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Transpo Group - PSA for Pasco Parking Study - Downtown Core
PROFESSIONAL SERVICES AGREEMENT TRANSPO THIS AGREEMENT is made and entered into between the City of Pasco, a Washington Municipal Corporation, hereinafter referred to as "City", and Transpo Group, hereinafter referred to as "Consultant," on the i ! day of iAc,k= , 2021. RECITALS WHEREAS, the City desires to have certain services and/or tasks performed as set forth below requiring specialized skills, training, equipment, and other supportive capabilities; and WHEREAS, the Consultant represents that it is qualified and possesses sufficient skills, experience, equipment, and necessary capabilities, including: technical and professional expertise, when required, to perform the services and/or tasks as set forth in this Agreement upon which the City is relying. NOW, THEREFORE, in consideration of the mutual covenants, and performances contained herein, the parties agree as follows: 1. Scope of Services. The Consultant shall perform such services and accomplish such tasks, including the furnishing of all labor, materials, facilities and equipment necessary for full performance thereof, as identified and designated as Consultant's Responsibilities throughout this Agreement, and as more particularly described in Scope of Work detailed in [Exhibit A], attached hereto and incorporated herein (the "Project"). 2. Term. This Project shall begin on the execution date listed above and promptly be completed by 07/15/2021. 3. Compensation and Payment. 3.1 Payment for services provided hereunder shall be made following the performance of such services. Such payment shall be full compensation for work performed or services rendered, and for all labor, materials, supplies, equipment, and incidentals necessary to complete the Project. 3.2 No payment shall be made for any services rendered by the Consultant except for services identified and set forth in this Agreement except as may be authorized by a written supplemental agreement approved by the City. 3.3 The City shall pay the Consultant for work performed under this Agreement upon timely submitted invoices detailing work performed and expenses for which reimbursement is sought. The City shall approve all invoices before payment is issued. Payment shall occur within thirty (30) days of receipt and approval of an invoice. Professional Services Agreement —Transpo Group Pasco Parking Study — Downtown Core Development Impacts Page 1 of 9 3.4 The City shall pay the Consultant for all work performed and expenses incurred under this Agreement, as follows. Fixed Sum: A total of $44,000 Task 1: Parking Study - $34,000 Task 2: Meetings - $10,000 4. Reports and Inspections. 4.1 The Consultant at such times and in such forms as the City may require, shall furnish to the City such statements, records, studies, surveys, reports, data, and information as the City may request pertaining to matters covered by this Agreement. 4.2 The Consultant shall, at any time during normal business hours and as often as the City or the Washington State Auditor may reasonably deem necessary, make available for examination all of its records and data with respect to all matters covered, directly or indirectly, by this Agreement and shall permit the City, or its designated authorized representative to audit and inspect other data relating to all matters covered by this Agreement. The City shall receive a copy of all audit reports made by the agency or firm as to the Consultant's activities. The City may, at its discretion, conduct an audit at its expense, using its own or outside auditors, of the Consultant's activities which relate, directly or indirectly, to this Agreement. Consultant shall be provided a copy of such reports. 4.3 The Consultant, during the term of this Agreement, shall obtain all permits and registration documents necessary for the performance of its work and for the execution of services at its own expense, and shall maintain its validity. Upon request, the Consultant shall deliver to the City copies of these licenses, registration documents, and permits or proof of their issuance or renewal. 4.4 Consultant shall maintain books, records and documents, which sufficiently and properly reflect all direct and indirect costs related to the performance of this Agreement, and shall maintain such accounting procedures and practices as may be necessary to assure proper accounting of all funds paid pursuant to this Agreement. These records shall be subject. at all reasonable times. to inspection, review, or audit as provided above. 4.5 The Consultant shall retain all books, records, documents or other material relevant to this Agreement for three (3) years after its expiration. Consultant agrees that the City, or its designee, shall have full access and right to examine any of said materials at all reasonable times during this period. 5. Ownership and Use of Documents. Professional Services Agreement —Transpo Group Pasco Parking Study — Downtown Core Development Impacts Page 2 of 9 5.1 All research, tests, surveys, preliminary data, information, drawings and documents made, collected, or prepared by the Consultant for performing the services subject to this Agreement, as well as any final product, collectively referred to as "work product," shall be deemed as the exclusive property of the City, including copyright as secured thereon. Consultant may not use them except in connection with the performance of the services under this Agreement or with the prior written consent of the City. Any prior copyrighted materials owned by the Consultant and utilized in the performance of the services under this Agreement, or embedded in with the materials, products and services provided thereunder, shall remain the property of the Consultant subject to a license granted to the City for their continued use of the products and services provided under this Agreement. Any work product used by the Consultant in the performance of these services which it deems as confidential," "proprietary," or a "trade secret" shall be conspicuously designated as such. 5.2 In the event of Consultant's default, or in the event that this Agreement is terminated prior to its completion, the work product of the Consultant, along with a summary of the services performed to date of default or termination, shall become the property of the City, and tender of the work product and summary shall be a prerequisite to final payment under this Agreement. The summary of services provided shall be prepared at no additional cost, if the Agreement is terminated through default by the Consultant. If the Agreement is terminated through convenience by the City, the City agrees to pay Consultant for the preparation of the summary of services provided. 6. Public Records. 6.1 Consultant acknowledges that the City is an agency subject to Chapter 42.56 RCW Public Records Act." All preliminary drafts or notes prepared or gathered by the Consultant, and recommendations of the Consultant are exempt prior to the acceptance by the City or public citation by the City in connection with City action. 6.2 If the Consultant becomes a custodian of public records of the City and request for such records is received by the City, the Consultant shall respond to the request by the City for such records within five (5) business days by either providing the records, or by identifying in writing the additional time necessary to provide the records with a description of the reasons why additional time is needed. Such additional time shall not exceed twenty (20) business days unless extraordinary good cause is shown. 