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HomeMy WebLinkAboutCP1515 16-18 2016 Local Street Pavement Reconstruction and Preservation Project CITY OF AUBU •RN T K �T Nancy Backus, Mayor WAS H II NGTONT � 25 West Main Street * Auburn WA 98001-4998 * wsvw.auburnwa.gov * 253-931-3000 July 8, 2016 CERTIFIED MAIL RETURN RECEIPT REQUESTED Justin Reynolds Miles Resources, LLC 400 Valley Avenue Northeast Puyallup, WA 98372 NOTICE TO PROCEED RE: Project CP1515, 2016 Local St Pavement Reconstruction & Preservation Project, Contract #16-18 You are hereby notified to proceed as of July 8, 2016 with the work on the above- referenced project, within the time period specified, in accordance with the provisions of the contract documents, copy enclosed. This project has 90 working days for completion. If you have any questions, please contact the inspector for the project, Seth Loop at 253-804-5082 or the Contract Administration Specialist Cindy West at 253-931-3002. Sincerely, Ingrid G Asst. Director of Engineering/City Engineer Community Development & Public Works Department IG/cw/as Enclosure cc: Dani Daskam, City Clerk Jai Carter, Street Systems Engineer Seth Loop, Project Inspector File 13.11 Project # CP1515 AUBURN * MORE THAN YOU IMAGINED CONTRACT Contract No. 16-18 THIS AGREEMENT AND CONTRACT, made and entered into, in triplicate, at Auburn, Washington, this h day of Suk , 2016, by and between the CITY OF AUBURN, WASHINGTON, a municipal corporation, and Miles Resources, LLC, 400 Valley Avenue Northeast, Puyallup, WA 98372, hereinafter called the CONTRACTOR. WITNESSETH: That, in consideration of the terms and conditions contained in the Contract Documents entitled "CP1515, 2016 Local Street Pavement Reconstruction and Preservation Project," which are by this reference incorporated herein and made a part of this Contract, the parties hereto covenant and agree as follows: I. The CONTRACTOR shall do all work and furnish all tools, materials and equipment for Project CPI515, 2016 Local Street Pavement Reconstruction and Preservation Project — the construction of approximately 3,100 linear feet of street improvements, 2,589 linear feet of storm drainage improvements, and 2,760 linear feet of water main improvements, work also includes excavation of existing roadway pavement and subgrade, new asphalt concrete roadway pavement and subgrade, 3,500 linear feet of street overlay, cement concrete curb and gutter reconstruction, driveway reconstruction, partial sidewalk reconstruction, curb ramp reconstruction, storm drainage collection and conveyance construction, water main and residential water service replacement, and other appurtenances for a unit bid price of two million three hundred seventy-five thousand one hundred nineteen dollars and seventy-five cents ($2,375,119.75) and Washington State Sales Tax of forty eight thousand eight hundred thirty-one dollars and seventy-one cents ($48,831.71) for a total contract value of two million four hundred twenty thousand nine hundred fifty one dollars and forty-six cents ($2,420,951.46) in accordance with and as described in the Contract Documents which are by this reference incorporated herein and made a part hereof, and shall perform any alterations in or additions to the work provided under this Contract and every part thereof. This Contract shall be executed by the Contractor and returned to the City within 7 calendar days after the receipt of the dated notification of award and the Contract time shall commence within 5 working days after execution of the Contract by the City and so designated on the Notice to Proceed. Physical completion shall be within 90 working days of the date on the Notice to Proceed. If said work is not completed within the time specified, the CONTRACTOR agrees to pay liquidated damages to the CITY OF AUBURN, as specified in Section 1-08.9 (Liquidated Damages) of the Standard Specifications. The CONTRACTOR shall provide and bear the expense of all equipment, work and labor of any sort whatsoever that may be required for the transfer of materials and for constructing and completing the work provided for in this Contract and every part thereof, except such as are mentioned in the Contract Documents to be furnished by the CITY OF AUBURN. II. The CITY OF AUBURN hereby promises and agrees with the CONTRACTOR to employ, and does employ the CONTRACTOR to provide the materials and to do and cause to be done the above described work and to complete and finish the same according to the Contract Documents and the terms and conditions herein contained and hereby contracts to • Contract Documents and the terms and conditions herein contained and hereby contracts to pay for the same according to said Contract Documents and the aforesaid proposal hereto attached, at the time and in the manner and upon the conditions provided for in this Contract. III. The CONTRACTOR for himself, and for his heirs, executors, administrators, successors, and assigns, does hereby agree to the full performance of all the covenants herein contained upon by part of the CONTRACTOR. IV. It is further provided that no liability shall attach to the CITY OF AUBURN, WASHINGTON by reason of entering into this Contract, except as expressly provided herein. IN WITNESS WHEREOF the parties hereto have caused this Contract to be executed the day and year first hereinabove written. CITY OF AUBURN, WASHINGTON By ;vy'�p��� rvA. acku Countersigned: this-]+4' day of V 1 , 20 I to ATTEST: Danielle E. Daskam,City Clerk APP: • 9 AS I • • M: , %IVA Daniel B. Heid,City Attorney MILES RESOURCES, LLC By %?ffiai Signature Brad Gr , General Manager • CONTRACT BOND CONTRACT NO. 16-18 BOND NO. 023036201 BOND TO CITY OF AUBURN, WASHINGTON KNOW ALL MEN BY THESE PRESENTS: That we, the undersigned, Miles Resources, LLC, 400 Valley Avenue Northeast,Puyallup,WA 98372, as principal, and. Liberty Mutual Insurance Company , a corporation, organized and existing under the laws of the State of Massachusetts as a surety corporation, and qualified under the laws of the State of Washington to become surety upon bonds of contractors with municipal corporations, as surety, are jointly and severally held and firmly bound to the City of Auburn, Washington, in the penal sum of Two Million Four Hundred Twenty Thousand Nine Hundred Fifty One Dollars&46/100(52,420,951.46) dollars, for the payment of which sum we jointly and severally bind ourselves and our successors, heirs, administrators or personal representatives as the case may be. This obligation is entered into in pursuance of the Statutes of the State of Washington and the Ordinances of the City of Auburn, Washington. Dated at Auburn, Washington, this 1±4^ day of ,\--lA‘.1 , 20 I&. Nevertheless, the conditions of the above obligation are such that: WHEREAS, the City of Auburn on the 20th day of June, 2016, let to the above bounden principal a certain Contract. The said Contract being numbered 16-18, and providing for the construction of Project CP1515, 2016 Local Street Pavement Reconstruction and Preservation Project - constructing approximately 3,100 linear feet of street improvements, 2,589 linear feet of storm drainage improvements, and 2,760 linear feet of water main improvements, work also includes excavation of existing roadway pavement and subgrade, new asphalt concrete roadway pavement and subgrade, 3,500 linear feet of street overlay, cement concrete curb and gutter reconstruction, driveway reconstruction, partial sidewalk reconstruction, curb ramp reconstruction, storm drainage collection and conveyance construction, water main and residential water service replacement, and other appurtenances (which Contract is referred to herein and is made a part hereof as though attached hereto), and WHEREAS, the said principal has accepted, or is about to accept, the said Contract, and undertake to perform the work therein provided for in the manner and within the time set forth: NOW, THEREFORE, if the above bounden principal shall faithfully and truly observed and comply with the terms, conditions, and provisions of said Contract in all respects and shall well and truly and fully do and perform all matters and things by them undertaken to be performed under said Contract, upon the terms proposed therein, and any and all duly authorized modifications of said Contract that may hereafter by made, and within the time prescribed therein, and until the same is accepted, and shall pay all laborers, mechanics, subcontractors and material men, and all persons who shall supply principal or subcontractors with provisions and supplies for the carrying on of said work and shall hold said City of Auburn, Washington, harmless from any loss or damage occasioned to any person or property by reason of any carelessness or negligence on the part of said principal or any subcontractor in the performance of said work, and shall in all respects faithfully perform said Contract according to law, and shall indemnify and hold the City of Auburn, Washington, harmless from any damage or expense by reason of failure of performance, as specified in said Contract, and The undersigned principal and the undersigned surety present this contract bond related to the Contract, PROVIDED that this document shall not be enforceable unless and until the City of Auburn awards and executes the Contract to the undersigned principal. No obligations under this bond, for the performance of the above-referenced contract, shall be enforceable until the City of Auburn has executed the contract to the undersigned principal. The Surety, hereby agrees that modifications and changes may be made in the terms and provisions of the aforesaid Contract without notice to Surety, and any such modifications or changes increasing the total amount to be paid the Principal shall automatically increase the obligation of the Surety on this Contract Bond in a like amount, such increase; however, not to exceed twenty — five percent (25%)of the original amount of this bond without the consent of the Surety. PROVIDED, however, that after the acceptance of this Contract and the expiration of the lien period, and if there are no liens pending, then the penal sum of this bond, shall be reduced to either ten percent (10%) of the value of the improvements to the City or two thousand dollars ($2,000), whichever is greater, to warranty against defects appearing or developing in the material or workmanship provided or performed under this Contract within a period of one (1) year after acceptance. Not withstanding the reduction of this bond, the principal and surety shall hold the City of Auburn harmless from all defects appearing or developing in the material or workmanship provided or performed under this Contract within a period of one (1) year after acceptance, THEN and in that event this obligation shall be void; but otherwise it shall be and remain in full force and effect. It is hereby expressly agreed that if any legal action is necessary to be brought under the conditions of this bond, that the decisions of the Courts of the State of Washington shall be binding. IN WITNESS WHEREOF, the above-bounden parties have executed this instrument this 28th .day of June _ _ , 2016 • /files 'esourc ,LLC Brad Grit f '' h, eneral Manager Liberty Mutual Insurance Company Surety yC � B -4 U Attorney in Fact y hia L.Jay Propel Insurance 925 4th Avenue,Suite 3200,Seattle,WA 98104 (206)e75-4200 Resident Agent's