b. Y u ha e fa l d to ful i l the te m o a co tr ct o v i e f l r s f n a

(3) Und r whi h the i sure , if a a chi e t, e c n d n r t c or agreement; e gi e r o surv y r, a sum s l a i i y fo n n e r e o s e i b l t r i such pro e t ca be re to e to use by t e f p r y n s r d h

a in u y o da a e a i in o t o the n j r r m g r s g u f re a r, re l ce e t, a j stm nt o re o a o "y ur p i p a m n d u e r m v l f o

i sure 's re de i g o fa l r to re de n d n r n r i u e n r pro uct o "y ur wo k o y u fu fi l n t e te m o d " r o r " r o r l l i g h r s f

th co t a t o gr e e t. e n r c r a e m n

pro e si n l se v ce , in l d n ho e l ste f s o a r i s c u i g t s i d

i Pa a r p n r g a h (2) a o e a d sup r i o y b v n e v s r ,

13. "In ure co t a t m a s: s d n r c " e n i spe t o , a chi e tu a o e g ne ri g n c i n r t c r l r n i e n

a. A co t a t fo a l a e o pre i e Ho e e , n r c r e s f m s s w v r

th t po t o o t e co t a t fo a l a e o a r i n f h n r c r e s f

a t v ti s. c i i e

14. "Le se wo k r" m a s a pe so l a e o y u b a d r e e n r n e s d t o y a

pre i e tha in e n f e a y pe so o m s s t d m i i s n r n r l bo l a in fi m unde a a r e e t be we n y u a r e s g r r n g e m n t e o o ga i a i n fo "pre i e da a e i no a r n z t o r m s s m g " s t n a d the la o le si g fi m to pe f rm dut e re a e n b r a n r , r o i s l t d

"i sure o tr ct ; n d c n a " to the co d ct o y ur bu i e s. "Le se wo k r" n u f o s n s a d r e

b. A i e ra k a re m n ; s d t c g e e t

c. An e se e t o li e se a re m nt e ce t in y a m n r c n g e e , x p

do s n t i cl d "te p ra y wo k r e o n u e a m o r r e "

15. "Lo di g o unl a i g" m a s th ha d i g o a n r o d n e n e n l n f

pro e ty p r : co ne ti n wi h co stru ti n o de o i i n n c o t n c o r m l t o

o e a

Af e i is m v d fro th pl ce whe e i is p r t r t o e m e a r t ti n o o i h n 5 e t o a ro d o s n r w t i 0 f e f a r i a ;

a. l

d. An o l ga i n, a re u re by o d na ce to b i t o s q i d r i n ,

a ce t d fo m v m n i t o o t a a rcra t c p e r o e e t n o r n o n i f ,

wa e cra t r "a t "; t r f o u o i d m i y a m n ci a i y e ce t i co ne ti n n e n f u i p l t , x p n n c o

wi h o k f r a m ni i a i y t w r o u c p l t ;

e. An e e a o a nt na ce a re m nt l v t r m i e n g e e ;

b. Whi e i is i o o a a rcra t wa e cra t o l t n r n n i f , t r f r

"a t "; r u o o

c. Whi e i is be n m v d fro a a rcra t l t i g o e m n i f , f. Tha pa t o a y o he co t a t o a re m nt t r f n t r n r c r g e e

wa e cra t o "a t " to th pl ce whe e i is t r f r u o e a r t p r a n n to y ur busi e s (i cl di g a e t i i g o n s n u n n

fi a l e i e e ; n l y d l v r d i de n fi a i n o a m ni i a i y i co ne t o n m i c t o f u c p l t n n c i n wi h wo k pe f r e fo a m n ci a i y und r t r r o m d r u i p l t ) e bu "l a i g o unl a i g do s no i cl de the t o d n r o d n " e t n u whi h y u a sum th to t li b l t o a o h r m v m nt o c o s e e r a i i y f n t e o e e f pro e ty by m a s o p r e n f a m ch n ca e a i l pa t to pa fo "bo i y in ur ", "pro e ty de i e o h r tha a ha r y y r d l j y p r v c , t e n n tr ck tha i no a ta he d u , t s t t c d da a e o "pe so a i j ry t a thi d pe so m g " r r n l n u " o r r n to t e a rcra t w t rcra t o "a t ". h i f , a e f r u o o o ga i a i n To t l a i i y m a s a li b l ty r r n z t o . r i b l t e n a i i 16. "M bi e e u pm n " m a s a y o the fo l wi g o l q i e t e n n f l o n th t wo l be i po e by l w i t e a se ce o a u d m s d a n h b n f ty e o la d v hi l s, i cl di g a y a ta he p s f n e c e n u n n t c d a y co t a t r g e m nt n n r c o a r e e m chi e y o e ui m nt a n r r q p e : Pa a r p r g a h f. do s no i cl de th t pa t o a y e t n u a r f n a. Bu l o e s, fa m m chi e y fo k i ts a d o h r l d z r r a n r , r l f n t e co tr ct o a re m n : n a r g e e t v hi l s de i n d fo use pri ci a l o f pub i e c e s g e r n p l y f l c (1) Tha i d m i i s a ra l o d fo "bo i y ro d ; t n e n f e i r a r d l a s i j ry o "pro e ty da a e a i i g o t o n u " r p r m g " r s n u f b. Ve i l s m i t i e fo use so e y o o ne t to h c e a n a n d r l l n r x co stru ti n o de o i i n o e a i ns, n c o r m l t o p r t o pre i e y u wn r e t m s s o o o r n ; wi hi 50 fe t o a y ra l o d pro e t a d t n e f n i r a p r y n

c. Ve i l s t a t a e n ra l r t e ds; h c e h t r v l o c w e r a a fe t ng a y ra l o d bri g o tre tl , f c i n i r a d e r s e

d. Ve i l s, whe he sel -pro e l d o no , h

c e t r f p l e r t

m i ta n d pri a i y to pro i e m b l ty to

pe m ne t y m u t d: r a n l o n e

b. An a t o o i si n co m t e in pro i i g o

c r m s o m i t d v d n r

fa l ng to pro i e fi st a n i e m r l v d o i i i i v d r a d o "Go d Sa i r o m ri a a t n

se v ce " to a pe so , un e s y u a e i the r i s r n l s o r n

bu i e s o occup ti n of pro i i g s n s r a o v d n (1) Po e cra e , sho e s, l a e s, di g rs o w r n s v l o d r g e r

dri l ; o l s r

pro e sio a e l h ca e se v ce f s n l h a t r r i s

18. "Pe so a a d a v r i i g i j ry m a s "pe so a r n l n d e t s n n u " e n r n l (2) Road construction or resurfacing

e ui m n such a gra e s, scra e s o i j ry o "a v rt sin n q p e t s d r p r r n u " r d e i g i j r ". u y

ro l rs; l e

e. Ve i l s no de crib d i Pa a r p h c e t s e n r g a h a. , b. , c.

19. "Pe so a n ur ": r n l i j y

a. M a s i j ry o he tha "a v rt sin in u y , e n n u , t r n d e i g j r " or d. a o e th t a e no se f pro e l d a d a e b v a r t l - p l e n r

m i t i e pri a i y to pro i e m b l t to a n a n d m r l v d o i i y

ca se by o e o m r o th fo l w ng u d n r o e f e l o i

o fe se : f n s pe m n n l a ta he e u p e t of the r a e t y t c d q i m n

fo l wi g t p s: l o n y e

(1) Ai co pr sso s, pum s a d ge e a o s, r m e r p n n r t r

(1) F l e a re t, de e t o r m ri o m n ; a s r s t n i n o i p s n e t

(2) M l ci us pr se ut o ; a i o o c i n i cl d ng spra i g, we d ng bui d ng n u i y n l i , l i

cl a i g ge ph si a e pl ra i n, l gh i g e n n , o y c l x o t o i t n

a d e l se v ci g e ui m nt r n w l r i n q p e ; o

(2) Che ry pi k rs a d si i a de i e use to r c e n m l r v c s d

ra se o o e o k rs; i r l w r w r e

(3) The wro gf l e i t o fro , wro gf l e tr n u v c i n m n u n y

i t , o in a i n o the ri h o pri a e n o r v s o f g t f v t

o cup ncy o a ro m dwe l n o pre i e c a f o , l i g r m s s

th t a pe so o cup e , pro i e tha the a r n c i s v d d t

wro g u v ct o , wro g u nt y o n a i n n f l e i i n n f l e r r i v s o f. Ve i l s no de crib d i Pa a r p h c e t s e n r g a h a. , b. , c.

or d. a o e m i ta n d pri a i y fo pu po e b v a n i e m r l r r s s

o h r tha th tra spo t t o o pe so s o t e n e n r a i n f r n r

ca g . r o

Ho e e , se f pro e l d v h cl s wi h th w v r l - p l e e i e t e

o the ri h o pri a e o cupa cy is f g t f v t c n

co m t e by o o be a f o the o ne , m i t d r n h l f w r

l nd o d o le so o tha ro m dwe l ng o a l r r s r f t o , l i r

pre i e ; m s s

(4) Ora o writ e pub i a i n incl di g l r t n l c t o , u n fo l wi g ty e o pe m n nt y at a he l o n p s f r a e l t c d

pu l ca i n by e e t o i m a s, o m t r a b i t o l c r n c e n f a e i l e ui m nt a e no "m bi e e u pm n " bu wil q p e r t o l q i e t t l

th t sl nd r o l b l a pe so o a a e s r i e s r n r be co si e e "a t s": n d r d u o

o ga i a i n o di pa a e a pe so 's o r n z t o r s r g s r n r (1) Eq i m nt de ig e ri a i y f r: u p e s n d p m r l o

(a) Sn w r m v l o e o a ;

o ga i a i n s go d , pro u ts o se v ce , r n z t o ' o s d c r r i s

pro i e t a the cl i i m d r he "sui " v d d h t a m s a e o t t

i bro g t by a pe so o o g n z ti n tha s u h r n r r a i a o t (b) Ro d m i t na ce but no a a n e n , t co stru ti n o r surfa i g; o

cl i s to ha e be n sl nd r d o i e n c o r e c n r a m v e a e e r l b l d, o e r

th t cl i s to ha e ha i s go ds, pro u ts a a m v d t o d c (c) St e t l a i g; r e c e n n

o se v ce di pa a e ; o r r i s s r g d r (2) Che ry pi ke s an sim l r de i e r c r d i a v c s

(5) Ora o wri te publ ca i n, in l d n l r t n i t o c u i g m un e o a t m bi e o truck cha sis o t d n u o o l r s

pu l ca i n by e e tr n c m a s, o m t ri l b i t o l c o i e n f a e a a d se t a se o o e o k rs; a d n u d o r i r l w r w r e n

(3) Ai co pr sso s, pum s a d ge e a o s, r m e r p n n r t r

i cl di g spra i g we di g bui di g n u n y n , l n , l n

that:

(a) Ap ro ri t s a pe so ' na e v i e p p a e r n s m , o c , cl a i g ge ph si a e pl ra i n, l gh i g e n n , o y c l x o t o i t n

a d e l se v ci g e ui m nt n w l r i n q p e

Ho e e , "m bi e e u p e t do s no i cl de a y w v r o l q i m n " e t n u n

ph t gr p r i e e s; o o o a h o l k n s r

(b) Unre so a l pl ce a pe so in a a n b y a s r n

fa se l gh l i t l nd v h cl th t is sub e t to a co pu so y o a e i e a j c m l r r

b. In l d s "bo i y in ur " ca se by o e o m r c u e d l j y u d n r o e financial responsibility law, or other motor vehicle

i sura ce l w, whe e i is l ce se o pri ci a l o the o f n e n n a r t i n d r n p l y f f e s s de crib d in Pa a ra h s e r g p a. ga a e Such la d v h cl s a e co sid re r g d n e i e r n e d a o e b v "a t s". u o

20. "Po l t n s" m a a y so i , l qu d ga e u o l u a t e n n l d i i , s o s r

17. "Occurr n e m a s: e c " e n

th rm l irr t n o co t m n nt i cl di g sm k , e a i a t r n a i a , n u n o e v po , so t, fu e , a i s, a k l s, che i a s a d a r o m s c d l a i m c l n a. A a ci e t, i cl di g co ti uo s o re e t d n c d n n u n n n u r p a e wa te Wa te in l d s m te i l to be re y l d, s s c u e a r a s c c e e po ure to substa t a l th sa e ge e a x s n i l y e m n r l re o di i n d o r cl i e c n t o e r e a m d ha m ul co di i n ; r r f n t o s o

21. "Pre i e da a e m a s:

m s s m g " e n n a l s r r t o a

a. Wit re pe t to th fi st pa a ra h o the h s c e r r g p f

e ce ti n in Ex l sio x p o s c u n j. o Se ti n f c o I

Co e a e v r g A Bo i y In ur And Pro e t d l j y p r y

co tr ct ca l fo wo k a m re th n

o e j b i e n o s t

(c) Whe tha pa t o the wo k do e a a n t r f r n t

j b si e ha be n put to it i t nd d o t s e s n e e

Da a e Li b l ty "pro e ty da a e to a y

m g a i i , p r m g " n

pre i e whi e re t d to y u fo a pe i d o m s s l n e o r r o f

se e o fe e co se ut v da s, in l d ng the v n r w r n c i e y c u i

co te ts o uch re i e ; r n n f s p m s s o

b. Wit re pe t to th e ce t o to Ex l si ns h s c e x p i n c u o c.

th o g r u h n. i he l st a a ra h o a a r p n t a p r g p f P r g a h 2.

o Se ti n f c o I Co e a e v r g A Bo i y Inj ry And d l u

Pro e ty Da a e L a i i y "pro e ty d m ge to p r m g i b l t , p r a a "

a y pre i e whi e re t d t y u fo a pe i d o n m s s l n e o o r r o f

m re th n se e co se ut v da s, o whi e o a v n n c i e y r l

te p ra i y o cup e by y u wi h pe m ssio o m o r l c i d o t r i n f

th o n r, ca se y e w e u d b :

(1) Fire;

(2) Ex l si n; p o o

use b ny p r o o rg n z t o th r y a e s n r o a i a i n o e

th n an th r co tr ct r or a o e n a o

subco t a t r wo k n o th sa e n r c o r i g n e m

pro e t j c

Wo k tha m y ne d se v ce m i t na ce r t a e r i , a n e n ,

co r ct o , re a r o re l ce e t, bu w i h r e i n p i r p a m n t h c

i o h rwi e co pl t , wi l be tre t d a s t e s m e e l a e s

co p e e m l t d

b. Do s no in l d "bo i y in u y o "pro e ty e t c u e d l j r " r p r

da a e a i i g o t o : m g " r s n u f

(1) The tr n po t ti n o pro e t , unl ss the a s r a o f p r y e

i j ry o da a e a i e o t o co d t o n n u r m g r s s u f a n i i n i

o on a v h cl no o n d o o e a e by r e i e t w e r p r t d

(3) Lightning; l a i g o unl a i g" o d n r o d n

(4) Sm k re ul i g fro fi e e pl sio o o e s t n m r , x o n r

y u, a d tha co di i n wa cre t d by the o n t n t o s a e " o h t e i l b ny f t a v h c e y a

i sure ; n d

l g t i g r i h n n ; o (2) The e i te ce o to l , uni sta l d x s n f o s n l e

(5) Wa e . t r

Bu "pre i e da a e un e thi Pa a r p t m s s m g " d r s r g a h

e ui m nt o ab nd n d o unuse q p e r a o e r d

m te i l ; r a r a s o

(3) Pro uct o o e a i n fo whi h th d s r p r t o s r c e b. do s no in l d "pro e ty da a e to a y e t c u e p r m g " n

cl ssi i a i n, li te i th De l ra i ns o a f c t o s d n e c a t o r pre i e ca se b : m s s u d y

(1) Rup u e bu sti g o o e a i n o pre sure t r , r n , r p r t o f s

i a po i y Sche u e sta e th t pro uct - n l c d l , t s a d s

co p e e o e a i n a e subj ct to the m l t d p r t o s r e re i f e i e ; l e d v c s

(2) Rup u e o bu sti g due to e p nsio o t r r r n x a n r

Ge e a g re a e Li i . n r l A g g t m t

23. "Pro e ty d m ge m a s: p r a a " e n swe l n o th co t n s o a y bui d n o l i g f e n e t f n l i g r

a. Ph si a in u y to ta gi l pro e t , in l d ng a l y c l j r n b e p r y c u i l stru tu e ca se b r e ul i g r m w t r; c r u d y o r s t n f o a e

re ul i g l ss o use o th t pro e t . Al such s t n o f f a p r y l or l ss o use wi l be de m d to o cur t t e t m f o f l e e c a h i e o

(3) Ex l si n o ste m bo l r , ste m pi e , p o o f a i e s a p s

th p y i a n u y t a ca se t r e h s c l i j r h t u d i ; o ste m e gi e o te m t r i e a n n s r s a u b n s

b. Lo s o use o ta gi l pro e ty tha i no s f f n b e p r t s t

ph si a l in ur d Al such l ss o use wi l be y c l y j e l o f l 22. "Products-completed operations hazard":

a. In l d s a l "bo i y in ur " a d "pro e ty c u e l d l j y n p r

de m d to o cur a the ti e o th "o curre ce e e c t m f e c n "

th t a se t a c u d i . da a e o cur i g a a fro pre i e y u m g " c r n w y m m s s o

F r the purp se o th s in ura ce "e e t o i da a o o s f i s n , l c r n c t " o n o re t a d a i in o t o "y ur pro uct o w r n n r s g u f o d " r

i n t a g bl ro e t . s o t n i e p p r y "y ur o k e ce t: o w r " x p

(1) Pro uct th t a e sti l in y ur phy ica d s a r l o s l

24. "Sl g n : o a "

a. M a s a phr se th t o h r u e fo he pu p se e n a a t e s s r t r o possession; or

(2) Wo k tha ha no y t be n co p e e o r t s t e e m l t d r

o t ra ti g a t n i n n t e r d e t sin f a t c n t e t o i h i a v r i g

b. Do s no in l d a phra e use a , o in the e t c u e s d s r , a a d n d. Ho e e , "y ur wo k wi l be b n o e w v r o r " l

na e o : m f de m d co pl t d a th e rl e t o the e e m e e t e a i s f fo l wi g i e : l o n t m s

(1) An pe so o o g n z t o , o he th n y u; y r n r r a i a i n t r a o or (a) Whe a l o th wo k ca l d fo i y u n l f e r l e r n o r co tr ct ha b e o p e e . n a s e n c m l t d

(2) An busin ss, o a y o th pre i e , y e r n f e m s s go ds, pro uct , se v ce o wo k o a y o d s r i s r r , f n

(b) Whe a l o th wo k to be do e a the n l f e r n t pe so r r a i a i n t e ha o r n o o g n z t o , o h r t n y u j b sit ha be n co pl t d i y u o e s e m e e f o r

25. "Su t m a s a civ l pro e d n i whi h da a e

i " e n i c e i g n c m g s

be a se o "bo i y in u y , "pro e ty da a e o c u f d l j r " p r m g " r

"pe so a a d a v rt si g i j ry to whi h thi

r n l n d e i n n u " c s

(a) You;

(b) Ot e s t a i g nd r y u a e r h r r d n u e o r n m ; o

(c) A pe so o or a i a i n who e r n r g n z t o s i sura ce a pl e a e a l ge "Su t i cl de : n n p i s r l e d i " n u s

bu i e s o a se s y u ha e a qu re ; s n s r s t o v c i d

a. An a b t a i n pro e di g i whi h such r i r t o c e n n c and

da a e a e cla m d a d to whi h th in ure m g s r i e n c e s d

m st subm t o do s sub i wi h o r co se t u i r e m t t u n n ;

(2) Co t i e s (o he tha v hi l s), m t ri l , n a n r t r n e c e a e a s

pa t o e u pm n furn she i co ne ti n r s r q i e t i d n n c o or

b. An o he al e n ti e di put re o ut o y t r t r a v s e s l i n

wi h uch g o s o ro uct t s o d r p d s

b. In l d s: c u e pr ce di g in whi h such d m ge a e cl i e o e n c a a s r a m d

(1) Wa ra ti s o re re e ta i ns m de a a y r n e r p s n t o a t n a d to whi h th in ure subm ts wit o r n c e s d i h u

ti e wi h re pe t to the fi n ss, qua i y m t s c t e l t , co se t. n n

26. "Te p ra y wo k r m a s a pe so who i m o r r e " e n r n s

du a i i y pe fo m n e o use o "y ur r b l t , r r a c r f o

pro uct ; nd d " a fu ni he to y u to substi ut fo a pe m ne t r s d o t e r r a n

(2) The pro i i g o o fa l re to pro i e v d n f r i u v d "e pl y e o l a e o to m e se so a o sho t m o e " n e v r e t a n l r r -

wa ni g o n tr ct o s. r n s r i s u i n te m w r l a o di i n . r o k o d c n t o s

27. "Ti l " m a s a na e o l t r r r a t sti o k t e e n m f a i e a y o r i c w r .

28. "Unso i i e co m n ca i n m a s a y l c t d m u i t o " e n n

co m n ca i n in a y fo m tha th re i i nt o m u i t o , n r , t e c p e f

c. Do s no i cl de v nd ng m ch ne o o h r e t n u e i a i s r t e

pro e ty re t d to o l ca e fo the use o p r n e r o t d r f

o h r b t no so d t e s u t l

31. "Y u o k : o r w r " such co m n ca i n di no spe i i a l re ue t to m u i t o d t c f c l y q s

a. M a s: e n re e v c i e

29. "Vo u t e wo k r m a s a pe so who i no y u l n e r r e " e n r n s t o r y ur e a f; a d o b h l n "e pl y e , a d who do a e hi o he wo k a d m o e " n n t s s r r r n

a t a th di e ti n o a d wi hi the sco e o c s t e r c o f n t n p f

(1) Wo k o o e a i n pe f rm d by y u o o r r p r t o s r o e o r n

(2) M te i l , pa t o e u pm n furn she in a r a s r s r q i e t i d du i s de e m n d by y u a d is no pa d a fe , t e t r i e o , n t i e

sa a y o o he co pe sa i n by y u o a y n e se l r r t r m n t o o r n o e l

co ne ti n wi h uch w r o pe a i n . n c o t s o k r o r t o s

b. In l d s: c u e fo he r o k p r o m d f r o r t i w r e f r e o y u

(1) Wa ra ti s o re re e ta i ns m de a a y r n e r p s n t o a t n

30. "Y u ro uct : o r p d " ti e wi h re pe t to the fi n ss, qua i y m t s c t e l t , a. M a s: e n du a i i y pe fo m n e o use o "y ur r b l t , r r a c r f o

(1) An go d o pro uct , o h r th n re l wo k ; a d y o s r d s t e a a r " n pro e ty m n f ct r d so d ha d e , p r , a u a u e , l , n l d

(2) The pro i i g o o fa l re to pro i e v d n f r i u v d di tr bu e r d spo e f y s i t d o i s d o b :

wa ni g o n tr ct o s. r n s r i s u i n

PLEASEREADTHEENTIREPOLICYCAREFULLY.

Variousprovisionsinthispolicyrestrictcoverage.Readtheentirepolicycarefullytodeterminerights,dutiesand whatisandisnotcovered.

Throughoutthispolicy,thewords"you"and"your"refertotheNamedInsuredshownintheDeclarationsandany otherpersonororganizationqualifyingasaNamedInsuredunderthispolicy.Thewords"we","us"and"our" refertothecompanyprovidingthisinsurance.

Theword"insured"meansanypersonororganizationqualifyingassuchunderSECTIONII–WHOISAN INSURED.

Otherwordsandphrasesthatappearinquotationmarkshavespecialmeaning.RefertoSECTIONVI–DEFINITIONS

SECTIONI–COVERAGES

1.Wewillpayonbehalfoftheinsuredthose sums,inexcessofthe"applicableunderlying limit",that the insuredbecomes legally obligatedtopayasdamagestowhich Coverage A of this insurance applies, providedthatthe"underlyinginsurance"would applytosuchdamagesbutfortheexhaustion ofitsapplicablelimitsofinsurance.Ifa sublimit is specified in any "underlying insurance",CoverageAofthisinsurance appliestodamagesthatareinexcessofthat sublimitonlyifsuchsublimitisshownforthat "underlyinginsurance"intheScheduleOf UnderlyingInsurance.

2.CoverageAofthisinsuranceissubjecttothe same terms, conditions, agreements, exclusionsanddefinitionsasthe"underlying insurance", except with respect to any

provisionstothecontrarycontainedinthis insurance.

3.Theamountwewillpayfordamagesislimited asdescribedinSECTIONIII–LIMITSOF INSURANCE

4.ForthepurposesofParagraph1.above:

a.Theapplicablelimitofinsurancestated forthepoliciesof"underlyinginsurance" intheScheduleOfUnderlyingInsurance willbeconsideredtobereducedor exhausted only by the following payments:

(1)Payments of judgments or settlements for damages that are covered by that "underlying insurance". However, if such "underlyinginsurance"hasapolicy periodwhichdiffersfromthepolicy periodofthisExcessFollow-Form AndUmbrellaLiabilityInsurance,any such payments for damages that wouldnotbecoveredbythisExcess

Follow-FormAndUmbrellaLiability Insurancebecauseofitsdifferent policy period will not reduce or exhaust the applicable limit of insurancestatedforsuch"underlying insurance";

(2)Paymentsof"medicalexpenses"that are covered by that "underlying insurance" and are incurred for "bodilyinjury"causedbyanaccident thattakesplaceduringthepolicy periodofthisExcessFollow-Form AndUmbrellaLiabilityInsurance;or

(3)Paymentsofdefenseexpensesthat are covered by that "underlying insurance",onlyifsuch"underlying insurance"includessuchpayments within the limits of insurance. However, if such "underlying insurance"hasapolicyperiodwhich differsfromthepolicyperiodofthis ExcessFollow-FormAndUmbrella Liability Insurance, any such paymentsfordefenseexpensesthat wouldnotbecoveredbythisExcess Follow-FormAndUmbrellaLiability Insurancebecauseofitsdifferent policy period will not reduce or exhaust the applicable limit of insurancestatedforsuch"underlying insurance".

Iftheapplicablelimitofinsurancestated forthepoliciesof"underlyinginsurance" intheScheduleOfUnderlyingInsurance isactuallyreducedorexhaustedbyother payments,CoverageAofthisinsurance isnotinvalidated.However,intheevent ofaloss,wewillpayonlytotheextent thatwewouldhavepaidhadsuchlimit notbeenactuallyreducedorexhausted bysuchotherpayments.

b.Ifany"underlyinginsurance"hasalimitof insurancegreaterthantheamountshown forthatinsuranceintheScheduleof UnderlyingInsurance,thisinsurancewill applyinexcessofthatgreateramount.If any"underlyinginsurance"hasalimitof insurance, prior to any reduction or exhaustion by payment of damages, "medicalexpenses"ordefenseexpenses describedinParagrapha.above,thatis lessthantheamountshownforthat insuranceintheScheduleOfUnderlying Insurance,thisinsurancewillapplyin excessoftheamountshownforsuch insuranceintheScheduleOfUnderlying Insurance.

5.Whenthe"underlyinginsurance"appliesona claims-madebasisandincludesaretroactive date provision, the retroactive date for CoverageAofthisinsuranceisthesameas the retroactive date of that "underlying insurance".

B.COVERAGEB–UMBRELLALIABILITY

1.Wewillpayonbehalfoftheinsuredthose sumsinexcessofthe"self-insuredretention" thattheinsuredbecomeslegallyobligatedto payasdamagesbecauseof"bodilyinjury", "property damage", "personal injury" or "advertisinginjury"towhichCoverageBof thisinsuranceapplies.