6.3 In the event the City receives a public records request for protected work product of the Consultant within its possession, the City shall, prior to the release of any protected work product or as a result of a public records request or subpoena, provide Consultant at least ten (10) business days prior written notice of the pending release and to reasonably cooperate with any legal action which may be initiated by the Consultant to enjoin or otherwise prevent such release. Professional Services Agreement— Transpo Group Pasco Parking Study — Downtown Core Development Impacts Page 3 of 9 7. Independent Contractor Relationship. 7.1 The parties intend that an independent contractor relationship is created by this Agreement. The City is interested primarily in the results to be achieved; subject to the scope of services and the specific requirements of this Agreement, the implementation of services will lie solely with the discretion of the Consultant. No agent, employee, officer or representative of the Consultant shall be deemed to be an employee, agent, officer, or representative of the City for any purpose, and the employees of the Consultant are not entitled to any of the benefits or privileges the City provides for its employees. The Consultant will be solely and entirely responsible for its acts and for the acts of its agents, employees, officers, subcontractors or representatives during the performance of this Agreement. 7.2 In the performance of the services provided in this Agreement, Consultant is an independent contractor with full authority to control and direct the performance of the details of the work, however, the results of the work contemplated herein must meet the approval of the City and shall be subject to the City's general rights of inspection and review to secure the satisfactory completion thereof. 7.3 The Consultant shall comply with all State and Federal laws including, but not limited to: 7.3.1 The definition requirements of RCW 50.04.140 (Employment Security). 7.3.2 RCW 51.08.195 (Industrial Insurance). 7.3.3 Obtain a City of Pasco business license. 7.4 The City may, at its sole discretion, require the Consultant to remove any employee, agent or servant from employment on this Project who, in the City's sole discretion, may be detrimental to the City's interest. 8. Indemnification. 8.1 The Consultant shall defend, indemnify, and hold harmless the City, its officers, officials, employees, and volunteers harmless from any and all claims, injuries, damages, losses or suits including attorney fees, arising out of or resulting from the acts, errors or omissions of the Consultant in performance of this Agreement, except for injuries and damages caused by the sole negligence of the City. 8.2 However, should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the Consultant, and the City, its officers, officials, employees, and volunteers, the Consultant's liability, including the duty and cost Professional Services Agreement —Transpo Group Pasco Parking Study — Downtown Core Development Impacts Page 4 of 9 to defend, hereunder shall be only to the extent of the Consultant's negligence. It is further specifically and expressly understood that the indemnification provided herein constitutes the Consultant's waiver of immunity under Industrial Insurance, Title 51 RCW, solely for purposes of this indemnification. This waiver has been mutually negotiated by the parties. The provisions of this section shall survive the expiration or termination of this Agreement. 8.3 No liability shall attach to the City by reason of entering into this Agreement except as expressly provided herein. 8.4 This indemnification shall include damages, penalties and attorney fees sustained as a result of Consultant's delayed or failed performance of Section 6 above. 9. Insurance. The Consultant shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Consultant, its agents, representatives, employees, or subcontractors. The Consultant's maintenance of insurance as required by the Agreement shall not be construed to limit the liability of the Consultant to the coverage provided by such insurance, or otherwise limit the City's recourse to any remedy available at law or in equity. 9.1 9.2 Minimum Scope of Insurance. Consultant shall obtain insurance of the types and coverage described below: 9.1.1 Automobile Liability insurance covering all owned, non -owned, hired and leased vehicles. Coverage shall be at least as broad as Insurance Services Office (ISO) form CA 00 01. 9.1.2 Commercial General Liability insurance shall be at least as broad as ISO occurrence form CG 00 01 and shall cover liability arising from premises, operations, stop -gap independent contractors and personal injury and advertising injury. The City shall be named as an additional insured under the Consultant's Commercial General Liability insurance policy with respect to the work performed for the City using an additional insured endorsement at least as broad as ISO endorsement form CG 20 26. 9.1.3 Workers' Compensation coverage as required by the Industrial Insurance laws of the State of Washington. 9.1.4 Professional Liability insurance appropriate to the Consultant's profession. Minimum Amounts of Insurance. Consultant shall maintain the following insurance limits: 9.2.1 Automobile Liability insurance with a minimum combined single limit for bodily injury and property damage of $1,000,000 per accident. Professional Services Agreement— Transpo Group Pasco Parking Study — Downtown Core Development Impacts Page 5 of 9 9.2.2 Commercial General Liability insurance shall be written with limits no less than: N $2,000,000 each occurrence; and N $2,000,000 general aggregate; 9.2.3 Professional Liability insurance shall be written with limits no less than: N $2,000,000 per claim; and N $2,000,000 policy aggregate limit; 9.3 Other Insurance Provision. The Consultant's Automobile Liability, Professional Liability, and Commercial General Liability insurance policies are to contain, or be endorsed to contain that they shall be primary insurance as respect the City. Any insurance, self-insurance, or self-insured pool coverage maintained by the City shall be excess of the Consultant's insurance and shall not contribute with it. 9.3.1 The Consultant's insurance shall be endorsed to state that coverage shall not be cancelled by either party, except after thirty (30) days prior written notice by certified mail, return receipt requested, has been given to the City. 9.4 Acceptability of Insurers. Insurance is to be placed with insurers with a current A.M. Best rating of not less than A: VII. 9.5 Verification of Coverage. Consultant shall furnish the City with original certificates and a copy of the amendatory endorsements, including, but not necessarily limited to, the additional insured endorsement, evidencing the insurance requirements of the Agreement before commencement of the work. 9.6 Notice of Cancellation. The Consultant shall provide the City with written notice of any policy cancellation within two (2) business days of their receipt of such notice. 9.7 City Full Availability of Consultant Limits. If the Consultant maintains higher insurance limits than the minimums shown above, the City shall be insured for the full available limits of Commercial General and Excess or Umbrella liability maintained by the Consultant, irrespective of whether such limits maintained by the Consultant are greater than those required by this Agreement or whether any certificate of insurance furnished to the City evidences limits of liability lower than those maintained by the Consultant. 