Address&Phone Number THIS POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND. This Power of Attorney limits the acts of those named herein,and they have no authority to bind the Company except in the manner and to the extent herein stated. • Certificate No. 73 American Fire and Casualty Company Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That Amedcan Fire 8 Casualty Company and The Ohio Casualty Insurance Company are corporations duly organized under the laws of the State of New Hampshire,that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts,and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana(herein collectively called the"Companies"),pursuant to and by authority herein set forth,does hereby name,constitute and appoint, Aliceon A.Keltner;Annelies M. Richie;Barbara A.Johnson;Brandon K. Bush;Brent E.Heilesen;Carley Espiritu;Christopher Kinyon; Cynthia L.Jay; Diane M.Harding;Eric A.Zimmerman;James B.Binder;Jamie Diemer;Jennifer L.Snyder;Jon J.Oja;Julie R.Truitt;Karen C. Swanson;Kristine A.Lawrence;Mitchell R.Smee;Peter J.Comfort all of the city of Tacoma ,state of WA each individually if there be more than one named,its true and lawful attorney-in-fact to make,execute,seal,acknowledge and deliver,for and on its behalf as surely and as its act and deed,any and all undertakings,bonds,recognizances and other surety obligations,in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF,this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 14th day of April , 2016 , PNo cggL �,v INs„ �,NscR �,„s°„ American Fire and Casualty Company v� �wrr0 �9r �”°W' 4,� T�we" "f w;" The Ohio Casualty Insurance Company m �` m " Liberty Mutual Insurance Company 1906 0 0 1919 n > 1912 ° 1991 a a o � W z z West merican Insurance Company N z : O d�`wHn.as�``Za W,,,/,',,,n,rswT�a° ��nan,,,F�r`e rMnn�/ /p/� /� 7 41 By: C STATE OF PENNSYLVANIA ss David`` M.Carey Assistant Secretary CO s3COUNTY OF MONTGOMERY c N . On this 14th_ day of April , 2016, before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of American Fire and 'zi- t) w Casualty Company,Liberty Mutual Insurance Company,The Ohio Casualty Insurance Company,and West American Insurance Company,and that he,as such,being authorized so to do, ay ILI `O 2, co execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. ` E W > IN WITNESS WHEREOF,I have hereunto subscribed m name and affixed my notarial seal at Plymouth Meeting,Pennsylvania,on the day and year first/�above written. O a en 10 SP pgsT COMMONWEALTH OF PENNSYLVANIA �(-� /G t 0 7 -� P�'yN° ve4 FCC Notarial Seal - 1 rim M C'5 r-o a t= a+ Teresa Pastella,Notary Public gy; ��-Or-/ O co ` OF Plymouth Twp.,Montgomery County Teresa Pastella,Notary Public • C ` Fr My Commission Expires March 2B,2017 CO ID:0 K1%,,,,,,,,,„ — Member.Pennsylvania Association or Notaries a E co C m This Power of Attorney is made and executed pursuant tWby"authority of the following By-laws and Authorizations of American Fire and Casualty Company,The Ohio Casualty Insurance W0 cc w Company,Liberty Mutual Insurance Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows: $9 173 m 2 ARTICLE IV—OFFICERS—Section 12.Power of Attorney.Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President,and subject O c .2)0 to such limitation as the Chairman or the President may prescribe,shall appoint such attomeys-in-fact,as may be necessary to act in behalf of the Corporation to make,execute,seal, as N 0.0 acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Such attomeys-in-fad,subject to the limitations set forth in their respective 9 S> E c powers of attomey,shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so —et O R executed,such instruments shall be as binding as if signed by the President and attested to by the Secretary.Any power or authority granted to any representative or attomey-in-fact under >J]N I— the provisions of this article may be revoked at any time by the Board,the Chairman,the President or by the officer or officers granting such power or authority. w a To C ARTICLE XIII—Execution of Contracts—SECTION 5.Surety Bonds and Undertakings.Any officer of the Company authorized for that purpose in writing by the chairman or the president, E m > d and subject to such limitations as the chairman or the president may prescribe,shall appoint such attomeys-in-fact,as may be necessary to act in behalf of the Company to make,execute, I—tV O ii seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Such attorneys-in-fact subject to the limitations set forth in their C� Z V respective powers of attorney,shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. V�I '4 Certificate of Designation—The President of the Company,acting pursuant to the Bylaws of the Company,authorizes David M.Carey,Assistant Secretary to appoint such attorneys-in- 12— fact as may be necessary to act on behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Authorization—By unanimous consent of the Company's Board of Directors,the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company,wherever appearing upon a certified copy of any power of attomey issued by the Company in connection with surety bonds,shall be valid and binding upon the Company with the same force and effect as though manually affixed. I,Gregory W.Davenport,the undersigned,Assistant Secretary,of American Fire and Casualty Company,The Ohio Casualty Insurance Company,Liberty Mutual Insurance Company,and West American Insurance Company do hereby ceNfy that the original power of attorney of which the foregoing is a full,true and correct copy of the Power of Attorney executed by said Companies,is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this ' day of C/ (k NA--- ,20 1 Jp FNpCggovINSUq NlrvsuR Q.,p)—"Pee, y‘.,.1-,"130,91, SOP d'c,WONrm a6srPWoxg97 e 2 n CT ¢ c a 1906 0 0 1919 X1912 ° 1991 By: �� i Gregory W.Davenport,Assistant Secretary ��D p - ' %4y�'vn,n to�`2ae °�ry,yurs`�`�.3� s�'rrra<,rvs =�. .n,Ai t 626 of BOO LMS_12873122013 Page 1 of 2 Consumer tools Agent and Company Lookup Orders Independent Review Decisions LIBERTY MUTUAL INSURANCE COMPANY Licensing I Appointments I Complaints J Orders I National,Info, I Ratings I Tax Filings Back to Search General information Contact information Name: LIBERTY MUTUAL INSURANCE COMPANY Registered address Mailing address Corporate family group: LIBERTY MUT GRP O. 175 BERKELEY ST 100 LIBERTY WAY Organization type: PROPERTY BOSTON, MA 02117 DOVER, NH 03820 WAOIC: 733 Telephone Telephone NAIC: 23043 617-357-9500 617-357-9500 Status: ACTIVE Admitted date: 10/30/1933 Ownership type: STOCK back to top Types of coverage authorized to sell p Insurance types Casualty Marine Ocean Marine Property Surety Vehicle t back to top Agents and agencies that represent this company (Appointments) p View agents View agencies back to cop Company complaint history o View complaints back to top Orders issued since 2015 o No orders are found t back to top Disciplinary orders 2008-2014 0 httnc•//urunM incnranre 'n/a onv/rnnciimertnnikit/Cmmnnnv/PmmnanvPrnfilp acnv9WA(lIl=7 7/1/2111A Page 2 of 2 No disciplinary orders are found Looking for other types of orders? Our Pre-2015 orders search allows you to search orders prior to 2015. back to top Premium tax filings by tax year a 2015 2014 2013 2012 2011 baC to,cop National information on insurance companies Wantmore information about this company?The NAIC's Consumer Information (CIS) page allows you to retrieve national financial and complaint information on Insurance companies, plus has information and tips to help you understand current insurance issues. back to top Ratings by financial organizations The following organizations rate insurance companies on their financial strength and stability. Some of these companies charge for their services. A.M. Best Weiss Group Ratings Standard and Poor's Corp Moody's Investors Service Fitch IBCA, Duff and Phelps Ratings ?back to too https://www.insurance.wa.gov/consumertoolkil/Company/CompanyProfile.aspx?W AOIC=7... 7/1/2016 A.M. Best's Consumer Insurance Information Center Page 1 of I A.M. Best's QQdM'ijayleq tnQtnnc® Center r s0 Member Center Loo In I Sign Un Need Coverage? :Search" How Does Your Insurerrp�] Ra1te? State Insurance Information Find insurers by state or coverage type. 'Enlii/'ier a company Name I laced a sure w Consumer Home I Terms to Know I Why a Best's Rang is Important I Contact Us (✓ Life 8 Retirement Q Health S,Disability Q Car 8 Home Q Other Life Events Liberty Mutual Insurance Company A Print this page to member or Liberty Mutual Inneianne Companies) AM nest 022e3 NAICC 23043 FEN4-Oa-t5-ua70 Address: 175 Berkeley Street Phone: 617-357-9500 Boston,MA 02117 Fax. 617374.5955 UNITED STATES Web: www LlbertyMutualGroup corn Best's Ratings View Definition —+X- cope Need More information? Financial Strength Rating' A n � " Purchase an insurer report,complete with Me� arating history,market share and a list of Outlook: Stable Credit RtiE competitive insurers for 8 9.95. Effective Dale: October 08,2015(Affirmed) ! View Sample Report Financial Size Category: XV(52 Billionlionor or greater) Licensing: The company is licensed in the District of Columbia,Northern Mariana Islands,Puerto Rico,U.S Virgin Islands and at stales II is also licensed in all Canadian provinces and territories Top Line(s)of Business m..eaapan pd.00 Premumawnneet 1. Inland Marine(view Definition) 2. Surety(View DeMaidn) 3. Auto(Personal)(view Minton i 4. Other Liability(Occurrence)rv�ne Ceteitan) 5 Other Liability(Claims-made)Mew oenniimn Top State(s)of Business(based open Deem wemiumawiman) 1. Massachusetts 2. California 3. New York 4. Canada 5. Other Alien Visit our NowsRoom for the latest News and Press Releases for this company and Its A M Best Group. 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Customer Service.1 Product Support I Member Center I Contact Info I Careers About A M Best I Site�Ma I Privacy Policy ISecurev I Terms or Use I Legal B Licensing Copyright 0 2016 A M.Best Company.Inc and/or its affiliates ALL RIGHTS RESERVED. http://www3.ambest.com/Consumers/CompanyProfile.aspx?BL=36&ambnum=002283&PP.:. 7/I/2016 Client#: 17793 MILESAND • ACORDr. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDPVYYY) 6/27/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsomont(s). PRODUCER N211TACT Sharnel Di Vona Propel Insurance PHONE,ext):253.310.4047 FM((AIC,No): 866.577.1326 (AIC,No Tacoma Commercial Insurance noDREss: Sharnel.Divona@propelinsurance.com 1201 Pacific Ave, Suite 1000 INSURER(S)AFFORDING COVERAGE NAIC Tacoma,WA 98402 INSURER A Continental Western Ins.Co. 10804 INSURED INSURER a:Axis Surplus Insurance Company 26620 Miles Resources LLC INSURER C: 400 Valley Ave NE Puyallup,WA 98372 INSURER O: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER ;pawn POLICY E%P LTR INSR WVD POLICY NUMBER (MMIDO ) (MM/UD/YYYY)_ LIMITS A GENERALUABILITY X X CPA2865825 14/0112016 04/01/2017 EACH OCCURRENCE $1,600,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Eaoc rrence) $1 00,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $10,000 X PD Ded: $1,000 PERSONAL$ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN_AGGREGATE� LIMIT APPL�IES PER PRODUCTS.COMP/OP AGG 52,000,000 7 POLICY IT( jgeT PLOC _ S A AUTOMOBILE LIABILITY X X CPA2865825 14/01/201604/01/2017 GOMeINEDBINGLE LIMIT (Ea aameml $1,000,000 X ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Por accident) S X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) l $ A x UMBRELLALIAB X OCCUR X X CPA2865825 14/01/2016 04/01/2017 EACH OCCURRENCE $5,000,000 7 EXCESS UAB CLAIMS-MADE AGGREGATE $5,000,000 OED X RETENTION SO $ A WORKERS COMPENSATION CPA2865825 14/01/2016 04/01/2017 TwCRTIAMu O AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETORIPARTNERIEXECUrIVE (WA Stop Gap only) EL EACH ACCIDENT 51,000,000 OFFICER/MEMBER EXCLUDED? N NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 Il yes.describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 B Contr Pollution ELZ793114012016 14101/2016 04/01/2017 $1,000,000/$2,000,000 A Installation Fltr CIM2982131 14/01/2016 04/01/2017 $100,000/$2,500 ded A Leased/Rented Eq. CIM2982131 14/01/2016 04/01/2017 $500,000/$5,000 ded DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,II more space Is required) RE:2016 Local Street Pavement Reconstruction and Preservation Project,Contract#16-18,Project#CP1515. The City of Aub irn and its officers,elected officials,employees, agents, and volunteers are additional insured per the attached endorsement. CERTIFICATE HOLDER CANCELLATION Cityof Auburn SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 25 West Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Auburn,WA 98001 AUTHORIZED REPRESENTATIVE 1 ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S2267892/M2175845 SXHOO This page has been left blank intentionally. COMMERCIAL GENERAL LIABILITY CL CG 00 13 08 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY PLATINUM ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. MEDICAL PAYMENTS If SECTION I-COVERAGE C MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part: 1. The Medical Expense Limit provided by this policy, subject to the terms of SECTION III - LIMITS OF INSURANCE, shall be the greater of: a. $10,000; or b. The Medical Expense Lirimit shown in the Declarations of this Coverage Part. B. FIRE, LIGHTNING, EXPLOSION, SMOKE AND SPRINKLER LEAKAGE DAMAGE TO PREMISES YOU RENT If damage to premises rented to you under Coverage A. is not otherwise excluded from this policy, the following applies: 1. The last paragraph of SECTION I-COVERAGE A.2. Exclusions is deleted and replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or sprinkler leakage to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in SECTION III - LIMITS OF INSURANCE. 2. Paragraph 6. of SECTION III - LIMITS OF INSURANCE is deleted and replaced by the following: 6. Subject to Paragraph 5. above, the greater of: a. $300,000; or b. the Damage To Premises Rented To You Limit shown in the Declarations; is the most we will pay under COVERAGE A for damages because of "property damage" to any one premises, while rented to you or temporarily occupied by you with the permission of the owner. 3. Paragraph 4.b.(1)(a)(ii) Other Insurance of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is deleted and replaced by the following: (ii) That is Fire, Lightning, Explosion, Smoke or Sprinkler Leakage insurance for premises rented to you or temporarily occupied by you with the permission of the owner; 4. Paragraph 9.a. of SECTION V- DEFINITIONS is deleted and replaced by the following: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke or sprinkler leakage to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract"; CL CG 00 13 08 13 Includes copyrighted material of Insurance Services Page 1 of 6 Office,Inc.with its permission C. LIMITED NON-OWNED WATERCRAFT 1. Paragraph g.(2) of SECTION I - COVERAGE A.2. Exclusions is deleted and replaced by the following: A watercraft you do not own that is: ' a. Less than 51 feet long; and b. Not used to carry persons or property for a charge. D. SUPPLEMENTARY PAYMENTS SECTION I - SUPPLEMENTARY PAYMENTS-COVERAGES A AND B is amended as follows: 1. The limit of insurance in paragraph 1.b. is increased from $250 to$2,500; and 2. The limit of insurance in paragraph 1.d. is increased from $250 to $500. E. AUTOMATIC ADDITIONAL INSURED - SPECIFIED RELATIONSHIPS - PRIMARY NON-CONTRIBUTORY The following is added to Paragraph 2. of SECTION II -WHO IS AN INSURED: e. Any person or organization described below, when you are obligated by virtue of a written contract or agreement that such person be added as an additional insured on your policy. When required by virtue of a written contract or agreement, coverage provided to any additional insured will be on a primary basis and will not seek contribution from the additional insured's policy. Only the following persons or organizations are additional insureds under this endorsement: (1) Managers Or Lessors Of Premises. The manager or lessor of a premise leased to you, but only with respect to liability arising from the ownership, maintenance or use of that part of the premises leased to you and subject to the following additional exclusions: This insurance does not apply to: (a) Any"occurrence" which takes place after you cease to be.a tenant of that premises. (b) Structural alterations, new construction or demolition operations performed by or on behalf of the manager or lessor. (2) Lessor Of Leased Equipment. Any person or organization from whom you lease equipment, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s). However, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. (3) Vendors. Any person or organization, but only with respect to "bodily injury" or • "property damage" arising out of "your products" shown in the Schedule which are distributed or sold in the regular course of the vendor's business, subject to the following additional exclusions: a. The insurance afforded the vendor does not apply to: 1. "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; 2. Any express warranty unauthorized by you; 3. Any physical or chemical change in the product made intentionally by the vendor; CL CG 00 13 08 13 Includes copyrighted material of Insurance Services Page 2 of 6 Office,Inc.with its permission 4. Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; 5. Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; 6. Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; 7. Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor. b. This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. (4) State Or Political Subdivision - Permits Or Authorizations Relating To Premises. Any state or political subdivision, subject to the following additional provision: This insurance applies only with respect to the following hazards for which the state or political subdivision has issued a permit in connection with premises you own, rent, or control and to which this insurance applies: (a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, 'canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar exposures;or (b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elevators covered by this insurance. Limits of insurance for such additional insured are the limits in this coverage form or the limits you and such additional insured agreed to by virtue of a contract or agreement, whichever is less. These limits are inclusive of and are not in addition to the Limits Of Insurance shown in the Declarations. When required by virtue of a written contract or agreement, coverage provided to any additional insured AUTOMATIC ADDITIONAL INSURED - SPECIFIED RELATIONSHIPS - PRIMARY NON-CONTRIBUTORY will be on a primary basis and will not seek contribution from the additional insured's policy. F. BROADENED NAMED INSURED-NEWLY ACQUIRED 180 DAYS Paragraph 3..of SECTION II -WHO IS AN INSURED is deleted and replaced by the following: Any organization you newly acquire or form, other than a joint venture, and over which you maintain ownership or majority interest of more than 50% will be a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier. b. COVERAGE A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization. c. COVERAGE B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. G. AGGREGATE LIMITS OF INSURANCE The General Aggregate Limit under SECTION III - LIMITS OF INSURANCE applies separately to each of your: CL CG 00 13 08 13 Includes copyrighted material of Insurance Services Page 3 of 6 Office, Inc.with its permission 1. Projects away from premises owned by or rented to you. 2. "Locations'owned by or rented to you. "Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad. • When paragraph B. Construction Project General Aggregate Limit on form CL CG 00 20 is a part of this policy, then paragraph G. Aggregate Limits of Insurance of this endorsement does not apply. H. KNOWLEDGE OF OCCURRENCE The following is added to paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of SECTION IV-COMMERCIAL GENERAL LIABILITY CONDITIONS: e. A report of an "occurrence", offense, claim or"suit" to: (1) You, if you are an individual, (2) A partner, if you are a partnership, (3) An executive officer, if you are a corporation, or (4) A manager, if you are a limited liability company; is considered knowledge and requires you to notify us of the "occurrence", offense, claim, or"suit"as soon as practicable. f. We are considered on notice of an "occurrence", offense, claim or "suit" that is reported to your Workers Compensation insurer for an event which later develops into an "occurrence", offense, claim or "suit" for which there is coverage under this policy. However, we will only be considered on notice if you notify us as soon as you know the claim should be addressed by this policy rather than your Workers' Compensation policy. I. UNINTENTIONAL OMISSIONS The following is added to paragraph 6. Representations of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: d. If you unintentionally fail to disclose any exposures existing at the inception date of your policy, we will not deny coverage under this Coverage Part solely because of such failure to disclose. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal. This provision does not apply to any known injury or damage which is excluded under any other provision of this policy. J. MENTAL ANGUISH Paragraph 3. of SECTION V- DEFINITIONS is deleted and replaced by the following: 3. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including mental anguish or death resulting from any of these at any time. K. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is amended by the addition of the following: We waive any right of recovery we may have because of payments we make for "bodily injury" or "property damage" arising out of your ongoing operations or "your work" done under a contract requiring such waiver with that person or organization and included in the "products-completed operations hazard". However, our rights may only be waived prior to the "occurrence" giving rise to the injury or damage for which we make payment under this Coverage'Part. The insured must do nothing after a loss to impair our rights. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce those rights. CL CG 00 13 08 13 Includes copyrighted material of Insurance Services Page 4 of 6 Office, Inc.with its permission Paragraph K. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS does not apply if another waiver of transfer of rights of recovery against others is endorsed separately to this policy. L. OTHER INSURANCE When Coverage applies in this General Liability Enhancement Endorsement, no other coverage or limit of insurance in the policy applies to loss or damage insured by this coverage. M. NON-EMPLOYMENT DISCRIMINATION LIABILITY (DEFENSE WITHIN LIMITS) The following is added to paragraph 14. "Personal and advertising injury" SECTION V - DEFINITIONS of COMMERCIAL GENERAL.LIABILITY COVERAGE FORM: h. Non-employment discrimination. Non-employment discrimination means violation of a person's civil rights with respect to such person's race, color, national origin, religion, gender, marital status, age, sexual orientation or preference, physical or mental condition, or any other protected class or characteristic established by any federal, state or local statutes, rules or regulations. Non-employment discrimination does not include violation of civil rights arising out of past, present or prospective employment. Our obligation under the Personal and Advertising Injury Liability Coverage to pay non- employment discrimination liability damages on your behalf applies only to the amount of damages in excess of$5,000 deductible as the result of any one offense regardless of the number of persons or organizations who sustain damages because of the offense. The most we will pay for all damages for non-employment discrimination is $15,000 annual aggregate. No other liability to pay sums or perform acts or services is covered. Supplemental Payments - Coverages A and B do not apply to non-employment discrimination coverage. N. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS OR OTHERS- AUTOMATIC, INCLUDING PRIMARY NON-CONTRIBUTORY 1. SECTION II - WHO IS AN INSURED is amended to include as an additional insured any person or organization for whom you are performing operations when you are obligated by virtue of a written contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused by your ongoing operations for the additional insured and only to the extent that such "bodily injury", "property damage" or "personal and advertising injury" is caused by your negligence or the negligence of those performing operations on your behalf. This insurance does not apply to "bodily injury", "property damage", "personal and advertising injury" included within the "products-completed operations hazard". This insurance does not apply to any additional insured scheduled on your policy by separate endorsement 2. Limits of Insurance Limits of insurance for such additional insured are the limits in this coverage form or the limits you and such additional insured agreed to by virtue of a contract or agreement, whichever is less. These limits are inclusive of and are not in addition to the Limits Of Insurance shown in the Declarations. 3. Exclusions A. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of: 1. The rendering of or failure to render any professional services by you or on your behalf, but only with respect to either or both of the following operations: CL CG 00 13 08 13 Includes copyrighted material of Insurance Services Page 5 o 6 Office, Inc.with its permission a. Providing engineering, architectural or surveying services to others in your capacity as an engineer, architect or surveyor; and b. Providing, or hiring independent professionals to provide, engineering, architectural or surveying services in connection with construction work you perform. 2. Subject to Paragraph 3. below, professional services include: a. Preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications; and b. Supervisory or inspection activities performed as part of any related architectural or engineering activities. 3. Professional services do not include services within construction means, methods, techniques, sequences and procedures employed by you or performed by or for the construction manager, its employees or its subcontractors in connection with your ongoing operations. B. "Bodily injury" or"property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. 4. Primary Non-Contributory When required by virtue of a written contract or agreement, coverage provided to any additional insured by ADDITIONAL INSURED - OWNERS, LESSEES, CONTRACTORS OR OTHERS - ONGOING OPERATIONS - AUTOMATIC, INCLUDING PRIMARY NON CONTRIBUTORY will be on a primary basis and will not seek contribution from the additional insured's policy. CL CG 00 13 08 13 Includes copyrighted material of Insurance Services Page 6 of 6 Office,Inc.with its permission POLICY NO: CPA 2865825 30 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Al #1 .5 ADDITIONAL INSURED - OWNERS, LESSEES, CONTRACTORS OR OTHERS - COMPLETED OPERATIONS - AUTOMATIC STATUS, INCLUDING PRIMARY NONCONTRIBUTORY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. SECTION II -WHO IS AN INSURED is amended For purposes of this endorsement, throughout the to include as an additional insured any person(s) policy, the terms "you" and "your" refer to the or organization(s) when you are obligated by Named Insured shown in the Declarations. virtue of a written contract or agreement that such B. Exclusions person or organization(s) be added as an additional insured to your policy. With respect to the insurance afforded to these Such person(s) or organization(s) is an additional additional insureds, the following additional insured only with respect to liability for "bodily exclusions apply to "bodily injury" and "property injury" or "property damage" or "personal and damage"arising out of: advertising injury"caused, in whole or in part by: 1. The rendering of or failure to render any (1) Acts or omissions of the Named Insured; professional services by you or on your behalf, or but only with respect to either or both of the following operations: (2) The acts or omissions of those acting on a. Providing engineering, architectural or behalf of the Named Insured; surveying services to others in your and included in the "products-completed capacity as an engineer, architect or operations hazard" surveyor; and This insurance applies only when you are required b. Providing, or hiring independent to add the additional insured by virtue of a written professionals to provide, engineering, contract or agreement, provided the contract or architectural or surveying services in agreement is: connection with construction work you 1. Currently in effect or becomes effective during perform. the term of this policy; and This exclusion applies even if the claims 2. Was executed prior to the "bodily injury" or against any insured allege negligence or "property damage" or "personal and other wrongdoing in the supervision, advertising injury". hiring, employment, training or monitoring of others by that insured, if the However: "occurrence" which caused the "bodily injury" or "property damage", or the a. The insurance afforded to such additional offense which caused the "personal and insured only applies to the extent permitted by advertising injury", involved the rendering law; and of, or the failure to render, any b. If coverage provided to the additional insured professional architectural, engineering or is required by a contract or agreement, the surveying services. insurance afforded to such additional insured 2. Subject to Paragraph 3. below, professional will not be broader than that which you are services include: required by the contract or agreement to provide for such additional insured. • Includes copyrighted material of Insurance Services Page 1 of 2 Office, Inc., with its permission a. Preparing, approving, or failing to prepare D. Other Insurance or approve, maps, shop drawings, For purposes of this endorsement, the following is opinions, reports, surveys, field orders, added to the Section IV - Commercial General change orders, or drawings and Liability Conditions, 4. Other Insurance specifications; and condition and supersedes any provision to the b. Supervisory or inspection activities contrary: !k performed as part of any related This insurance is excess of all other insurance architectural or engineering activities. available to an additional insured whether on a 3. Professional services do not include services primary, excess, contingent or any other basis. within construction means, methods, But, if required by a written contract or written techniques, sequences and procedures agreement to be primary and noncontributory,this employed by you or performed by or for the insurance will be primary to and will not seek construction manager, its employees or its contribution from any insurance on which the subcontractors in connection with your additional insured is a Named Insured. • ongoing operations. No other coverage or limit in the policy applies to C. Limits of Insurance loss or damage insured by this coverage. With respect to the insurance afforded to these additional insureds, the following is added to Section III -Limits Of Insurance: • If coverage provided to the additional insured is required by a contract or agreement, the most we Will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the' applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 Includes copyrighted material of Insurance Services Office, Inc:, with its permission I POLICY NO: CPA 2865825 30 COMMERCIAL GENERAL LIABILITY I THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 1 i Al #1 .0A GENERAL LIABILITY PLATINUM AMENDMENT - ADDITIONAL INSURED - Provision N. (Revised) 1 4 i This endorsement modifies insurance provided under the following: 1 COMMERCIAL GENERAL LIABILITY PLATINUM ENDORSEMENT 1 I A. Provision N.ADDITIONAL INSURED-OWNERS, b. If the written contract specifically requires LESSEES OR CONTRACTORS - AUTOMATIC you to provide additional insured INCLUDING PRIMARY NON-CONTRIBUTORY coverage via the 10/01 edition of CG2010 is deleted in its entirety and replaced with the (aka CG 20 10 10 01) or via the 11/85 following: edition of CG2010 (aka CG 20 10 11 85), N. ADDITIONAL INSURED - OWNERS, then in paragraph 2.a. above, the words I LESSEES OR CONTRACTORS - caused in whole or in part by are replaced AUTOMATIC INCLUDING PRIMARY by the words arising out of. ! NON-CONTRIBUTORY c. The insurance afforded to such additional 1. Section II -Who is An Insured is amended insured only applies to the extent to include as an additional insured any permitted by law. person(s)or organization(s)for whom you are d. If coverage provided to the additional required by virtue of a written contract or insured is required by a contract or agreement that such person(s) or agreement, the insurance afforded to organization(s) be added as an additional such additional insured will not be broader insured on your policy. than that which you are required by the 2. The insurance provided to the additional contract or agreement to provide for such additional insured. insured is limited as follows: a. Such person or organization is an e. This insurance ends at the earliest of the additional insured only with respect to following times: liability for "bodily injury", "property (1) When any Named Insured(s) work damage" or "personal and advertising called for in the written contract has injury"caused in whole or in part by: been completed it (1) Acts or omissions of the Named (2) When all of any Named Insured(s) j Insured; or work done at a job site has been j completed if the written contract calls ij (2) The acts or Omissions of those acting for work at more than one job site on behalf of the Named Insured; (3) When that part of any Named in the performance of the Named Insured(s)work done at a job site has Insured's ongoing work for the additional been put to its intended use by any insured(s)specified in the written contract person(s) or organization(s) other provided the contract or agreement than the Named Insured or those ii requires you to provide the additionalacting on the Named Insured(s) insured such coverage and is: behalf. I I. Currently in effect or becomes Work that may need service, maintenance, effective during the term of this correction, repair or replacement, but is i policy; and otherwise complete, will be treated as H. Was executed prior to the "bodily completed. P injury", "property damage" or f. This insurance does not apply to any "personal and advertising injury", additional insured scheduled on your policy by separate endorsement. Includes copyrighted material of Insurance Services Page 1 of 3 3 Office, Inc., with its permission i . 