2.CoverageBofthisinsuranceappliesto "bodilyinjury"or"propertydamage"onlyif:

a.The"bodilyinjury"or"propertydamage"is causedbyan"occurrence"thattakes placeanywhereintheworld;

b.The"bodilyinjury"or"propertydamage" occursduringthepolicyperiod;and

c.Priortothepolicyperiod,noinsuredlisted underParagraph1.inParagraphB., COVERAGE B – UMBRELLA LIABILITY,ofSECTIONII–WHOISAN INSUREDandno"employee"authorized byyoutogiveorreceivenoticeofan "occurrence"orclaim,knewthatthe "bodilyinjury"or"propertydamage"had occurred,inwholeorinpart.Ifsucha listedinsuredorauthorized"employee" knew,priortothepolicyperiod,thatthe "bodily injury" or "property damage" occurred,inwholeorinpart,thenany continuation,changeorresumptionof such"bodilyinjury"or"propertydamage" duringorafterthepolicyperiodwillbe deemedtohavebeenknownpriortothe policyperiod.

3.CoverageBofthisinsuranceappliesto "personalinjury"or"advertisinginjury" causedbyanoffensearisingoutofyour business,butonlyiftheoffensewas committed during the policy period anywhereintheworld.

4.Theamountwewillpayfordamagesislimited asdescribedinSECTIONIII–LIMITSOF INSURANCE

5."Bodilyinjury"or"propertydamage":

aWhichoccursduringthepolicyperiod;and b.Whichwasnotpriorto,butwasduring,the policyperiodknowntohaveoccurredby anyinsuredlistedunderParagraph1.in Paragraph B., COVERAGE B –

UMBRELLALIABILITYofSECTIONII–WHOISANINSURED,orany"employee" authorizedbyyoutogivenoticeofan "occurrence"orclaim; includes any continuation, change or resumptionofthe"bodilyinjury"or"property damage"aftertheendofthepolicyperiod.

6."Bodilyinjury"or"propertydamage"willbe deemed tohave been known tohave occurredattheearliesttimewhenanyinsured listedunderParagraph1.inParagraphB., COVERAGEB–UMBRELLALIABILITY,of SECTIONII–WHOISANINSUREDorany "employee"authorizedbyyoutogiveor receivenoticeofan"occurrence"orclaim:

a.Reportsall,oranypart,ofthe"bodily injury"or"propertydamage"tousorany otherinsurer;

b.Receivesawrittenorverbaldemandor claimfordamagesbecauseofthe"bodily injury"or"propertydamage";or

c.Becomesawarebyanyothermeansthat the"bodilyinjury"or"propertydamage" hasoccurredorhasbeguntooccur.

7.Damagesbecauseof"bodilyinjury"include damages claimed by any person or organizationforcare,lossofservicesordeath resultingatanytimefromthe"bodilyinjury".

8.CoverageBofthisinsurancedoesnotapply todamagescoveredbyany"underlying insurance"orthatwouldhavebeencovered byany"underlyinginsurance"butforthe exhaustionofitsapplicablelimitofinsurance.

C.COVERAGE C – CRISIS MANAGEMENT SERVICEEXPENSES

1.Wewillreimbursetheinsured,orpayonthe insured'sbehalf,"crisismanagementservice expenses"towhichCoverageCapplies.

2.CoverageCofthisinsuranceappliesto"crisis managementserviceexpenses"that:

a.Ariseoutofa"crisismanagementevent" thatfirstcommencesduringthepolicy period;

b.Areincurredbytheinsured,aftera"crisis managementevent"firstcommencesand beforesucheventends;and

c.Aresubmittedtouswithin180daysafter the"crisismanagementadvisor"advises youthatthe"crisismanagementevent" nolongerexists.

3.A"crisismanagementevent"willbedeemed to:

a Firstcommenceatthetimewhenany "executiveofficer"firstbecomesawareof an"event"or"occurrence"thatleadsto that"crisismanagementevent";and b Endwhenwedecidethatthecrisisno longer exists or when the Crisis ManagementServiceExpensesLimithas beenexhausted,whicheveroccursfirst.

4.The amount we will pay for "crisis managementserviceexpenses"islimitedas describedinSECTIONIII–LIMITSOF INSURANCE

5.A"self-insuredretention"doesnotapplyto "crisismanagementserviceexpenses".

6.Anypaymentof"crisismanagementservice expenses" that we make will not be determinativeofourobligationsunderthis insurancewithrespecttoanyclaimor"suit"or createanydutytodefendorindemnifyany insuredforanyclaimor"suit".

D.DEFENSEANDSUPPLEMENTARYPAYMENTS

1.Wewillhavetherightanddutytodefendthe insured:

a.UnderCoverageA,againsta "suit" seekingdamagestowhichsuchcoverage applies,if:

(1)The"applicableunderlyinglimit"isthe applicablelimitofinsurancestatedfor apolicyof"underlyinginsurance"in the Schedule Of Underlying Insuranceandsuchlimithasbeen exhaustedsolelyduetopaymentsas permittedinParagraphs4.a.(1),(2) and(3)ofCOVERAGEA–EXCESS FOLLOW-FORM LIABILITY of SECTIONI–COVERAGES;or

(2)The"applicableunderlyinglimit"isthe applicable limit of any "other insurance"andsuchlimithasbeen exhaustedbypaymentsofjudgments, settlementsormedicalexpenses,or relatedcostsorexpenses(ifsuch costs or expenses reduce such limits).

Forany"suit"forwhichwehavetheright anddutytodefendtheinsuredunder CoverageA,defenseexpenseswillbe withinthelimitsofinsuranceofthispolicy whensuchexpensesarewithinthelimits ofinsuranceoftheapplicable"underlying insurance";or

b.UnderCoverageB,againsta "suit" seekingdamagestowhichsuchcoverage applies.

2.Wehavenodutytodefendanyinsured againstany"suit":

a.Seekingdamagestowhichthisinsurance doesnotapply;or

b.Ifanyotherinsurerhasadutytodefend.

3.Whenwehavethedutytodefend,wemay,at ourdiscretion,investigateandsettleanyclaim or"suit".Inallothercases,wemay,atour discretion,participateintheinvestigation, defenseandsettlementofanyclaimor"suit" fordamagestowhichthisinsurancemay apply.Ifweexercisesuchrighttoparticipate, allexpensesweincurindoingsowillnot reducetheapplicablelimitsofinsurance.

4.Ourdutytodefendendswhenwehaveused uptheapplicablelimitofinsuranceinthe paymentofjudgmentsorsettlements,or defenseexpensesifsuchexpensesarewithin thelimitsofinsuranceofthispolicy.

5.Wewillpay,withrespecttoaclaimwe investigateorsettle,or"suit"againstan insuredwedefend:

a.Allexpensesweincur.

b.Thecostof:

(1)Bail bonds required because of accidentsortrafficlawviolations arisingoutoftheuseofanyvehicleto whichthisinsuranceapplies;or

(2)Appealbondsandbondstorelease attachments; butonlyforbondamountswithinthe applicablelimitofinsurance.Wedonot havetofurnishthesebonds.

c.Allreasonableexpensesincurredbythe insuredatourrequesttoassistusinthe investigationordefenseofsuchclaimor "suit",includingactuallossofearningsup to$1,000adaybecauseoftimeofffrom work.

d.Allcourtcoststaxedagainsttheinsured inthe"suit".However,thesepaymentsdo notincludeattorneys'feesorattorneys' expensestaxedagainsttheinsured.

e.Prejudgmentinterestawardedagainstthe insuredonthatpartofthejudgmentwe pay.Ifwemakeanoffertopaythe applicablelimitofinsurance,wewillnot payanyprejudgmentinterestbasedon thatperiodoftimeaftertheoffer.

f. Allinterestthataccruesonthefullamount ofanyjudgmentafterentryofthe judgmentandbeforewehavepaid, offeredtopayordepositedincourtthe partofthejudgmentthatiswithinthe

applicablelimitofinsurance.Ifwedonot paypartofthejudgmentforanyreason otherthanitismorethantheapplicable limitofinsurance,wewillnotpayany interestthataccruesonthatportionofthe judgment.

Withrespecttoaclaimweinvestigateor settle,or"suit"againstaninsuredwedefend underCOVERAGEA–EXCESSFOLLOWFORMLIABILITY,thesepaymentswillnot reducetheapplicablelimitsofinsurance,but onlyiftheapplicable"underlyinginsurance" providesforsuchpaymentsinadditiontoits limitsofinsurance.Withrespecttoaclaimwe investigateorsettle,or"suit"againstan insuredwedefendunder COVERAGEB–UMBRELLALIABILITY,thesepaymentswill notreducetheapplicablelimitsofinsurance.

SECTIONII–WHOISANINSURED

A.COVERAGEA–EXCESSFOLLOW-FORM LIABILITY

WithrespecttoCoverageA,thefollowingpersons andorganizationsqualifyasinsureds:

1.The Named Insured shown in the Declarations;and

2.Anyotherpersonororganizationqualifyingas aninsuredinthe"underlyinginsurance".If youhaveagreedtoprovideinsuranceforthat personororganizationinawrittencontractor agreement:

a.Thelimitsofinsuranceaffordedtosuch personororganizationwillbe:

(1)Theamountbywhichtheminimum limitsofinsuranceyouagreedto providesuchpersonororganization inthatwrittencontractoragreement exceedthetotallimitsofinsuranceof allapplicable"underlyinginsurance"; or

(2)Thelimitsofinsuranceofthispolicy; whicheverisless;and

b.Coverageunderthispolicydoesnotapply tosuchpersonororganizationifthe minimumlimitsofinsuranceyouagreed toprovidesuchpersonororganizationin thatwrittencontractoragreementare whollywithinthetotallimitsofinsurance of all available applicable "underlying insurance".

B.COVERAGEB–UMBRELLALIABILITY

WithrespecttoCoverageB:

1.The Named Insured shown in the Declarationsisaninsured.

2.Ifyouare:

a.Anindividual,yourspouseisalsoan insured,butonlywithrespecttothe conductofabusinessofwhichyouare thesoleowner.

b.A partnership or joint venture, your members, your partners and their spousesarealsoinsureds,butonlywith respecttotheconductofyourbusiness.

c.Alimitedliabilitycompany,yourmembers arealsoinsureds,butonlywithrespectto the conduct of your business. Your managersarealsoinsureds,butonlywith respecttotheirdutiesasyourmanagers.

d.Anorganizationotherthanapartnership, jointventureorlimitedliabilitycompany, your"officers"anddirectorsarealso insureds,butonlywithrespecttotheir dutiesasyour"officers"ordirectors.Your stockholdersarealsoinsureds,butonly with respect to their liability as stockholders.

e.Atrust,yourtrusteesarealsoinsureds, butonlywithrespecttotheirdutiesas trustees.

3.Eachofthefollowingisalsoaninsured:

a.Your "volunteer workers" only while performingdutiesrelatedtotheconduct ofyourbusiness,oryour"employees", otherthaneitheryour"officers"(ifyouare anorganizationotherthanapartnership, jointventureorlimitedliabilitycompany) oryourmanagers(ifyouarealimited liabilitycompany),butonlyforactswithin thescopeoftheiremploymentbyyouor whileperformingdutiesrelatedtothe conductofyourbusiness.However,none of these "employees" or "volunteer workers"areinsuredsfor:

(1)"Bodilyinjury"or"personalinjury":

(a)To you, to your partners or members(ifyouareapartnership orjointventure),toyourmembers (if you are a limited liability company), to a co-"employee" whileinthecourseofhisorher employmentorperformingduties relatedtotheconductofyour business, or to your other "volunteer workers" while performingdutiesrelatedtothe conductofyourbusiness;

(b)To the spouse, child, parent, brother or sister of that co"employee"or"volunteerworker"

asaconsequenceofParagraph (1)(a)above;

(c)Forwhichthereisanyobligation tosharedamageswithorrepay someone else who must pay damages because of the injury describedinParagraph(1)(a)or (b)above;or

(d)Arisingoutofhisorherproviding orfailingtoprovideprofessional healthcareservices.

Unlessyouareinthebusinessor occupation of providing professional health care services, Paragraphs (1)(a),(b),(c)and(d)abovedonot applyto"bodilyinjury"arisingoutof providingorfailingtoprovidefirstaid or"GoodSamaritanservices"byany of your "employees" or "volunteer workers"otherthananemployedor volunteer doctor. Any such "employees" or "volunteer workers" providingorfailingtoprovidefirstaid or"GoodSamaritanservices"during their work hours for you will be deemedtobeactingwithinthescope of their employment by you or performing duties related to the conductofyourbusiness.

(2)"Propertydamage"toproperty:

(a)Owned,occupiedorusedby;or

(b)Rentedto,inthecare,custodyor controlof,oroverwhichphysical controlisbeingexercisedforany purposeby;

you, any of your "employees" or "volunteer workers", any of your partnersormembers(ifyouarea partnershiporjointventure),oranyof yourmembers(ifyouarealimited liabilitycompany).

b.Anyperson(otherthanyour"employee" or "volunteer worker"), or any organization, while acting as your real estatemanager.

c.Anypersonororganizationhavingproper temporarycustodyofyourpropertyifyou die,butonly:

(1)Withrespecttoliabilityarisingoutof the maintenance or use of that property;and

(2)Until your legal representative has beenappointed.

d.Yourlegalrepresentativeifyoudie,but onlywithrespecttodutiesassuch.That

representativewillhaveallyourrightsand dutiesunderthisinsurance.

4.Anyorganization,otherthanapartnership, jointventureorlimitedliabilitycompany,of whichyouarethesoleowner,orinwhichyou maintainanownershipinterestofmorethan 50%,onthefirstdayofthepolicyperiodisan insuredandwillqualifyasaNamedInsured. Nosuchorganizationisaninsuredorwill qualifyasaNamedInsuredfor"bodilyinjury" or"propertydamage" that occurred, or "personalinjury"or"advertisinginjury"caused byanoffensecommittedafterthedate,ifany, duringthepolicyperiod,thatyounolonger maintainanownershipinterestofmorethan 50%insuchorganization.

5.Anyorganizationyounewlyacquireorform, otherthanapartnership,jointventureor limitedliabilitycompany,andofwhichyouare thesoleowner,orinwhichyoumaintainan ownershipinterestofmorethan50%,isan insuredandwillqualifyasaNamedInsuredif thereisnoothersimilarinsuranceavailableto thatorganization.However:

a.Coverageunderthisprovisionisafforded onlyuntilthe180thdayafteryouacquire orformtheorganizationortheendofthe policyperiod,whicheverisearlier;and

b.Coverageforsuchorganizationdoesnot applyto:

(1)"Bodilyinjury"or"propertydamage" thatoccurred;or

(2)"Personal injury" or "advertising injury"arisingoutofanoffense committed; beforeyou acquired or formed the organization.

Nopersonororganizationisaninsuredorwill qualifyasaNamedInsuredwithrespecttothe conductofanycurrentorpastpartnership,joint ventureorlimitedliabilitycompanythatisnot shownasaNamedInsuredintheDeclarations. Thisparagraphdoesnotapplytoanysuch partnership, joint venture or limited liability companythatotherwisequalifiesasaninsured underParagraphB.ofSECTIONII–WHOISAN INSURED

C.COVERAGEC– CRISISMANAGEMENT SERVICEEXPENSES

WithrespecttoCoverageC,thefollowingpersons andorganizationsareinsuredsandwillqualifyas NamedInsureds:

1.The Named Insured shown in the Declarations.

2.Anyorganization,otherthanapartnership, jointventureorlimitedliabilitycompany,of whichyouarethesoleowner,orinwhichyou maintainanownershipinterestofmorethan 50%,onthefirstdayofthepolicyperiod.No suchorganizationisaninsuredorwillqualify asaNamedInsuredfor"crisismanagement serviceexpenses"arisingoutofa"crisis managementevent"thatfirstcommences afterthedate,ifany,duringthepolicyperiod, thatyounolongermaintainanownership interest of more than 50% in such organization.

3.Anyorganizationyounewlyacquireorform, otherthanapartnership,jointventureor limitedliabilitycompany,andofwhichyouare thesoleowner,orinwhichyoumaintainan ownershipinterestofmorethan50%,ifthere isnoothersimilarinsuranceavailabletothat organization.However:

a.Coverageunderthisprovisionisafforded onlyuntilthe180thdayafteryouacquire orformtheorganizationortheendofthe policyperiod,whicheverisearlier;and

b.Coverageforsuchorganizationdoesnot applyto "crisis management service expenses" arising out of a "crisis managementevent"thatoccurredbefore youacquiredorformedtheorganization, evenifan"executiveofficer"onlyfirst becomes aware of an "event" or "occurrence"thatleadstosuch"crisis managementevent"afterthedateyou acquiredorformedtheorganization.

Nopersonororganizationisaninsuredorwill qualifyasaNamedInsuredwithrespecttothe conductofanycurrentorpastpartnership,joint ventureorlimitedliabilitycompanythatisnot shownasaNamedInsuredintheDeclarations.

SECTIONIII–LIMITSOFINSURANCE

A.TheLimitsofInsuranceshownintheDeclarations andtherulesbelowfixthemostwewillpayforthe amountsdescribedbelowtowhichthisinsurance appliesregardlessofthenumberof:

1.Insureds;

2.Claimsmadeor"suits"brought;

3.Numberofvehiclesinvolved;

4.Personsororganizationsmakingclaimsor bringing"suits";or

5.Coveragesprovidedunderthisinsurance.

AsindicatedinParagraphD.1.ofSECTIONI–COVERAGES,forany"suit"forwhichwehave therightanddutytodefendtheinsuredunder CoverageA,defenseexpenseswillbewithinthe

limitsofinsuranceofthispolicywhensuch expensesarewithinthelimitsofinsuranceofthe applicable"underlyinginsurance".

B.TheGeneralAggregateLimitisthemostwewill payforthesumofall:

1.Damages;and

2.Defenseexpensesifsuchexpensesare withinthelimitsofinsuranceofthispolicy; except:

1.Damagesanddefenseexpensesbecauseof "bodilyinjury"or"propertydamage"included inthe"autohazard";

2.Damagesanddefenseexpensesbecauseof "bodilyinjury"or"propertydamage"included in the "products-completed operations hazard";or

3.Damagesanddefenseexpensesforwhich insuranceisprovidedunderanyAircraft Liabilitycoverageincludedas"underlying insurance" towhich noaggregatelimit applies.

C.TheProducts-CompletedOperationsAggregate Limitisthemostwewillpayforthesumofall:

1.Damages;and

2.Defenseexpensesifsuchexpensesare withinthelimitsofinsuranceofthispolicy; becauseof"bodilyinjury"or"propertydamage" includedinthe"products-completedoperations hazard".

D.SubjecttoParagraphB.orC.above,whichever applies,theOccurrenceLimitisthemostwewill payforthesumofall:

1.Damages,anddefenseexpensesifsuch expensesarewithinthelimitsofinsuranceof thispolicy,underCoverageAarisingoutof anyone"event"towhichthe"underlying insurance"appliesalimitofinsurancethatis separate from any aggregate limit of insurance;and

2.DamagesunderCoverageBbecauseofall "bodilyinjury","propertydamage","personal injury"or"advertisinginjury"arisingoutofany one"occurrence".

Forthepurposesofdeterminingtheapplicable OccurrenceLimit,allrelatedactsoromissions committedintheprovidingorfailingtoprovide firstaidor"GoodSamaritanservices"toanyone personwillbeconsideredone"occurrence".

E.TheCrisisManagementServiceExpensesLimit isthemostwewillpayforthesumofall"crisis managementserviceexpenses"arisingoutofall "crisismanagementevents".Paymentofsuch "crisismanagementserviceexpenses"isin additionto,andwillnotreduce,anyotherlimitof insuranceofthispolicy.

F.Thelimitsofinsuranceofthispolicyapply separatelytoeachconsecutiveannualperiodand toanyremainingperiodoflessthan12months, startingwiththebeginningofthepolicyperiod shownintheDeclarations.Ifthepolicyperiodis extendedafterissuanceforanadditionalperiodof lessthan12months,theadditionalperiodwillbe deemedpartofthelastprecedingperiodfor purposesofdeterminingthelimitsofinsurance.

SECTIONIV–EXCLUSIONS

Thisinsurancedoesnotapplyto:

A.WithrespecttoCoverageAandCoverageB: 1.

Asbestos

a.Damagesarisingoutoftheactualor allegedpresenceoractual,allegedor threatened dispersal of asbestos, asbestosfibersorproductscontaining asbestos,providedthatthedamagesare causedorcontributedtobythehazardous propertiesofasbestos.

b.Damagesarisingoutoftheactualor allegedpresenceoractual,allegedor threateneddispersalofanysolid,liquid, gaseous or thermal irritant or contaminant, including smoke, vapors, soot,fumes,acids,alkalis,chemicalsand waste,andthatarepartofanyclaimor "suit"whichalsoallegesanydamages describedinParagrapha.above.

c.Anyloss,costorexpensearisingoutof any:

(1)Request,demand,orderorstatutory orregulatoryrequirementthatany insuredorotherstestfor,monitor, clean up, remove, contain, treat, detoxifyorneutralize,orinanyway respondto,orassesstheeffectsof, asbestos,asbestosfibersorproducts containingasbestos;or

(2)Claimor"suit"byoronbehalfofany governmentalauthorityoranyother personororganizationbecauseof testingfor,monitoring,cleaningup, removing, containing, treating, detoxifyingorneutralizing,orinany way responding to, or assessing theeffectsof,asbestos,asbestos fibersorproductscontainingasbestos.

2.Employment-RelatedPractices

Damagesbecauseofinjuryto:

a.Apersonarisingoutofany:

(1)Refusaltoemploythatperson;

(2)Termination of that person's employment;or

(3)Employment-relatedpractice,policy, actoromission,suchascoercion, demotion,evaluation,reassignment, discipline, failure to promote or advance,harassment,humiliation, discrimination,libel,slander,violation oftheperson'srightofprivacy, maliciousprosecutionorfalsearrest, detentionorimprisonment,appliedto ordirectedatthatperson,regardless ofwhethersuchpractice,policy,act oromissionoccurs,isappliedoris committedbefore,duringorafterthe timeofthatperson'semployment;or

b.Thespouse,child,parent,brotheror sisterofthatpersonasaconsequenceof injurytothatpersonasdescribedin Paragraphsa.(1),(2)or(3)above.

Thisexclusionapplies:

a.Whethertheinsuredmaybeliableasan employerorinanyothercapacity;and

b.Toanyobligationtosharedamageswith orrepaysomeoneelsewhomustpay damagesbecauseoftheinjury.

3.ERISA,COBRAAndSimilarLaws

Anyobligationoftheinsuredunder:

a.The Employees Retirement Income SecurityActOf1974(ERISA)oranyof itsamendments;

b.The Consolidated Omnibus Budget ReconciliationActof1985(COBRA)or anyofitsamendments;or

c.Anysimilarcommonorstatutorylawof anyjurisdiction.

4.MedicalExpensesOrPayments

Anyobligationoftheinsuredunderany "medicalexpenses"ormedicalpayments coverage.

5.NuclearMaterial

Damagesarisingoutof:

a.The actual, alleged or threatened exposureofanypersonorpropertyto;or

b.The"hazardousproperties"of; any"nuclearmaterial".

Asusedinthisexclusion:

a."Hazardous properties" includes radioactive,toxicorexplosiveproperties;

b."Nuclear material" means "source material","specialnuclearmaterial"or "by-productmaterial";and

c."Source material", "special nuclear material"and"by-productmaterial"have

themeaningsgiventhemintheAtomic Energy Act of 1954 or any of its amendments.

6.UninsuredorUnderinsuredMotorists,NoFaultAndSimilarLaws

Anyliabilityimposedontheinsured,orthe insured'sinsurer,underanyofthefollowing laws:

a.Uninsuredmotorists;

b.Underinsuredmotorists;

c.Autono-faultorotherfirst-partypersonal injuryprotection(PIP);

d.Supplementary uninsured/underinsured motorists(NewYork);or

e.Medical expense benefits and income lossbenefits(Virginia).

7.War

Damagesarisingoutof:

a.War,includingundeclaredorcivilwar;or

b.Warlike action by a military force, includingactioninhinderingordefending againstanactualorexpectedattack,by any government, sovereign or other authorityusingmilitarypersonnelorother agents;or

c.Insurrection,rebellion,revolution,usurped poweroractiontakenbygovernmental authorityinhinderingordefendingagainst anyofthese.

8.WorkersCompensationAndSimilarLaws

Anyobligationoftheinsuredunderaworkers compensation, disability benefits or unemployment compensation law or any similarlaw.

B.WithrespecttoCoverageB:

1.

ExpectedOrIntendedBodilyInjuryOr PropertyDamage

"Bodilyinjury"or"propertydamage"expected orintendedfromthestandpointoftheinsured. Thisexclusiondoesnotapplyto"bodilyinjury" or"propertydamage"resultingfromtheuseof reasonable force to protect persons or property.

2.ContractualLiability

"Bodilyinjury","propertydamage","personal injury"or"advertisinginjury"forwhichthe insuredisobligated topay damages by reasonoftheassumptionofliabilityina contractoragreement.Thisexclusiondoes notapplytoliabilityfordamagesthatthe insuredwouldhaveintheabsenceofthe contractoragreement.

3.LiquorLiability

"Bodilyinjury"or"propertydamage"forwhich anyinsuredmaybeliablebyreasonof:

a.Causingorcontributingtotheintoxication ofanyperson,includingcausingor contributingtotheintoxicationofany personbecausealcoholicbeverageswere permittedtobebroughtonyourpremises forconsumptiononyourpremises;

b.Thefurnishingofalcoholicbeveragestoa personunderthelegaldrinkingageor undertheinfluenceofalcohol;or

c.Any statute,ordinanceorregulation relatingtothesale,gift,distributionoruse ofalcoholicbeverages.

4.EmployersLiability

"Bodilyinjury"to:

a.An"employee"oftheinsuredarisingout ofandinthecourseof:

(1)Employmentbytheinsured;or

(2)Performingduties related tothe conductoftheinsured'sbusiness;or

b.Thespouse,child,parent,brotheror sister of that "employee" as a consequenceof"bodilyinjury"described inParagrapha.above.

Thisexclusionapplies:

a.Whethertheinsuredmaybeliableasan employerorinanyothercapacity;and

b.Toanyobligationtosharedamageswith orrepaysomeoneelsewhomustpay damagesbecauseofthe"bodilyinjury".

5.Pollution

a."Bodily injury", "property damage", "personalinjury"or"advertisinginjury" arisingoutoftheactual,allegedor threateneddischarge,dispersal,seepage, migration, release or escape of "pollutants".

b.Anyloss,costorexpensearisingoutof any:

(1)Request,demand,orderorstatutory orregulatoryrequirementthatany insuredoranyotherpersonor organizationtestfor,monitor,clean up,remove,contain,treat,detoxifyor neutralize,orinanywayrespondto, orassesstheeffectsof,"pollutants"; or

(2)Claimor"suit"byoronbehalfofany governmentalauthorityoranyother personororganizationbecauseof testingfor,monitoring,cleaningup,

removing, containing, treating, detoxifyingorneutralizing,orinany wayrespondingto,orassessingthe effectsof,"pollutants".

6.Aircraft

"Bodilyinjury"or"propertydamage"arising outoftheownership,maintenance,useor entrustmenttoothersofanyaircraftownedor operatedbyorrentedorloanedtoany insured.Useincludesoperationand"loading orunloading".

Thisexclusionapplieseveniftheclaims againstanyinsuredallegenegligenceorother wrongdoing in the supervision, hiring, employment,trainingormonitoringofothers bythatinsured,ifthe"occurrence"which caused the "bodily injury" or "property damage" involved the ownership, maintenance,useorentrustmenttoothersof anyaircraftthatisownedoroperatedbyor rentedorloanedtoanyinsured.

7.Auto

"Bodilyinjury"or"propertydamage"arising outoftheownership,maintenance,useor entrustmenttoothersofany"auto".Use includesoperationand"loadingorunloading".

Thisexclusionapplieseveniftheclaims againstanyinsuredallegenegligenceorother wrongdoing in the supervision, hiring, employment,trainingormonitoringofothers bythatinsured,ifthe"occurrence"which caused the "bodily injury" or "property damage" involved the ownership, maintenance,useorentrustmenttoothersof any"auto".

Thisexclusiondoesnotapplyto"bodilyinjury" or "property damage" caused by an "occurrence"thattakesplaceoutsideofthe United States of America (including its territoriesandpossessions),PuertoRicoand Canada.