9.8 Failure to Maintain Insurance. Failure on the part of the Consultant to maintain the insurance as required shall constitute a material breach of contract, upon which the City may, after giving five (5) business days notice to the Consultant to correct the breach, immediately terminate the Agreement or, at its discretion, procure or renew Professional Services Agreement —Transpo Group Pasco Parking Study — Downtown Core Development Impacts Page 6 of 9 such insurance and pay any and all premiums in connection therewith, with any sums so expended to be repaid to the City on demand, or at the sole discretion of the City, offset against funds due the Consultant from the City. 10. Nondiscrimination. In the performance of this Agreement, the Consultant will not discriminate against any employee or applicant for employment on the grounds of race, creed, color, national origin, sex, marital status, age or the presence of any sensory, mental or physical handicap; provided that the prohibition against discrimination in employment because of handicap shall not apply if the particular disability prevents the proper performance of the particular worker involved. The Consultant shall ensure that applicants are employed, and that employees are treated during employment in the performance of this Agreement without discrimination because of their race, creed, color, national origin, sex, marital status, age or the presence of any sensory, mental or physical handicap. Consultant shall take such action with respect to this Agreement as may be required to ensure full compliance with local, State and Federal laws prohibiting discrimination in employment. 11. Covenant Against Contingent Fees. The Consultant warrants that it has not employed nor retained any company, firm, or person, other than a bona fide employee working exclusively for the Consultant, to solicit or secure this Agreement; and that it has not paid or agreed to pay any company, person or firm, other than a bona fide employee working exclusively for the Consultant, any fee, commission, percentage, brokerage fee, gift, or other consideration contingent upon or resulting from the award or making of this Agreement. For breach or violation of this warranty, the City shall have the right to terminate this Agreement. 12. Assignment and Subcontracting. 12.1 The City has awarded this Agreement to the Consultant due to its unique qualifications to perform these services. The Consultant shall not assign (or subcontract other than as specifically identified in Exhibit A) its performance under this Agreement or any portions of this Agreement without the prior written consent of the City, which consent must be sought at least thirty (30) days prior to the date of any proposed assignment. 12.2 Any work or services assigned or subcontracted hereunder shall be subject to each provision of this Agreement including Section 6, Public Records; Section 10, Nondiscrimination; proper bidding procedures where applicable; and all local, State and Federal statutes, ordinances and guidelines. 12.3 Any technical or professional service subcontract not listed in this Agreement, must have prior written approval by the City. 13. Termination. Professional Services Agreement— Transpo Group Pasco Parking Study — Downtown Core Development Impacts Page 7 of 9 13.1 Termination for Convenience. Either party may terminate this Agreement for any reason upon giving the other party no less than ten (10) business days written notice in advance of the effective date of such termination. 13.2 Termination for Cause. If the Consultant fails to perform in the manner called for in this Agreement, or if the Consultant fails to comply with any other provisions of this Agreement and fails to correct such noncompliance within five (5) business days of written notice thereof, the City may terminate this Agreement for cause. Termination shall be effected by serving a notice of termination on the Consultant setting forth the manner in which the Consultant is in default. The Consultant will only be paid for services and expenses complying with the terms of this Agreement, incurred prior to termination. 14. General Provisions. 14.1 For the purpose of this Agreement, time is of the essence. 14.2 Notice. Notice provided for in this Agreement shall be sent by: 14.2.1 Personal service upon the Project Administrators; or 14.2.2 Certified mail to the physical address of the parties, or by electronic transmission to the e-mail addresses designated for the parties below. 14.3 The Project Administrator for the purpose of this Agreement shall be: 14.3.1 For the City: Dan Ford, or his/her designee City Engineer 525 N 3rd Ave Pasco, WA 99301 forddgpasco-wa.gov 14.3.2 For the Consultant: Dan McKinney, or his/her designee 12131 113th Ave NE, Suite 203 Kirkland, WA 98034 dan.mckinney&transpogroup.com 15. Dispute Resolution. 15.1 This Agreement has been and shall be construed as having been made and entered into and delivered within the State of Washington and it is agreed by each party hereto that this Agreement shall be governed by the laws of the State of Washington. 15.2 In the event of a dispute regarding the enforcement, breach, default, or interpretation of this Agreement, the Project Administrators, or their designees, Professional Services Agreement —Transpo Group Pasco Parking Study — Downtown Core Development Impacts Page 8 of 9 shall first meet in a good faith effort to resolve such dispute. In the event the dispute cannot be resolved by agreement of the parties, said dispute shall be resolved by arbitration pursuant to RC W 7.04A, as amended, with both parties waiving the right of a jury trial upon trial de novo, with venue placed in Pasco, Franklin County, Washington. The substantially prevailing party shall be entitled to its reasonable attorney fees and costs as additional award and judgment against the other. 16. Nonwaiver. Waiver by the City of any provision of this Agreement or any time limitation provided for in this Agreement shall not constitute a waiver of any other similar event or other provision of this Agreement. 17. Integration. This Agreement between the parties consists in its entirety of this document and any exhibits, schedules or attachments. Any modification of this Agreement or change order affecting this Agreement shall be in writing and signed by both parties. 18. Authorization. By signature below, each party warrants that they are authorized and empowered to execute this Agreement binding the City and the Consultant respectively. IN WITNESS WHEREOF, the parties have caused this Agreement to be executed on the date first written above. CITY OF PASCO, WASHINGTON Z-i Rick White, C&ED Director ATTEST: Debra C. Barham, City Clerk APPROVED ,AUTO FORM: Felon Ww, PLLC, Professional Services Agreement —Transpo Group Pasco Parking Study — Downtown Core Development Impacts CONSULTANT a i Daniel G McKinney Jr 2021.05.14 09:38:25-07'00' Dan McKinney, Transpo Group Page 9 of 9 Exhibit A—Scope of Services, Fee & Schedule Client Name: City of Pasco Project Name: Pasco Parking Study – Downtown Core Development Impacts Exhibit Dated: April 7, 2021 TG: 1.21074.PR Scope of Services The City of Pasco is experiencing growth within the Downtown area. The future development includes projects that will eliminate some of the existing parking supply as well as increase parking demands. The intent of this work is to assess existing parking supply and demand and anticipated future changes in parking supply and increases in parking demand with known development proposals. Specifically, there are anticipated losses in parking with the Peanuts Park project and near-term growth is anticipated to demand more parking within downtown. The study will focus on the area between N 5th Avenue and 2nd Avenue and W Columbia Street and W Clark Street, which consists of 17 blocks. Task 01—Parking Study This task includes developing the existing and future near-term parking context within the downtown core area of Pasco to understand potential future parking needs. Meetings are included as part of Task 02. 