1 I g. For purposes of paragraph A. of this 4. Limits of Insurance endorsement, the terms "you" and "your" With respect to the insurance afforded to is refer to the Named Insured shown in the q Declarations. these additional insureds, the following is added to Section III -Limits Of Insurance: 3. Exclusions coverage provided to the additional insured With respect to the insurance afforded to is required by a contract or agreement, the these additional insureds, the following most we will pay on behalf of the additional additional exclusions apply to "bodily injury", insured is the amount of insurance: I "property damage" or "personal and a. Required by the contract or agreement; or advertising injury" arising out of: a. The rendering of or failure to render any b. Available under the applicable Limits of j professional services by you or on your Insurance shown in the Declarations; behalf, but only with respect to either or whichever is less. both of the follovaing operations: This endorsement shall not increase the (1) Providing engineering, architectural applicable Limits of Insurance shown in the or surveying services to others in your Declarations. • capacity as an engineer, architect or 5. Other Insurance surveyor; and R (2) Providing, or hiring independent For purposes of this endorsement, the - professionals to provide, engineering, following is added to the Section IV architectural or surveying services in Commercial General Liability Conditions, connection with construction work 4.Other Insurance condition and supersedes any provision to the contrary: I you perform. b. Subject to Paragraph c. below, This insurance Is excess of all other insurance available to an additional insured whether on professional services include: a primary, excess, contingent or any other t. (1) Preparing, approving, or failing to basis. But, if required by a written contract or I prepare or approve, maps, shop written agreement to be primary and drawings, opinions, reports, surveys, noncontributory, this insurance will be primary field orders, change orders, or to and will not seek contribution from any drawings and specifications; and insurance on which the additional insured is a (2) Supervisory or inspection activities Named Insured. performed as part of any related No other coverage or limit in the policy applies architectural or engineering activities. to loss or damage insured by this coverage. c. Professional services do not include B. The following coverage is added: i services within construction means, e methods, techniques, sequences and CONTRACTUAL LIABILITY RAILROADS procedures employed by you or 1. With respect to operations performed for a it performed by or for the construction Railroad within 50 feet of railroad property,the i manager, its employees or its definition of"insured contract" in Section V - subcontractors in connection with your Definitions is replaced by the following: G ongoing operations. 9. "Insured Contract'means: & This exclusion applies even if the claims I against any insured(s) alleged negligence or a. A contract for a lease of premises. 3 other wrongdoing in the supervision, hiring, However, that portion of the contract employment, training or monitoring of others for a lease of premises that by that insured, if the "occurrence" which indemnifies any person or , caused the "bodily injury" or "property organization for damage by fire to damage", or the offense which caused the premises while rented to you or t temporarily occupied by you with i "personal and advertising injury", involved the rendering of, or the failure to render, any permission of the owner is not an professional architectural, engineering or insured contract"; I surveying services. b. A sidetrack agreement; II c. Any easement or license agreement; G t Page 2 of 3 Includes copyrighted material of Insurance Services 1 Office, Inc., with its permission 1 d. An obligation, as required by ordinance,to No other coverage or limit in the policy applies indemnify a municipality, except in to loss or damage insured by this coverage. connection with work for a municipality; e. An elevator maintenance agreement; f. That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for"bodily injury" or"property damage"to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f.does not include that part of any contract or agreement: (1) That indemnifies an architect, engineer or surveyor for Injury or damage arising out of: (a) Preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; (2) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, including those listed in Paragraph (1) above and supervisory, inspection, architectural or engineering activities. 2. Other Insurance For purposes of this endorsement, the following is added to the Section IV - Commercial General Liability Conditions, 4.Other Insurance condition and supersedes any provision to the contrary: This insurance is excess of all other insurance that is Railroad Protective Liability or similar coverage for "your work" performed for a Railroad. But, if required by a written contract or written agreement to be primary and noncontributory,this insurance will be primary to and will not seek contribution from any insurance on which the Railroad is a Named Insured. Includes copyrighted material of Insurance Services Page 3 of 3 Office, Inc., with its permission This page has been left blank intentionally. COMMERCIAL AUTO CL CA 01 49 02 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTOMOBILE EXPANSION ENDORSEMENT - PLATINUM This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to the coverages provided by this endorsement, the provisions of the Business Auto Coverage Form apply unless modified by this endorsement. A. NEWLY ACQUIRED OR FORMED ORGANIZA- ganization is liable for"bodily injury" or "prop- TIONS erty damage": because of the conduct of an The following is added to Paragraph A.1. Who Is "insured" under Paragraphs a. or b. under An Insured of Section II - Covered Autos Liability Paragraph A.1. Who Is An Insured of Section II - Covered Autos Liability Coverage, caused Coverage: by an"accident"and resulting from the owner- Any organization you newly acquire or form, other ship, maintenance or use of a covered "auto"; than a partnership, joint venture or limited liability 2. The written contract or agreement described company or any organization excluded either by above must have been executed prior to the this Coverage Part or by endorsement, and over "accident" that caused the "bodily injury" or which you maintain ownership or majority interest "property damage" and be in effect at the time of more than 50 percent will qualify as a Named Insured. However: of such "accident"; 1. This insurance does not apply to any newly ac- 3. The insurance afforded to any such additional quired or formed organization that is an "in_ "insured"does not apply to any"accident" e- sured" under any other automobile policy or gond the period of time required by the written would be an "insured" under such policy but contract or agreement described above; for its termination or the exhaustion of its Limit 4. The most we will pay on behalf of such addi- of Insurance. tional "insUred(s)" is the lesser of: 2. Coverage does not apply to "bodily injury" or a. The Limits of Insurance specified in the "property damage" that occurred before you written contract or agreement described acquired or formed the organization. above;or 3. Coverage under this provision is afforded only b. The Limits of Insurance shown in the Dec- until the 180th day after you acquire or form larations. the organization or the end of the policy pe- This provision shall not increase the Limit of riod, whichever is earlier. Insurance shown in the Declarations in this B. ADDITIONAL INSURED BY CONTRACT OR policy or coverage part; and AGREEMENT 5. The following changes are made to Paragraph The following is added to Paragraph A.1., Who Is 5. Other Insurance of B. General Conditions An Insured of Section II - Covered Autos Liability under Section IV- Business Auto Conditions: Coverage: a. The following is added to Paragraph 5.a.: When you have agreed in a written contract or If required by the written contract or agreement to include a person or organization as an additional "insured", such person or organiza- agreement described above, the insur- tion is included as an "insured" subject to the fol- ante afforded to the additional insured un- der this provision will be primary to, and lowing: will not seek contribution from, the addi- 1. Such person or organization is an additional tional insured's own insurance. "insured" only to the extent such person or or- b. Paragraph 5.c. is deleted in its entirety. CL CA 01 49 02 15 Includes copyrighted material of Insurance Services Page 1 of 5 Office, Inc., with its permission 6. Paragraph A.1.c. under Section II - Covered 2. We will also pay reasonable and necessary Autos Liability Coverage is deleted in its en- expenses to facilitate the return of the stolen tirety. "auto"to you. 7. The definition of"insured contract"under Sec- 3. It is agreed and understood and it is our stated tion V- Definitions is amended to add the fol- intent that expenses incurred by you under the lowing: Transportation Expenses Coverage Exten- sionAn "insured contract" does not include that will not also be covered or paid under the part of any contract or agreement: Rental Reimbursement Coverage provided by this endorsement or any rental reimbursement That pertains to the ownership, maintenance coverage added by separate endorsement to or use of an "auto" and which indemnifies a this policy. person or organization for other than the vicar- H. EXTENDED COVERAGE - AIRBAGS ious liability of such person or organization for - "bodily injury or"property damage"caused by The following is added to Exclusion B.3.a. of Sec- your operation or use of a covered "auto". tion III- Physical Damage Coverage: However, a person or organization is.an addi- However, this exclusion does not apply to the un- tional "insured"under this provision only to the intended discharge of an airbag. extent such person or organization is not This coverage is excess over any other collectible named as an "insured" by separate endorse- insurance or warranty providing Stich airbag cov- ment to this policy. erage. C. EMPLOYEES AS INSUREDS I. AUTO LOAN/LEASE GAP COVERAGE The following is added to Paragraph A.1.Who Is The following is added to Section III - Physical An Insured Section II - Covered Autos Liability Damage Coverage, Paragraph C. Limits of Insur- Coverage: ance. Any"employee" of yours is an "insured"while us- 4. In the event of a total "loss" to a covered ing a covered "auto"you don't own, hire or borrow "auto", we will pay any unpaid amount due on in your business or your personal affairs. the lease or loan for a covered "auto", less: D. INCREASED COVERAGE- BAIL BONDS a. The amount under the Physical Damage The Supplementary Payments Coverage Exten- Coverage section of the policy; and sion of Section II - Covered Autos Liability Cover- b. Any: age is amended as follows: The Limit of Insurance in paragraph A.2.a.