8.Watercraft

"Bodilyinjury"or"propertydamage"arising outoftheownership,maintenance,useor entrustmenttoothersofanywatercraftowned oroperatedbyorrentedorloanedtoany insured.Useincludesoperationand"loading orunloading".

Thisexclusionapplieseveniftheclaims againstanyinsuredallegenegligenceorother wrongdoing in the supervision, hiring, employment,trainingormonitoringofothers bythatinsured,ifthe"occurrence"which caused the "bodily injury" or "property damage" involved the ownership,

maintenance,useorentrustmenttoothersof anywatercraftthatisownedoroperatedby orrentedorloanedtoanyinsured.

Thisexclusiondoesnotapplytoawatercraft:

a.Whileashoreonpremisesownedbyor rentedtoanyinsured;or

b.Thatis50-feetlongorlessandthat:

(1)Youown;or

(2)Youdonotownandisnotbeingused tocarryanypersonorpropertyfora charge.

9.ElectronicData

Damagesclaimedforthelossof,lossofuse of,damageto,corruptionof,inabilityto access,orinabilitytomanipulate"electronic data".

10.DamageToProperty,ProductsOrWork "Propertydamage"to:

a.Propertyyou own, rent or occupy, includinganycostsorexpensesincurred by you, or any other person or organization, for repair, replacement, enhancement,restorationormaintenance ofsuchpropertyforanyreason,including preventionofinjurytoapersonor damagetoanother'sproperty;

b.Premisesyousell,giveawayorabandon ifthe"propertydamage"arisesoutofany partofthosepremises;

c.Propertyloanedtoyou;

d.Personalpropertyinthecare,custodyor controloftheinsured;

e.Thatparticularpartofrealpropertyon which you or any contractors or subcontractors working directly or indirectlyonyourbehalfareperforming operations if the "propertydamage" arisesoutofthoseoperations;

f. Thatparticularpartofanypropertythat mustberestored,repairedorreplaced because"yourwork"wasincorrectly performedonit;

g."Yourproduct"arisingoutof"your product"oranypartofit;or

h."Yourwork"arisingoutof"yourwork"or anypartofitandincludedinthe "products-completedoperationshazard".

11.DamageToImpairedPropertyOrProperty NotPhysicallyInjured

"Propertydamage"to"impairedproperty",or propertythathasnotbeenphysicallyinjured, arisingoutof:

a.A defect, deficiency, inadequacy or dangerousconditionin"yourproduct"or "yourwork";or

b.Adelayorfailurebyyou,oranyoneacting onyourbehalf,tofulfillthetermsofa contractoragreement.

Thisexclusiondoesnotapplytothelossof useofotherpropertyarisingoutofsudden and accidental physical injury to "your product"or"yourwork"afterithasbeenputto itsintendeduse.

12.Recall Of Products, Work Or Impaired Property

Damages claimed for any loss, cost or expenseincurredbyyouorothersfortheloss ofuse,withdrawal,recall,inspection,repair, replacement,adjustment,removalordisposal of:

a."Yourproduct";

b."Yourwork";or

c."Impairedproperty"; ifsuchproduct,workorpropertyiswithdrawn orrecalledfromthemarketorfromuseby any person or organization becauseof a known or suspected defect, deficiency, inadequacyordangerousconditioninit.

13.Violation Of Consumer Financial ProtectionLaws

"Bodilyinjury","propertydamage","personal injury"or"advertisinginjury"arisingoutofany actualorallegedviolationofa"consumer financialprotectionlaw",oranyother"bodily injury","propertydamage","personalinjury"or "advertisinginjury"allegedinanyclaimor "suit"thatalsoallegesanysuchviolation.

14.UnsolicitedCommunication

"Bodilyinjury","propertydamage","personal injury"or"advertisinginjury"arisingoutofany actualorallegedviolationofanylawthat restrictsorprohibitsthesending,transmitting ordistributingof"unsolicitedcommunication".

15.Access

OrDisclosureOfConfidentialOr PersonalInformation

"Bodilyinjury","propertydamage","personal injury"or"advertisinginjury"arisingoutofany accesstoordisclosureofanyperson'sor organization's confidential or personal information.

16.KnowingViolationOfRightsOfAnother

"Personalinjury"or"advertisinginjury"caused byoratthedirectionoftheinsuredwiththe knowledgethattheactwouldviolatetherights ofanotherandwouldinflict"personalinjury" or"advertisinginjury".

17.Material Published With Knowledge Of Falsity

"Personalinjury"or"advertisinginjury"arising outoforalorwrittenpublication,including publicationbyelectronicmeans,ofmaterial,if donebyoratthedirectionoftheinsuredwith knowledgeofitsfalsity.

18.MaterialPublishedOrUsedPriorToPolicy Period

a."Personal injury" or "advertising injury" arisingoutoforalorwrittenpublication, includingpublicationbyelectronicmeans, ofmaterialwhosefirstpublicationtook placebeforethebeginningofthepolicy period;or

b."Advertising injury" arising out of infringement of copyright, "title" or "slogan" in your "advertisement" whose firstinfringementinyour"advertisement" wascommittedbeforethebeginningof thepolicyperiod.

19.CriminalActs

"Personalinjury"or"advertisinginjury"arising outofacriminalactcommittedbyoratthe directionoftheinsured.

20.BreachOfContract

"Personalinjury"or"advertisinginjury"arising outofabreachofcontract.

21.QualityOrPerformanceOfGoods–Failure ToConformToStatements

"Advertisinginjury"arisingoutofthefailureof goods,productsorservicestoconformwith anystatementofqualityorperformancemade inyour"advertisement".

22.WrongDescriptionOfPrices

"Advertisinginjury"arisingoutofthewrong descriptionofthepriceofgoods,productsor servicesstatedinyour"advertisement".

23.IntellectualProperty

"Personalinjury"or"advertisinginjury"arising outofanyactualorallegedinfringementor violationofanyofthefollowingrightsorlaws, oranyother"personalinjury"or"advertising injury"allegedinanyclaimor"suit"thatalso allegesanysuchinfringementorviolation:

a.Copyright;

b.Patent;

c.Tradedress;

d.Tradename;

e.Trademark;

f. Tradesecret;or

g.Otherintellectualpropertyrightsorlaws.

Thisexclusiondoesnotapplyto:

a."Advertising injury" arising out of any actualorallegedinfringementorviolation ofanother'scopyright,"title"or"slogan"in your"advertisement";or

b.Anyother"personalinjury"or"advertising injury"allegedinanyclaimor"suit"that also alleges any such infringement or violationofanother'scopyright,"title"or "slogan"inyour"advertisement".

24.Insureds In Media And Internet Type Business

"Personalinjury"or"advertisinginjury"arising outofanoffensecommittedbyaninsured whosebusinessis:

a.Advertising,"broadcasting"orpublishing;

b.Designingordeterminingcontentofwebsitesforothers;or

c.AnInternetsearch,access,contentor serviceprovider.

ThisexclusiondoesnotapplytoParagraphs a.(1),(2)and(3)ofthedefinitionof"personal injury".

Forthepurposesofthisexclusion:

a.Creating and producing correspondence writtenintheconductofyourbusiness, bulletins,financialorannualreports,or newslettersaboutyourgoods,productsor services will not be considered the businessofpublishing;and

b.Theplacingofframes,bordersorlinks,or advertising,foryouorothersanywhereon the Internet will not, by itself, be considered the business of advertising, "broadcasting"orpublishing.

25.ElectronicChatroomsOrBulletinBoards

"Personalinjury"or"advertisinginjury"arising outofanelectronicchatroomorbulletinboard theinsuredhosts,ownsoroverwhichthe insuredexercisescontrol.

26.UnauthorizedUseOfAnother'sNameOr Product

"Personalinjury"or"advertisinginjury"arising outoftheunauthorizeduseofanother'sname orproductinyoure-mailaddress,domain nameormetatag,oranyothersimilartactics tomisleadanother'spotentialcustomers.

C.WithrespecttoCoverageC:

Newly Acquired, Controlled Or Formed Entities

"Crisismanagementserviceexpenses"arisingout ofa"crisismanagementevent"thatinvolvesany organizationyounewlyacquireorformandthat occurredpriortothedateyouacquiredorformed thatorganization,evenifan"executiveofficer" onlyfirstbecomesawareofan"event"or "occurrence" that leads to such "crisis managementevent"afterthedateyouacquiredor formedsuchorganization.

SECTIONV–CONDITIONS

A.APPEALS

1.Iftheinsuredortheinsured's"underlying insurer"electsnottoappealajudgmentwhich exceedsthe"applicableunderlyinglimit"or "self-insuredretention",wemaydoso.

2.Ifweappealsuchajudgment,wewillpayall costsoftheappeal.Thesepaymentswillnot reducetheapplicablelimitsofinsurance.In noeventwillourliabilityexceedtheapplicable limitofinsurance.

B.BANKRUPTCY

1.Bankruptcyorinsolvencyoftheinsuredorof theinsured'sestatewillnotrelieveusofour obligationsunderthisinsurance.

2.Intheeventofbankruptcyorinsolvencyof any"underlyinginsurer",thisinsurancewill not replacesuch bankruptor insolvent "underlying insurer's" policy, and this insurancewillapplyasifsuch"underlying insurer" had not become bankrupt or insolvent.

C.CANCELLATION

1.ThefirstNamedInsuredshowninthe Declarationsmaycancelthisinsuranceby mailingordeliveringtousadvancewritten noticeofcancellation.

2.Wemaycancelthisinsurancebymailingor deliveringtosuchfirstNamedInsuredwritten noticeofcancellationatleast:

a.10daysbeforetheeffectivedateof cancellationifwecancelfornonpayment ofpremium;or

b.60daysbeforetheeffectivedateof cancellationifwecancelforanyother reason.

3.Wewillmailordeliverournoticetosuchfirst NamedInsured'slastmailingaddressknown tous.

4.Noticeofcancellationwillstatetheeffective dateofcancellation.Thepolicyperiodwillend onthatdate.

5.Ifthisinsuranceiscancelled,wewillsend suchfirstNamedInsuredanypremiumrefund due.Ifwecancel,therefundwillbeprorata.If suchfirstNamedInsuredcancels,therefund maybelessthanprorata.Thecancellation willbeeffectiveevenifwehavenotmadeor offeredarefund.

6.Ifnoticeismailed,proofofmailingwillbe sufficientproofofnotice.

D.CHANGES

Thispolicycontainsalltheagreementsbetween youandusconcerningtheinsuranceafforded.No changecanbemadeinthetermsofthis insuranceexceptwithourconsent.Thetermsof thisinsurancecanbeamendedorwaivedonlyby endorsementissuedbyusandmadeapartofthis policy.

E.CURRENCY

Paymentsfordamagesorexpensesdescribedin Paragraph5.ofParagraphD.,DEFENSEAND SUPPLEMENTARYPAYMENTS,ofSECTIONI –COVERAGESwillbeinthecurrencyofthe UnitedStatesofAmerica.Atoursoleoption,we maymakethesepaymentsinadifferentcurrency. Anynecessarycurrencyconversionforsuch paymentswillbecalculatedbasedontherateof exchangepublishedintheWallStreetJournal immediatelypreceedingthedatethepaymentis processed.

F.DUTIES REGARDING AN EVENT, OCCURRENCE,CLAIMORSUIT

1.Youmustseetoitthatwearenotifiedas soon as practicable of an "event" or "occurrence"whichmayresultinaclaim underthisinsurance.Totheextentpossible, noticeshouldinclude:

a.How,whenandwherethe"event"or "occurrence"tookplace;

b.The names and addresses of any personsororganizationssustaininginjury, damageorloss,andthenamesand addressesofanywitnesses;and

c.Thenatureandlocationofanyinjuryor damagearisingoutofthe"event"or "occurrence".

2.Ifaclaimismadeor"suit"isbroughtagainst anyinsuredwhichmayresultinaclaimunder thisinsurance,youmustseetoitthatwe receivewrittennoticeoftheclaimor"suit"as soonaspracticable.

3.WithrespecttoCoverageA,theinsured must:

a.Cooperatewithusintheinvestigation, settlementordefenseofanyclaimor "suit";

b.Complywiththetermsofthe"underlying insurance";and

c.Pursue all rights of contribution or indemnity against any person or organizationwhomaybeliabletothe insuredbecauseoftheinjury,damageor lossforwhichinsuranceisprovidedunder thispolicyoranypolicyof"underlying insurance".

4.WithrespecttoCoverageB,theinsured must:

a.Immediatelysenduscopiesofany demands,notices,summonsesorlegal papersreceivedinconnectionwiththe claimor"suit";

b.Authorizeustoobtainnecessaryrecords andotherinformation;

c.Cooperatewithusintheinvestigation, settlementordefenseofanyclaimor "suit";and

d.Assistus,uponourrequest,inthe enforcementofanyrightagainstany personororganizationwhichmaybe liabletotheinsuredbecauseofinjuryor damagetowhichCoverageBmayapply.

5.Noinsuredwill,exceptatthatinsured'sown expense, voluntarily make a payment, assumeanyobligation,makeanyadmission orincuranyexpense,otherthanforfirstaid for"bodilyinjury"coveredbythisinsurance, withoutourconsent.

6.Knowledgeofan"event","occurrence",claim or"suit"byyouragent,servantor"employee" willnotconstituteknowledgebyyou,unless yourinsuranceorriskmanager,oranyone workinginthecapacityasyourinsuranceor riskmanager,oranyoneyoudesignatewith theresponsibilityofreportingan"event", "occurrence",claimor"suit":

a.Hasreceivednoticeofsuch"event", "occurrence",claimor"suit"fromsuch agent,servantor"employee";or

b.Otherwisehasknowledgeofsuch"event", "occurrence",claimor"suit".

G.DUTIESREGARDINGACRISISMANAGEMENT EVENT

Youmust:

1.Notify us within 30 days ofa "crisis managementevent"thatmayresultin"crisis managementserviceexpenses".

2.Provide written notice of the "crisis managementevent"assoonaspracticable. Totheextentpossible,noticeshouldinclude:

a.How, when and where that "crisis managementevent"tookplace;

b.The names and addresses of any personsororganizationssustaininginjury, damageorloss,andthenamedand addressesofanywitnesses;

c.Thenatureandlocationofanyinjuryor damage arising out of that "crisis managementevent";and

d.Thereasonthat"crisismanagement event"islikelytoinvolvedamages coveredbythisinsuranceinexcessofthe "applicable underlying limit" or"selfinsuredretention"andinvolveregionalor nationalmediacoverage.

H.EXAMINATION OF YOUR BOOKS AND RECORDS

Wemayexamineandaudityourbooksand recordsastheyrelatetothisinsurance:

1.Atanytimeduringthepolicyperiod;

2.Uptothreeyearsaftertheendofthepolicy period;and

3.Withinoneyearafterfinalsettlementofall claimsunderthisinsurance.

I. EXTENDEDREPORTINGPERIODOPTION

1.Whenthe"underlyinginsurance"appliesona claims-madebasis,anyautomaticorbasic "extended reporting period" in such "underlyinginsurance"willapplytothis insurance.

2.Whenthe"underlyinginsurance"appliesona claims-madebasisandyouelecttopurchase an optional or supplemental "extended reporting period" in such "underlying insurance,"that"extendedreportingperiod" willapplytothisinsuranceonlyif:

a.A written request to purchase an ExtendedReportingPeriodendorsement forthisinsuranceismadebyyouand receivedbyuswithin90daysafterthe endofthepolicyperiod;

b.Youhavepaidallpremiumsdueforthis policyatthetimeyoumakesuchrequest;

c.Youpromptlypaytheadditionalpremium wechargefor theExtended Reporting Period endorsement for this insurance when due. We will determine that additional premium after we have receivedyourrequestfortheExtended Reporting Period endorsement for this insurance.Thatadditionalpremiumisnot subjecttoanylimitationstatedinthe "underlyinginsurance"ontheamountor percentage of additional premium that may be charged for the "extended reporting period" in such "underlying insurance";and

d.That Extended Reporting Period endorsementisissuedbyusandmadea partofthispolicy.

3.AnyExtendedReportingPeriodendorsement forthisinsurancewillnotreinstateorincrease theLimitsofInsuranceorextendthepolicy period.

4.Exceptwithrespecttoanyprovisionstothe contrarycontainedinParagraphs1.,2.or3. above, all provisions of any option to purchase an "extended reporting period" grantedtoyouinthe"underlyinginsurance" applytothisinsurance.

J.INSPECTIONSANDSURVEYS

1.Wehavetherightbutarenotobligatedto:

a.Make inspections and surveys at any time;

b.Giveyoureportsontheconditionswe find;and

c.Recommendchanges.

2.Any inspections, surveys, reports or recommendations relate only to insurability andthepremiumstobecharged.Wedonot make safety inspections. We do not undertaketoperformthedutyofanyperson ororganizationtoprovideforthehealthor safetyofworkersorthepublic.Wedonot warrantthatconditions:

a.Aresafeorhealthful;or

b.Complywithlaws,regulations,codesor standards.

K.LEGALACTIONAGAINSTUS

1.Nopersonororganizationhasarightunder thisinsurance:

a.Tojoinusasapartyorotherwisebringus intoa"suit"askingfordamagesfroman insured;or

b.Tosueusonthisinsuranceunlessallof itstermshavebeenfullycompliedwith.

2.Apersonororganizationmaysueusto recoveronanagreedsettlementoronafinal judgmentagainstaninsured.Wewillnotbe liablefordamagesthat:

a.Arenotpayableunderthetermsofthis insurance;or

b.Areinexcessoftheapplicablelimitof insurance.

Anagreedsettlementmeansasettlement andreleaseofliabilitysignedbyus,the insuredandtheclaimantortheclaimant's legalrepresentative.

L.MAINTENANCEOFUNDERLYINGINSURANCE

1.Theinsuranceaffordedbyeachpolicyof "underlyinginsurance"willbemaintainedfor thefullpolicyperiodofthisExcessFollowFormAndUmbrellaLiabilityInsurance.This provisiondoesnotapplytothereductionor exhaustionoftheaggregatelimitorlimitsof such "underlying insurance" solely by paymentsaspermittedinParagraphs4.a.(1), (2)and(3)ofCOVERAGEA–EXCESS FOLLOW-FORMLIABILITYofSECTIONI–COVERAGESAssuchpoliciesexpire,you willrenewthematlimitsandwithcoverageat leastequaltotheexpiringlimitsofinsurance. If you fail to comply with the above requirements,CoverageAisnotinvalidated. However,intheeventofaloss,wewillpay onlytotheextentthatwewouldhavepaidhad youcompliedwiththeaboverequirements.

2.The first Named Insuredshowninthe Declarationsmustgiveuswrittennoticeof anychangeinthe"underlyinginsurance"as respects:

a.Coverage;

b.Limitsofinsurance;

c.Terminationofanycoverage;or

d.Exhaustionofaggregatelimits.

3.Ifyouareunabletorecoverfromany "underlyinginsurer" becauseyou failto complywithanytermorconditionofthe "underlyinginsurance",CoverageAisnot invalidated.However,wewillpayforanyloss onlytotheextentthatwewouldhavepaidhad youcompliedwiththattermorconditionin that"underlyinginsurance".

M.OTHERINSURANCE

Thisinsuranceisexcessoveranyvalidand collectible"otherinsurance"whethersuch"other insurance"isstatedtobeprimary,contributing,

excess,contingentorotherwise.Thisprovision doesnotapplytoapolicyboughtspecificallyto applyasexcessofthisinsurance.

However,ifyouspecificallyagreeinawritten contractoragreementthattheinsuranceprovided toanypersonororganizationthatqualifiesasan insuredunderthisinsurancemustapplyona primarybasis,oraprimaryandnon-contributory basis,theninsuranceprovidedunderCoverageA issubjecttothefollowingprovisions:

1.Thisinsurancewillapplybeforeany"other insurance"thatisavailabletosuchadditional insured which covers that person or organizationasanamedinsured,andwewill notsharewiththat"otherinsurance",provided thattheinjuryordamageforwhichcoverage issoughtiscausedbyan"event"thattakes placeoriscommittedsubsequenttothe signingofthatcontractoragreementbyyou.

2.Thisinsuranceisstillexcessoveranyvalid andcollectible"otherinsurance",whether primary,excess,contingentorotherwise, whichcoversthatpersonororganizationas anadditionalinsuredorasanyotherinsured thatdoesnotqualifyasanamedinsured.

N.PREMIUM

1.ThefirstNamedInsuredshowninthe Declarationsisresponsibleforthepaymentof allpremiumsandwillbethepayeeforany returnpremiums.

2.Ifthepremiumisaflatcharge,itisnotsubject to adjustment except as provided in Paragraph4.below.

3.Ifthepremiumisotherthanaflatcharge,itis anadvancepremiumonly.The earned premiumwillbecomputedattheendofthe policyperiod,orattheendofeachyearofthe policyperiodifthepolicyperiodistwoyears or longer, at the rate shown in the Declarations, subject to the Minimum Premium.

4.Additionalpremiummaybecomepayable whencoverageisprovidedforadditional insuredsundertheprovisionsofSECTIONII –WHOISANINSURED

O.PREMIUMAUDIT

Thepremiumforthispolicyistheamountstated inItem5.oftheDeclarations.Thepremiumisa flat charge unless it is specified in the Declarationsasadjustable.

P.PROHIBITED COVERAGE – UNLICENSED INSURANCE

1.Withrespecttolosssustainedbyanyinsured inacountryorjurisdictioninwhichwearenot licensed to provide this insurance, this insurancedoesnotapplytotheextentthat insuringsuchlosswouldviolatethelawsor regulationsofsuchcountryorjurisdiction.

2.Wedonotassumeresponsibilityfor:

a.Thepaymentofanyfine,fee,penaltyor otherchargethatmaybeimposedonany personororganizationinanycountryor jurisdictionbecausewearenotlicensed toprovideinsuranceinsuchcountryor jurisdiction;or

b.Thefurnishingofcertificatesorother evidenceofinsuranceinanycountryor jurisdictioninwhichwearenotlicensedto provideinsurance.

Q.PROHIBITED COVERAGE – TRADE OR ECONOMICSANCTIONS

Wewillprovidecoverageforanyloss,or otherwisewillprovideanybenefit,onlytothe extentthatprovidingsuchcoverageorbenefit doesnotexposeusoranyofouraffiliatedor parentcompaniesto:

1.Anytradeoreconomicsanctionunderanylaw orregulationoftheUnitedStatesofAmerica; or

2.Any otherapplicabletradeoreconomic sanction,prohibitionorrestriction.

R.REPRESENTATIONS

Byacceptingthisinsurance,youagree:

1.ThestatementsintheDeclarationsandany subsequent notice relatingto"underlying insurance"areaccurateandcomplete;

2.Those statements are based upon representationsyoumadetous;and

3.Wehaveissuedthisinsuranceinrelianceupon yourrepresentations.

S.SEPARATIONOFINSUREDS

ExceptwithrespecttotheLimitsofInsurance, andanyrightsordutiesspecificallyassignedin thispolicytothefirstNamedInsuredshowninthe Declarations,thisinsuranceapplies:

1.AsifeachNamedInsuredweretheonly NamedInsured;and

2.Separatelytoeachinsuredagainstwhom claimismadeor"suit"isbrought.

T.WAIVERORTRANSFEROFRIGHTSOF RECOVERYAGAINSTOTHERSTOUS

1.Iftheinsuredhasrightstorecoverallorpart ofanypaymentwehavemadeunderthis insurance,thoserightsaretransferredtous andtheinsuredmustdonothingafterlossto impairthem.Atourrequest,theinsuredwill bringsuitortransferthoserightstousand helpus,andwithrespecttoCoverageA,the "underlyinginsurer",enforcethem.

Iftheinsuredhasagreedinacontractor agreementtowaivethatinsured'srightof recoveryagainstanypersonororganization, wewaiveourrightofrecoveryagainstthat personororganization,butonlyforpayments wemakebecauseofan"event"thattakes placeoriscommittedsubsequenttothe executionofthatcontractoragreementby suchinsured.

2.Reimbursementofanyamountrecoveredwill bemadeinthefollowingorder:

a.First,toanypersonororganization (includingusortheinsured)whohaspaid anyamountinexcessoftheapplicable limitofinsurance;

b.Next,tous;and

c.Then,toanypersonororganization (includingtheinsuredandwithrespectto CoverageA,the"underlyinginsurer")that isentitledtoclaimtheremainder,ifany.

3.Expensesincurredintheprocessofrecovery will be divided among all persons or organizationsreceivingamountsrecovered accordingtotheratiooftheirrespective recoveries.

U.TRANSFEROFYOURRIGHTSANDDUTIES UNDERTHISINSURANCE

1.Yourrightsanddutiesunderthisinsurance maynotbetransferredwithoutourwritten consentexceptinthecaseofdeathofan individualNamedInsured.

2.Ifyoudie,yourrightsanddutieswillbe transferredtoyourlegalrepresentativebut onlywhileactingwithinthescopeofdutiesas yourlegalrepresentative.Untilyourlegal representativeisappointed,anyonehaving propertemporarycustodyofyourpropertywill haveyourrightsanddutiesbutonlywith respecttothatproperty.

V.UNINTENTIONALOMISSIONORERROR

Theunintentionalomissionof,orunintentional errorin,anyinformationprovidedbyyouwhichwe relieduponinissuingthispolicywillnotprejudice yourrightsunderthisinsurance.However,this

provisiondoesnotaffectourrighttocollect additionalpremiumortoexerciseourrightsof cancellationornonrenewalinaccordancewith applicableinsurancelawsorregulations.

W.WHENLOSSISPAYABLE

Ifweareliableunderthisinsurance,wewillpay forinjury,damageorlossafter:

1.Theinsured'sliabilityisestablishedby:

a.Acourtdecision;or

b.A written agreement between the claimant,theinsured,any"underlying insurer"andus;and

2.Theamountofthe"applicableunderlying limit"or"self-insuredretention"ispaidbyor onbehalfoftheinsured.

SECTIONVI–DEFINITIONS

A.Withrespecttoallcoveragesofthisinsurance:

1."Applicableunderlyinglimit"meansthesumof:

a.Theapplicablelimitofinsurancestated forthepoliciesof"underlyinginsurance" intheScheduleOfUnderlyingInsurance subjecttotheprovisionsinParagraphs 4.a.(1),(2)and(3)ofCOVERAGEA–EXCESSFOLLOW-FORMLIABILITYof SECTIONI–COVERAGES;and

b.Theapplicablelimitofinsuranceofany "otherinsurance"thatapplies.

Thelimitsofinsuranceinanypolicyof "underlyinginsurance"willapplyevenif:

a.The "underlying insurer" claims the insuredfailedtocomplywithanytermor conditionofthepolicy;or

b.The "underlying insurer" becomes bankruptorinsolvent.

2."Autohazard"meansall"bodilyinjury"and "propertydamage"towhichliabilityinsurance affordedunderanautopolicyof"underlying insurance"wouldapplybutfortheexhaustion ofitsapplicablelimitsofinsurance.

3."Electronicdata"meansinformation,factsor programsstoredasoron,createdorusedon, ortransmittedtoorfromcomputersoftware (includingsystemsandapplicationssoftware), hardorfloppydisks,CD-ROMs,tapes,drives, cells,dataprocessingdevicesoranyother mediawhichareusedwithelectronically controlledequipment.

4."Event"meansan "occurrence",offense, accident,act,error,omission,wrongfulactor loss.

5."Extendedreportingperiod"meansanyperiod oftime,startingwiththeendofthepolicy periodofyourclaims-madeinsurance,during whichclaimsor"suits"maybefirstmade, broughtorreportedforthatinsurance.

6."Medical expenses" means expenses to whichanyMedicalPaymentssectionofany policy of Commercial General Liability "underlyinginsurance"applies.

7."Otherinsurance"meansinsurance,orthe fundingoflosses,thatisprovidedby,through oronbehalfof:

a.Anotherinsurancecompany;

b.Us oranyofouraffiliated insurance companies;

c.Anyriskretentiongroup;

d.Anyself-insurancemethodorprogram,in whichcasetheinsuredwillbedeemedto betheproviderofsuchinsurance;or

e.Any similar risk transfer or risk managementmethod.