1. Parking Inventory. Transpo will conduct a field inventory of public and private parking within the study area including on- and off-street parking supply. It is assumed if the study area includes private parking that the City will work with the property owner to gain permission to collect parking data, if needed. The City will provide any available data related to parking supply. 2. Existing Parking Data Collection. Parking occupancy counts will be conducted for two (2) days one mid -weekday and a Saturday. The data will be collected for up to 6 hours each day with one-hour sweeps in the study area. Transpo will work with City staff on the specific hours of the data collection. 3. Existing and Future Land Use. The City will provide existing land use types and sizes for the parcels within the study area. The City will also provide future land use plans with the study area including types, sizes, parking displacement, proposed parking and site plans and traffic and parking studies for future developments (if available). Transpo will summarize the existing and future land use by parcel. 4. Existing Parking Occupancy and Demand Analysis. Transpo will calculate on -street and off-street parking occupancy for the study area as a whole as well as for individual block faces and parking lots. Both average and peak occupancy will be calculated for the weekday and weekend condition. The parking analysis will be summarized in both spreadsheet and GIS format. Transpo will also estimate existing parking demand based on the Institute of Transportation Engineers (ITE) Parking Generation as a point of comparison and to provide context of how the current COVID-19 pandemic may be impacting parking. 5. Future Parking Demand. Future increases in peak parking demand will be determined for the anticipated future land use based on Pasco parking studies and ITE Parking Generation. The total future parking needs for the study area will be based on the analysis of existing conditions plus the future growth projections. Consideration will be given to time of day for the parking demand. 6. Future Supply Needs and Location. Based on the estimated total future parking demand for the study area, Transpo will determine the amount of parking supply needed to support existing and land uses. In addition, Transpo will identify "hotspots" of where potential parking deficiencies/needs are located within the study area to help determine where the City might consider providing new parking. 7. Documentation. A draft study will be prepared documenting all analyses, findings, and conclusions. Transpo will finalize the study following up to one rounds of review comments from City staff. Transpo will also prepare an excel spreadsheet with all the data in summary tables and graphs/maps for the existing conditions data. 1.21074.PR Consultant Deliverables Draft and Final Technical Study Summarizing Analysis and Findings Excel and Map Summaries of data City Responswulties Confirm parking study areas Provide GIS database of study area if available Plans and descriptions of work for any capital projects that will change street on -street and off- street parking including but not limited to Lewis Street Corridor, Lewis Street Overpass and Peanuts Park projects Provide future Land use plans within the study area including type, size, site plans (if available), amount of parking displaced and proposed Provide traffic and parking studies for future developments, if available Provide information on current property vacancies and existing land use Review and provide feedback on deliverables Task 02—Meetings The project manager will coordinate with the City internal stakeholders on the findings of the data collection and analysis and to gain input on key elements of the study. Three (3) meetings are included as part of this scope and will likely include two (2) meetings with City staff to discuss initial findings and recommendations and one (1) presentation to City Council. Transpo will prepare meeting materials and a summary of the meeting as applicable. Fee A fee for each task is outlined in Table 1. Reimbursable expenses are invoiced at cost plus fifteen percent 15%). Table 1. Fee by Task Task Description Fee' 01 Parking Study $34,000 02 Meetings $10,000 Total $44,000 1. Time -and -materials basis Transpo will work closely with the project team and Pasco staff to assure all efforts are directed in a manner consistent with overall project objectives. Should the scope of services or project information change following contract execution, Transpo will notify the Client if these changes will affect the fee and require a contract amendment. Schedule Transpo anticipated 8 weeks to complete the draft parking study. The schedule will depend timely feedback from City staff. This schedule can be impacted by factors outside the control of Transpo. Should the scope of services or project information change following contract execution, Transpo will notify the Client if these changes will affect the schedule and require a contract amendment. 1.21074.PR Parking Study Area - Downtown Core FIGURE Downtown Parking Study transpogroup Tr Aor0%. 2021-1.32pm n,ckg Downtow Pam , wing S?utlylGraphics%OVVG\21074 Giaphics.dWq Lavout. A '%! i SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 5/24/2021 AssuredPartners Design Professionals Insurance Services,LLC 3697 Mt.Diablo Blvd Suite 230 Lafayette CA 94549 Jennifer Aguirre (510)465-3090 DesignProCerts@AssuredPartners.com License#:6003745 Charter Oak Fire Insurance Company 25615 TRANGRO-08 Beazley Insurance Company Inc 37540TranspoGroupUSA,Inc. 12131 113th Ave NE,Suite 203 Kirkland,WA 98034 425 821-3665 Travelers Property Casualty Company of America 25674 HARTFORD INSURANCE COMPANY 38288 The Travelers Indemnity Company of Connecticut 25682 1849511325 A X 1,000,000 X 1,000,000 X Contractual Liab 10,000 X XCU Included 1,000,000 2,000,000 X Y Y 6805H922543 1/1/2021 1/1/2022 2,000,000 E 1,000,000 X X Y Y BA3R390266 1/1/2021 1/1/2022 C X X 5,000,000CUP4F6253381/1/2021 1/1/2022 5,000,000 X 10,000 D A XY57WECZS7222 6805H922543 1/1/2021 1/1/2021 1/1/2022 1/1/2022 WA Stop Gap 1,000,000 1,000,000 1,000,000 B Professional Liability Claims Made Form C1D535210501 1/1/2021 1/1/2022 $2,000,000 $4,000,000 Per Claim Annual Aggregate Project Number/Name:#1.21074.00 /Downtown Pasco Parking Study -- City of Pasco,its officers,officials,employees,and volunteers are named as Additional Insured on General Liability and Auto Liability,per policy forms,with respect to the operations of the Named Insured as required by written contract or agreement.General Liability is Primary/Non-Contributory per policy form wording. 