(2) is (1) Overdue lease/loan payments at the increased to $5,000. time of the "loss"; E. INCREASED COVERAGE - LOSS OF EARN- (2) Financial penalties imposed under a INGS lease for excessive use, abnormal wear and tear or high mileage; The Supplementary Payments Coverage Exten- (a) Security deposits not returned by the sion of Section II - Covered Autos Liability Cover- lessor; age is amended as follows: The Limit of Insurance in paragraph A.2.a.(4) is (4) Costs for extended warranties, Credit increased to$1,000. Life Insurance, Health, Accident or Disability Insurance purchased with F. FELLOW EMPLOYEE COVERAGE the loan or lease; and The Fellow Employee Exclusion contained in Sec- (5) Carry-over balances from previous tion II-Covered Autos Liability Coverage does not loans or leases. apply. This coverage is excess over any other col- J. GLASS REPAIR -NO DEDUCTIBLE. lettable insurance. G. COVERAGE EXTENSION-TRANSPORTATION The following is added to Paragraph D.Deductible EXPENSES of Section III - Physical Damage Coverage: Paragraph A.4.a. Transportation Expenses of Any Comprehensive Coverage deductible shown in the Declarations does not apply to "loss" to Section III- Physical Damage Coverage is amended as follows: glass when you elect to patch or repair rather than replace the glass. 1. The Limits of Insurance are increased to $75 K. INCREASED COVERAGE - ELECTRONIC per day to a maximum of$2,500. EQUIPMENT Page 2 of 5 Includes copyrighted material of Insurance Services CL CA 01 49 02 15 Office, Inc., with its permission The$1,000 limit indicated in Paragraph C.1.b.un- The following is added to Paragraph A.4. Cover- der Section III- Physical Damage Coverage is in- age Extensions of Section III - Physical Damage creased to $2,500. Coverage: L. EXTENDED COVERAGE - PERSONAL PROP- If hired "autos" are covered "autos" for Covered ERTY Autos Liability Coverage and if Physical Damage The following is added to Paragraph A.4. Cover- Coverage is provided for any"auto"you own, then the Physical Damage coverages provided are ex- age Extensions of Section III - Physical Damage tended to "autos' you lease, rent, hire or borrow Coverage: from someone other than your "employees", part- Physical Damage Coverage on a covered "auto" ners or members of their households subject to the may be extended to "loss" to your personal prop- following: erty or, if you are an individual, the personal prop- 1. The most we will pay in any one "loss" is the erty of a family member, that is in the covered lesser of: "auto" at the time of "loss" and caused by an "ac- cident" and resulting from the ownership, mainte- a. The actual cash value of the "auto"; nance or use of a covered "auto". b. The cost to repair or replace the "auto"; or The insurance provided by this coverage exten- c. $100,000. sion is excess over any other collectible insur- - ance. The most we will pay for any one"loss" un- 2. Paragraph 1. above is subject to a deductible. der this coverage extension is$500. However,our The deductible shall be equal to the amount of payment for"loss"to personal property will only be the highest deductible shown for any owned for the account of the owner of the property. "auto" of the same classification for that cov- Under this provision, personal property does not erage. In the event there is no owned "auto" include and we will not pay for "loss" of currency, of the same classification,the highest deduct- coins, securities or contraband. ible for any owned "auto" will apply for that coverage. No deductible applies to this coverage extension. No deductible will apply to "loss" caused by M. TOWING fire or lightning. Paragraph A.2. Towing of Section III - Physical 3. Hired Auto Physical Damage Coverage is Damage Coverage, is replaced by the following: subject to the following: If a private passenger type "auto" or light truck a. If symbol 8 is shown in the Covered Auto "auto"(0-10,000 Lbs.GVW)is provided both Com- section of the Declarations page for any of prehensive and Collision Coverage,we will pay up the Physical Damage coverages, then the to $150 for towing and labor costs incurred each Hired Auto Physical Damage coverage time such "auto" is disabled. If a medium, heavy described in this endorsement does not or extra-heavy truck or extra-heavy Truck-tractor apply. "auto" (greater than 10,000 Lbs. GVW) is provided both Comprehensive and Collision Coverage, we b. Other than indicated in Paragraphs a. di- will pay up to $250 for towing and labor costs in- rectly above, coverage provided under curred each time such "auto" is disabled. How- this provision will be excess over any ever, the labor must be performed at the place of other collectible insurance or coverage. disablement. 4. In addition to the limit set forth in Paragraph 1. N. FIRE EXTINGUISHER RECHARGE above we will pay up to $500 per day, to a maximum of$3,500 per"loss" for: The following is added to Paragraph A.4. Cover- a. Any costs or fees associated with the age Extensions of Section IV - Physical Damage "loss"to a hired "auto"; and Coverage: When fire extinguishers are kept in your covered b. Loss of use of the hired"auto", provided it "auto"and any are discharged in an attempt to ex- tinguish a fire, we will pay the lesser of the actual which you are legally liable, and as a re- cost of recharging or replacing such fire extin- sult of which a monetary loss is sustained guisher(s). by the leasing or rental concern. No deductible applies to this coverage However, Paragraph A.4.b. Loss of Use Ex- penses under Section III - Physical Damage Coy- 0. HIRED AUTO PHYSICAL DAMAGE COVER- erage of the Business Auto Coverage Form does AGE not apply. P. RENTAL REIMBURSEMENT COVERAGE CL CA 01 49 02 15 Includes copyrighted material of Insurance Services Page 3 of 5 Office, Inc., with its permission We will pay for rental reimbursement expenses in- (3) Your members or managers, if you curred by you for the rental of an "auto" because are designated in the Declarations as of"loss" to a covered"auto". a limited liability company; 1. Payment applies in addition to the otherwise (4) Your executive officers if you are des- applicable amount of each coverage you have ignated in the Declarations as an or- on the covered "auto". ganization other than an individual, 2. No deductible applies to this coverage. partnership,joint venture or limited li- ability company; and 3. We will pay only for those expenses incurred (5) The spouse of any person named in during the policy period beginning 24 hours af- Paragraphs 1.a.(1). through 1.a.(4) ter the"loss"and ending, regardless of the ex- while a resident of the same house- piration date of the policy, with the lesser of hold; the following number of days: a. The number of days when the covered Except: "auto" has been repaired or replaced, or (a) Any "auto" owned by that individ- ual or by any member of his or y her household. 4. Our payment is limited to the lesser of the fol- (b) Any"auto"used by that individual lowing amounts or his or her spouse while working a. Necessary and actual expenses incurred; in a business of selling, servicing, or repairing or parking "autos". b. Not more than $75 for any one day; 2. Changes In Auto Medical Payments And 5. We will pay up to an additional $300 for the Uninsured And Underinsured Motorists Coverages reasonable and necessary expenses you in- cur to remove your materials and equipment The following is added to Who Is An Insured: from the covered"auto"and replace such ma- Any individual named in 1.a above and his or terials and equipment on the rental "auto". her "family members" are "insured" while "oc- 6. This coverage does not apply while there are cupying" or while a pedestrian when being spare or reserve "autos" available to you for struck by any "auto"you don't own except: your operations. Any "auto" owned by that individual or by any 7. If"loss"results from the total theft of a covered "family member". "auto" of the "private passenger type", we will 3. Changes In Physical Damage Coverage pay under this coverage only that amount of your rental reimbursement expenses which is Any private passenger type "auto" you don't not already provided for under the Physical own, hire or borrow is a covered "auto" while Damage Coverage EXtension of the Business in the care,custody or control of any individual Auto Coverage Form or any endorsements named in O.1.a. above or his or her spouse thereto while a resident of the same house-hold ex- However, this provision does not apply to the cept: extent that rental reimbursement is provided a. Any"auto" owned by that individual or by by separate endorsement to this policy. any member of his or her household; or O. DRIVE OTHER CAR COVERAGE b. Any"auto"used by that individual or his or her spouse while working in a business of 1. The following is added to Section II -Covered Autos Liability Coverage: selling, servicing,repairing or parking"au- tos". a. Any "auto" you don't own, hire or borrow 4. The most we will pay for the total of all dam- is a covered "auto" for Liability Coverage ages under Covered Autos Liability Uninsured while being used by: Motorists Coverage and Underinsured Motor- (1) You, if you are designated in the Dec- ists Coverage is the Limit Of Insurance shown larations as an individual; in the Declarations as applicable to owned (2) Your partners or members, if you are "autos". designated in the Declarations as a 5. Our obligation to pay for, repair, return or re- partnership or joint venture; place damaged or stolen property under Phys- ical Damage Coverage, will be reduced by a deductible equal to the amount of the highest Page 4 of 5 Includes copyrighted material of Insurance Services CL CA 01 49 02 15 Office, Inc., with its permission deductible shown for any owned private pas- prejudice the coverage provided to you. However, senger type "auto" applicable to that cover- this provision does not affect our right to collect age. If there are no owned private passenger additional premium or exercise our right of cancel- type "autos", the deductible shall be $250 for lation or nonrenewal. Comprehensive Coverage and $500 for Colli- U. LIBERALIZATION sion Coverage. No deductible will apply to "loss" caused by fire or lightning. If we revise this endorsement to provide greater 6. Additional Definition coverage without additional premium charge, we will automatically provide the additional coverage As used in this DRIVE OTHER CAR Provi- to all endorsement holders as of the day the revi- sion: sion is effective in your state. "Family member" means a person related to the individual named in 1.a. by blood, mar- riage or adoption who is a resident of the indi- vidual's household, including a ward or foster child. R. KNOWLEDGE OF AN ACCIDENT, CLAIM,SUIT OR LOSS The following is added to Paragraph A.2. of Sec- tion IV - Business Auto Conditions: Your obligation to provide prompt notice of an "ac- cident", claim, "suit" or "loss" is satisfied if you or a person designated by you to be responsible for insurance matters is notified of, or in any manner made aware of an"accident",claim, "suit"or"loss" and provides us such notice as soon as practica- ble S. WAIVER OF SUBROGATION BY CONTRACT OR AGREEMENT The following is added to Paragraph A.5 of Sec- tion IV - Business Auto Conditions: We waive any right of recovery we may have against a person or organization because of pay- ments we make for "bodily injury" or "property damage" when you and such person or organiza- tion have agreed in writing in a contract or agree- ment to waive such right of recovery, provided: 1. Such written contract or agreement was: a. Made prior to the "accident" or "loss" resulting in the covered "bodily injury" or "property damage"; and b. Was in effect at the time of the covered "bodily in- jury" or"property damage". 