"Otherinsurance"doesnotinclude:

a.Any"underlyinginsurance";or

b.Any policy of insurance specifically purchasedtobeexcessofthelimitsof insuranceofthispolicyshowninthe Declarations.

8."Products-completedoperationshazard":

a.Includesall"bodilyinjury"and"property damage"occurringawayfrompremises youownorrentandarisingoutof"your product"or"yourwork"except:

(1)Productsthatarestillinyourphysical possession;or

(2)Work that has not yet been completed or abandoned. However, "yourwork"willbedeemedcompleted attheearliestofthefollowingtimes:

(a)Whenalltheworkcalledforin your contract has been completed;

(b)Whenalltheworktobedoneat thejobsitehasbeencompletedif yourcontractcallsforworkat morethanonejobsite;or

(c)Whenthatpartoftheworkdone atajobsitehasbeenputtoits intendedusebyanypersonor organization other than another contractor or subcontractor workingonthesameproject.

Work that may need service, maintenance, correction, repair or replacement,butwhichisotherwise complete, will be treated as completed.

b.Does not include "bodily injury" or "propertydamage"arisingoutof:

(1)Thetransportationofproperty,unless theinjuryordamagearisesoutofa conditioninoronavehiclenotowned oroperatedbyyou,andthatcondition was created by the "loading or unloading" of that vehicle by any insured;

(2)The existence of tools, uninstalled equipmentorabandonedorunused materials;or

(3)Productsoroperationsforwhichthe classification listed in a policy of Commercial General Liability "underlying insurance" states that products-completed operations are subject to the General Aggregate Limit.

9."Suit"meansacivilproceedingwhichalleges damages."Suit"includes:

a.An arbitration proceeding in which damagesareclaimedandtowhichthe insuredmustsubmitordoessubmitwith ourconsent;or

b.Any other alternative dispute resolution proceedingtowhichtheinsuredsubmits withourconsent.

10."Underlyinginsurance":

a.Meansthepolicyorpoliciesofinsurance listed in the Schedule Of Underlying Insurance.

b.Includesanyrenewalorreplacementof such policies if such renewal or replacementisduringthepolicyperiodof this Excess Follow-Form And Umbrella LiabilityInsurance.

c.Doesnotincludeanypartofthepolicy periodofanyofthepoliciesdescribedin Paragraphsa.orb.abovethatbegan before,orthatcontinuesafter,thepolicy periodofthisExcessFollow-FormAnd UmbrellaLiabilityInsurance.

11."Underlyinginsurer"meansanyinsurerwhich providesapolicyofinsurancelistedinthe ScheduleOfUnderlyingInsurance.

B.WithrespecttoCoverageBand,totheextentthat thefollowingtermsarenotdefinedinthe "underlyinginsurance",toCoverageA:

1."Advertisement" means a notice that is broadcastorpublishedtothegeneralpublic orspecificmarketsegmentsaboutyour goods,productsorservicesforthepurposeof attractingcustomersorsupporters.Forthe purposesofthisdefinition:

a.Notices that are published include materialplacedontheInternetoron similar electronic means of communication;and

b.Regardingwebsites,onlythatpartofa websitethat isaboutyourgoods, productsorservicesforthepurposesof attracting customers orsupporters is consideredanadvertisement.

2."Advertisinginjury":

a.Meansinjury,otherthan"personalinjury", causedbyoneormoreofthefollowing offenses:

(1)Oralorwrittenpublication,including publicationbyelectronicmeans,of materialinyour"advertisement"that slanders or libels a person or organizationordisparagesaperson's ororganization'sgoods,productsor services,providedthattheclaimis madeorthe"suit"isbroughtbya personororganizationthatclaimsto havebeenslanderedorlibeled,or thatclaimstohavehaditsgoods, productsorservicesdisparaged;

(2)Oralorwrittenpublication,including publicationbyelectronicmeans,of materialinyour"advertisement"that:

(a)Appropriatesaperson'sname, voice,photographorlikeness;or

(b)Unreasonablyplacesapersonin afalselight;or

(3)Infringementofcopyright,"title"or "slogan" in your "advertisement", providedthattheclaimismadeorthe "suit"isbroughtbyapersonor organizationthatclaimsownershipof suchcopyright,"title"or"slogan".

b.Includes"bodilyinjury"causedbyoneor more of the offenses described in Paragrapha.above.

3."Auto"means:

a.Alandmotorvehicle,trailerorsemitrailer designedfor travelon public roads,

including any attached machinery or equipment;or

b.Anyotherlandvehiclethatissubjecttoa compulsoryorfinancialresponsibilitylaw or other motor vehicle insurance law whereitislicensedorprincipallygaraged.

However, "auto" does notinclude"mobile equipment".

4."Bodilyinjury"means:

a.Physical harm, including sickness or disease,sustainedbyaperson;or

b.Mental anguish, injury or illness, or emotionaldistress,resultingatanytime fromsuch physicalharm, sicknessor disease.

5."Broadcasting"meanstransmittinganyaudio orvisualmaterialforanypurpose:

a.Byradioortelevision;or

b.In,byorwithanyotherelectronicmeans ofcommunication,suchastheInternet,if thatmaterialispartof:

(1)Radio or television programming beingtransmitted;

(2)Other entertainment, educational, instructional, music or news programmingbeingtransmitted;or

(3)Advertisingtransmittedwithanysuch programming.

6."Consumer financial identity information" meansanyofthefollowinginformationfora personthatisusedorcollectedforthe purposeofservingasafactorinestablishing suchperson'seligibilityforpersonalcredit, insuranceoremploymentorforthepurpose ofconductingabusinesstransaction:

a.Partoralloftheaccountnumber,the expirationdateorthebalanceofany credit, debit, bank or other financial account;

b.Informationbearingonaperson'scredit worthiness, credit standing or credit capacity;

c.Socialsecuritynumber;

d.Driver'slicensenumber;or

e.Birthdate.

7."Consumerfinancialprotectionlaw"means:

a.TheFairCreditReportingAct(FCRA)and anyofitsamendments,includingtheFair and Accurate Credit Transactions Act (FACTA);

b.California'sSong-BeverlyCreditCardAct andanyofitsamendments;or

c.Anyotherlaworregulationthatrestricts orprohibitsthecollection,dissemination, transmission, distribution or use of "consumerfinancialidentityinformation".

8."Employee" includes a "leased worker". "Employee"doesnotincludea"temporary worker".

9."Good Samaritan services" means any emergency medical services for which no compensationisdemandedorreceived.

10."Impairedproperty"meanstangibleproperty, otherthan"yourproduct"or"yourwork",that cannotbeusedorislessusefulbecause:

a.It incorporates"your product"or "your work"thatisknownorthoughttobe defective, deficient, inadequate or dangerous;or

b.Youhavefailedtofulfillthetermsofa contractoragreement; ifsuchpropertycanberestoredtousebythe repair,replacement,adjustmentorremovalof "yourproduct"or"yourwork"oryourfulfilling thetermsofthecontractoragreement.

11."Leasedworker"meansapersonleasedto you by a labor leasing firm under an agreementbetweenyouandthelaborleasing firm,toperformdutiesrelatedtotheconduct ofyourbusiness."Leasedworker"doesnot includea"temporaryworker".

12."Loadingorunloading"meansthehandlingof property:

a.Afteritismovedfromtheplacewhereitis acceptedformovementintoorontoan aircraft,watercraftor"auto";

b.Whileitisinoronanaircraft,watercraft or"auto";or

c.Whileitisbeingmovedfromanaircraft, watercraftor"auto"totheplacewhereit isfinallydelivered; but"loadingorunloading"doesnotinclude themovementofpropertybymeansofa mechanicaldevice,otherthanahandtruck, thatisnotattachedtotheaircraft,watercraft or"auto".

13."Mobileequipment"meansanyofthefollowing typesoflandvehicles,includinganyattached machineryorequipment:

a.Bulldozers,farmmachinery,forkliftsand othervehiclesdesignedforuseprincipally offpublicroads.

b.Vehiclesmaintainedforusesolelyonor nexttopremisesyouownorrent.

c.Vehiclesthattraveloncrawlertreads.

d.Vehicles, whether self-propelled or not, maintainedprimarilytoprovidemobilityto permanentlymounted:

(1)Power cranes, shovels, loaders, diggersordrills;or

(2)Road construction or resurfacing equipmentsuchasgraders,scrapers orrollers.

e.VehiclesnotdescribedinParagrapha.,b., c.ord.abovethatarenotself-propelled andaremaintainedprimarilytoprovide mobility to permanently attached equipmentofthefollowingtypes:

(1)Air compressors, pumps and generators, including spraying, welding,buildingcleaning,geophysical exploration,lightingandwellservicing equipment;or

(2)Cherry pickers and similar devices usedtoraiseorlowerworkers.

f. VehiclesnotdescribedinParagrapha.,b., c.ord.abovemaintainedprimarilyfor purposesotherthanthetransportationof personsorcargo.

However,self-propelledvehicleswiththe following types of permanently attached equipmentarenot"mobileequipment"but willbeconsidered"autos":

(1)Equipmentdesignedprimarilyfor:

(a)Snowremoval;

(b)Road maintenance, but not constructionorresurfacing;or

(c)Streetcleaning;

(2)Cherry pickers and similar devices mounted on automobile or truck chassisandusedtoraiseorlower workers;and

(3)Air compressors, pumps and generators, including spraying, welding,buildingcleaning,geophysical exploration,lightingandwellservicing equipment.

However,"mobileequipment"doesnotinclude anylandvehiclethatissubjecttoacompulsory orfinancialresponsibilitylaw,orothermotor vehicleinsurancelaw,whereitislicensedor principallygaraged.Suchlandvehiclesare considered"autos".

14."Occurrence"means:

a.Withrespectto"bodilyinjury"or"property damage":

(1)Anaccident,includingcontinuousor repeatedexposuretosubstantiallythe same general harmful conditions, whichresultsin"bodilyinjury"or "propertydamage".All"bodilyinjury" or"propertydamage"causedbysuch exposuretosubstantiallythesame generalharmfulconditionswillbe deemed to be caused by one "occurrence";or

(2)Anactoromissioncommittedin providingorfailingtoprovidefirstaid or"GoodSamaritanservices"toa personbyanyofyour"employees"or "volunteerworkers"otherthanan employedorvolunteerdoctor,unless youareinthebusinessoroccupation ofprovidingprofessionalhealthcare services;

b.Withrespectto"personalinjury",an offensearisingoutofyourbusinessthat resultsin"personalinjury".All"personal injury"causedbythesameorrelated injuriousmaterial,actoroffensewillbe deemed to be caused by one "occurrence",regardlessofthefrequency orrepetitionthereof,thenumberandkind ofmediausedorthenumberofpersons or organizations making claims or bringing"suits";and

c.Withrespectto"advertisinginjury",an offensecommitted inthe course of advertisingyourgoods,productsand servicesthatresultsin"advertisinginjury".

All"advertisinginjury"causedbythe sameorrelatedinjuriousmaterial,actor offensewillbedeemedtobecausedby one "occurrence", regardless of the frequency or repetition thereof, the numberandkindofmediausedorthe number of persons or organizations makingclaimsorbringing"suits".

15."Officer"meansapersonholdinganyofthe officerpositionscreatedbyyourcharter, constitution,bylawsoranyothersimilar governingdocument.

16."Personalinjury":

a.Meansinjury,otherthan"advertising injury",causedbyoneormoreofthe followingoffenses:

(1)False arrest, detention or imprisonment;

(2)Maliciousprosecution;

(3)Thewrongfulevictionfrom,wrongful entryinto,orinvasionoftherightof privateoccupancyofaroom,dwelling orpremisesthatapersonoccupies, provided that the wrongful eviction, wrongfulentryorinvasionoftheright ofprivateoccupancyiscommittedby oronbehalfoftheowner,landlordor lessor of that room, dwelling or premises;

(4)Oralorwrittenpublication,including publication by electronic means, of material that slanders or libels a personororganizationordisparages a person's or organization's goods, products or services, provided that theclaimismadeorthe"suit"is broughtbyapersonororganization thatclaimstohavebeenslanderedor libeled,orthatclaimstohavehadits goods, products or services disparaged;or

(5)Oralorwrittenpublication,including publication by electronic means, of materialthat:

(a)Appropriates a person's name, voice,photographorlikeness;or

(b)Unreasonablyplacesapersonin afalselight.

b.Includes"bodilyinjury"causedbyoneor more of the offenses described in Paragrapha.above.

17."Pollutants"meananysolid,liquid,gaseousor thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkalis, chemicals and waste. Waste includes materials to be recycled, reconditioned or reclaimed.

18."Propertydamage"means:

a.Physical injury to tangible property, includingallresultinglossofuseofthat property.Allsuchlossofusewillbe deemed tooccur atthe time ofthe physicalinjurythatcausedit;or

b.Lossofuseoftangiblepropertythatisnot physicallyinjured.Allsuchlossofusewill bedeemedtooccuratthetimeofthe "occurrence"thatcausedit.

For the purposes of this insurance, "electronicdata"isnottangibleproperty.

19."Self-insuredretention"isthegreaterof:

a.TheamountshownintheDeclarations whichtheinsuredmustfirstpayunder CoverageBfordamagesbecauseofall

"bodily injury", "property damage", "personal injury" or "advertising injury" arisingoutofanyone"occurrence";or

b.Theapplicablelimitofinsuranceofany "otherinsurance"thatapplies.

20."Slogan":

a.Meansaphrasethatothersuseforthe purposeofattractingattentionintheir advertising.

b.Doesnotincludeaphraseusedas,orin, thenameof:

(1)Anypersonororganizationotherthan you;or

(2)Anybusiness,oranyofthepremises, goods,products,servicesorwork,of anypersonororganizationotherthan you.

21."Temporaryworker"meansapersonwhois furnishedtoyoutosubstituteforapermanent "employee"onleaveortomeetseasonalor short-termworkloadconditions.

22."Title"meansthenameofaliteraryorartistic work.

23."Unsolicited communication" means any communication,inanyform,thattherecipient ofsuchcommunicationdidnotspecifically requesttoreceive.

24."Volunteerworker"meansapersonwhois notyour"employee",andwhodonateshisor herworkandactsatthedirectionofand withinthescopeofdutiesdeterminedbyyou, and isnot paida fee, salary orother compensationbyyouoranyoneelsefortheir workperformedbyyou.

25."Yourproduct":

a.Means:

(1)Anygoodsorproducts,otherthan real property, manufactured, sold, handled,distributedordisposedofby:

(a)You;

(b)Otherstradingunderyourname; or

(c)Apersonororganizationwhose business or assets you have acquired;and

(2)Containers (other than vehicles), materials, parts or equipment furnished in connection with such goodsorproducts.

b.Includes:

(1)Warrantiesorrepresentationsmade atanytimewithrespecttothefitness, quality,durability,performanceoruse of"yourproduct";and

(2)Theprovidingoforfailuretoprovide warningsorinstructions.

c.Doesnotincludevendingmachinesor otherpropertyrentedtoorlocatedforthe useofothersbutnotsold.

26."Yourwork":

a.Means:

(1)Workoroperationsperformedbyyou oronyourbehalf;and

(2)Materials, parts or equipment furnishedinconnectionwithsuch workoroperations.

b.Includes:

(1)Warrantiesorrepresentationsmade atanytimewithrespecttothefitness, quality,durability,performanceoruse of"yourwork";and

(2)Theprovidingoforfailuretoprovide warningsorinstructions.

C.WithrespecttoCoverageC:

1."Crisismanagementadvisor"meansany publicrelationsfirmorcrisismanagement firmapprovedbyusthatishiredbyyouto perform"crisismanagementservices"in connectionwitha"crisismanagementevent".

2."Crisismanagementevent"meansan"event" or"occurrence"thatyour"executiveofficer" reasonablydetermineshasresulted,ormay result,in:

a.DamagescoveredbythisCoverageAor CoverageBthatareinexcessofthetotal applicable limits of the "underlying insurance"or"self-insuredretention";and

b.Significantadverseregionalornational mediacoverage.

3."Crisis management service expenses" meansamountsincurredbyyou,aftera "crisismanagementevent"firstcommences andbeforesucheventends:

a.Forthereasonableandnecessary:

(1)Feesandexpensesofa"crisis management advisor" in the performance for you of "crisis managementservices"solelyfora "crisismanagementevent";and

(2)Costsforprinting,advertising,mailing of materials or travel by your directors, officers, employees or agentsora "crisismanagement advisor" solely for a "crisis managementevent";and

b.Forthefollowingexpensesresultingfrom such"crisismanagementevent",provided thatsuchexpenseshavebeenapproved byus:

(1)Medicalexpenses;

(2)Funeralexpenses;

(3)Psychologicalcounseling;

(4)Travelexpenses;

(5)Temporarylivingexpenses;

(6)Expensestosecurethesceneofa "crisismanagementevent";or

(7)Anyotherexpensespre-approvedby us.

4."Crisismanagementservices"meansthose servicesperformedbya"crisismanagement advisor" in advising you or minimizing potential harm to you from a "crisis management event" by maintaining or restoringpublicconfidenceinyou.

5."Executiveofficer"meansyour:

a.ChiefExecutiveOfficer;

b.ChiefOperatingOfficer;

c.ChiefFinancialOfficer;

d.President;

e.GeneralCounsel;

f. Generalpartner(ifyouareapartnership);or

g.Sole proprietor (if you are a sole proprietorship); oranypersonactinginthesamecapacityas anyindividuallistedabove.

ADDITIONAL INSURED WITHPRIMARY/NONCONTRIBUTORYPROVISION ENDORSEMENT

Itis understood and agreed thatthe Policy is amended as follows:

The Section ofthe Policy entitled COVERAGE, the sub-section entitled DEFENSE & SETTLEMENT is amended by the addition ofthe following:

Additional Insured with Primary/Non-Contributory Provision

I. We also have the right and duty todefenda claim againstany person or organization whom you are required toadd as an additional insured under this Policy under a written contract or written agreement, provided such contract or agreement:

1. is currently in effect or becomes effective during the term of thispolicy;

2. was executed prior tothe bodily injury or property damage for which such additional insured seeks coverage; and

3. expressly requires making the person or organization an additional insured for pollution coverage suchas is provided by thispolicy.

II. The insurance provided tothe additional insured islimited as follows:

1. The person or organization is an additional insured only with respect to liability for bodily injury or property damage:

a. caused entirely by your negligent acts or omissions or those of others working on your behalf; and

b. for which you would be covered under thispolicy,if the claim hadbeen brought against you

2. If defense of such a claim results in the additional insured's legal obligation to pay compensatory damages for bodily injury or property damage described in paragraph 2.a. above, then subject to all ofthe terms and conditions of thispolicy, we will pay such damages in excess ofthe self-insured retention uptothe applicable Limit of Liability.

3. This insurance is excess of all other insurance available tothe additional insured,whether ona primary, excess, contingent or any other basis. But if required by written contract or agreement tobe primary and non-contributory, this insurance will be primary and non-contributory relative to insurance on which the additional insured is a Named Insured.

4. Any coverage granted by this provision shall apply only tothe extent permissible by law.

All other terms and conditions ofthe Policy remain unchanged.

This endorsement, which forms a part ofand is for attachment tothe policy issued by the designated Insurers, takes effect onthe Policy Effective dateof said policy atthe hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shownbelow, and expires concurrently with said policy.

ADDITIONAL INSURED WITHPRIMARY/NONCONTRIBUTORYPROVISION ENDORSEMENT

Itis understood and agreed thatthe Policy is amended as follows:

The Section ofthe Policy entitled COVERAGE, the sub-section entitled DEFENSE & SETTLEMENT is amended by the addition ofthe following:

Additional Insured with Primary/Non-Contributory Provision

I. We also have the right and duty todefenda claim againstany person or organization whom you are required toadd as an additional insured under this Policy under a written contract or written agreement, provided such contract or agreement:

1. is currently in effect or becomes effective during the term of thispolicy;

2. was executed prior tothe bodily injury or property damage for which such additional insured seeks coverage; and

3. expressly requires making the person or organization an additional insured for pollution coverage suchas is provided by thispolicy.

II. The insurance provided tothe additional insured islimited as follows:

1. The person or organization is an additional insured only with respect to liability for bodily injury or property damage:

a. caused entirely by your negligent acts or omissions or those of others working on your behalf; and

b. for which you would be covered under thispolicy,if the claim hadbeen brought against you

2. If defense of such a claim results in the additional insured's legal obligation to pay compensatory damages for bodily injury or property damage described in paragraph 2.a. above, then subject to all ofthe terms and conditions of thispolicy, we will pay such damages in excess ofthe self-insured retention uptothe applicable Limit of Liability.

3. This insurance is excess of all other insurance available tothe additional insured,whether ona primary, excess, contingent or any other basis. But if required by written contract or agreement tobe primary and non-contributory, this insurance will be primary and non-contributory relative to insurance on which the additional insured is a Named Insured.

4. Any coverage granted by this provision shall apply only tothe extent permissible by law.

All other terms and conditions ofthe Policy remain unchanged.

This endorsement, which forms a part ofand is for attachment tothe policy issued by the designated Insurers, takes effect onthe Policy Effective dateof said policy atthe hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shownbelow, and expires concurrently with said policy.

SUBROGATION AMENDMENT ENDORSEMENT

Itis understood and agreed thatthe Section ofthe Policy entitled CONDITIONS, the Condition entitled Subrogation, is deleted inits entirety and replaced by the following:

Subrogation

If any of you have rights to recover amounts from another, those rights are transferred to us tothe extent of our payment. You must do everything necessary to secure these rights and must do nothing after a claim is made to jeopardize them. We hereby waive subrogation rights againstany person or organization with whom the Named Insured has made a written agreement, prior toa claim or circumstance, to waive such rights, tothe extent provided in such agreement.

All other terms and conditions ofthe Policy remain unchanged.

This endorsement, which forms a part ofand is for attachment tothe Policy issued by the designated Insurers, takes effect onthe effective dateof said Policy atthe hour stated in said Policy, unless another effective date is shownbelow, and expires concurrently with said Policy.

AS-14423

Meeting Date: 10/21/2025

AGREEMENT - Supplemental Agreement 1 - Local Agency Real Estate Professional Services Consultant Agreement - Real Property Appraisal Review Services - Appraisal & Consulting Group

Submitted For: Susan Eugenis, Public Works

Department: Public Works

Subject and Summary Statement

Submitted By: Lynn Ruffe, Public Works

Information

Attached is Amendment No. 1 to the Personal Services Agreement established September 19, 2023 on Agenda AS-13045 between Cowlitz County and Appraisal and Consulting Group. The original agreement established appraisal services for various Public Works projects and will expire on December 31, 2025. These services are used to augment staff and meet the training and experience requirements of Washington State Department of Transportation (WSDOT). Amendment No. 1 is issued for the purpose of extending the original agreement to December 31, 2026.

Will Staff Attend - NAME OF STAFF or No Yes

Department Recommendation

It is the recommendation of the Department of Public Works that the Board move to approve Amendment No. 1 to the Personal Services Agreement with Appraisal and Consulting Group, extending the original contract through December 31, 2026.

Attachments

Supplemental Agreement No. 1  Original Local Agency Agreement

Form Review

Inbox Reviewed By Date

Susan Eugenis Susan Eugenis

Form Started By: Lynn Ruffe

10/14/2025 03:07 PM

Started On: 10/14/2025 02:36 PM

SupplementalAgreement Number

1

OriginalAgreementNumber

AS-13045

Appraisal&ConsultingGroup,LLC 13306NWCornellRd#201 Portland,OR97229

503-740-8729

OrganizationandAddress Phone:

As-Needed 09/19/2023 12/31/2025

As-Needed

DescriptionofWork

50,000

ProvideappraisalandreviewappraisalservicesforCountyprojectsonanas-neededbasis.Typicalprojects mayincludebutarenotlimitedtoroadwayprojects,waterprojects,sewerprojects,andparkprojects.

TheLocalAgencyof

CowlitzCountyPublicWorks

Appraisal&ConsultingGroup,LLC

09/19/2023 AS-13045

desirestosupplementtheagreemententeredintowith andexecutedon andidentiedasAgreementNo. Allprovisionsinthebasicagreementremainine��ectexceptasexpresslymodiedbythissupplement. Thechangestotheagreementaredescribedasfollows: I

Section1,SCOPEOFWORK,isherebychangedtoread:

ScopeofWorkshallcontinuetobeestablisheduponrequestofCowlitzCountyPublicWorks.

II

SectionIV,TIMEFORBEGINNINGANDCOMPLETION,isamendedtochangethenumberofcalendardays forcompletionoftheworktoread:

extendingtheexpirationdateofcontractfrom12/31/2025to12/31/2026.

III

SectionV,PAYMENT,shallbeamendedasfollows: assetforthintheattachedExhibitA,andbythisreferencemadeapartofthissupplement. Ifyouconcurwiththissupplementandagreetothechangesasstatedabove,pleasesignintheAppropriate spacesbelowandreturntothisocefornalaction.

Overallcontractislimitedto$50,000.00.Separatetaskordersshallbenegotiatedforprojectswhenservices areneeded.

BOCC Agenda

Meeting Date: 10/21/2025

Amendment No. 1 to Agreement No. 2023-0033-01 with JLS Newco, LLC

Submitted For: Shawn Roewe

Department: Public Works

Subject and Summary Statement

Submitted By: Ashley Claussen

Information

On March 26, 2024, the Board of County Commissioners executed a Material Sales Agreement with JL Storedahl & Sons for removal of dredged materials. Since that time, the company has undergone a name change and now operates as JLS Newco, LLC.

This Amendment No. 1 extends the contract end date to December 31, 2026 and increases the minimum quantity of material to be removed from the site to 175,000 cubic yards.

Will Staff Attend - NAME OF STAFF

Yes - Shawn Roewe

Department Recommendation

The Department of Public Works recommends that the Cowlitz County Board of Commissioners move to approve and authorize Amendment No. 1 to the Material Sales Agreement with JLS Newco, LLC.

Attachments

Amendment No. 1  Agreement

Form Started By: Ashley Claussen

Form Review

Started On: 10/14/2025 05:58 PM

BOCC Agenda

Meeting Date: 10/21/2025

Amendment One to Interlocal Grant Agreement City of Longview

Submitted For: Kathy Funk-Baxter

Submitted By: Kathy Funk-Baxter Department: Office of Financial Management

Information

Subject and Summary Statement

Amendment One to the Interlocal Grant Agreement with the City of Longview to extend the end date of the agreement to June 30, 2026.

Will Staff Attend - NAME OF STAFF

Kathy Funk-Baxter, Finance Director

Department Recommendation

The Office of Financial Management recommends the Commissioners approve the amendment to the interlocal Grant agreement with the City of Longivew.  The amendment does not increase the total award of $450,000 for the Minit Valley Pro Golf Shop but extends the end date of the agreement to June 30, 2026.  There have been delays in starting construction on this project.

Attachments

Original interlocal grant agreement  city of longview application  Amendment one interlocal grant agreement

Form Review

Form Started By: Kathy Funk-Baxter

Started On: 10/13/2025 01:49 PM

c) Is the project ready to proceed? If the project is not ready to proceed, describe what must be completed before the project is ready and estimate a start date.

The project is not ready to proceed currently as there are steps in the city procurement process that need to be followed. The city would have to go through public bidding and get the cost approved through Longview City Council. Having a grant awarded to the city would make this an easier process. After council approval, permits would need to be issued. The siding permit can be issued the same day as application. Permitting for the roof would need plan review for the roofing structure on the exterior of the pro shop. That review process would take up to five weeks. An estimated start date for the project would be September 15, 2025.

d) If applicable, list all permits and environmental reviews required and give their current status (applied for, permit issued, etc.)

No environmental reviews would be required for this permit. Building plan review would be required for the roofing on the exterior of the Pro Shop.

e) Estimate the date for project completion.

Depending on contractor availability, the estimated time to complete the project would be two to three months. The project would be completed December of 2025.

f) Does this proposed project duplicate existing capacity in the community-either public or private?