30 Day NOC/10 Day for NonPay of Prem City of Pasco 525 N 3rd Ave Pasco WA 99301 This endorsement modifies insurance provided under the following: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL PURPOSE ENDORSEMENT POLICY NUMBER: CG2037 (07-04) - ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS 680-5H922543-21-47 OFFICE PAC THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -COMPLETED OPERATIONS THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE NAMES OF ADDITIONAL INSURED PERSON(S) OR ORGANIZATION(S): Any person or organization that you agree in a written contract to include as an additional insured on this Coverage Part for "bodily injury" or "property damage" included in the products-completed operation s hazard, provided that such contract was signed by you before, and is in effect when, the "bodily injury or "property damage" occurs. LOCATION AND DESCRIPTION OF COMPLETED OPERATIONS:Any project to which a written contract with the Additional Insured Person(s) or Organization(s) in the Schedule applies. (INFORMATION REQUIRED TO COMPLETE THIS SCHEDULE, IF NOT SHOWN ABOVE, WILL BE SHOWN IN THE DECLARATIONS.) A. SECTION II - WHO IS AN INSURED IS AMENDED TO INCLUDE AS AN ADDITIONAL INSURED THE PERSON(S) OR ORGANIZATION(S) SHOWN IN THE SCHEDULE, BUT ONLY WITH RESPECT TO LIABILITY FOR "BODILY INJURY", "PROPERTY DAMAGE" CAUSED, IN WHOLE OR IN PART, BY "YOUR WORK" AT THE LOCATION DESIGNATED AND DESCRIBED IN THE SCHEDULE OF THIS ENDORSEMENT PERFORMED FOR THAT ADDITIONAL INSURED AND INCLUDED IN THE "PRODUCTS-COMPLETED OPERATIONS HAZARD". CG 20 37 07 04 Copyright ISO Properties, Inc. 2004 Page of CG T8 02 01 20 11 This endorsement modifies insurance provided under the following: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL PURPOSE ENDORSEMENT POLICY NUMBER: CGD361 (03-05) - ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR 680-5H922543-21-47 OFFICE PAC THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE NAMES OF ADDITIONAL INSURED PERSON(S) OR ORGANIZATION(S): Any person or organization that you agree in a written contract to include as an additional insured on this Coverage Part, provided that such written contract was signed by you before,and is in effect when, the "bodily injury" or "property damage" occurs or the "personal injury" or "advertising injury" offense is committed. LOCATION OF COVERED OPERATIONS: Any project to which a written contract with the Additional Insured Person(s) or Organization(s) in the Schedule applies. (INFORMATION REQUIRED TO COMPLETE THIS SCHEDULE, IF NOT SHOWN ABOVE, WILL BE SHOWN IN THE DECLARATIONS.) A. SECTION II - WHO IS AN INSURED IS AMENDED TO INCLUDE AS AN ADDITIONALINSURED THE PERSON(S) OR ORGANIZATION(S) SHOWN IN THE SCHEDULE, BUT ONLY WITH RESPECT TO LIABILITY FOR "BODILY INJURY", "PROPERTY DAMAGE", PERSONAL INJURY OR "ADVERTISING INJURY" CAUSED, IN WHOLE OR IN PART, BY: 1. YOUR ACTS OR OMISSIONS; OR 2. THE ACTS OR OMISSIONS OF THOSE ACTING ON YOUR BEHALF; IN THE PERFORMANCE OF YOUR ONGOING OPERATIONS FOR THE ADDITIONAL INSURED(S) AT THE LOCATION(S) DESIGNATED ABOVE. B. WITH RESPECT TO THE INSURANCE AFFORDED TO THESE ADDITIONAL INSURED, THE FOLLOWING ADDITIONAL EXCLUSIONS APPLY: Page of CG T8 01 01 20 12 This endorsement modifies insurance provided under the following: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL PURPOSE ENDORSEMENT POLICY NUMBER: CGD361 (03-05) - ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR 680-5H922543-21-47 OFFICE PAC THIS INSURED DOES NOT APPLY TO "BODILY INJURY" OR "PROPERTY DAMAGE" OCCURRING, OR "PERSONAL INJURY" OR "ADVERTISING INJURY" ARISING OUT OF AN OFFENSE COMMITTED, 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. CG D3 61 03 05 Copyright 2005 The St. Paul Travelers Companies, Inc. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page of CG T8 01 01 20 22 COMMERCIAL GENERAL LIABILITY c. Method Of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this methoo, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. d. Primary And Non-Contributory Insurance If Required By Written Contract If you specifically agree in a written contract or agreement that the insurance afforded to an insured under this Coverage Part must apply on a primary basis, or a primary and non- contributory basis. this insurance is primary to other insurance that is available to such insured which covers such insured as a named insured, and we will not share with that other insurance, provided that: (1) The "bodily injury'' or "property damage" for which coverage is sought occurs; and (2) The "personal and advertising injury" for which coverage is sought is caused by an offense that is committed; subsequent to the signing of that contract or agreement by you. 5. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit perioo we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium, we will return the excess to the first Named Insured. c. The first Named Insured must keep records of the information we need for premium computation , and send us copies at such times as we may request. 6. Representations By accepting this policy, you agree: a. The statements in the Declarations are accurate and complete; b. Those statements are based upon representations you made to us; and c. We have issued this policy in reliance upon your representations. The unintentional omission of, or unintentional error in, any information provided by you which we relied upon in issuing this policy will not prejudice your rights under this insurance. However, this provision does not affect our right to collect additional premium or to exercise our rights of cancellation or nonrenewal in accordance with applicable insurance laws or regulations. 7. Separation Of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this Coverage Part to the first Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom claim is made or "suit" is brought. 8. Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. 9. When We Do Not Renew If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured shown in the Declarations written not ice of the nonrenewal not less than 30 days before the expiration date. If notice is mailed, proof of mailing will be sufficient proof of notice. SECTION V -DEFINITIONS 1. "Advertisement" means a notice that is broadcast or published to the general public or specific market segments about your goods, products or services for the purpose of attracting customers or supporters. For the purposes of this definition: a. Notices that are published include material placed on the Internet or on similar electronic means of communication; and b. Regarding websites, only that part of a website that is about your goods, prooucts or services for the purposes of attracting customers or supporters is considered an advertisement. Page 16 of 21 © 2017 The Travelers Indemnity Company. All rights reserved. CG T1000219 Includes copyrighted material of Insurance Services Office, Inc. with its permiss ion. Policy #6805H922543 6805H9225436805H922543 COMMERCIAL GENERAL LIABILITY that is available to any of your "employees"occupational therapist or occupational for "bodily injury" that arises out of providingtherapy assistant, physical therapist or or failing to provide "incidental medicalspeech-language pathologist; or services" to any person to the extent not(b)First aid or "Good Samaritan services"subject to Paragraph 2.a.(1)of Section II –by any of your "employees" or "volunteer Who Is An Insured.workers", other than an employed or volunteer doctor. Any such "employees"K. MEDICAL PAYMENTS – INCREASED LIMIT or "volunteer workers" providing or failing The following replaces Paragraph 7.ofto provide first aid or "Good Samaritan SECTION III – LIMITS OF INSURANCE:services" during their work hours for you 7.Subject to Paragraph 5.above, the Medicalwill be deemed to be acting within the scope of their employment by you or Expense Limit is the most we will pay under performing duties related to the conduct Coverage C for all medical expenses of your business.because of "bodily injury" sustained by any one person, and will be the higher of:3.The following replaces the last sentence of Paragraph 5.of SECTION III – LIMITS OF a.