2. The covered "bodily injury" or "property damage" must arise out of the operations specified in such written contract or agreement. 3. At our request you must provide us with a copy of the aforementioned written contract or agreement. T. UNINTENTIONAL OMISSIONS The following is added Paragraph B.2. of Section IV- Business Auto Conditions: If you fail to disclose any hazards existing at the inception date of this policy, such failure will not CL CA 01 49 02 15 Includes copyrighted material of Insurance Services Page 5 of 5 Office, Inc., with its permission This page has been left blank intentionally. 1 POLICY NO: CPA 2865825 30 COMMERCIAL LIABILITY UMBRELLA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Al #6.0 ADDITIONAL INSURED - PRIMARY NONCONTRIBUTORY This endorsement modifies insurance provided under the following: COMMERCIAL LIABILITY UMBRELLA COVERAGE FORM Paragraph 5. Other Insurance of SECTION IV-CONDITIONS, COMMERCIAL LIABILITY UMBRELLA COVERAGE FORM is deleted and replaced with the following: 44 5. Other Insurance a. This insurance is excess over, and shall not contribute with any of the other insurance, whether primary, excess, contingent or on any other basis except as shown under 5.c. below. This condition will not apply to insurancespecifically written as excess over this Coverage Part. When this insurance is excess, we will have no duty under Coverages A or B to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that"suit". If no other insurer defends, We will undertake to do so, biut we will be entitled to the insured's rights against all those other insurers. b. When this insurance is excess over other insurance, we will pay only our share of the"ultimate net loss"that exceeds the sum of: (1) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (2) The total of all deductible and self-insured amounts under all that other insurance. c. The insurance is excess of all other insurance available to an additional insured whether on a primary, excess, contingent or any other basis. But, if required by a written contract or Written agreement to be f primary and noncontributory, this insurance will be primary to, and will not seek contribution from, any insurance on which the additional insured is a Named Insured. No other coverage or limit in the policy applies to loss or damage insured by this coverage. ( ( i Includes copyrighted material of Insurance Services Page 1 of 1 Office, Inc., with its permission This page has been left blank intentionally. COMMERCIAL LIABILITY UMBRELLA CL CU 24 74 09 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL LIABILITY UMBRELLA COVERAGE PART The Transfer Of Rights Of Recovery Against Others To Us Condition under Section IV - Conditions is amended by the addition of the following: We waive any right of recovery we may have because of payments we make for "bodily injury" or "property damage" arising out of your ongoing operations or "your work" done under a written contract requiring such waiver with that person or organization and included in the"products-completed operations hazard". However, our rights may only be waived prior to the "occurrence"giving rise to the injury or damage for which we make payment under this Coverage Part. The insured must do nothing after a loss to impair our rights. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce those rights. CL CU 24 74 09 13 Includes copyrighted material of Insurance Services Page 1 of 1 Offices, Inc. with its permission This page has been left blank intentionally. Page I of 2 Consumer tools Agent and Company Lookup Orders Independent Review Decisions CONTINENTAL WESTERN INSURANCE COMPANY Licensing I Appointments I Complaints. I Orders I National Info I Ratings I Tax Filings Back to Search General information Contact information Name: CONTINENTAL WESTERN INSURANCE COMPANY Registered addressMailing address Corporate family group: WR BERKLEY CORP GRP o 11201 DOUGLAS 11201 DOUGLAS AVE Organization type: PROPERTY 9URBANDALE, IA 50322 URBANDALE, IA 50322 WAOIC: 116648 Telephone Telephone NAIC: 10804 800-235-2942 800-235-2942 Status: ACTIVE Admitted date: 08/23/1995 Ownership type: STOCK back to top Types of coverage authorized to sell q. Insurance types Casualty Marine • • Property Surety Vehicle back to top Agents and agencies that represent this company (Appointments) o View agents View agencies t back to top Company complaint history o View complaints 1'back to top Orders issued since 2015 o No orders are found back„f953p Disciplinary orders 2008-2014 0. haps://www.insurance.wa.gov/consumertoolkit/Company/CompanyProfile.aspx?WAOIC=1... 7/1/2016 A.M. Best's Consumer Insurance Information Center Page 1 of I A1..M..�wBelslt''sr 1nC1le:'n/�q ((�� ^6 C.Qnsun1.eL [FI5MRrance Qea.tev Member Center Loom IIga.Q2 Need Coverage? semt.- How Does Your Insurer,qR�ate? State Insurance Information Find insurers by state or coverage type [Enter a Company Name I 1 [select a state Consumer Home I Terms to Know I Why a Bear's Raung is Important I Contact Us Life&Retirement O Health&Disability Q Car&Home O Other Life Events Continental Western Insurance Company 8 Print this page .member ow R Berkley Imuran croup) M eenV 00971 NAIC C 15504 FUN 0 42a5s4770 Address' P.O.Box 1594 Phone 515.473.3000 Des Moines,IA 50306-1594 Fax: 515-473-3015 UNITED STATES Web www cwgins com Best's Rating's View Definition pr.�( Need More Information? Financial Strength Rating. A+ 96 �n eV Purchase an insurer report,complete with Outlook'. Stable 1s I rating history market share and a list of Credit Re competitive insurers for$9.95 Effective Date. February 26,2016(Affirmed) k� Financial Size Category: XV($2 Billion or greater) daE View Sample Report y'' Licensing: The company is licensed in the District of Columbia,AL,AK,AZ.AR,CO,CT,DE,GA,HI,10.IL.IN,IA.KS,KY,LA.ME.MD,MA.MI,MN,MS,MO,MT,NE,NV,NH,NJ, NM,NY,NC,ND,OH,OK,OR,PA SC,SD,TN,TX,UT,VT,VA,WA,WV,WI and WY. Top Line(s)of Business (based apo°Direct Premama written) 1. Commercial Multiple Peril rview Defeat]i 2. Auto(Commercial)(View Dennison) 3 Workers Compensation(view vermilion) 4. Other Liability(Occurrence)(View Definition I 5 Boiler and Machinery(view Definition) Top Stato(s)of Business Reese°upon Dire..Premmms Watenl 1. Washington 2. Minnesota 3 Nebraska a. Kansas 5 Iowa Visit our NewsRoom for the latest News and Press Releases for this company and its A.M.Best Group. 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Customer Service I Product Support I Member Center I Contact Info I Careers About A M Best I Site Map I Privacy Policy I Security I Terms of Use I Legal B Licensing Copyright 0 2016 A.M Best Company,Inc andlor its affiliates ALL RIGHTS RESERVED. http://www3.ambest.com/Consumers/CompanyProfile.aspx?BL=36&amb) um=000971&PP... 7/1/2016 Carriers Surplus Lines Association of-Washington Page 1 of 1 Documents I V en'corsntn I Calendar of Eons I FAQs I Contact Us I SEARCH 1 .:out Us 1 Sews I Filing lntormagon I Brokerage Firms I Corners I SLIP I La As dr Repulsions I Education I Links I Manual Home> Carriers Carrier Requirements Carriers List of Active Carriers Inclusion on this fist does not indicate that the carner meets the requirement as an appiepnate insurer.The Surplus Line Broker is sourly responsible for determining the quafilicatmns of each wirer.Being on this list means the carrier is recognized by no Surplus Line Association of Washington and slings by brokers for the corner will be accepted for examination Search By Insurer Name or City. Acis r Search ; tt Insurer Nome I Address 'i City 1 Elate AMS SPECIALrr EUROPE SE 1 MOUNT HERBERT COURT DUBLIN IE AXIS SURPLUS INSURANCE CO tPANIV 111 SOUTH WACKER DRIVE I CHICAGO I IL 2 o 2Rans About Us I News I Ftlmg informetron I Brokerage Firms I Carnet I SLIP Laws E.Re5Ns lions 1 Euccasnn I Links I islenual Home 1 Documents I MembersNe I Calendar of Events I FAP I Contact Us Copyngh1 O 2016 Surplus Line Association of Washington.All Rights Reserved II] http:/hvwv.sufpluslines.org/carriers/ 7/1/2016 A.M. Best's Consumer Insurance Information Center Page 1 of I A.M. Best's Q ULti$er I^% C Ke Qenter in Member Center Lop In l Sign UP Need Coverage? How Does Your insurer Rate?lllState Insurance Information Find insurers by state Or coverage type. jEnrer a Company Name J] I Seine a slate vl Consumer Home I Terms to Know I Vvhy a Basis Rang is Important I Contact Us 0 Life E.Retirement O Health 8 Disability Q Car 8 Homo O Other Life Events AXIS Surplus Insurance Company Bi Print this page le member aiA5tS ineuenc•Group) •M Best tr 12515 NANO•29020 FEIN 010941125 Address' 11680 Great Oaks Way Phone: 676-746-9400 Suite 500 Fax: 678-746-3420 Alpharetta,GA 30022 Web. www axiscaprtal corn UNITED STATES Bests Ratings View Definition $, 10-f Need More information? Financial Strength Rating A+ OMB, IP!„pea Purchase an insurer repon,complete with ♦ rating history,market shore and o list of Outlook: Stable 0,1.5": JCredit�Re `rt j competitive insurers for$9.95. Effective Dale: August 04,2015(Affirmed) 4,r m.4.E�` View Sample Report Financial Size Category. XV($2 Billion or greater) Licensing: It also operates on a surplus lines or non-admitted basis in the District Of Columbia,Puerto Rico and all states. Top Line(s)of Business Iea.adupono,eci Premium wettest 1. Other Liability(Occurrence)Mee Denmbpn I 2. Other Liability(Claims-mado)Wee Dsnn'et I 3, AllIed Linos(View oeMmme I 4. Fire(vim.oensmnnI 5 Earthquake New Dennnron I Top State(s)of Business(based open ogee Premum.