There are three other public golf courses in Cowlitz County that provide similar services to Mint Valley. Longview Country Club offers a course that requires private membership. The city is committed to leveraging Mint Valley as a key draw for recreation and tourism. The city is making significant upgrades to the irrigation system, has replaced aging golf carts, and recently completed a renovation and remodel of the tennis and racquetball club next to thecourse. Using this funding for the Pro Shop would ensure that the Pro Shop remains a cornerstone of the Mint Valley Recreation Complex. While other courses exist within Cowlitz County, we maintain that the Mint Valley Golf Course, Pro Shop, and Racquet Club provide an enjoyable experience to golfers and individuals that visit the area. By continuing our committed investment and working with other agencies such as Cowlitz County, we can continue to the evolution and sustainability of the Mint Valley recreational complex.

SECTION 6: PROJECT GOALS

Describe how your public facility project meets the goals identified in R.C.W. 82.14.370, as amended, namely financing of public facilitiesservingeconomic develop purposes in rural counties. “Economic development purposes” is defined in the statute as “those purposes that facilitate the creation or retention of businesses and jobs in a county.” Check and discuss any or all that apply, specifically:

8

Promote the ongoing operation of business in rural distressed areas; Promote the expansion of existing business in rural distressed areas; | |Attract new businesses to rural distressed areas;

B Assist in the development of new businesses from within rural distressed areas; Provide family wage jobs to the citizens of rural distressed areas.

Specifically identify the number and type of family wage jobs that will be created or retained as a result of your project:

Construction

Permanent full tune

Permanent part-time

Seasonal

No. of jobs: No. of jobs: No. ofjobs: 10

No. ofjobs: 25

Promote the development of communities of excellence in rural distressed areas;

SECTION 8: PROJECT TIME LINE

Preliminary Engineering Report

Environmental Review(s)

All Required Permits Obtained

Land/Right-of-Way Acquisition

Prepare Bid Documents

Award Construction Contract(s)

Begin Construction-Shovel ready

Project Operational

DUE NOT LATER THAN: March 17, 2025 @ 4:30 p.m.

Estimated Completion Date (month - year)

N/A

N/A

September 15, 2025

N/A

June 15, , 2025

August 11,2025

September 15,2025

December 1, 2025

SUBMIT AN ELECTRONIC ORIGINAL AND FIVE (5) PAPER COPIES TO:

Cowlitz County, Office of Administrative Services funkbaxterk@cowlitzwa.gov

Attn: Kathy Funk-Baxter 207 Fourth Avenue North #308

Kelso, WA 98626

Telephone: (360) 577-3065, ext. #6984

Meeting Date: 10/21/2025

RESOLUTION: CERTIFYING THE 2026 BUDGET - Silver Lake Flood Control District

Submitted For: Patrick Harbison, Public Works

Submitted By: Emilie Cochrane, Public Works

Department: Public Works

Subject and Summary Statement

Information

The attached Resolution is the final step in the budget process for Silver Lake Flood Control District.  The 2026 Budget Resolution has been approved and executed by the Board of Supervisors under their Resolution No. 2025-01 and is presented to the Board of County Commissioners for certification.

Will Staff Attend - NAME OF STAFF or No

Yes

Department Recommendation

It is the recommendation of the Department of Public Works that the Board move to certify the 2026 budget for Silver Lake Flood Control District and execute the Resolution.

Attachments

2026 Final Budget

Inbox

Emilie Cochrane

Susan Eugenis

Mike Moss, Public Works

Form Started By: Emilie Cochrane

Form Review

Reviewed By

Emilie Cochrane

Date

10/15/2025 09:40 AM

Started On: 10/13/2025 05:07 PM

Meeting Date: 10/21/2025

RESOLUTION: CERTIFYING THE 2025 BUDGET - Lexington Flood Control Zone District

Submitted For: Patrick Harbison, Public Works

Submitted By: Emilie Cochrane, Public Works

Department: Public Works

Subject and Summary Statement

Information

The attached Resolution is the final step in the budget process for Lexington Flood Control District.

The 2026 Budget Resolution has been approved and executed by the Board of Supervisors under their Resolution No. 25-01 and is presented to the Board of County Commissioners for certification.

Will Staff Attend - NAME OF STAFF or No

Yes

Department Recommendation

It is the recommendation of the Department of Public Works that the Board move to certify the 2026 budget for Lexington Flood Control Zone District and execute the Resolution.

Attachments

2026 Final Budget

Form Review

Inbox Reviewed By Date

Susan Eugenis

Mike Moss, Public Works

Form Started By: Emilie Cochrane

Started On: 10/14/2025 09:29 AM

Meeting Date: 10/21/2025

Resolution Certifying the 2026 Consolidated Diking Improvement District No. 1

Submitted For: Kelly Grayson, Clerk of the Board

Submitted By: Kelly Grayson, Clerk of the Board

Department: Commissioners Office

Subject and Summary Statement

Information

Resolution Certifying the 2026 Consolidated Diking Improvement District No. 1

Will Staff Attend - NAME OF STAFF

Department Recommendation

Resolution

Form Started By: Kelly Grayson

Final Approval Date: 10/15/2025

Attachments

Form Review

Started On: 10/15/2025 11:56 AM

BOCC Agenda

Meeting Date: 10/21/2025

Letter to Col. Kathryn Sanborn, U.S. Army Corps of Engineers regarding Mount St. Helen's Sedimentation Issues

Submitted For: Kelly Grayson, Clerk of the Board

Submitted By: Kelly Grayson, Clerk of the Board Department: Commissioners Office

Information

Subject and Summary Statement

Letter dated 10/12/2025 to Col. Kathryn P. Sanborn, Commander, Seattle District, U.S. Army Corps of Engineers regarding the Accelarating Sedimentation Issues in the Toutle, Cowlitz, and Columbia River systems.

Will Staff Attend - NAME OF STAFF

Department Recommendation

Letter

Form Started By: Kelly Grayson

Final Approval Date: 10/08/2025

Attachments

Form Review

Started On: 10/08/2025 03:02 PM

BOCC Agenda

Meeting Date: 10/21/2025

Letter dated 10/21/25 to Raymond Van Tongeren reappointing him to the Great Rivers Behavioral Health Advisory Board

Submitted For: Kelly Grayson, Clerk of the Board

Submitted By: Kelly Grayson, Clerk of the Board Department: Commissioners Office

Information

Subject and Summary Statement

Letter dated 10/21/2025 to Raymond Van Tongeren reappointing him to the Great Rivers Behavioral Health Advisory Board. This is a 3-year term that expires September 30, 2028.

Will Staff Attend - NAME OF STAFF

Department Recommendation

Letter

Form Started By: Kelly Grayson

Attachments

Form Review

Started On: 10/08/2025 03:05 PM Final Approval Date: 10/08/2025

Board of Cowlitz County Commissioners

October 21, 2025

Raymond Van Tongeren

Dear Mr. Van Tongeren ,

Richard R. Dahl, Chairman District 3

Steve Rader, Commissioner District 1

Steven L. Ferrell, Commissioner District 2

Kelly Grayson, Clerk of the Board

The Cowlitz County Board of Commissioners is pleased to reappoint you to the Great Rivers Behavioral Health Advisory Board for a 3-year term, expiring on September 30, 2028.

We sincerely appreciate your willingness to serve in this important role and are delighted by your commitment. Please also the Completion Certificate for the Open Public Meetings Act (OPMA) and Public Records Act (PRA) Training, either by mail or via email at cowlitz@cowlitzwa.gov. As a reminder, as part of your new role, any records created or maintained in relation to your government duties, including through personal email or phone, are subject to the Public Records Act. Should you have any questions regarding this, feel free to contact our Public Records Department at 360-577-3020.

Sincerely,

Board of County Commissioners of Cowlitz County, Washington

Richard R. Dahl, Chairman

Steve Rader, Commissioner

Steven L. Ferrell, Commissioner

cc: Commissioner’s Record

Cowlitz County Board of Commissioners (360)577-3020 Fax (360) 423-9987

207 North 4th Avenue

cowlitz@cowlitzwa.gov

Kelso, WA 98626

www.co.cowlitz.wa.us

BOCC Agenda

Meeting Date: 10/21/2025

Letter dated 10/21/25 to Marin Fox reappointing her to the Great Rivers Behavioral Health Advisory Board

Submitted For: Kelly Grayson, Clerk of the Board

Submitted By: Kelly Grayson, Clerk of the Board

Department: Commissioners Office

Subject and Summary Statement

Information

Letter dated 10/21/2025 to Marin Fox reappointing her to the Great Rivers Behavioral Health Advisory Board. This is a 3-year term that expires September 30, 2028.

Will Staff Attend - NAME OF STAFF

Department Recommendation

Letter

Form Started By: Kelly Grayson

Final Approval Date: 10/08/2025

Attachments

Form Review

Started On: 10/08/2025 03:10 PM

Board of Cowlitz County Commissioners

October 21, 2025

Marin Fox

Dear Ms. Fox ,

Richard R. Dahl, Chairman District 3

Steve Rader, Commissioner District 1

Steven L. Ferrell, Commissioner District 2

Kelly Grayson, Clerk of the Board

The Cowlitz County Board of Commissioners is pleased to reappoint you to the Great Rivers Behavioral Health Advisory Board for a 3-year term, expiring on September 30, 2028.

We sincerely appreciate your willingness to serve in this important role and are delighted by your commitment. Please also the Completion Certificate for the Open Public Meetings Act (OPMA) and Public Records Act (PRA) Training, either by mail or via email at cowlitz@cowlitzwa.gov. As a reminder, as part of your new role, any records created or maintained in relation to your government duties, including through personal email or phone, are subject to the Public Records Act. Should you have any questions regarding this, feel free to contact our Public Records Department at 360-577-3020.

Sincerely,

Board of County Commissioners of Cowlitz County, Washington

Richard R. Dahl, Chairman

Steve Rader, Commissioner

Steven L. Ferrell, Commissioner

cc: Commissioner’s Record

Cowlitz County Board of Commissioners (360)577-3020 Fax (360) 423-9987

207 North 4th Avenue

cowlitz@cowlitzwa.gov

Kelso, WA 98626

www.co.cowlitz.wa.us

BOCC Agenda

Meeting Date: 10/21/2025

Letter dated 10/21/25 to Gena James reappointing her to the Great Rivers Behavioral Health Advisory Board

Submitted For: Kelly Grayson, Clerk of the Board

Submitted By: Kelly Grayson, Clerk of the Board Department: Commissioners Office

Information

Subject and Summary Statement

Letter dated 10/21/2025 to Gena James reappointing her to the Great Rivers Behavioral Health Advisory Board. This is a 3-year term that expires September 30, 2028.

Will Staff Attend - NAME OF STAFF

Department Recommendation

Form Review

Form Started By: Kelly Grayson

Started On: 10/08/2025 03:12 PM Final Approval Date: 10/08/2025

Board of Cowlitz County Commissioners

October 21, 2025

Gena James

Dear Ms. James ,

Richard R. Dahl, Chairman District 3

Steve Rader, Commissioner District 1

Steven L. Ferrell, Commissioner District 2

Kelly Grayson, Clerk of the Board

The Cowlitz County Board of Commissioners is pleased to reappoint you to the Great Rivers Behavioral Health Advisory Board for a 3-year term, expiring on September 30, 2028.

We sincerely appreciate your willingness to serve in this important role and are delighted by your commitment. Please also the Completion Certificate for the Open Public Meetings Act (OPMA) and Public Records Act (PRA) Training, either by mail or via email at cowlitz@cowlitzwa.gov. As a reminder, as part of your new role, any records created or maintained in relation to your government duties, including through personal email or phone, are subject to the Public Records Act. Should you have any questions regarding this, feel free to contact our Public Records Department at 360-577-3020.

Sincerely,

Board of County Commissioners of Cowlitz County, Washington

Richard R. Dahl, Chairman

Steve Rader, Commissioner

Steven L. Ferrell, Commissioner

cc: Commissioner’s Record

Cowlitz County Board of Commissioners (360)577-3020 Fax (360) 423-9987

207 North 4th Avenue

cowlitz@cowlitzwa.gov

Kelso, WA 98626

www.co.cowlitz.wa.us

BOCC Agenda

Meeting Date: 10/21/2025

Letter dated 10/21/25 Beth Follows reappointing her to the Great Rivers Behavioral Health Advisory Board

Submitted For: Kelly Grayson, Clerk of the Board

Submitted By: Kelly Grayson, Clerk of the Board

Department: Commissioners Office

Subject and Summary Statement

Information

Letter dated 10/21/2025 to Beth Follows reappointing her to the Great Rivers Behavioral Health Advisory Board. This is a 3-year term that expires September 30, 2028.

Will Staff Attend - NAME OF STAFF

Department Recommendation

Letter

Form Started By: Kelly Grayson

Final Approval Date: 10/08/2025

Attachments

Form Review

Started On: 10/08/2025 03:13 PM

Board of Cowlitz County Commissioners

October 21, 2025

Beth Follows

Dear Ms. Follows ,

Richard R. Dahl, Chairman District 3

Steve Rader, Commissioner District 1

Steven L. Ferrell, Commissioner District 2

Kelly Grayson, Clerk of the Board

The Cowlitz County Board of Commissioners is pleased to reappoint you to the Great Rivers Behavioral Health Advisory Board for a 3-year term, expiring on September 30, 2028.

We sincerely appreciate your willingness to serve in this important role and are delighted by your commitment. Please also the Completion Certificate for the Open Public Meetings Act (OPMA) and Public Records Act (PRA) Training, either by mail or via email at cowlitz@cowlitzwa.gov. As a reminder, as part of your new role, any records created or maintained in relation to your government duties, including through personal email or phone, are subject to the Public Records Act. Should you have any questions regarding this, feel free to contact our Public Records Department at 360-577-3020.

Sincerely,

Board of County Commissioners of Cowlitz County, Washington

Richard R. Dahl, Chairman

Steve Rader, Commissioner

Steven L. Ferrell, Commissioner

cc: Commissioner’s Record

Cowlitz County Board of Commissioners (360)577-3020 Fax (360) 423-9987

207 North 4th Avenue

cowlitz@cowlitzwa.gov

Kelso, WA 98626

www.co.cowlitz.wa.us

BOCC Agenda

Meeting Date: 10/21/2025

Letter dated 10/21/25 to Carol Searing reappointing to Fair Board.

Submitted For: Kelly Grayson, Clerk of the Board

Submitted By: Kelly Grayson, Clerk of the Board

Department: Commissioners Office

Subject and Summary Statement

Information

Letter dated 10/21/2025 to Carol Searing reappointing her to the Fair Board. This is a 4-year term that expires October 31, 2029.

Will Staff Attend - NAME OF STAFF

Department Recommendation

Letter

Form Started By: Kelly Grayson

Final Approval Date: 10/13/2025

Attachments

Form Review

Started On: 10/13/2025 11:49 AM

Board of Cowlitz County Commissioners

October 21, 2025

Carol Searing

Dear Ms. Searing ,

Richard R. Dahl, Chairman District 3

Steve Rader, Commissioner District 1

Steven L. Ferrell, Commissioner District 2

Kelly Grayson, Clerk of the Board

The Cowlitz County Board of Commissioners is pleased to reappoint you to the Fair Board for a 4-year term, expiring on October 31, 2029.

We sincerely appreciate your willingness to serve in this important role and are delighted by your commitment. Please also the Completion Certificate for the Open Public Meetings Act (OPMA) and Public Records Act (PRA) Training, either by mail or via email at cowlitz@cowlitzwa.gov. As a reminder, as part of your new role, any records created or maintained in relation to your government duties, including through personal email or phone, are subject to the Public Records Act. Should you have any questions regarding this, feel free to contact our Public Records Department at 360-577-3020.

Sincerely,

Board of County Commissioners of Cowlitz County, Washington

Richard R. Dahl, Chairman

Steve Rader, Commissioner

Steven L. Ferrell, Commissioner

cc: Commissioner’s Record Event Center

Cowlitz County Board of Commissioners (360)577-3020 Fax (360) 423-9987

207 North 4th Avenue

cowlitz@cowlitzwa.gov

Kelso, WA 98626

www.co.cowlitz.wa.us

BOCC Agenda

Meeting Date: 10/21/2025

Letter dated 10/21/25 to Mary Grochow reappointment to the Fair Board.

Submitted For: Kelly Grayson, Clerk of the Board

Submitted By: Kelly Grayson, Clerk of the Board

Department: Commissioners Office

Subject and Summary Statement

Information

Letter dated 10/21/2025 to Mary Grochow reappointing her to the Fair Board. This is a 4-year term that expires October 31, 2029.

Will Staff Attend - NAME OF STAFF

Department Recommendation

Letter

Form Started By: Kelly Grayson

Final Approval Date: 10/13/2025

Attachments

Form Review

Started On: 10/13/2025 11:53 AM

Board of Cowlitz County Commissioners

October 21, 2025

Mary Grochow

Dear Ms. Grochow ,

Richard R. Dahl, Chairman District 3

Steve Rader, Commissioner District 1

Steven L. Ferrell, Commissioner District 2

Kelly Grayson, Clerk of the Board

The Cowlitz County Board of Commissioners is pleased to reappoint you to the Fair Board for a 4-year term, expiring on October 31, 2029.

We sincerely appreciate your willingness to serve in this important role and are delighted by your commitment. Please also the Completion Certificate for the Open Public Meetings Act (OPMA) and Public Records Act (PRA) Training, either by mail or via email at cowlitz@cowlitzwa.gov. As a reminder, as part of your new role, any records created or maintained in relation to your government duties, including through personal email or phone, are subject to the Public Records Act. Should you have any questions regarding this, feel free to contact our Public Records Department at 360-577-3020.

Sincerely,

Board of County Commissioners of Cowlitz County, Washington

Richard R. Dahl, Chairman

Steve Rader, Commissioner

Steven L. Ferrell, Commissioner

cc: Commissioner’s Record Event Center

Cowlitz County Board of Commissioners (360)577-3020 Fax (360) 423-9987

207 North 4th Avenue

cowlitz@cowlitzwa.gov

Kelso, WA 98626

www.co.cowlitz.wa.us

BOCC Agenda

Meeting Date: 10/21/2025

Letter dated 10/9/25 from Patrick Harbison Diking Engineer from the Silver Lake Flood Control District re Silver Lake Regulating Structure Inspection Report

Submitted For: Kelly Grayson, Clerk of the Board

Submitted By: Kelly Grayson, Clerk of the Board Department: Commissioners Office

Information

Subject and Summary Statement

Letter dated 10/9/2025 from Patrick Harbison, Diking Engineer, Silver Lake Flood Control District of Cowlitz County regarding the Silver Lake Regulating Structure Inspection Report.

Will Staff Attend - NAME OF STAFF

Department Recommendation

Letter

Form Started By: Kelly Grayson

Final Approval Date: 10/15/2025

Attachments

Form Review

Started On: 10/15/2025 11:58 AM

BOCC Agenda

Meeting Date: 10/21/2025

FERC Notice 9/26/25 RE 2025 Site-Specific Seismic Hazard Analysis Update, Yale Project

Submitted For: Kelly Grayson, Clerk of the Board

Submitted By: Kelly Grayson, Clerk of the Board

Department: Commissioners Office

Subject and Summary Statement

Information

Federal Energy Regulatory Commission (FERC) Notice dated 9/26/25 regarding the 2025 Site-Specific Seismic Hazard Analysis Update, Yale Project.

Will Staff Attend - NAME OF STAFF

Department Recommendation

Notice

Form Started By: Kelly Grayson

Final Approval Date: 10/15/2025

Attachments

Form Review

Started On: 10/15/2025 04:03 PM

BOCC Agenda

Meeting Date: 10/21/2025

POSSESSION AND USE AGREEMENT and RIGHT OF ENTRY - Sweet Birch Drive Emergency Storm Sewer Repair - Ryan and Shantina Ellis

Submitted For: Susan Eugenis, Public Works

Department: Public Works

Subject and Summary Statement

Submitted By: Emilie Cochrane, Public Works

Information

Upon staking the easement between 141 and 132 Sweet Birch Drive and locating the associated storm drainpipe, it was found that the pipe was not centered within the easement and the adjacent home was built close to the easement.  To minimize risk to the home, it was decided that the pipe would be relocated.  In order to complete the work, A Possession and Use Agreement and Right of Entry were obtained from the homeowner of 141 Sweet Birch Road. The Possession and Use Agreement and the Right of Entry will be terminated upon establishment of the new easement.

Will Staff Attend - NAME OF STAFF or No

Yes

Department Recommendation

It is the recommendation of the Department of Public Works that the Board acknowledge the Possession and Use Agreement, recorded on October 6, 2025, under AFN 3777675 for the Commissioner's official record.

Attachments

Possession and Use Agreement

Right of Entry

Vicinity Map

Inbox

Susan Eugenis

Mike Moss, Public Works

Form Started By: Emilie Cochrane

Form Review

Reviewed By Date

Susan Eugenis 10/14/2025 01:04 PM

Mike Moss 10/14/2025 03:09 PM

Started On: 10/14/2025 12:17 PM

BOCC Agenda

Meeting Date: 10/21/2025

EASEMENT - Perpetual Road and Utility Easement - Ryderwood Suplemental Water Source - Project No. 2948 - RH Emerson & Sons

Submitted For: Susan Eugenis, Public Works

Department: Public Works

Subject and Summary Statement

Submitted By: Emilie Cochrane, Public Works

Information

Cowlitz County Department of Public Works established Project 2948 - Ryderwood Supplemental Water Source to address drought resiliency for the 500 residents of Ryderwood, WA. Concerns of water scarcity were raised after Campbell Creek suffered a dry spell in 2018. Negotiations were held with R.H. Emmerson & Sons, a subsidiary to Sierra Pacific, to purchase an easement on parcels WN1001001 and WN1002002 where water lines will connect the existing water treatment plant to the new water reservoir.

Will Staff Attend - NAME OF STAFF or No

Yes

Department Recommendation

It is the recommendation of the Department of Public Works that the Board acknowledge the recorded Perpetual Road and Utiltity Easement from R.H. Emmerson to Cowlitz County for the Commissioners record.

Attachments

Perpetual Road and Utility Easement

Vicinity Map

Form Review

Inbox Reviewed By Date

Susan Eugenis

Form Started By: Emilie Cochrane

Susan Eugenis

10/14/2025 04:20 PM

Started On: 10/14/2025 02:43 PM

WN1003001
WN1101001
WN0301001
WN0901001
WN1002004

BOCC Agenda

Meeting Date: 10/21/2025

DEED - Warranty Deed - Ryderwood Supplemental Water Source - Project No. 2948 - R.H. Emmerson & Sons

Submitted For: Susan Eugenis, Public Works

Department: Public Works

Subject and Summary Statement

Submitted By: Emilie Cochrane, Public Works

Information

Cowlitz County Department of Public Works established Project 2948 - Ryderwood Supplemental Water Source to address drought resiliency for the 500 residents of Ryderwood, WA. Concerns of water scarcity were raised after Campbell Creek suffered a dry spell in 2018. Negotiations were held with R.H. Emmerson & Sons, a subsidiary to Sierra Pacific, to purchase a piece of land on parcel WN1001001 where a new reservoir will store water and feed into the water treatment plant in times of drought. While parcel WN1001001 is Designated as Forest Lands, the portion purchased was not classified.

Will Staff Attend - NAME OF STAFF or No

Yes

Department Recommendation

It is the recommendation of the Department of Public Works that the Board acknowledge the recorded Warranty Deed from R.H. Emmerson to Cowlitz County for the Commissioners record.

Attachments

Warranty Deed

Notice of Removal of Designated Forest Land

Vicinity Map

Form Review

Inbox Reviewed By Date

Susan Eugenis

Form Started By: Emilie Cochrane

Susan Eugenis

10/14/2025 04:20 PM

Started On: 10/14/2025 03:11 PM

WN1003001
WN1101001
WN0301001
WN0901001
WN1002004

BOCC Agenda

Meeting Date: 10/21/2025

EASEMENT - Perpetual Road and Utility Easement - Ryderwood Suplemental Water Source - Project No. 2948 - Dennis and Sally Jean Hall

Submitted For: Susan Eugenis, Public Works

Department: Public Works

Subject and Summary Statement

Submitted By: Emilie Cochrane, Public Works

Information

Cowlitz County Department of Public Works established Project 2948 - Ryderwood Supplemental Water Source to address drought resiliency for the 500 residents of Ryderwood, WA. Concerns of water scarcity were raised after Campbell Creek suffered a dry spell in 2018. Negotiations were held with Dennis and Sally Hall to purchase an easement on parcel WN1002010 where water lines will connect the existing water treatment plant to the new water reservoir.

Will Staff Attend - NAME OF STAFF or No

Yes

Department Recommendation

It is the recommendation of the Department of Public Works that the Board acknowledge the recorded Perpetual Road and Utility Easement from Dennis and Sally Hall to Cowlitz County for the Commissioners record.

Attachments

Easement

Vicinity Map

Inbox

Susan Eugenis

Form Started By: Emilie Cochrane

Form Review

Reviewed By Date

Susan Eugenis

10/14/2025 04:20 PM

Started On: 10/14/2025 03:35 PM

WN1003001
WN1101001
WN0301001
WN0901001
WN1002004

BOCC Agenda

Meeting Date: 10/21/2025

APPROVAL OF EXPENDITURES – Drainage Improvement District No. 1 – August 2025 Vouchers

Submitted For: Susan Eugenis, Public Works

Submitted By: Emilie Cochrane, Public Works Department: Public Works

Information

Subject and Summary Statement

On October 9, 2025, the Supervisor for Drainage Improvement District No. 1 ratified payments of the expenses incurred in August 2025 for $29,652.84.  Attached is the Voucher Ratification outlining said expenses. These expenses are included in the 2025 Budget.

Will Staff Attend - NAME OF STAFF or No

Yes

Department Recommendation

Drainage Improvement District No. 1 recommends approval of the August 2025 ratification of the vouchers in the total amount of $29,652.84.

APPROVED this 21st day of October 2025.

BOARD OF COUNTY COMMISSIONERS OF COWLITZ COUNTY, WASHINGTON

Richard R. Dahl, Chairman

Steve Rader, Commissioner

Steven L. Ferrell, Commissioner

Attest:_______________________________              Kelly Grayson, Clerk of the Board

Fiscal

Expenditure Required $: 29,652.84

Budget Sufficient Y-N: Y

Amendment Required Y-N: N

Source of Funds - What Dept ? : Drain 1

Grant Y-N: N

Impact

Voucher Ratification

Inbox

Susan Eugenis

Emilie Cochrane

Susan Eugenis

Mike Moss, Public Works

Form Started By: Emilie Cochrane

Attachments

Form Review

Reviewed By Date

Emilie Cochrane 10/14/2025 07:15 AM

Susan Eugenis 10/14/2025 08:31 AM

Mike Moss 10/14/2025 12:44 PM

Started On: 10/13/2025 04:50 PM

AS-14368 Motion Items 17.

BOCC Agenda

Meeting Date: 10/21/2025

Contract 25-031 Goodwill of the Olympics and Rainier Region

Submitted For: Gena James

Submitted By: Wheeldon Jennifer Department: Health/Human Services

Information

Subject and Summary Statement

The purpose of this County Contract # 25-031 with Goodwill of the Olympics and Rainier Region is to provide the delivery of Developmental Disability Employment Services.

This contract is paid on a cost reimbursement basis, not to exceed $87,000.00 during the period July 1, 2025 through June 30, 2026. Funding for this contract is passed through from the County's contract with the Washington State Department of Social and Health Services Developmental Disabilities Administration.

Will Staff Attend - NAME OF STAFF

Gena James will attend.

Department Recommendation

It is the recommendation of the Cowlitz County Health & Human Services that the Cowlitz County Board of Commissioners move to approve this contract # 25-031 with Goodwill of the Olympics and Rainier Region.