$10,000; orINSURANCE: b.The amount shown in the Declarations ofFor the purposes of determining the this Coverage Part for Medical Expenseapplicable Each Occurrence Limit, all related Limit.acts or omissions committed in providing or failing to provide "incidental medical L. AMENDMENT OF EXCESS INSURANCE services", first aid or "Good Samaritan CONDITION – PROFESSIONAL LIABILITYservices" to any one person will be deemed The following is added to Paragraph 4.b.,to be one "occurrence".Excess Insurance, of SECTION IV –4.The following exclusion is added to COMMERCIAL GENERAL LIABILITYParagraph2.,Exclusions, of SECTION I –CONDITIONS: COVERAGES – COVERAGE A – BODILY This insurance is excess over any of the otherINJURY AND PROPERTY DAMAGE insurance, whether primary, excess, contingentLIABILITY:or on any other basis, that is ProfessionalSale Of Pharmaceuticals Liability or similar coverage, to the extent the "Bodily injury" or "property damage" arising loss is not subject to the professional services out of the violation of a penal statute or exclusion of Coverage A or Coverage B. ordinance relating to the sale of M. BLANKET WAIVER OF SUBROGATION –pharmaceuticals committed by, or with the WHEN REQUIRED BY WRITTEN CONTRACTknowledge or consent of the insured.OR AGREEMENT5.The following is added to the DEFINITIONS The following is added to Paragraph 8.,TransferSection: Of Rights Of Recovery Against Others To Us,"Incidental medical services" means:of SECTION IV – COMMERCIAL GENERAL a.Medical, surgical, dental, laboratory, x-LIABILITY CONDITIONS: ray or nursing service or treatment,If the insured has agreed in a written contract oradvice or instruction, or the related agreement to waive that insured's right offurnishing of food or beverages; or recovery against any person or organization, we b.The furnishing or dispensing of drugs or waive our right of recovery against such personmedical, dental, or surgical supplies or or organization, but only for payments we makeappliances.because of: 6.The following is added to Paragraph 4.b.,a."Bodily injury" or "property damage" thatExcess Insurance, of SECTION IV –occurs; orCOMMERCIAL GENERAL LIABILITY b."Personal and advertising injury" caused byCONDITIONS: an offense that is committed;This insurance is excess over any valid and subsequent to the signing of that contract orcollectible other insurance, whether primary, excess, contingent or on any other basis,agreement. CG D3 79 02 19 ú 2017 The Travelers Indemnity Company. All rights reserved.Page 5 of 6 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Policy #6805H922543 COMM RCI L AUTOE A T IS ENDORSEMENT CHANGES T E POLICY.PL ASE READ IT CAREFULLY.H H E BLANKET ADDITIONAL INSURED Thi e dorseme t m d fie i surance prov ded under he f l o ing:s n n o i s n i t o l w BUS NE S A TO OV RAGE F RMI S U C E O M TO CA RI R COV RA E F RMO R R E E G O The fo lo ing i added to Parag aphl w s r c.in A.1.,Who be ween you and that pe son or organiza ion,that istrt Is An Insu edr,of SECTION II CO E ED AU OV R T S si ned by yo be o e the "bodi y injury or "prope tyg u f r l " r L ABI I Y CO E AGEI L T V R in the BUSIN SS AUTE O dam ge occur and that is in ef e t during the pol cya " s f c i CO ERAGE FO MVR and Pa agraphr e.in A.1.,Who Is pe iod,to nam as an addi ional insured fo Cov redretr e An Insu edr,of SECT ON II CO ERED AU OIV T S Auto Liabil ty Cov rage,but o ly fo dam ges tos i e n r a L ABI I Y CO ERAGEI L T V in the MOT R CARRIEOR whi h this insurance applie an only to the ex ent ocs d t f CO ERAGE FO MVR,whichev r Co erage Form i that perso 's o o ganizat o 'se v s n r r i n lia il ty fo the co ductb i r n pa t o y ur poli y o anot er "in ured".r f o c :f h s Thi i cl de any perso or organi ation who you ares n u s n z re ui ed unde a written cont a t o ag ee entq r r r c r r m CA 4 37 2 16T 0 ©2016 The Travelers Indemnity Company.All rights reserved.Page 1 of 1 Includes copyrighted material of nsurance Services OfIf ce,Inc.with its permis ion.i s Policy:BA3R390266 COMM RCI L AUTOE A T IS ENDORSEMENT CHANGES T E POLICY.PL ASE READ IT CAREFULLY.H H E BLANKET ADDITIONAL INSURED PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE Thi e dorseme t m d fie i surance prov ded under he f l o ing:s n n o i s n i t o l w BUS NE S A TO OV RAGE F RMI S U C E O 2.PROVISIONS The fol o ing i added to Paragraphl w s B 5..,O het r In u ances r of SE TION IV BUSIN SS AUTCE O1.The fo lowing is added to Paragraphl A.1.c.,Who COND T ONI I S:Is An Insu edr,of SE TION Il COV REDCE AU OS LIAB LIT CO E AGET I Y V R :Re ardle s o the prov sions o pa ag aph a.a dg s f i f r r n Thi i cludes any pe son or organization who yos n r u pa ag aphr r d.of this part 5.O her Insurance,t this are requi ed under a writ en co tra t ort n c r i suran e i prim ry to and non-contri utory witn c s a b h ag ee ent betwee yo and that perso or m n u n r appl cable othe in urance under which anir s organi a ion,that is signed by you be o e thez t f r addi ional insured person o o ganiza io is thetr r t n "bodi y inju y or "property dam ge o curs andl r "a " c fi st nam d insured when the writ en co tra t or e t n c r that i i e fe t during the poli y period,to nams n f c c e ag ee ent be ween you and that person or m t r a an addit onal i sured fo Cov red Autos i n r e s organi ation,that is signed by you be o e thezf r Lia il ty Cov rage,but only fo dam ges to whi hb i e r a c "bo ily inj ry or "property dam ge o curs andd u "a " c th s insuran e applie and only to the ex ent oi c s t f that i in e fe t duri g the pol cy period,requi es f c n i r sthatpersonsoroganizaio's l abi i y fo the' r t n i l t r th s i surance to be prim ry an non-contri utory.i n a d bconductoanothe"in ured".f r s CA 4 74 2 16T 0 ©2016 The T avelers Indemnit Company.All righryts reserved.Pa e 1 of 1g Includes copyrighted material of nsurance Services OfIf ce,Inc.with its permis ion.i s POLICY NUMBER: BA3R390266 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. BLANKET WAIVER OF SUBROGATION This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM The following replaces Paragraph A.5.,Transfer of required of you by a written contract executed Rights Of Recovery Against Others To Us,of the prior to any "accident"or "loss",provided that the CONDITIONS Section:"accident"or "loss"arises out of the operations 5.Transfer Of Rights Of Recovery Against Oth-contemplated by such contract.The waiver ap- ers To Us plies only to the person or organization desig- nated in such contract.We waive any right of recovery we may have against any person or organization to the extent CA T3 40 02 15 ©2015 The Travelers Indemnity Company.All rights reserved.Page 1 of 1 Includes copyrighted material of Insurance Services Office,Inc.with its permission. Policy #BA3R390266 FormWC990301B Printed in U.S.A. (Ed. 8/00) Process Date: Endorsement Number: Effective hour is the same as stated on the Information Page of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WORKERS’ COMPENSATION BROAD FORM ENDORSEMENT EXTENDED OPTIONS Policy Number: Effective Date: Named Insured and Address: Section I of this endorsement expands coverage provided under WC 00 00 00. Section II of this endorsement provides additional