%mean) 1. Texas 2. California 3 New York 4. Florida 5. Now Jersey Visit our NewsRoom for the latest News and Press Releases for this company and its A M.Best Group. Terms of Use All information provided on ole A.M.Best website,including but not limited to text.data,ratings,reports,images,photos,graphics,and charts is owned by or licensed to A.M.Best Company and is protected by United States copyright laws and international treaty provisions.A.M.Best and its licensors retain all copyright and other proprietary nghts to the website content. Best's Credit Ratings,obtained through any source,may not he reproduced,dnirrbuled to Thvd Parties,or stored in a database or retriovol system in any form for commercial purposes wilhouf she prior written permission of the A.M.Best Company.All unauthorized use of Best's Credit Ratings or other published information is strictly prohibited.By logging into Best's Member Center or accessing This site,you accept and agree to be bound by our complete Terms of Use Customer Service I Product Su000d I Member Center I Contact Info I Careers About AM Best I Site Map I Pnvocv Policy I S2 yrit I Terms of Use I Legal 8 Licensinn Copyright®2016 A M Best Company,Inc and/or its affiliates ALL RIGHTS RESERVED http://www3.ambest.com/Consumers/CompanyProfile.aspx?B L=36&ambnum=012515&PP... 7/1/2016 BOND IN LIEU OF RETAINAGE (Retainage Bond -RCW 60.28) Bond No. 023036205 KNOW ALL PERSONS BY THESE PRESENTS, THAT Miles Resources, LLC, 400 Valley Avenue Northeast, Puyallup, WA 98372 a corporation organized under the laws of the State of Washington and registered to do business in the State of Washington as a contractor, as Principal, and Liberty Mutual Insurance Company a corporation organized under the laws of the State of Massachusetts and registered to transact business in the State of Washington as surety, as Surety, their heirs, executors, administrators, successors and assigns, are jointly and severally held and bound to the City of Auburn, Washington, hereinafter called CITY, and are similarly held and bound unto the beneficiaries of the trust fund created by RCW 60.28, in the sum of five percent (5%) of all amounts earned by the Principal on the contract described below. THE CONDITIONS OF THIS BOND OBLIGATION ARE THAT: WHEREAS, on the7"day of , u 2016, the Principal executed Contract No. 16-18 with the CITY for ProjectNLmber CP1515, 2016 Local Street Pavement Reconstruction and Preservation Project; and WHEREAS, said contract and RCW 60.28 require the CITY to withhold from the Principal the sum of five percent (5%)from monies earned by the Principal on estimates during the progress of the construction, hereinafter referred to as earned retained funds; and WHEREAS, the Principal has requested that the CITY not retain any earned retained funds as allowed under RCW 60.28; NOW, THEREFORE, the condition of this obligation is such that the surety is held and bound to the CITY and to the beneficiaries of the trust fund created by RCW 60.28 in the sum of five percent (5%) of the final contract cost which shall include any increases due to change orders, increases in quantities of work, addition of new items of work, or otherwise, hereafter referred to as the final contract cost. If all purposes of RCW 60.28 and all contract obligations are fulfilled, then this obligation shall be null and void; otherwise, it shall remain in full force and effect until release is authorized in writing by the CITY. IT IS FURTHER EXPRESSLY AGREED THAT: 1.. The liability of the Surety under this bond shall not exceed five percent (5%) of the final contract cost, if no monies are retained by the CITY pursuant to RCW 60.28 on estimates during the progress of construction. Retainage Bond Page 1 of 3 2. In the event this bond ceases to comply with CITY standards, the CITY reserves the right to resume the actual withholding of earned retained funds according to the contractors designated option for management of retainage under RCW 60.28.011(4). In the event the CITY resumes withholding of earned retained funds, the liability of the Surety under this bond shall not exceed the actual amount of the earned retained funds which were covered by this bond and released by the CITY prior to resumption of actual withholding. 3. The Surety hereby consents to and waives notice of any extension in the time for performance of the contract, assignment of obligations under the contract, or contract alteration, amendment, or change order. 4. Any suit under this bond must be instituted within the time period provided by applicable law with venue in King County, Washington.. This bond and any proceeds therefrom shall be subject to all claims and liens and in the same manner and priority as set forth for retained percentages in RCW 60.28. 5. Until written release of this obligation by the CITY, this bond may not be terminated or canceled by the Principal or the Surety for any reason. Any extension of time for the Principal's performance on the contract, assignments of obligations under the contract, or any amendment to the contract or change orders of any kind shall not release the Surety from its obligation under this bond. 6. The contractor shall comply with all applicable requirements of RCW 60.28. 7. RCW 60.28 requires the CITY to accept a retainage bond in lieu of withholding earned retained funds and the Surety hereby waives any defense that this bond or bond form is void or otherwise not authorized by law. 8. Any claim or suit against the CITY to foreclose the liens provided for by RCW 60.28 shall be effective against the Principal and Surety and any judgment under 60:28 against the CITY shall be conclusive against the Principal and Surety. WITNESS our hands this 28th day of June , 2016 PRINCIPAL: Miles Resources, LLC 400 Valley Avenue Northeast Puyallup, WA 987 By: ri (Signature] .uth-.rized presentative) Brad Griffi , General Manager PrintlType Name Retainage Bond Page 2 of 3 SURETY: Liberty Mutual Insurance Company By: -(It aerje"--- (Sighatire of Attorney in-Fact for Stirzty. D V Cynthia L.Jay (Typed Name of Attorney-iri-Fact) Dated June 28,2016 Local Agent Name, Phone, & Address Propel Insurance (206)676-4200 925 4th Avenue,Suite 3200 Seattle,WA 96104 CITY OF AUBURN: Accepted By: Ingrid Ga , Asst. ' for of Engineering Services/City Engineer Dated: 1Sj told Appro es as to •rt'• / 4 Da '= B. Heid, Ctty-Attomey 'This bond must be accompanied by a fully executed Power of Attorney appointing the Attorney-in-Fact before it becomes effective. Retainage Band Page 3 of 3 CHIS POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND. This Power of Attorney limits the acts of those named herein,and they have no authority to bind the Company except In the manner and to the extent herein stated. Certificate No. 7328994 American Fire and Casualty Company Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That American Fire 8 Casualty Company and The Ohio Casually Insurance Company are corporations duly organized under the laws of the Slate of New Hampshire,that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts,and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana(herein collectively called the"Companies"),pursuant to and by authority herein set forth,does hereby name,constitute and appoint, Aliceon A.Keltner;Annelies M.Richie;Barbara A.Johnson;Brandon K.Bush;Brent E.Heilesen;Carley Espiritu;Christopher Kinyon; Cynthia L.Jay;Diane M.Harding;Eric A.Zimmerman;James B.Binder;Jamie Diemer;Jennifer L. Snyder;Jon J.Oja;Julie R.Truitt;Karen C. Swanson;Kristine A. Lawrence;Mitchell R.Smee; Peter J.Comfort all of the city of Tacoma ,state of WA each individually if there be mom than one named,its true and lawful attomey-in-fact to make,execute,seal,acknowledge and deliver,for and on its behalf as surety and as its act and deed,any and all undertakings,bonds,recognizances and other surety obligations,in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF,this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 14th day of April , 2016 j4 pNO CgSr� �SY INSp `1NSbq 1Nsuq American Fire and Casualty Company "eti e. 9r< iell iN g9y Fti ,yroMra'yr"^ "nen e The Ohio Casualty Insurance Company y o Liberty Mutual Insurance Company m c r 1906 2 0 1919 0 0 1912 ° 1991 a C s z p - / WesysttAmancenn��II.InnnnyyysuranceCompanyca ui b`'4y°w a° }tan !,5'W,,. `°*do W��°"ec„u �2 3\mn,n s Y `7 "' N • • • f d at By: STATE OF PENNSYLVANIA ss David M.Care Assistant Secretary C to .:A COUNTY OF MONTGOMERY C m tico On this 14th day of April , 2016 , before me personally appeared David M. Carey,who acknowledged himself to be the Assistant Secretary of American Fire and 2:131- 0 ts:Fu w Casualty Company,Liberty Mutual Insurance Company,The Ohio Casualty Insurance Company,and West American Insurance Company,and that he,as such,being authorized so to do, 0„fn p 2 execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. ro W R � E I- > IN WITNESS WHEREOF.I have hereunto subscribed m name and affixed my notarial seal at Plymouth Meeting,Pennsylvania,on the day and year first above written. O O. Z'N 891 PAS COMMONWEALTH OF PENNSYLVANIA r+0 m 5.0131""11(A oew CC FCI Notarial Seal Q C"y 0 1. 7 Teresa Pastella,Notary Public By; db-41,1416O CO 0 or Plymouth Twp„Montgomery County 1-'O G ` �Y My Commission Expires March 28,2017 Teresa Pastella.Notary Public as C W M O \......./ �� Member,Pennsylvania Association of Notaries co E ori W am C r«p This Power of Attomey is made and executed pursuant to ancrby authority of the following By-laws and Authorizations of American Fire and Casualty Company,The Ohio Casualty Insurance Dnp y Company,Liberty Mutual Insurance Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows: «tr 0 ON w.3 to ID ARTICLE IV-OFFICERS-Section 12.Power of Attomey.Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President,and subject 0 c ice'4, to such limitation as the Chairman or the President may prescribe,shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Corporation to make,execute,seal, 3r m O S acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Such attorneys-in-fact,subject to the limitations set forth in their respective to 2 E aipowers of attorney,shall have hill power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so N p A executed,such instruments shall be as binding as if signed by the President and attested to by the Secretary.Any power or authority granted to any representative or attomey-in-fact under >JD Tthe provisions of this article may be revoked at any time by the Board,the Chairman,the President or by the officer or officers granting such power or authority t aer .5 C ARTICLE XIII-Execution of Contracts-SECTION 5.Surety Bonds and Undertakings.My officer of the Company authorized for that purpose in writing by the chairman or the president, « > 2 and subject to such limitations as the chairman or the president may prescribe.shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Company to make,execute, -IN x5,4,4 2 ; seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Such attorneys-in-fact subject to the limitations set forth in their Cao respective powers of attorney,shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so V 0 executed such instruments shall be as binding as if signed by the president and attested by the secretary. O'4 Certificate of Designation-The President of the Company,acting pursuant to the Bylaws of the Company,authorizes David M.Carey,Assistant Secretary to appoint such attomeys-in- ~1- fact as may be necessary to act on behalf of the Company to make,execute,seal,acknowledge and deliver as surety any end all undertakings,bonds,recognizances and other surety obligations, Authorization-By unanimous consent of the Company's Board of Directors,the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company,wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds,shall be valid and binding upon the Company with the same force and effect as though manually affixed. I,Gregory W.Davenport,the undersigned,Assistant Secretary,of American Fire and Casualty Company,The Ohio Casualty Insurance Company,Liberty Mutual Insurance Company,and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full,true and correct copy of the Power of Attomey executed by said Companies,is in full force and effect and has not been revoked. / IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this r\_day of LA.._s.,� ,20 I SG . ces P�PNO Mw�L9Ci fr M�9ym F1Jzyq rcnn 6��r rt0 ';Keux';Ke 19 n 1912 1991 By: a d`b „ ix. oh,. n^`tae w��=a \ �i Gregory W.Davenport,Assistant Secretary a. 'mm,✓ • f • I, • • 624 of 800 LMS 12073 122013