Fiscal Impact

Expenditure Required $: $87,000.00

Budget Sufficient Y-N: y

Amendment Required Y-N: n

Source of Funds - What Dept ? : 14001

Grant Y-N:

Contract

Insurance Certificate

Attachments

Form Review

Inbox Reviewed By Date

Jamie Drake Jamie Drake 09/23/2025 08:18 AM

Gena James Gena James 09/23/2025 11:46 AM

Form Started By: Wheeldon Jennifer

Started On: 09/23/2025 08:01 AM

SUBRECIPIENT GRANT AGREEMENT

Number: 25-031

1. Purpose of Subrecipient Grant Agreement. This Subrecipient Grant Agreement (“Agreement”) is made by and between COWLITZ COUNTY, a political subdivision of the State of Washington, (hereinafter called “County” or “Cowlitz County”) and Goodwill of the Olympics and Rainier Region (hereinafter called “Subrecipient”) to set forth the terms and conditions by which the County will provide the Subrecipient with a grant award to be used to pay or reimburse necessary expenditures incurred for services for persons with developmental disabilities

2. Term. This Agreement shall take effect on July 1, 2025 and terminate on June 30, 2026

3. Scope of Eligible Expenditures. Grant funds may only be used to pay or reimburse eligible expenditures consistent and as detailed in Attachment A - Scope of Work for Project (the “Project”)

4. Grant Award. The Subrecipient is awarded a total of $87,000.00

5. Budget. The Grant Award shall be expended by the Subrecipient as set forth in Attachment BBudget.

6. Subrecipient Responsibilities. Subrecipient agrees to administer the Grant Award proceeds consistent with this Agreement. Subrecipient shall provide the County with certification using the form of Attachment C that Grant Award funds will be used for eligible expenditures. Subrecipient shall request payment from the County as outlined in Attachment B

7. Reporting Requirements. In addition to the responsibilities outlined herein and in Attachment A - Scope of Work for Project, at least once a quarter, and at the conclusion of either the grant expenditure or the grant contract period, the Subrecipient shall provide a report on the progress made to date on the Project, using such forms and meeting such requirements as determined by the County. Such reports shall be provided by the Subrecipient to the County electronically to the County’s Project Manager identified herein.

8. Access to and Maintenance of Records Subrecipient shall maintain internal controls, accounts and records, including personnel, property, financial, and programmatic records and other such records as may be deemed necessary by the County, for a period of six (6) years to ensure proper accounting for all Grant Award funds and compliance with this Agreement. Subrecipient acknowledges that records may be subject to disclosure under the Public Records Act, Chapter 42.56 RCW.

Subrecipient agrees that the County or any duly authorized representatives shall have at any time and from time to time during normal business hours, access to any work product, books, documents, papers, and records of Subrecipient which are related to this Agreement, for the purpose of inspection, audits, examinations, and making excerpts, copies and transcriptions.

9. Termination. The following provisions apply regarding termination of this Agreement:

a. Termination for Loss of Funding. The County shall have the right to terminate this Agreement upon advance written notice if the funds relied upon for the Grant Award are terminated, suspended, or otherwise lost or impaired in whole or in part.

b. Termination for Convenience. Either party may terminate this Agreement for convenience upon giving the other party at least 30 days’ advance written notice. In that event, the Subrecipient will be entitled to payment only for those expenses and costs reasonably and actually incurred prior to the effective date of the termination.

25-031

Last Date Revised: 01/22/2025 Admin Form: 1615.1

c. Termination for Default. If either party defaults in its performance under this Agreement, the nondefaulting party may give the defaulting party written notice that it has 30 days in which to cure the default. If the default is not cured within 30 days of notice, the nondefaulting party may terminate this Agreement. In the event of such a termination, the nondefaulting party shall have all rights and remedies available to it under the law.

However, if a notice of termination for default has been issued and it is later determined for any reason that the Subrecipient was not in default, the rights and obligations of the parties shall be the same as if the notice of termination had been issued pursuant to the Termination for Public Convenience paragraph hereof.

10. Termination Procedure The following provisions apply in the event that this Agreement is terminated:

a. The Subrecipient shall cease to perform hereunder as of the effective date of termination and shall comply with all reasonable instructions contained in the notice of termination, if any.

b. The Subrecipient shall provide the County with an accounting of authorized services provided through the effective date of termination.

11. Conflict of Interest. Subrecipient designees, agents, members, officers, employees, consultants, and any other public official who exercise or who has exercised any functions or responsibilities with respect to the Project during his or her tenure, or who is in a position to participate in a decision-making process or gain inside information with regard to the Project, are barred from any interest, direct or indirect, in any grant or proceeds of the Project, or benefit therefrom, which is part of this Agreement at any time during or after such person’s tenure.

12. Governing Laws. This Agreement shall be governed by and construed in accordance with the laws of the State of Washington. The venue for any dispute regarding or arising out of this Agreement shall be Cowlitz County Superior Court.

13. Personnel. The Subrecipient will secure at its own expense all labor and materials required to perform any work in connection with the Project. The Subrecipient shall be responsible for all applicable payroll, labor and industries premiums, and taxes. All employees and subcontractors of the Subrecipient shall be covered by Industrial Insurance in full compliance with Title 51 RCW. The Subrecipient shall defend and indemnify the County, and their officials, officers, employees, and agents from and against all claims arising from any actual or alleged violation of the Subrecipient’s duties under this section or applicable law. Solely for the purposes of this indemnification provision, the Subrecipient expressly waives its immunity under Title 51 RCW and acknowledges that this waiver was mutually negotiated by the parties. The Subrecipient’s duty to defend and indemnify shall survive the termination of this Agreement.

14. Contract Representatives. The parties’ designated representatives shall be responsible for the administration of this Agreement and for receiving notices given in connection with this Agreement. The following are designated as the representatives of the parties:

For the County:

For the Subrecipient:

Name: Gena James Lori Forte Harnick

Title: Deputy Director President and CEO

Department: Health & Human Services Goodwill

Address: 1952 9th Ave Longview, WA 98632 1030 15th Ave Ste 300 Longview, WA 98632

Telephone: (360) 414-5599 360-501-8340

E-mail: HHSContracts@cowlitzwa.gov LoriFH@goodwillwa.org

Fax: (360) 425-7531

UEI: TZ8RNRDSRNN1 FMJGRH7NFLA4

UBI: 08-300-3788 278-004-647

15. Notices. Any notice required or permitted to be made under this Agreement may be given personally, by facsimile, or by first-class, registered or certified mail. A notice personally delivered to the other party is deemed given upon proper delivery. A notice sent by first-class, registered or certified mail is deemed given three days after mailing, if properly addressed and having proper postage. Notices delivered by facsimile shall be deemed to have been given on the date of transmission if received during the subrecipient’s business day or, if not, on the subrecipient’s next business day.

16. Insurance Requirements. The Subrecipient shall maintain in full force and effect during the term of this Agreement, and until final acceptance of the work, public liability and property damage insurance with companies or through sources approved by the state insurance commissioner pursuant to RCW Title 48, as now or hereafter amended. The County, its appointed and elected officials, agents and employees, shall be specifically named as additional insureds in a policy with the same company which insures the Subrecipient or by endorsement to an existing policy or with a separate carrier approved pursuant to RCW Title 48, as now or hereafter amended, and the following coverages shall be provided:

COMPREHENSIVE GENERAL LIABILITY:

Bodily injury, including death.

Property damage

ERRORS AND OMISSIONS or PROFESSIONAL LIABILITY with an Extended Reporting Period Endorsement (two year tail).

WORKERS COMPENSATION:

EMPLOYER’S LIABILITY/Stop Gap:

$1,000,000 Per occurrence

$1,000,000 Per occurrence

$2,000,000 Aggregate

$1,000,000 Per occurrence

$2,000,000 Aggregate

Statutory amount Waiver of Title 51 Rights

$1,000,000 Per occurrence

AUTOMOBILE: coverage on owned, non-owned, rented and hired vehicles

Bodily injury, liability, including death and property damage liability

$1,000,000 Combined Single Limit

All Subrecipient’s and Subrecipient’s subcontractors’ insurance policies and additional named insured endorsements shall provide primary insurance coverage and be non-contributory. Any insurance, self-insured retention, deductible, risk retention or insurance pooling maintained or participated in by the County shall be excess and not contributory to such insurance policies. All Subrecipient’s and Subrecipient’s subcontractors’ liability insurance policies must be endorsed to show this primary coverage.

Upon request, the Subrecipient shall provide a full and complete and certified copy of all requested insurance policies to the County. The County reserves the right, but not the obligation, to revise any insurance requirement, not limited to limits, coverages and endorsements, or to reject any insurance policies which fail to meet the requirements of this Agreement. Additionally, the County reserves the right, but not the obligation, to review and reject any proposed insurer providing coverage based upon the insurer’s financial condition or licensing status in Washington. Any deductibles and/or self-insured retentions exceeding $10,000 or any stop-loss provisions, the County shall have the right to request and review the Subrecipient’s most recent annual financial reports and audited financial statements as a condition of approval.

Subrecipient hereby agrees to waive subrogation with respect to each insurance policy maintained under this Agreement. When required by an insurer, or if a policy condition does not

permit Subrecipient to enter into a pre-loss agreement to waive subrogation without an endorsement, then Subrecipient agrees to notify the insurer and obtain such endorsement. This requirement shall not apply to any policy which includes a condition expressly prohibiting waiver of subrogation by the insured or which voids coverage should the Subrecipient enter into such a waiver of subrogation on a pre-loss basis.

The County, its departments, elected and appointed officials, employees, agents and volunteers shall be named as additional insureds on Subrecipient’s and Subrecipient’s subcontractors’ insurance policies by way of endorsement for the full available limits of insurance maintained by the Subrecipient and subcontractor, and all coverage shall be primary and non-contributory. A state or notion of additional insured status on a Certificate of Insurance shall not satisfy these requirements. [This endorsement shall not be required if the Subrecipient is a governmental entity and is insured through a governmental entity risk pool authorized by the State of Washington.]

The Subrecipient shall, for each required insurance policy, provide a Certificate of Insurance, with endorsements attached, evidencing all required coverages, limits, deductibles, self-insured retentions and endorsements and which is conditioned upon the County receiving thirty (30) days prior written notice of reduction in coverages, cancellation or non-renewal. Each Certificate of Insurance and all insurance notices shall be provided to: ATTN: County Project Manager, Cowlitz County Health & Human Services, 1952 9th Avenue, Longview, WA 98632. This Agreement shall be void ab initio if the proof of coverage is not timely supplied.

The insurance maintained under this Agreement shall not in any manner limit or qualify the liabilities or obligations of the Subrecipient under this Agreement. All insurance policy deductibles and self-insured retentions for policies maintained under this Agreement shall be paid by the Subrecipient

Compensation and/or payments due to the Subrecipient under this Agreement are expressly conditioned upon the Subrecipient’s strict compliance with all insurance requirements. Payment to the Subrecipient shall be suspended in the event of non-compliance. Upon receipt of evidence of Subrecipient’s compliance, payments not otherwise subject to withholding or set-off will be released to the Subrecipient. This Agreement shall be void ab initio if the proof of coverage is not timely supplied.

If the Errors and Omissions or Professional Liability insurance obtained is an occurrence policy as opposed to a claims-made policy, the Extended Reporting Period Endorsement is not required.

17. Indemnification. To the fullest extent permitted by the law, the Subrecipient shall indemnify, defend, and hold harmless Cowlitz County and the officials, officers, employees, and agents of each of them, from and against all claims in any way resulting from or arising out of the performance of this Agreement, whether such claims arise from the acts, errors or omissions of the Subrecipient, its subcontractors, third parties, Cowlitz County, or anyone directly or indirectly employed by any of them or anyone for whose acts, errors or omissions any of them may be liable. “Claim” means any loss, claim, suit, action, liability, damage or expense of any kind or nature whatsoever, including but not limited to attorneys’ fees and costs, attributable to personal or bodily injury, sickness, disease, or death, or to injury to or destruction of property, including the loss of use resulting therefrom. The Subrecipient’s duty to indemnify, defend, and home harmless includes not is not limited to claims by the Subrecipient’s or any subcontractor’s officers, employees, or agents. The Subrecipient’s duty, however, does not extend to claims arising from the sole negligence or willful misconduct of Cowlitz County, or tis officials, officers, employees, and agents. Solely for the purposes of this indemnification provision, the Subrecipient expressly waives its immunity under Title 51 RCW and acknowledges that this waiver was mutually negotiated by the parties. This section shall survive the expiration or termination of this Agreement.

18. Debarment Certification. The Subrecipient, by signature to this Agreement, certifies that the Subrecipient is not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded in this Agreement by any federal department or agency from participating in transactions (Debarred). The Subrecipient also agrees to include the above requirement in all subcontracts into which it enters. The Subrecipient shall immediately notify the County if, during the term of this Contract, the Subrecipient becomes debarred. The County may immediately terminate this Contract by providing Subrecipient written notice if Subrecipient becomes debarred during the term hereof.

19. Compliance with Laws. The Subrecipient and its officials, officers, employees, agents, and subcontractors shall comply with all applicable federal, state, and local laws, regulations, rules, and policies. The County shall have no obligation to ensure such compliance.

20. Religious Activities. If the Subrecipient is a faith-based or religious organization, it retains its independence and may continue to carry out its mission, including the definition, development, practice, and expression of its religious beliefs. Such a subrecipient, however, may not use any funding provided under this Agreement to support or engage in any explicitly religious activities, including activities that involve overt religious content such as worship, religious instruction, or proselytization, nor may such a subrecipient condition the provision of services provided pursuant to this Agreement upon a participant’s engaging in any such explicitly religious activities.

21. Permissible Use Warranty The Subrecipient recognizes and agrees that the Grant Award consists of ‘pass-through’ funds coming from Washington State Department of Social and Health Services Division of Developmental Disabilities. Subrecipient agrees to use the Grant Award funds awarded to it in accordance with Attachment A and in accordance with all applicable rules and requirements in accordance with Chapter 71A.14 RCW Its purpose is to advance the state legislature policy to provide a coordinated and comprehensive state and local program of services for persons with developmental disabilities The Subrecipient warrants that its planned and actual uses of the Grant Award herein constitute permissible uses consistent with Attachment A and the pass-through funding requirements discussed immediately above. This section shall survive termination of this Agreement.

22. Organizational Status Warranty. The Subrecipient warrants that it is duly organized, existing and in good standing under the laws of the State of Washington.

23. Relationship of the Parties. This Agreement, and the parties’ and the County’s activities under it, shall not be construed as creating any kind of partnership or joint venture, nor shall it be construed as creating any kind of independent contractor, agency or employment relationship between the parties or the County.

24. No Third-Party Rights. This Agreement is entered into by the parties solely for their own benefit and it creates or grants no rights of any kind to any other party.

25. Assignment. The Subrecipient shall not assign any of its rights or delegate any of its duties under this Agreement without the prior express written consent of the County, which may be granted or refused at the County’s sole discretion.

26. Waiver. No term or condition of this Agreement shall be deemed waived unless such waiver is expressly agreed to in writing by the party granting the waiver. In addition, waiver of any breach of this Agreement shall not be deemed a waiver of any prior or subsequent breach.

27. Amendment. This Agreement can only be amended in writing, and only upon execution by both parties.

28. Entire Agreement. The parties acknowledge that this Agreement is the complete expression of their agreement regarding the subject matter of this Agreement. Any oral or written representations or understandings not incorporated into this Agreement are specifically excluded.

29. Headings. The headings in this Agreement are for convenience only and shall not be deemed to affect the meaning of its provisions.

30. Severability. If any provision of this Agreement is held by a court of competent jurisdiction to be invalid, such invalidity shall not affect the validity of the remaining provisions that can be given effect without the invalid provision, provided that the underlying intent of the parties can still be given effect.

31. Signature Authority. Each person signing this Agreement on behalf of a party warrants that he or she has full authority to sign this Agreement on that party’s behalf.

32. Counterparts. This Agreement may be executed in counterparts, each of which shall be deemed an original and all of which together shall be deemed one agreement. Each counterpart may be executed and delivered by facsimile to the other party.

33. Attachments. The following attachments are incorporated into this Agreement by reference.

a. Attachment A – Scope of Work for Project

b. Attachment B – Budget

c. Attachment C – Certification Form

d. Attachment D – Retirement Certification

e. Attachment E – Data Security Requirements

IN WITNESS WHEREOF, the parties have executed this Agreement on this day of , 2025

SUBRECIPIENT:

Signature

BOARD OF COUNTY COMMISSIONERS OF COWLITZ COUNTY, WASHINGTON

Richard R. Dahl, Chairman

Steven L. Ferrell, Commissioner Print name:

Steve Rader, Commissioner

Title: ATTEST:

CONTRACT HAS BEEN APPROVED AS TO FORM BY COWLITZ COUNTY , Clerk of the Board PROSECUTING ATTORNEY Date

SCOPE OF WORK FOR PROJECT

The Subrecipient shall ensure services, and staff, and otherwise do all things necessary for or incidental to the performance of work, as set forth below:

1. Definitions The words and phrases listed below, as used in this Grant Agreement, shall each have the following definitions:

a. “Acuity Level” means the level of an Client’s abilities and needs as determined through the DDA assessment.

b. “ALTSA Web Access (AWA)” means a web-based portal to the Developmental Disabilities Administration CARE system designed to support county services for DDA clients.

c. “Additional Consumer Services” refers to indirect Client service types as follows:

(1) “Community Information and Education”: Activities to inform and/or educate the general public about developmental disabilities and related services. These may include information and referral services; activities aimed at promoting public awareness and involvement; and community consultation, capacity building and organization activities.

(2) “Training”: To increase the job related skills and knowledge of staff, providers, volunteers, or interning students in the provision of services to people with developmental disabilities. Also to enhance program related skills of board or advisory board members.

(3) “Other Activities” reserved for special projects and demonstrations categorized into the following types:

(a) Infrastructure projects: Projects in support of Clients (services not easily tracked back to a specific working age Client) or that directly benefit a Client(s) but the Client is not of working age. Examples include planning services like generic job development e.g. “Project Search”.

(b) Start-up projects: Projects that support an agency or directly benefit the agency. Examples include equipment purchases and agency administrative support.

(c) Partnership Project: Collaborative partnerships with school districts, employment providers, DVR, families, employers and other community collaborators needed to provide the employment supports and services young adults with developmental disabilities require to become employed during the school year they turn twenty-one (21).

d. “Budget and Accounting Reporting System (BARS)” means a master classification of balance sheet, revenue and expenditure/expense accounts.

e. “CFR” means the Code of Federal Regulations. All references in this Agreement and any Program Agreement to CFR chapters or sections shall include any successor, amended, or replacement regulation.

f. “Client” means a person with a developmental disability as defined in Chapter 388-823 WAC who is currently eligible and active with the Developmental Disabilities Administration or is an identified PASRR Client.

g. “Competitive Integrated Employment” means work performed by an individual on a parttime or full-time basis, within an integrated setting within the community that meets HCBS settings requirements. The Client must be compensated at minimum wage or higher, using the higher of the Federal, State, or local rate, and at a rate comparable to the wage paid to non-disabled workers performing the same tasks, including receiving the same benefits and opportunities for advancement.

h. “Confidential Information” or “Data” means information that is exempt from disclosure to the public or other unauthorized persons under Chapter 42.56 RCW or other federal or state laws. Confidential information includes, but is not limited to, Personal Information.

i. “DDA Case Resource Manager (CRM)” means case manager for DDA Clients.

j. “County Service Authorization (CSA)” means authorization for county services.

k. “Developmental disabilities (DD)” means a disability attributable to intellectual disability, cerebral palsy, epilepsy, autism, or other neurological or other condition of an individual found by the secretary to be closely related to an intellectual disability or to require

treatment similar to that required for individuals with intellectual disabilities, which disability originates before the individual attains age eighteen, which has continued or can be expected to continue indefinitely, and which constitutes a substantial limitation to the individual.

l. “Developmental Disabilities Administration DDA” means a division within the Department of Social and Health Services.

m. “DDA Regional office (DDA Region)” means the regional DDA office that supports DDA clients.

n. “Debarment” means an action taken by a federal official to exclude a person or business entity from participating in transactions involving certain federal funds.

o. “DSHS” means the Department of Social and Health Services of the state of Washington.

p. “Division of Vocational Rehabilitation (DVR)” means a division within the Department of Social and Health Services.

q. “Employment Outcome Payment” means a payment to providers for transition students born between specific dates; have high acuity; are authorized for Individual employment; and student obtains a competitive integrated job within a specific timeframes. If the job is a minimum of ten hours of work per week an additional amount will be include in the payment.

r. “General Terms and Conditions” means the contractual provisions contained within that agreement, which govern the contractual relationship between DSHS and the county

s. “High Acuity Client” means a DDA Client who requires significant and intensive support in the community, often due to complex needs, as determined through the DDA assessment.

t. “Medicaid Home and Community Based Services (HCBS)” means services that occur in a Client’s home or community rather than institutions or other isolated settings. These programs serve a variety of targeted populations groups, such as people with intellectual or developmental disabilities, physical disabilities, and/or mental illness.

u. “Preadmission Screening and Resident Review (PASRR)” means individuals with intellectual disabilities or related conditions (ID/RC) who have been referred for nursing facility (NF) care.

v. “Person Centered Service Plan or PCSP” means a document that authorizes and identifies the DDA paid services to meet a Client’s assessed needs. Formerly referred to as the Individual Support Plan.

w. “Personal Information” means information identifiable to any person including, but not limited to, information that relates to a person’s name, health, finances, education, business, use or receipt of governmental services or other activities, addresses, telephone numbers, social security numbers, driver’s license numbers, other identifying numbers, and any financial identifiers.

x. “Quality Assurance” means an adherence to all Program Agreement requirements, including DDA Policy 6.13, Provider Qualifications for Employment and Day Program Services, County Guidelines and the Criteria for Evaluation, as well as a focus on reasonably expected levels of performance, quality and practice.

y. “Quality Improvement” means a focus on activities to improve performance above minimum standards and reasonably expected levels of performance, quality and practice.

z. “RCW” means the Revised Code of Washington. All references in this Agreement and any Program Agreement to RCW chapters or sections shall include any successor, amended, or replacement statue. Pertinent RCW chapters can be accessed at http://apps.leg.wa.gov/rcw/.

aa. “Secretary” means the individual appointed by the Governor, State of Washington, as the head of the DSHS, of his/her/their designee.

bb. “Secured Area” means an area to which only authorized representatives of the entity possessing the confidential information access. Secured Areas may include buildings, rooms or locked storage container (such as a filing cabinet) within a room, as long as access to the Confidential Information is not available to unauthorized personnel.

cc. “Service Provider” is a qualified Client service vendor who is contracted to provide Employment and Day Program services.

Date Revised: 01/09/2025

dd. “Subcontractor” is the service provider contracted by the County to provide services.

ee. “Trusted Systems” include only the following methods of physical delivery: (1) handdelivery by a person authorized to have access to the Confidential Information with written acknowledgment of receipt; (2) United States Postal Service (“USPS”) first class mail, or USPS delivery services that Tracking, such as Certified Mail, Express Mail or Registered Mail; (3) commercial delivery services (e.g., FedEx, UPS, DHL) which offer tracking and receipt confirmation; and (4) the Washington State Campus mail system For electronic transmission, the Washington State Governmental Network (SGN) is a Trusted System for communications within that Network.

ff. “USC” means the United States Code. All references in this Agreement and any Program Agreement to USC chapters and sections shall include any successor, amended, or replacement statute.

gg. “WAC” means the Washington Administrative Code. All references in this Agreement and any Program Agreement to WAC chapters or sections shall include any successor, amended, or replacement of regulation. Pertinent WAC chapters or sections can be accessed at http://apps.leg.wa.gov/wac/.

2. Purpose.

a. Direct Client Services

i. “Community Inclusion” or “CI”: services are individualized services and provided in integrated community settings with other individuals without disabilities The activities are based on Client interests and provide opportunities typically experienced by the general public of similar age in their local community, accessible by public transit or a reasonable commute from their home. The goal of the service is to support clients to participate, contribute, and develop relationships with community members who are not paid staff. These services may be authorized for individuals aged 62 and older. These services may be authorized in addition to or instead of employment support (Individual Employment or Group Supported Employment) for working age individuals who have received nine months of employment support.

ii. “Individual Supported Employment” or “IE”: services are a part of an Client’s pathway to employment and are tailored to individual needs, interests, and abilities, and promote career development. These are individualized services necessary to help persons with developmental disabilities obtain and continue integrated employment at or above the state’s minimum wage in the general workforce. These services may include intake, discovery, assessment, job preparation, job marketing, job supports, record keeping and support to maintain a job.

iii. “Individualized Technical Assistance” or “ITA”: services are a part of an Client’s pathway to individual employment or community inclusion. This service provides assessment and consultation to the employment provider to identify and address existing barriers to employment or community inclusion. This is in addition to supports received through supported employment or community inclusion services for Clients who have not yet achieved their goal.

iv. Job Foundations Partnership Project is for transition students born between specific dates; have high acuity; are authorized for Individual employment; and student obtains a competitive integrated job within specific timeframes.

v. “Job Foundation Report” is a document derived from employment readiness activities performed by students who are between ages 19 through 20 that identifies actionable next step for employment. The employment service providers developing the Job Foundation report will be supporting students with employment activities on average of 35 hours.

b. Coordination. Working collaboratively, the parties shall administer DD services within the county as set forth below:

Date Revised: 01/09/2025

The DDA region shall:

i. Inform and include the County in the discharge planning of Clients leaving institutions and returning to the community who will need program funding;

ii. Inform the County of Clients who have had their waiver status changed;

iii. Work with the County when referring Clients for services and will withdraw referrals when authorization is not issued;

iv. Authorize new service within five (5) working days and will extend existing service authorization before expiration date;

v. Inform Clients of service changes through Planned Action Notice(s);

vi. Work with the County to document planned services in the Client’s Person Centered Service Plan including notification of assessment dates;

vii. Work with the County when terminating services;

viii. Work with the County in participating in evaluation of the Subrecipient

The County shall:

ix. Work with the DDA Region and the Subrecipient when Clients are referred for services, authorized services, and/or for support modifications;

x. Work with DDA Region and the Subrecipient to document planned services in the Client’s Person Centered Service Plan;

xi. Assist with informing the DDA Region of any potential service level changes not documented in the Client’s DD Assessment prior to any changes; and

xii. Work with the DDA Region and the Subrecipient regarding service termination.

xiii. Notify and work with the DDA Regional Employment Specialist when performing evaluations of the Subrecipient

The Subrecipient shall:

xiv. Facilitate the County’s attendance at employment plan meetings as requested.

xv. Work with the DDA Region and the County when Clients are referred for services;

xvi. Work with DDA Region and the County to document planned services in the Client’s Person Centered Service Plan;

xvii. Assist with informing the DDA Region and County of any potential service level changes not documented in the individual’s DD Assessment prior to any changes; and

xviii. Work with the DDA Region and the County regarding service termination.