coverage usually only provided by endorsement. Section III of this endorsement is a Schedule of Covered States. You may use the index to locate these coverage features quickly: INDEX SUBJECT PAGE SUBJECT PAGE SECTION I 2 B. Part One Does Not Apply 3 2 C. Application of Coverage 3PARTS ONE and TWO 2 D. Additional Exclusions 301 We Will Also Pay 2 E. West Virginia 3PART - THREE 2 EXTENDED OPTIONS 402 How This Insurance Works 2401 Employers’ Liability InsurancePART - SIX 2402 Unintentional Failure to Disclose03 Transfer of Your Rights and Duties 2 Hazards04 Cancellation 2403 Waiver of Our Right to Recover from05 Liberalization 2 OthersSECTION II 2404 Foreign Voluntary CompensationVOLUNTARY COMPENSATION INSURANCE 4A. How This Reimbursement Applies06 Voluntary Compensation Insurance 24B. We Will ReimburseA. How This Insurance Applies 24C. ExclusionsB. We Will Pay 35D. Before We PayC. Exclusions 35E. Recovery From OthersD. Before We Pay 35F. Reimbursement For Actual LossE. Recovery From Others 3 SustainedF. Employers’ Liability Insurance 35G. RepatriationEMPLOYERS’ LIABILITY STOP GAP 35H. Endemic DiseaseENDORSEMENT 505 Longshore and Harbor Workers’07 Employers’ Liability Stop Gap 3 Compensation Act CoverageCoverageEndorsementA. Stop Gap Coverage Limited to 36SECTION IIIMontana, North Dakota, Ohio,601 Schedule of Covered StatesWashington, West Virginia and Wyoming Page 1 of 6 Policy Expiration Date: ______ _______________ _______________ © 2000, The Hartford 57WECZS7222 01/01/2021 Transpo Group USA,Inc. Kirkland,WA 98034 SECTION I PARTS ONE and TWO the Information Page, coverage will not be afforded for that state unless we are notified1. WE WILL ALSO PAY sixtywithin days.D. We Will Also Pay Part Oneof (WORKERS’ COMPENSATION INSURANCE); and PART SIX E. We Will Also Pay Part Twoof (EMPLOYERS’3. Transfer Of Your Rights and DutiesLIABILITY INSURANCE) is replaced by the C. Transfer Of Your Rights and Duties Part 6offollowing: (Conditions) is replaced by the following:We Will Also Pay Your rights or duties under this policy may notWe will also pay these costs, in addition to be transferred without our written consent.other amounts payable under this insurance, sixtyIf you die and we receive notice withinas part of any claim, proceeding, or suit we days after your death, we will cover your legaldefend: representative as insured.1. reasonable expenses incurred at our 4. CancellationINCLUDINGrequest, loss of earnings; 2. D. Cancellation Part 6Paragraph of of2. premiums for bonds to release (Conditions) is replaced by the following:attachments and for appeal bonds in bond amounts up to the limit of our liability 2. We may cancel this policy. We must mail or under this insurance;15deliver to you not less than days advance written notice stating when the cancellation is3. litigation costs taxed against you; to take effect. Mailing that notice to you at4. interest on a judgment as required by law your mailing address shown in Item 1 of theuntil we offer the amount due under this Information Page will be sufficient to provelaw; and notice.5. expenses we incur.5. Liberalization If we adopt a change in this form that wouldPART THREE broaden the coverage of this form without extra2. How This Insurance Applies charge, the broader coverage will apply to this 4. A. How This Insurance AppliesParagraph of policy. It will apply when the change becomes Part 3of (Other States Insurance) is replaced by effective in your state. the following: 4. If you have work on the effective date of this policy in any state not listed in Item 3.A. of SECTION II VOLUNTARY COMPENSATION AND EMPLOYERS’ 2. The bodily injury must arise out of and in the course of employment or incidental toLIABILITY COVERAGE work in a state shown in Item 3.A. of the6. Voluntary Compensation Insurance Information Page. A. How This Insurance Applies 3. The bodily injury must occur in the United This insurance applies to bodily injury by States of America, its territories or accident or bodily injury by disease. Bodily possessions, or Canada, and may occur injury includes resulting death.elsewhere if the employee is a United States or Canadian citizen, or otherwise1. The bodily injury must be sustained by any legal resident, and legally employed, in theofficer or employee not subject to the United States or Canada and temporarilyworkers’ compensation law of any state away from those places.shown in Item 3.A. of the Information Page. FormWC990301B Page 2 of 6Printed in U.S.A. (Ed. 8/00) 4. Bodily injury by accident must occur keep an amount equal to our expenses of during the policy period. recovery and the benefits we paid. We will pay the balance to the persons entitled to it. If5. Bodily injury by disease must be caused the persons entitled to the benefits of thisor aggravated by the conditions of the insurance make a recovery from others, theyofficer’s or employee’s employment. The must reimburse us for the benefits we paidofficer’s or employee’s last day of last them.exposure to the conditions causing or aggravating such bodily injury by disease F. Employers’ Liability Insurance must occur during the policy period.Part Two (Employers’ Liability Insurance) B. We Will Pay applies to bodily injury covered by this endorsement as though the State ofWe will pay an amount equal to the benefits Employment was shown in Item 3.A. of thethat would be required of you as if you and Information Page.your employees were subject to the workers’ compensation law of any state shown in Item This provision 6. does not apply in New Jersey or 3.A. of the Information Page. We will pay Wisconsin. those amounts to the persons who would be EMPLOYERS’ LIABILITY STOP GAP COVERAGEentitled to them under the law.7. Employers’ Liability Stop Gap CoverageC. Exclusion A. This coverage only applies in Montana, NorthThis insurance does not cover:Dakota, Ohio, Washington, West Virginia and 1. any obligation imposed by workers’Wyoming. compensation or occupational disease law B. Part One (Workers’ Compensation Insurance)or any similar law.does not apply to work in states shown in 2. bodily injury intentionally caused or Paragraph A above. aggravated by you.C. Part Two (Employers’ Liability Insurance) 3. officers or employees who have elected applies in the states, shown in Paragraph A., not to be subject to the state workers’as though they were shown in Item 3.A. of the compensation law.Information Page. 4. partners or sole proprietors not covered ExclusionsD. Part Two, Section C. is changed under the Standard Sole Proprietors,by adding these exclusions. Partners, Officers and Others Coverage This insurance does not cover;Endorsement.5. bodily injury intentionally caused orD. Before We Pay aggravated by you or in Ohio bodily injury Before we pay benefits to the persons entitled resulting from an act which is determined to them, they must:by an Ohio court of law to have been committed by you with the belief than an1. Release you and us, in writing, of all injury is substantially certain to occur.responsibility for the injury or death. However, the cost of defending such2. Transfer to us their right to recover from claims or suits in Ohio is covered.others who may be responsible for the 13. bodily injury sustained by any member ofinjury or death. the flying crew of any aircraft.3. Cooperate with us and do everything 14. any claim for bodily injury with respect tonecessary to enable us to enforce the right which you are deprived of any defense orto recover from others. defenses or are otherwise subject toIf the persons entitled to the benefits of this penalty because of