3. Program Outcomes. The Subrecipient shall provide qualified Employment Program Service for consumer support services that include the following program outcomes:

a. Monthly Community Inclusion (CI) service support hours will be based on the Client’s CI service level per WAC 388-828-9310 for all Clients who began receiving CI services July 1, 2011 and forward.

i. To ensure health and safety, promote positive image and relationships in the community, increase competence and individualized skill-building, and achieve other expected benefits of CI, services will occur individually or in a group of no more than two (2) or three (3) Clients with similar interests and needs.

ii. CI services will focus on activities that are typically experienced by the general public. Support to participate in segregated activities and/or specialized activities will not be reimbursed.

b. Clients in an employment program will be supported to work towards a living wage. A living wage is the amount needed to enable a Client to meet or exceed living expenses. Clients should be supported to average twenty (20) hours of community work per week or eighty-six (86) hours per month; however, each person’s preferred hours of employment should be taken into consideration. The amount of service a Client receives will be based on his/her demonstrated need, acuity level and work history per WAC 388-828.

c. The Client’s DDA PCSP is the driver for service. The County Service Authorization (CSA) and updated Planned Rates information will not exceed the Client’s DDA PCSP. Service changes will not occur until the Client has received proper notification from DDA.

d. All Clients will have an Individualized Employment or Community Inclusion plan to identify Client’s preferences. Minimum plan elements are outlined in the reference document “Criteria for Evaluation.” A copy of the Client’s individualized plan will be provided to the Client, their CRM, guardian and others as appropriate.

e. Six-month progress reports describing the progress made towards achieving Client’s goal will be provided by the Subrecipient to the CRM, participant, and/or guardian, if any, within 30 days following the six-month period. The report will summarize activities and outcomes made towards Client’s individualized goal(s).

f. All Clients will be contacted according to Client need and at least once per month.

g. If Clients in Individualized Employment or Group Supported Employment, have not obtained paid employment at minimum wage or better within six (6) months, the Subrecipient will assure the following steps are taken:

i. Review the progress toward employment goals;

ii. Provide evidence of consultation with the Client/guardian; and

iii. Develop additional strategies with the Client/guardian, County, employment support staff, case manager, and others identified by the Client. Strategies may include providing technical assistance, changing to a new provider, and/or providing additional resources as needed to support the Client’s pursuit of employment. The additional strategies will be documented for each Client and kept in the Client’s file(s).

h. If after twelve (12) months the Client remains unemployed, an additional review will be conducted. The Subrecipient will address steps outlined in the previous six month progress report in the next six month progress report. When requesting to participate in CI, the Client shall communicate directly with his or her DDA Case Manager. The DDA Case Manager is responsible for authorizing CI services.

i. For Individual Employment where the service provider is also the Client’s employer, long term funding will remain available to the service provider employer for six months after the employee DDA Client’s date of hire. At the end of the six month period, if the DDA Client continues to need support on the job, another service provider who is not the employer of record must provide the support unless the County and/or DDA issues prior written approval for the service provider to continue to provide long-term supports if needed. If the County and/or DDA approves the continuation of long-term supports where the Subrecipient is also the Client’s employer, the County and/or DDA will regularly monitor these positions to assure fading efforts occur when appropriate and any potential conflict of interest is addressed.

j. Individual Employment staff hours must be attributed to the “Individual Employment and Billable Activity Phase(s)”.

k. Employment and day services must adhere to the Home and Community Based settings (HCBS) requirements of 42CFR 441 530(c)(4), including that:

i. The setting is integrated in the greater community and supports Clients to have full access to the greater community;

ii. Ensures the Client receives services in the community to the same degree of access as individuals not receiving Medicaid HCBS;

iii. The setting provides opportunities to seek employment and work in competitive integrated settings; and

iv. The setting facilities individual choice regarding services and supports, and who provides them.

l. Partnership Project

i. A Job Foundation document will be completed per guidelines for eligible students. Eligible students are DDA clients who were born between:

1. For fiscal year 2026: 9/1/05 through 8/31/06.

2. For fiscal year 2027: 9/1/06 through 8/31/07.

ii. These students currently attending school and have completed an application to participate in this Value Based Payment (VBP) project. The VBP project application will include the following minimum criteria identified in the sample application found at:

https://www.dshs.wa.gov/sites/default/files/DDA/dda/documents/Job%20Foundati on%20Application_040720%20%28002%29.docx

iii. The Subrecipient will collaborate with School District staff to complete the Job Foundation document and then provide a copy to the County. To be a qualified provider for the Partnership Project the Subrecipient must have a current contract with the Division of Vocational Rehabilitation; a contract in good standing with the County and cannot be in provisional status; a minimum of two years’ experience providing Individual Employment with demonstrated job placement skills. The Job Foundation recommendation will only have actionable next steps towards integrated competitive employment

4. Performance monitoring. The County will monitor the Subrecipient’s performance by tracking work progress, reviewing payment requests for applicable costs, and ensuring that all requirements under this Agreement are met. Substandard performance as determined solely by the County constitutes noncompliance with this Agreement.

If action to correct substandard performance is not taken by the Subrecipient within 30 days after being notified by the County, then the County may terminate the Agreement as described herein.

Additional Requirements: The Subrecipient will maintain and make available, if requested, documentation demonstrating accomplishments of the contract. Such documentation may include, but is not limited to, the following:

a. Services provided

b. Number of hours of service

c. Data Collection

d. Completed evaluation tools

e. Backup reports/data for invoicing.

Site Visits: The Subrecipient will coordinate visits with the County Contract Representative for contract compliance, organizational due diligence, program evaluation, technical assistance, and Continuous Quality Improvement.

5. Client Eligibility: Client eligibility and service referral are the responsibility of DDA under chapter 388-823 WAC (Eligibility) and chapter 388-825 WAC (Service Rules). Only persons referred by DDA shall be eligible for direct Client services under this Agreement. It is DDA’s responsibility to determine and authorize the appropriate direct service(s) type. Direct Client services provided without current County Service Authorization are not reimbursable under this Agreement.

6. Credentials and Minimum Requirements:

a. Sufficient Policies and Procedures for establishment and maintenance of adequate internal control systems: The Subrecipient will maintain written policy procedural manuals for information systems, personnel, and accounting/finance in sufficient detail such that operations can continue should staffing change or absences occur. Policies shall be dated and include dates when updated.

b. Background/Criminal History Check: A background/criminal history clearance is required every three years for all employees, subcontractors, and/or volunteers who may have unsupervised access to vulnerable DSHS Clients, in accordance with RCW 43.43.830845, RCW 74.15.030, and chapter 388 WAC. If the entity reviewing the application elects to hire or retain an individual after receiving notice that the applicant has a conviction for an offense that would disqualify the applicant from having unsupervised access to vulnerable adults as defined in chapter 74.34 RCW, then the County shall deny payment for any subsequent services rendered by the disqualified individual provider. The DSHS Background Check Central Unit (BCCU) must be utilized to obtain background clearance.

Date Revised: 01/09/2025

c. The Subrecipient shall meet qualifications as outlined in the DDA Policy 6.13, Program Qualifications for Employment and Day Program Providers.

7. Home and Community Based Waiver Services Assignment of Medicaid Billing Rights: The Subrecipient agrees to assign to DDA its Medicaid billing rights for services to DDA Clients eligible under Title XIX program in this Agreement. Written documentation shall be available to the County and/or DSHS on request.

8. Reporting Abuse and Neglect: The Subrecipient staff who are mandated reporters under RCW 74.34.020(13) must comply with reporting requirements described in RCW 74.34.035, .040 and chapter 26.44 RCW. If the Subrecipient is notified by the County and/or DSHS that a staff member is cited or on the registry for a substantiated finding, then that associated staff will be prohibited from providing services under this Agreement.

9. The Subrecipient will promptly report to the County and DSHS per DDA Policy 6.08, Incident Management and Reporting Requirements for County and County-Contracted Providers, if:

a. They have reasonable cause to believe that abandonment, abuse, financial exploitation or neglect (as defined in RCW 74.34.020) of a person who has a developmental disability (as defined in RCW 71A.10.020) has occurred, and,

b. If they have reason to suspect that sexual or physical assault of such a person has occurred, they shall also immediately report to the appropriate law enforcement agency.

10. Subrecipient is specifically authorized to have data storage on portable devices or media in accordance with Attachment E. Data Security Requirements.

11. Certification Regarding Ethics. By signing this Agreement, the Subrecipient certifies that the Subrecipient is in compliance with Chapter 42.23 RCW and shall comply with Chapter 42.23 RCW throughout the term of this Agreement and any Program Agreement.

12. Certification Regarding Russian Government Contracts and/or Investments Subrecipient shall abide by the requirements of Governor Jay Inslee’s Directive 22-03 and all subsequent amendments. The Subrecipient, by signature to this Agreement, certifies that the Subrecipient is not presently and agency of the Russian government, an entity which is Russian-state owned to any extent, or an entity sanctioned by the United States government in response to Russia’s invasion of Ukraine. The Subrecipient also agrees to include the above certification in any and all Subcontracts into which it enters. The Subrecipient shall immediately notify the County if, during the term of this Agreement, the Subrecipient does not comply with this certification. The County may immediately terminate this Agreement by providing the Subrecipient written notice if Subrecipient does not comply with certification during the term hereof.

13. The Subrecipient shall comply with the following referenced documents found at DDA Internet site https://www.dshs.wa.gov/dda/county-best-practices under “County Best Practices”:

a. DDA Policy 4.11, County Services for Working Age Adults;

b. Chapter WAC 388-850, chapter 388-828 WAC, WAC 388-845-0001, 0030, 0210, 0215, 0220, 0600-0610, 1030-1040, 2100, 2110;

c. Criteria for Evaluation;

d. DDA Guiding Values;

e. County Guide to Achieve DDA’s Guiding Values;

f. DDA Guidelines for Community Assessments with Employment and Vocational Programs; and

g. Disability Rights Washington (formerly Washington Protection and Advocacy System) Access Agreement.

14. The Subrecipient shall ensure that all staff, working with clients receiving Community Access or Individual Employment Services, complete the following DDA online courses upon hire http://gowise.org/training/wa-state-dda-online-courses/:

a. DDA-5.06: WA State Client Rights;

b. DDA-6.13CG: WA State County Guidelines;

c. DDA-6.13ESP: WA State Employment Service Plans for Employment providers or DDA 6.13CSP: Community Access Service Plans for Community Inclusion providers.

d. The Subrecipient shall ensure that all staff working with clients receiving Community Inclusion services receive annual training on Community Inclusion services and plan writing that incorporates the Community Inclusion Quality Review Tool. https://www.dshs.wa.gov/dda/county-best-practices under “Community Inclusion”

Date Revised: 01/09/2025

15. Qualified Providers: A qualified provider must be an agency contracted with a county or DDA.

16. Quality Assurance and Service Evaluation: The Subrecipient shall develop and have available an evaluation system to review services. The evaluation system must have both a Quality Assurance and a Quality Improvement component, and both must include objective measures. The objective measures at a minimum will include performance indicators, by acuity, that include the number of new jobs; job loss and reasons for job loss; the percentage employed earning minimum wage or better; and the average number of hours worked. The Subrecipient’s service evaluation system shall serve as the method to demonstrate to the County that they continue to be a qualified provider. A copy of such evaluation system shall be provided upon request to County for review and approval.

17. Evaluation: The County shall evaluate and review services delivered to reasonably assure compliance and quality at least one visit to the Subrecipient during the biennium. The County shall maintain written documentation of all evaluations, recommendations and corrective action plans which will be provided to the DDA upon their request.

18. Intermediate Care Facilities for Intellectual Disabilities (ICF/ID) Agreement. If applicable per 42 CFR 483.410, the Subrecipient shall assure that all programs serving persons living in ICF/ID facilities develop a plan and coordinate their services with the facility on behalf of the ICF/ID resident. The County and/or DDA will supply the Subrecipient a list of ICF/ID residents who attend a day program.

19. Single State Medicaid Agency – Health Care Authority (HCA): HCA, as the single state Medicaid Agency, has administrative authority for Title XIX coverage per 42 CFR 431.10. DSHS is the operating agency for the Home and Community Based Waivers for services for people with developmental disabilities. The Subrecipient and County only has responsibility for services covered in this agreement.

20. DSHS/DRW Access Agreement: The Subrecipient assures the County that it has reviewed the Access Agreement. The DRW February 27, 2001 Access Agreement with DDA is incorporated by reference. The agreement covers DRW’s access to individuals with developmental disabilities, Clients, programs and records, outreach activities, authority to investigate allegations of abuse and neglect, and other miscellaneous matters and is binding for all providers of DDA contracted services.

21. Confidentiality. The Subrecipient shall:

a. Follow all requirements as outlined in Attachment E.

b. Ensure the security of Confidential Information;

c. Not use, publish, transfer, sell or otherwise disclose any Confidential Information gained by reason of this Agreement for any purpose that is not directly connected with the performance of the services contemplated hereunder, except:

i. As provided by law; or,

ii. In the case of Personal Information, with the prior written consent of the person or personal representative of the person who is the subject of the Personal Information.

d. Protect and maintain all Confidential Information gained by reason of this Agreement against unauthorized use, access, disclosure, modification or loss. This duty requires the Subrecipient to employ reasonable security measures, which include restricting access to the Confidential Information by:

i. Allowing access only to staff that have an authorized business requirement to view the Confidential Information.

ii. When transporting client records containing Confidential Information outside a Secure Area, one or more of the following as appropriate:

1. Use a Trusted Network; or

2. Encrypting the Confidential Information, including:

a. Email and/or email attachments.

b. Confidential Information when it is stored on portable devices or media including but not limited to laptop computers and flash memory devices, documents, or other media.

iii. Ensure the security of Confidential Information transmitted via fax (facsimile) by:

Date Revised: 01/09/2025

1. Verifying the recipient phone number to prevent accidental transmittal of Confidential Information to unauthorized persons

2. Communicating with the intended recipient before transmission to ensure that the fax will be received only by an authorized person.

3. Verifying after transmittal that the fax was received by the intended recipient.

BUDGET

1. Budget. The County shall reimburse the Subrecipient in an amount not to exceed $87,000.00. Unspent grant proceeds will be reallocated at the discretion of the County

The Subrecipient shall budget funds awarded in such a manner to ensure availability of services throughout the entire term of this Agreement subject to available funds.

The Subrecipient may submit, in writing to the County Contract Representative, a request to adjust the budget at any time during the agreement period. The County will respond to all request in writing with determination. Requests may:

a. Change the individual line budget,

b. Not change the total agreement award.

2. Payment. Subject to Section 1, the County shall reimburse the Subrecipient for costs and expenses necessary to perform activities described in the Scope of Work for Project and as indicated in the CCHHS Contractor Toolkit located online at www.co.cowlitz.wa.us/cchhscontractors, and as updated. The Subrecipient shall ensure that requests for reimbursements are based on billings supported by appropriate documentation of costs and expenses actually incurred. Additionally, the Subrecipient shall ensure that invoices include receipts, reports, and other detailed documentation of charges as requested by the County Contract Representative.

The County will not process any payments for invoices received after the 15th of the month following the end of this agreement, unless prior approval from the County.

3. Invoices. The Subrecipient shall submit invoices using the County’s form, or such other form as approved by the County. Consideration for services shall be payable upon receipt of properly completed invoices which shall be submitted to the County Contract Representative within this Agreement, by the Subrecipient, not more often than monthly. The invoices shall describe and document to the County’s satisfaction a description of the work performed, activities accomplished, the progress of the project, and fees All documentation including reports must be submitted with the billing documents

The Subrecipient shall submit invoices to the County on or before the 15th of the month, regardless of what day of the week the 15th falls on, following the month of services were performed.

The final invoice must be received by the County no later than the 15th of the month, regardless of what day of the week the 15th falls on, following the end of this contract. The final invoice due date is subject to change based on funding requirements.

4. Duplication. The Subrecipient assures that work performed and invoiced does not duplicate work to be charged to the County and State of Washington under any other Contract or agreement with the Subrecipient

5. Advance Payment. The County shall not make any payments in advance or in anticipation of the delivery of services to be provided pursuant to this Agreement.

6. Authorized Services. The County shall pay the Subrecipient only for authorized services provided in accordance with this Agreement. If this Agreement is terminated for any reason, the County shall pay only for services authorized and provided through the date of termination.

Any activities related to research and development (R&D) are not allowable.

7. Recovery of Costs Claimed in Error. If the Subrecipient claims and the County and/or DDA reimburses for expenditures under this Contract which the County later finds were one (1) claimed in error or two (2) not allowable costs under the terms of the Contract, the County shall recover those costs and the Subrecipient shall fully cooperate with the recovery

8. Subrecipient agrees that the Washington State Department of Social and Health Services Division of Developmental Disabilities and the State of Washington are not liable for claims or damages arising from Subrecipient’s performance under this Agreement.

9. Program Specific Conditions:

a. Consumer Services

The Subrecipient may bill at the rate authorized on the County Service Authorization for the number of unit(s) per consumer per month for:

i. Community Inclusion

ii. Individual Supported Employment

iii. Individualized Technical Assistance

b. The Subrecipient shall transmit client data utilizing a secured method approved by the County.

c. Provide all data described in the Employment Outcomes Instructions and monthly invoice, which is hereby incorporated by reference.

d. Assure the integrity of data submitted to the County. When data is submitted and rejected due to errors or an error is later identified, the Subrecipient will correct and resubmit the data within fifteen (15) days.

e. Reimbursement for Client Services: A claim for each individual is made by indicating the number of service units delivered to each individual listed and the fee per unit. Units are defined as:

i. An “Hour” is at least fifty (50) minutes of direct service. Partial hour to the quarter may be recorded.

f. The County shall pay for only services to DD referred consumers authorized to receive the direct services(s) type, which the County has agreed to support.

g. Clients will be assisted in accessing DVR services per the DDA/DVR MOU https://www.dshs.wa.gov/sites/default/files/DDA/dda/documents/DVRDDA%20MOU%20%282018%29-Headquarters.pdf. Client services shall not be reimbursed under this Program Agreement when the same services paid for under Rehabilitation Act of 1973 by DVR, Public Law 94-142 or any other source of public or private funding.

h. Production/commercial profits generated by the work of County-funded consumers shall be used to support County funded services as needed.

i. The Individual Employment Phases & Billable Activities document defines the individual Client services that the County reimburses. That document is located on the DSHS DDA County Best Practices Web site at https://www.dshs.wa.gov/dda/county-best-practices

j. High acuity Clients who are authorized for Individual employment, Subrecipient may receive one outcome payment if client obtains a new competitive integrated job at a minimum of ten hours of work per week for a minimum of 4 out of each 6 months during the fiscal year.

k. The Community Inclusion Billable Activities document defines the individual Client services that the County reimburses. That document is located on the DSHS DDA County Best Practices Web site at https://www.dshs.wa.gov/dda/county-best-practices

l. Client who are authorized for Community Inclusion who have an acuity of F which equals 18 support hours per month or G which equals 20 support hours per month as based on the Support Intensity Scale (SIS), provider may receive on outcome payment per month if provider delivers a minimum of 80% of the authorized hours.

m. A new Community Inclusion referral is defined as a Client who has a new County Service Authorization (CSA). Incentive/outcome payment to accept and support overall increased CSAs billed over the year may be requested from DDA if funds are available.

n. Community Inclusion case notes and 6-month progress report summary review that scores 16 points or more with the “Community Inclusion Case Note Review Tool” when used in conjunction with a Community Inclusion plan that has scored 20+ points with the Community Inclusion plan Quality review tool, Subrecipient may receive an outcome payment.

o. All outcome payments are described in the “Outcome Payment Table for Individual Employment and Community Inclusion” chart in the DDA billing instructions found here: https://www.dshs.wa.gov/sites/default/files/DDA/dda/documents/AWA%20Billing%20Instr uctions%207.1.2025%20FINAL.pdf

p. Partnership Project:

i. The Subrecipient will receive $3,000 per student for each completed Job Foundation document that is at a satisfactory or above rating

ii. Subrecipients with transition students, as outlined in Attachment A, Section 3m, high acuity transition students who authorized for Individual employment, the Subrecipient may receive one outcome payment if transition student obtains a competitive integrated job approved by the County within the timeframes outlined below. If the job is at a minimum of ten hours of work per week the Subrecipient will be eligible for an additional $1,000 payment.

July 1st – September 30th

October 1st – December 31st

January 1st – March 31st

April 1st - June 30th $250

Please note a current County Service Authorization for Individual Employment must be in place prior to outcome payment.

q. Training

i. The Subrecipient shall:

1. Make every effort to minimize the cost of individuals training by seeking out scholarships and stipends, shared transportation and lodging when applicable to help reduce costs. Any additional costs will be the sole responsibility of the Subrecipient.

2. Inform individuals of allowable travel and training expenses.

3. Submit copies of itemized receipts, MapQuest directions, travel itineraries, conference registration including agenda pertaining to all requested reimbursements. Expenses without backup documentation will not be reimbursed.

r. Seek prior approval from the County Program Manager or designee on additional state approved concurrent services training, implementation activities, and services.

s. Fiscal Responsibility. The Subrecipient must demonstrate the ability to safeguard public funds including maintaining books, records, documents and other materials relevant to the provision of goods and services

Date Revised: 1/09/2025

t. Timeliness of and Modification to Billings: All initial invoices with signed documentation must be received by the County within ten (10) calendar days following the last day of the month in which the service is provided. Corrected invoices and documentation including re-posted billing information will be accepted throughout the fiscal year as long as they are received within thirty (30) calendar days of the associated fiscal year unless an extension is approved by the County. Payment will not be made on any invoice submitted past thirty (30) calendar days after the Contract period.

Date Revised: 1/09/2025

Form: 1615.1

CERTIFICATION

I, Lori Forte Harnick, am the President and CEO of Goodwill of the Olympics and Rainier Region and I certify that:

2. I have authority and approval from the governing body on behalf of Goodwill of the Olympics and Rainier Region to accept proceeds from the County per Agreement for services for persons with developmental disabilities by and between the County and Goodwill of the Olympics and Rainier Region.

3. I certify the use of funds submitted for reimbursement or payment under this agreement will be used only to cover those costs that:

a. Are necessary expenditures incurred in support of services for persons with developmental disabilities Were incurred during the period that begins on July 1, 2025 through June 30, 2026.

4. I understand Goodwill of the Olympics and Rainier Region receiving funds pursuant to this certification shall retain documentation of all uses of the funds, including but not limited to invoices and/or sales receipts and such documentation shall be produced to the County upon request and may be subject to audit by the State Auditor.

I hereby certify that I have read the above certification, and that the information and my statements provided herein by me are true and correct to the best of my knowledge, and by my signature on this document acknowledge my understanding that any intentional or negligent misrepresentation or falsification of any of the information in this document could subject me to punishment under federal, civil liability and/or in criminal penalties, including but not limited to fine or imprisonment or both under Title 18, United States Code Sec. 1001, et seq. And punishment under Federal law.

Printed Name Signature

Title Date

RETIREMENT CERTIFICATION

COUNTY RETAINS THIS FORM

Individual contractors and service providers must complete and sign

1. WA Department of Retirement Systems: Independent Contractor Verification and State Retirement Status Reporting Form [WAC 415-02-110; DRS Email 13-011; DRS Email 09-001]

SECTION 1: INDIVIDUAL CONTRACTOR COMPLETES THIS SECTION AND SIGNS:

1. Did you retire from one of the State of Washington Retirement Systems? YES NO

2. Did you retire before age 65 using the 2008 early retirement factors (ERF)? YES NO

3. Will you be receiving direct compensation for your services? YES NO

4. Will you be receiving indirect compensation for your services? YES NO

CONTRACTOR (Full, individual name of contractor):

Signature: Social Security No.:

Date:

SECTION 2: COUNTY COMPLETES THIS SECTION AND RETAINS FOR AUDIT PURPOSES:

[Use Member Reporting Verification (MRV) to verify the past retirement membership]

1. Contractor has been a member of a Washington State Retirement System YES NO If YES, what system and plan?

(TRS)

Law Enforcement Officers’ & Fire Fighters’ Retirement System (LEOFF)

Washington State Patrol Retirement System (WSPRS) Plan 1

2 Judicial Retirement System (JRS)

5. Is the contractor a retiree of a Washington State Retirement System? Yes No

6. Did the contractor retire before age 65 using the 2008 ERF? Yes No

I have verified the information above using MRV or by contacting DRS, and I have evaluated the individual Contractor, Independent Contractor or Service Provider under WAC 415-02-110 and/or DRS Form-MS 344 (R 5/09), and the Internal Revenue Service rules governing independent contractor status.

COUNTY OFFICIAL/DEPARTMENT REPRESENTATIVE:

Signature:

Date Revised: 1/09/2025

Date:

COUNTY RETAINS THIS FORM

DATA SECURITY REQUIREMENTS

1. Definitions. The words and phrases listed below, as used in this Attachment E, shall each have the following definitions:

a. “AES” means the Advanced Encryption Standard, a specification of Federal Information Processing Standards Publications for the encryption of electronic data issued by the National Institute of Standards and Technology (http://nvlpubs.nist.gov/nistpubs/FIPS/NIST.FIPS.197.pdf).

b. “Authorized User(s)” means an individual or individuals with an authorized business need to access DSHS Confidential Information, and who has or have been authorized to do so.

c. “Category 4 Data” is data that is confidential and requires special handling due to statutes or regulations that require especially strict protection of the data and from which especially serious consequences may arise in the event of any compromise of such data. For purposes of this contract, data classified as Category 4 refers to data protected by: the Health Insurance Portability and Accountability Act (HIPAA).

d. “Cloud” means data storage on servers hosted by an entity other than the Contractor and on a network outside the control of the Contractor. Physical storage of data in the cloud typically spans multiple servers and often multiple locations. Cloud storage can be divided between consumer grade storage for personal files and enterprise grade for companies and governmental entities. Examples of consumer grade storage would include iCloud, Dropbox, Box.com, and many other entities. Enterprise cloud vendors include Microsoft Azure, Amazon Web Services, O365, and Rackspace.

e. “Encrypt” means to encode Confidential Information into a format that can only be read by those possessing a “key”; a password, digital certificate or other mechanism available only to authorized users. Encryption must use a key length of at least 256 bits for symmetric keys, or 2048 bits for asymmetric keys. When a symmetric key is used, the Advanced Encryption Standard (AES) must be used if available.

f. “Hardened Password” means a string of at least eight characters containing at least three of the following four character classes: Uppercase alphabetic, lowercase alphabetic, numeral, and special characters such as an asterisk, ampersand or exclamation point.

g. “Mobile Devices” means a computing device, typically smaller than a notebook, which runs a mobile operating system, such as iOS, Android, or Windows Phone. Mobile Devices include smart phones, most tablets, and other form factors.

h. “Multi-factor Authentication” means controlling access to computers and other IT resources by requiring two or more pieces of evidence that the user is who they claim to be. These pieces of evidence consist of something the user knows, such as a password or PIN; something the user has such as a key card, smart card, or physical token; and something the user is, a biometric identifier such as a fingerprint, facial scan, or retinal scan. “PIN” means a personal identification number, a series of numbers which act as a password for a device. Since PINs are typically only four to six characters, PINs are usually used in conjunction with another factor of authentication, such as a fingerprint.

i. “Portable Device” means any computing device with a small form factor, designed to be transported from place to place. Portable devices are primarily battery powered devices with base computing resources in the form of a processor, memory, storage, and network access. Examples include, but are not limited to, mobile phones, tablets, and laptops. Mobile Device is a subset or Portable Device.

j. “Portable Media” means any machine readable media that may routinely be stored or moved independently of computing devices. Examples include magnetic tapes, optical discs (CDs or DVDs), flash memory (thumb drive) devices, external hard drives, and internal hard drives that have been removed from a computing device.

k. “Secure Area” means an area to which only authorized representatives of the entity possessing the Confidential Information have access, and access is controlled through use of a key, card key, combination lock, or comparable mechanism. Secure Areas may include buildings, rooms or locked storage containers (such as a filing cabinet or desk drawer) within a room, as long as access to the Confidential Information is not available

Date Revised: 1/09/2025

to unauthorized personnel. In otherwise Secure Areas, such as an office with restricted access, the Data must be secured in such a way as to prevent access by non-authorized staff such as janitorial or facility security staff, when authorized Contractor staff are not present to ensure that non-authorized staff cannot access it.

l. “Trusted Network” means a network operated and maintained by the Contractor, which includes security controls sufficient to protect DSHS Data on that network. Controls would include a firewall between any other networks, access control lists on networking devices such as routers and switches, and other such mechanisms which protect the confidentiality, integrity, and availability of the Data.

m. “Unique User ID” means a string of characters that identifies a specific user and which, in conjunction with a password, passphrase or other mechanism, authenticates a user to an information system.

2. Authority. The security requirements described in this document reflect the applicable requirements of Standard 141.10 (https://ocio.wa.gov/policies) of the Office of the Chief Information Officer for the state of Washington, and of the DSHS Information Security Policy and Standards Manual. Reference material related to these requirements can be found here: https://www.dshs.wa.gov/ffa/keeping-dshs-client-information-private-and-secure, which is a site developed by the DSHS Information Security Office and hosted by DSHS Central Contracts and Legal Services.