default in premiuminsurance fail to do those things, our duty to under the provisions of the workers’pay ends at once. If they claim damages from compensation law or laws of a stateyou or from us for the injury or death, our duty shown in Paragraph A.to pay ends at once. E. This insurance applies to damages for whichE. Recovery From Others you are liable under West Virginia Code Annot. If we make a recovery from others, we will S 23-4-2. FormWC990301B Page 3 of 6Printed in U.S.A. (Ed. 8/00) EXTENDED OPTIONS 1. Employers’ Liability Insurance 4. Foreign Voluntary Compensation and Employers’ Liability ReimbursementItem 3.B. Information Pageof the is replaced by the following:A. How This Reimbursement Applies B. Employers’ Liability Insurance:This reimbursement provision applies to bodily injury by accident or bodily injury by disease.Part Two1. of the policy applies to work in Bodily injury includes resulting death.each state listed in Item 3.A. 1. The bodily injury must be sustained by an officer or employee.The Limits of Liability under Part Two are 2. The bodily injury must occur in the coursethe higher of: of employment necessary or incidental to work in a country not listed in ExclusionBodily Injury C.1. of this provision.$500,000 Each Accidentby Accident 3. Bodily injury by accident must occur during the policy period.Bodily Injury $500,000 Policy Limitby Disease 4. Bodily injury by disease must be caused or aggravated by the conditions of your Bodily Injury employment. The officer or employee’s $500,000 Each Employee last exposure to those conditions of yourby Disease employment must occur during the policy period.OR B. We Will Reimburse 2. The amount shown in the Information We will reimburse you for all amounts paid by Page.you whether such amounts are: EXTENDED OPTIONSThis provision 1 of does not 1. voluntary payments for the benefits that apply in New York because the Limits Of Our would be required of you if you and your Liability are unlimited.officers or employees were subject to any workers’ compensation law of the state ofIn this provision the limits are changed from hire of the individual employee.$500,000 $1,000,000to in California. 2. sums to which Part Two (Employers’2. Unintentional Failure to Disclose Hazards Liability Insurance) would apply if theIf you unintentionally should fail to disclose all Country of Employment were shown inexisting hazards at the inception date of your Item 3.A. of the Information Page.policy, we shall not deny coverage under this C. Exclusionspolicy because of such failure. This insurance does not cover:3. Waiver of Our Right To Recover From Others 1. any occurrences in the United States,A. We have the right to recover our payments Canada, and any country or jurisdictionfrom anyone liable for an injury covered by this which is the subject of trade or economicpolicy. We will not enforce our right against sanctions imposed by the laws orany person or organization for whom you regulations of the United States ofperform work under a written contract that America in effect as of the inception daterequires you to obtain this agreement from us. of this policy.This agreement shall not operate directly or 2. any obligation imposed by a workers’indirectly to benefit anyone not named in the compensation or occupational diseaseagreement. law, or similar law.B. This provision 3. does not apply in the states 3. bodily injury intentionally caused orof Pennsylvania and Utah. aggravated by you. FormWC990301B Page 4 of 6Printed in U.S.A. (Ed. 8/00) 4. liability for any consequence, whether of America necessarily incurred as a direct direct or indirect, of war, invasion, act of result of bodily injury. Foreign enemy, hostilities (whether war be Our reimbursement shall be limited as follows:declared or not), civil war, rebellion,1. to the amount by which such expensesrevolution, insurrection or military or exceed the normal cost of returning theusurped power. No endorsement now or officer or employee if in good health, orsubsequently attached to this policy shall 2. in the event of death, to the amount bybe construed as overriding or waiving this which such expenses exceed the normallimitation unless specific reference is cost of returning the officer or employee ifmade thereto. alive and in good health.D. Before We Pay In no event shall our reimbursement exceedBefore we reimburse you for the benefits to the the bodily injury by accident limit shown inpersons entitled to them, you must have them:Item 3.B. of the Information Page as respects 1. release you and us, in writing, of all any one such officer or employee whether responsibility for the injury or death,dead or alive. 2. transfer to us their right to recover from H. Endemic Diseaseothers who may be responsible for their The word “disease” includes any endemicinjury or death,diseases.3. cooperate with us and do everything The coverage applies as if endemic diseasesnecessary to enable us to enforce the right were included in the provisions of the workers’to recover from others.compensation law.If the persons entitled to the benefits paid fail 5. Longshore and Harbor Workers’ Compensationto do these things, our duty to reimburse ends Act Coverageat once. If they claim damages from us for the injury or death, our duty to reimburse ends at General Section C. Workers’ Compensation once.Law is replaced by the following: E. Recovery From Others C. Workers’ Compensation Law If we make a recovery from others, we will Workers’ Compensation Law means the keep an amount equal to our expenses of workers or workers’ compensation law and recovery and the benefits we reimbursed. We occupational disease law of each state or will pay the balance to the persons entitled to territory named in Item 3.A. of the Information it. If persons entitled to the benefits make a Page and the Longshore and Harbor Workers’ recovery from others, they must repay us for Compensation Act (33 USC Sections 901- the amounts that we have reimbursed you.950). It includes any amendments to those laws that are in effect during the policy period.F. Reimbursement for Actual Loss Sustained It does not include any other federal workersThis endorsement provides only for or workers’ compensation law, other federalreimbursement for the loss you actually occupational disease law or the provisions ofsustain. In order for you to recover loss or any law that provide nonoccupational disabilityexpenses under this reimbursement you must:benefits. 1. actually sustain and pay the loss or Part Two (Employers’ Liability Insurance), C.expense in money after trial, or Exclusions, exclusion 8, does not apply to 2. secure our consent for the payment of the work subject to the Longshore and Harbor loss or expense.Workers’ Compensation Act. G. Repatriation This coverage does not apply to work subject to the Defense Base Act, the OuterOur reimbursement includes the additional Continental Shelf Lands Act, or theexpenses of repatriation to the United States Nonappropriated Fund Instrumentalities Act. FormWC990301B Page 5 of 6Printed in U.S.A. (Ed. 8/00) SECTION III 1. SCHEDULE OF COVERED STATES B. If a state, shown in Item 3.A. of the Information Page, approves this endorsement after theA. This endorsement only applies in the states effective date of this policy, this endorsementlisted in this Schedule of Covered States.will apply to this policy. The coverage will apply in the new state on the effective date of the state approval. C. Schedule of Covered States: Countersigned by Authorized Representative FormWC990301B Page 6 of 6Printed in U.S.A. (Ed. 8/00)