3. Administrative Controls. The Contractor must have the following controls in place:

a. A documented security policy governing the secure use of its computer network and systems, and which defines sanctions that may be applied to Contractor staff for violating that policy.

b. If the Data shared under this agreement is classified as Category 4 data, the Contractor must be aware of and compliant with the applicable legal or regulatory requirements for that Category 4 Data.

c. If Confidential Information shared under this agreement is classified as Category 4 data, the Contractor must have a documented risk assessment for the system(s) housing the Category 4 Data.

4. Authorization, Authentication, and Access. In order to ensure that access to the Data is limited to authorized staff, the Contractor must:

a. Have documented policies and procedures governing access to systems with the shared Data

b. Restrict access through administrative, physical, and technical controls to authorized staff.

c. Ensure that user accounts are unique and that any given user account logon ID and password combination is known only to the one employee to whom that account is assigned. For purposes of non-repudiation, it must always be possible to determine which employee performed a given action on a system housing the Data based solely on the logon ID used to perform the action

d. Ensure that only authorized users are capable of accessing the Data.

e. Ensure that an employee’s access to the Data is removed immediately:

i. Upon suspected compromise of the user credentials.

ii. When their employment, or the contract under which the Data is made available to them, is terminated.

iii. When they no longer need access to the Data to fulfill the requirements of the contract.

f. Have a process to periodically review and verify that only authorized users have access to systems containing DSHS Confidential Information

g. When accessing the Data from within the Contractor’s network (the Data stays within the Contractor’s network at all times), enforce password and logon requirements for users within the Contractor’s network, including:

i. A minimum length of 8 characters, and containing at least three of the following character classes: uppercase letters, lowercase letters, numerals, and special characters such as an asterisk, ampersand, or exclamation point.

Date Revised: 1/09/2025

Form: 1615.1

ii. That a password does not contain a user’s name, logon ID, or any form of their full name.

iii. That a password does not consist of a single dictionary word. A password may be formed as a passphrase which consists of multiple dictionary words.

iv. That passwords are significantly different from the previous four passwords. Passwords that increment by simply adding a number are not considered significantly different.

h. When accessing Confidential Information from an external location (the Data will traverse the Internet or otherwise travel outside the Contractor’s network), mitigate risk and enforce password and logon requirements for users by employing measures including:

i. Ensuring mitigations applied to the system don’t allow end-user modification.

ii. Not allowing the use of dial-up connections.

iii. Using industry standard protocols and solutions for remote access. Examples would include RADIUS and Citrix.

iv. Encrypting all remote access traffic from the external workstation to Trusted Network or to a component within the Trusted Network. The traffic must be encrypted at all times while traversing any network, including the Internet, which is not a Trusted Network.

v. Ensuring that the remote access system prompts for re-authentication or performs automated session termination after no more than 30 minutes of inactivity.

vi. Ensuring use of Multi-factor Authentication to connect from the external end point to the internal end point.

i. Passwords or PIN codes may meet a lesser standard if used in conjunction with another authentication mechanism, such as a biometric (fingerprint, face recognition, iris scan) or token (software, hardware, smart card, etc.) in that case:

i. The PIN or password must be at least 5 letters or numbers when used in conjunction with at least one other authentication factor

ii. Must not be comprised of all the same letter or number (11111, 22222, aaaaa, would not be acceptable)

iii. Must not contain a “run” of three or more consecutive numbers (12398, 98743 would not be acceptable)

j. If the contract specifically allows for the storage of Confidential Information on a Mobile Device, passcodes used on the device must:

i. Be a minimum of six alphanumeric characters.

ii. Contain at least three unique character classes (upper case, lower case, letter, number).

iii. Not contain more than a three consecutive character run. Passcodes consisting of 12345, or abcd12 would not be acceptable.

k. Render the device unusable after a maximum of 10 failed logon attempts.

5. Protection of Data. The Contractor agrees to store Data on one or more of the following media and protect the Data as described:

a. Hard disk drives. For Data stored on local workstation hard disks, access to the Data will be restricted to Authorized User(s) by requiring logon to the local workstation using a Unique User ID and Hardened Password or other authentication mechanisms, which provide equal or greater security, such as biometrics or smart cards.

b. Network server disks. For Data stored on hard disks mounted on network servers and made available through shared folders, access to the Data will be restricted to Authorized Users through the use of access control lists which will grant access only after the Authorized User has authenticated to the network using a Unique User ID and Hardened Password or other authentication mechanisms which provide equal or greater security, such as biometrics or smart cards. Data on disks mounted to such servers must be located in the area, which is accessible only to authorized personnel, with access controlled through use of a key, card key, combination lock, or comparable mechanism.

Date Revised: 1/09/2025

For DSHS Confidential Information stored on these disks, deleting unneeded Data is sufficient as long as the disks remain in a Secure Area and otherwise meet the requirements listed in the above paragraph. Destruction of the Data as outlined in Attachment E, Section 8. Data Disposition may be deferred until the disks are retired, replaced, or otherwise taken out of the Secure Area.

c. Optical discs (CDs or DVDs) in local workstation optical disc drives. Data provided by the County and/or DSHS on optical discs which will be used in local workstation optical disc drives and which will not be transported out of a Secure Area. When not in use for the contracted purpose, such discs must be Stored in a Secure Area. Workstations which access DSHS Data on optical discs must be located in an area which is accessible only to authorized personnel, with access controlled through use of a key, card key, combination lock, or comparable mechanism.

d. Optical discs (CDs and DVDs) in drive or jukeboxes attached to servers. Data provided by the County and/or DSHS on optical discs which will be attached to network servers and which will not be transported out of a Secure Area. Access to Data on these discs will be restricted to Authorized Users through the use of access control lists which will grant access only after the Authorized User has authenticated to the network using a Unique User ID and Hardened Password or other authentication mechanisms which provide equal or greater security, such as biometrics or smart cards. Data on discs attached to such servers must be located in an area which is accessible only to authorized personnel, with access controlled through use of a key, card key, combination lock, or comparable mechanism.

e. Paper documents. Any paper records must be protected by storing the records in a Secure Area, which is only accessible to authorized personnel. When not in use, such records must be stored in a Secure Area.

f. Remote Access

i. Access to and use the Data over the State Governmental Network (SGN) or Secure Access Washington (SAW) will be controlled by DSHS staff who will issue authentication credentials (e.g. a Unique User ID and Hardened Password) to Authorized Users on Contractor staff. Contractor will notify the County and DSHS staff immediately whenever an Authorized User in possession of such credentials is terminated or otherwise leaves the employ of the Contractor, and whenever an Authorized User’s duties change such that the Authorized User no longer requires access to perform work for this Contract.

ii. Access to and use the Data over the County’s secured file share system will be controlled by the County Program Manager who will issue access to Authorized Users on Contractor staff. Contractor will notify the County immediately whenever an Authorized User in possession of such credentials is terminated or otherwise leaves the employ of the Contractor, and whenever an Authorized User’s duties change such that the Authorized User no longer requires access to perform work for this Contract.

g. Data storage on portable devices or media.

i. Except where otherwise specified herein, DSHS Data shall not be stored by the Contractor on portable devices or media unless specifically authorized within the terms and conditions of this Contract. If so authorized, the Data shall be given the following protections:

1. Encrypt the Data.

2. Control access to devices with a Unique User ID and Hardened Password or stronger authentication method such as a physical token or biometrics.

3. Manually lock devices whenever they are left unattended and set devices to lock automatically after a period of inactivity, if this feature is available. Maximum period of inactivity is 20 minutes.

4. Apply administrative and physical security to Portable Devices and Portable Media by:

a. Keeping them in a Secured Area when not in use

Date Revised: 1/09/2025

Form: 1615.1

b. Using check-in/check-out procedures when they are shared, and c. Taking frequent inventories

ii. When being transported outside of a Secured Area, Portable Devices and Portable Media with DSHS Confidential Information must be under the physical control of Contractor staff with authorization to access the Data, even if the Data is encrypted.

h. Data stored for backup purposes.

i. DSHS Confidential Information may be stored on Portable Media as part of a Contractor’s existing, documented backup process for business continuity or disaster recover purposes. Such storage is authorized until such time as that media would be reused during the course of normal backup operations. If backup media is retired while DSHS Confidential Information still exists upon it, such media will be destroyed at that time in accordance with the disposition requirements in Attachment E Section 8. Data Disposition.

ii. Data may be stored on non-portable media (e.g. Storage Area Network drives, virtual media, etc.) as part of a Contractor’s existing, documented backup process for business continuity or disaster recovery purposes. If so, such media will be protected as otherwise described in this attachment. If this media is retired while DSHS Confidential Information still exists upon it, the data will be destroyed at that time in accordance with the disposition requirements in Attachment E, Section 8. Data Disposition.

i. Cloud storage. DSHS Confidential Information requires protections equal to or greater than those specified elsewhere within this attachment. Cloud storage of Data is problematic as neither DSHS, the County, nor the Contractor has control of the environment in which the Data is stored. For this reason:

i. DSHS Data will not be stored in any consumer grade Cloud solution, unless all of the following conditions are met:

1. Contractor has written procedures in place governing use of the Cloud storage and Contractor attest to the Program Manager listed in the contract and keep a copy of that attestation for your records in writing that all such procedures will be uniformly followed.

2. The Data will be Encrypted while within the Contractor network.

3. The Data will remain Encrypted during transmission to the Cloud.

4. The Data will remain Encrypted at all times while residing within the Cloud storage solution.

5. The Contractor will possess a decryption key for the Data, and the decryption key will be possessed only by the Contractor.

6. The Data will not be downloaded to non-authorized systems, meaning systems that are not on the contractor network

7. The Data will not be decrypted until downloaded onto a computer within the control of an Authorized User and within either the DSHS or Contractor’s network.

ii. Data will not be stored on an Enterprise Cloud storage solution unless either:

1. The Cloud storage provider is treated as any other Sub-Contractor, and agrees in writing to all of the requirements within this attachment; or,

2. The Cloud storage solution used is HIPAA compliant.

iii. If the Data includes protected health information covered by the Health Insurance Portability and Accountability Act (HIPAA), the Cloud provider must sign a Business Associate Agreement prior to Data being stored in their Cloud solution.

6. System Protection. To prevent compromise of systems which contain DSHS Data or through which that Data passes:

a. Systems containing DSHS Data must have all security patches or hotfixes applied within 3 months of being made available.

b. The Contractor will have a method of ensuring that the requisite patches and hotfixes have been applied within the required timeframes.

7.

c. Systems containing DSHS Data shall have an Anti-Malware application, if available, installed.

d. Anti-Malware software shall be kept up to date. The product, its anti-virus engine, and any malware database the system uses, will be no more than one update behind current.

Data Segregation

a. DSHS category 4 data must be segregated or otherwise distinguishable from non-DSHS data. This is to ensure that when no longer needed by the Contractor, all DSHS Data can be identified for return or destruction. It also aids in determining whether DSHS Data has or may have been compromised in the event of a security breach. As such, one or more of the following methods will be used for data segregation.

i. DSHS Data will be kept on media (e.g hard disk, optical disc, tape, etc.) which will contain no non-DSHS data.

ii. DSHS Data will be stored in a logical container on electronic media, such as a partition or folder dedicated to DSHS Data.

iii. DSHS Data will be stored within a database which will contain no non-DSHS data. And/or,

iv. DSHS Data will be stored within a database and will be distinguishable from nonDSHS data by the value of a specific field or fields within database records.

v. When stored as physical paper documents, DSHS Data will be physically segregated from non-DSHS data in a drawer, folder, or other container.

b. When it is not feasible or practical to segregate DSHS Data from non-DSHS data, then both the DSHS Data and the non-DSHS data with which it is commingled must be protected as described in this attachment.

8. Data Disposition. When the contracted work has been completed or when the Data is no longer needed, except as noted in Attachment E, Section 5.b. Data shall be returned to the County or destroyed. Media on which Data may be stored and associated acceptable methods of destruction are as follows:

Data stored on: Will be destroyed by: Server or workstation hard disks, or

Removable media (e.g. floppies, USB flash drives, portable hard disks) excluding optical discs

Paper documents with sensitive or Confidential Information

Paper documents containing Confidential Information requiring special handling (e.g. protected health information)

Optical discs (e.g. CDs or DVDs)

Magnetic tape

Using a “wipe” utility which will overwrite the Data at least three (3) times using either random or single character data, or

Degaussing sufficiently to ensure that the Data cannot be reconstructed, or

Physically destroying the disk

Recycling through a contracted firm provided the contract with the recycler assures that the confidentiality of Data will be protected.

On-site shredding, pulping, or incineration

Incineration, shredding, or completely defacing the readable surface with a coarse abrasive

Degaussing, incinerating or crosscut shredding

9. Notification of Compromise or Potential Compromise. The compromise or potential compromise of DSHS shared Data must be:

a. Reported to the County Program Manager designated in this Contract within one (1) business day of discovery,

b. Reported to the DSHS Privacy Officer at dshsprivacyofficer@dshs.wa.gov within one (1) business day of discovery, and

Date Revised: 1/09/2025

c. Contractor must also take actions to mitigate the risk of loss and comply with any notification or other requirements imposed by law or DSHS.

10. Data shared with Subcontractors. If DSHS Data provided under this Contract is to be shared with a subcontractor, the Contract with the subcontractor must include all of the data security provisions within this Contract and within any amendments, attachments, or exhibits within this Contract. If the Contractor cannot protect the Data as articulated within this Contract, then the contract with the sub-Contractor must be submitted to the County Program Manager for review and approval.

Last Date Revised: 1/09/2025

Form: 1615.1

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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s).

Propel Insurance 1201 Pacific Avenue; Suite 1000 COM Middle Market Tacoma, WA 98402-4321 Kellie Hogan 800 499-0933 866

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.

1,000,000 100,000 1,000,000 3,000,000 1,000,000

1,000,000

If yes, describe under

DESCRIPTION OF OPERATIONS below

5,000,000 5,000,000

1,000,000 1,000,000 1,000,000

County Human Services Department 900 Ocean Beach Hwy Suite 1-B Longview, WA 98632

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.

This page has been left blank intentionally.

Timed Items 18.

BOCC Agenda

Meeting Date: 10/21/2025

Ordinance Amending CCC to Reflect Codification of Amendment by the State of Code Reviser

Submitted For: Jason Laurine

Submitted By: Kelly Grayson, Clerk of the Board Department: Prosecuting Attorney

Information

Subject and Summary Statement

Ordinance to Reflect Codification of Amendment by the state Office of Code Reviser to RCW 36.32.120(10), Re-numbering it as RCW 36.32.120(11), effective July of 2025, and Amending Cowlitz County Code Sections 12.55.070, 15.50.120, 15.50.130, 16.20.100, and 16.22.110, and updating Section 2.06.120 to Incorporate said Statutory Amendment.

Will Staff Attend - NAME OF STAFF

Department Recommendation

Call for Public Hearing  Oridinance

Form Started By: Kelly Grayson

Final Approval Date: 10/08/2025

Attachments

Form Review

Started On: 10/08/2025 02:49 PM

BOCCAgenda

MeetingDate: 09/23/2025

Ordinance-AmendingCCCduetoCodificationAmendmentRevising36.32.120(10)to36.32.120(11)

SubmittedFor: JasonLaurine

SubmittedBy: KellyGrayson,ClerkoftheBoard Department: ProsecutingAttorney

Information

SubjectandSummaryStatement

CallforPublicHearingtoadoptanOrdinancereflectingCodificationofAmendmentbytheStateOffice ofCodeRevisertoRCW36.32.120(10),renumberingitasRCW36.32.120(11),effectiveJulyof2025, amendingCowlitzCountyCodeSections12.55.070,15.50.120,15.50.130,16.20.100,and16.22.110, andupdatingSection2.06.120scheduledforOctober21,2025at9:30a.m.

WillStaffAttend-NAMEOFSTAFF DepartmentRecommendation

Ordinance

FormStartedBy:KellyGrayson

FinalApprovalDate:09/22/2025

FormReview

StartedOn:09/22/202508:20AM

BEFORE BOARD OF COMMISSIONERS OF COWLITZ COUNTY, WASHINGTON

In the Matter of Setting a Public Hearing for ) Amendments to County Code sections 12.55.070, ) 15.50.120, 15.50.130, 16.20.100, 16.22.110, and ) RESOLUTION NO. 2.06.120 to reflect the recent statutory citation ) re-numbering of RCW 36.32.120 (11). )

WHEREAS, it appears to this Board that it is in the best interest of public and in compliance with the laws of the State of Washington, to address the recent re-numbering of RCW 36.32.120(11), by revising, amending and updating County Code sections 12.55.070, 15.50.120, 15.50.130, 16.20.100, 16.22.110, and 2.06.120 to reflect the current statutory citation; and

WHEREAS, it is required by law that a public hearing be held on any ordinance amendment by the Board of County Commissioners based upon RCW 36.32.120;

NOW, THEREFOR, IT IS HEREBY RESOLVED that a public hearing will be held on the 21st day of October 2025, at the hour of 9:30 a.m., in the chambers of the Board, third floor, County Administration Building 207 Fourth Avenue North, Kelso, Washington to hear all concerned in the matter of the proposed ordinance amending the aforementioned sections of County Code to conform with state statute.

BE IT FURTHER RESOLVED that notice be given not less than ten (10) days prior to the public hearing as required by law.

DONE IN OPEN SESSION this day of September 2025.

Attest: BOARD OF COUNTY COMMISSIONERS

Kelly Grayson, Clerk of the Board

Richard Dahl, Board Chairman

Steven L. Ferrell, Commissioner

AgendaQuick-Approved as to Form, Only: by Jason Laurine Senior Civil Deputy

Steve Rader, Commissioner Cowlitz Prosecuting Attorney’s Office

BEFORE BOARD OF COMMISSIONERS OF COWLITZ COUNTY, WASHINGTON

In the Matter of Adopting an Ordinance to Reflect ) Codification of Amendment by the state Office of ) Code Reviser to RCW 36.32.120(10), Re-numbering ) ORDINANCE NO. it as RCW 36.32.120(11), effective July of 2025, and ) Thereby Prompting Amendments to Cowlitz County ) Code Sections 12.55.070, 15.50.120, 15.50.130, ) 16.20.100, and 16.22.110, and updating Section ) 2.06.120 to Incorporat e said Statutory Amendment.)

WHEREAS, the Cowlitz County Code (“CCC” or “Code”) incorporates references to various state statutes, maintained and codified by the Washington State Office of Code Reviser; and

WHEREAS, various sections of Code incorporate or reference RCW 36.32.120(10) for purposed of abatement of public nuisance; and

WHEREAS, the Office of Code Reviser in updating the Revised Code of Washington (RCW) has renumbered subsection (10) of RCW 36.32.120 to read subsection (11) as of July 27, 2025 ; and

WHEREAS, the Board of Commissioners recognizes the need to repeal, amend, and revise statutory and regulatory references within its Code to conform to current numbering and citations, and all without amending the substantive content and standards, and authorizations of those Code sections enacted under RCW 36.32.120 and related authority;

NOW, THEREFORE, BE IT HEREBY ORDAINED by the Board of County Commissioners, to provide for conformance in citation and reference to current state laws within Code , that:

Section 1. Cowlitz County Code (CCC) 12 55 070 and Ord. No. 16 -106 §1 – Cost of abatement , is hereby amended and revised, to replace the wording “ the provisions of RCW 36.32.120 (10) ” with “ the provisions of RCW 36.32.120 (11) ”.

IT IS HEREBY FURTHER ORDAINED that:

Section 2. CCC 15.50.120, Ord. 09-137 § 1- Violations, is hereby amended and revised, to replace the wording “ as provided in RCW 36.32.120 (10) ” with “ as provided in RCW 36.32.120 (11) ”.

IT IS HEREBY FURTHER ORDAINED that:

Section 3. CCC 15.50.130, Ord. 09-137 § 1 – Cost of abatement , is hereby amended and revised, to replace the wording “ the provisions of RCW 36.32.120 (10) ” with “ the provisions of RCW 36.32.120 (11) ”.

In the Matter of Amending Cowlitz County Codes from the Renumbering of State Law

IT IS HEREBY FURTHER ORDAINED that:

Section 4. CCC 16.20.110, Ord. 22-063 § 2 & Ord. 17-062 § 1 Enforcement is hereby amended and revised, to replace the wording “ in RCW 36.32.120 (10) ” with “ in RCW 36.32.120 (11) ”.

IT IS HEREBY FURTHER ORDAINED that:

Section 5. CCC 16.22.110, Ord. 13-007 § 1 Enforcement is hereby amended and revised, to replace the wording “ in RCW 36.32.120 (10) ” with “ in RCW 36.32.120 (11) ”.

AND, IT IS HEREBY FURTHER ORDAINED that:

Section 6. CCC 2.06.120, Ord. 01-022 §1 Abatement, is hereby repealed, amended and revised, as set forth below:

2.06.120 Abatement.

Whenever the county deems it necessary, it may take all appropriate measures to abate any violation of a land use ordinance or a public nuisance. The costs of such measures shall be a joint and several obligation of all persons responsible for the violation. The county may recover its abatement costs through an appropriate legal action against any and all such persons pursuant to RCW 36.32.120 (11).

Section 7 . Codification. Only Code repeals and amendments, as set forth in Sections 1 through 6, above, shall be codified.

Section 8. Severability. The provisions of this Ordinance are declared separate and severable. If any section, paragraph, clause, or phrase of this Ordinance is for any reason held to be unconstitutional or invalid, such decision shall not affect the validity of the remaining portions of this Ordinance

Section 9. Repeal, Amendment and Revision As to the aforementioned Ordinances being repealed, amended and revised as set forth above, all other sections and provisions of these prior ordinances that were neither expressly referenced nor repealed, amended or revised hereunder shall remain in full force and effect. Such amendment, repeal and revision shall not be construed as affecting any existing obligation, right or registration acquired under the ordinance or portions of ordinance amended, nor as affecting any proceeding instituted thereunder, nor any rule, regulation, tax or order promulgated thereunder, nor the administrative action taken thereunder, except as set forth herein Further, it is not the intention of these actions to reenact any ordinance or portions or sections of any ordinance previously revised, repealed or amended, unless this ordinance herein specifically states such intent to reenact such revised, repealed or amended ordinances.

Section 10. Effective Date. These provisions are in the public interest and shall take effect immediately upon adoption by the Board of County Commissioners.

APPROVED THIS ____day of __________, 2025, after a public hearing was held on _____________________, 2025, pursuant to Notice published on the ____day of _____________, 2025 in The Daily News.

Attest: BOARD OF COUNTY COMMISSIONERS

Kelly Grayson, Clerk of the Board

Richard Dahl, Board Chairman

Steven L. Ferrell, Commissioner

AgendaQuick-Approved as to Form, Only: by Jason Laurine Senior Civil Deputy Steve Rader, Commissioner Cowlitz Prosecuting Attorney’s Office

In the Matter of Amending Cowlitz County Codes from the Renumbering of State Law

BEFORE BOARD OF COMMISSIONERS OF COWLITZ COUNTY, WASHINGTON

In the Matter of Adopting an Ordinance to Reflect) Codification of Amendment by the state Office of) Code Reviser to RCW 36.32.120(10), Re-numbering) ORDINANCE NO. it as RCW 36.32.120(11), effective July of 2025, and) Thereby Prompting Amendments to Cowlitz County) Code Sections 12.55.070, 15.50.120, 15.50.130, ) 16.20.100, and 16.22.110, and updating Section)

2.06.120 to Incorporate said Statutory Amendment.)

WHEREAS, the Cowlitz County Code (“CCC” or “Code”) incorporates references to various state statutes, maintained and codified by the Washington State Office of Code Reviser; and

WHEREAS, various sections of Code incorporate or reference RCW 36.32.120(10) for purposed of abatement of public nuisance; and

WHEREAS, the Office of Code Reviser in updating the Revised Code of Washington (RCW) has renumbered subsection (10) of RCW 36.32.120 to read subsection (11) as of July 27, 2025; and

WHEREAS, the Board of Commissioners recognizes the need to repeal, amend, and revise statutory and regulatory references within its Code to conform to current numbering and citations, and all without amending the substantive content and standards, and authorizations of those Code sections enacted under RCW 36.32.120 and related authority;

NOW, THEREFORE, BE IT HEREBY ORDAINED by the Board of County Commissioners, to provide for conformance in citation and reference to current state laws within Code, that:

Section 1. Cowlitz County Code (CCC) 12.55.070 and Ord. No. 16-106 §1 – Cost of abatement, is hereby amended and revised, to replace the wording “ the provisions of RCW 36.32.120 (10) ” with “ the provisions of RCW 36.32.120 (11) ”.

IT IS HEREBY FURTHER ORDAINED that:

Section 2. CCC 15.50.120, Ord. 09-137 § 1- Violations, is hereby amended and revised, to replace the wording “ as provided in RCW 36.32.120 (10) ” with “ as provided in RCW 36.32.120 (11) ”.

IT IS HEREBY FURTHER ORDAINED that:

Section 3. CCC 15.50.130, Ord. 09-137 § 1 – Cost of abatement, is hereby amended and revised, to replace the wording “ the provisions of RCW 36.32.120 (10) ” with “ the provisions of RCW 36.32.120 (11) ”.

In the Matter of Amending Cowlitz County Codes from the Renumbering of State

IT IS HEREBY FURTHER ORDAINED that:

Section 4. CCC 16.20.110, Ord. 22-063 § 2 & Ord. 17-062 § 1 — Enforcement is hereby amended and revised, to replace the wording “ in RCW 36.32.120 (10) ” with “ in RCW 36.32.120 (11) ”.

IT IS HEREBY FURTHER ORDAINED that:

Section 5. CCC 16.22.110, Ord. 13-007 § 1—Enforcement is hereby amended and revised, to replace the wording “ in RCW 36.32.120 (10) ” with “ in RCW 36.32.120 (11) ”.

AND, IT IS HEREBY FURTHER ORDAINED that:

Section 6. CCC 2.06.120, Ord. 01-022 §1—Abatement, is hereby repealed, amended and revised, as set forth below:

2.06.120 Abatement.

Whenever the county deems it necessary, it may take all appropriate measures to abate any violation of a land use ordinance or a public nuisance. The costs of such measures shall be a joint and several obligation of all persons responsible for the violation. The county may recover its abatement costs through an appropriate legal action against any and all such persons pursuant to RCW 36.32.120 (11).

Section 7 . Codification. Only Code repeals and amendments, as set forth in Sections 1 through 6, above, shall be codified.

Section 8. Severability. The provisions of this Ordinance are declared separate and severable. If any section, paragraph, clause, or phrase of this Ordinance is for any reason held to be unconstitutional or invalid, such decision shall not affect the validity of the remaining portions of this Ordinance.

Section 9. Repeal, Amendment and Revision. As to the aforementioned Ordinances being repealed, amended and revised as set forth above, all other sections and provisions of these prior ordinances that were neither expressly referenced nor repealed, amended or revised hereunder shall remain in full force and effect. Such amendment, repeal and revision shall not be construed as affecting any existing obligation, right or registration acquired under the ordinance or portions of ordinance amended, nor as affecting any proceeding instituted thereunder, nor any rule, regulation, tax or order promulgated thereunder, nor the administrative action taken thereunder, except as set forth herein Further, it is not the intention of these actions to reenact any ordinance or portions or sections of any ordinance previously revised, repealed or amended, unless this ordinance herein specifically states such intent to reenact such revised, repealed or amended ordinances.

Section 10. Effective Date. These provisions are in the public interest and shall take effect immediately upon adoption by the Board of County Commissioners.

In the Matter of Amending Cowlitz County Codes from the Renumbering of State

APPROVED THIS 21st day of October, 2025, after a public hearing was held on October 21, 2025, pursuant to Notice published on the 30th day of September 2025 in The Daily News.

Attest:BOARD

OF COUNTY COMMISSIONERS

Kelly Grayson, Clerk of the Board

Richard Dahl, Board Chairman

Steven L. Ferrell, Commissioner

AgendaQuick-Approved as to Form, Only: by Jason Laurine Senior Civil Deputy

Steve Rader, Commissioner Cowlitz Prosecuting Attorney’s Office

In the Matter of Amending Cowlitz County

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