Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Alta Planning + Design Inc; 2022-03-18; PSA22-1777TRAN
PSA22-1777TRAN City Attorney Approved Version 6/12/18 1 AGREEMENT FOR SAFE ROUTES TO SCHOOL PROGRAM SERVICES ALTA PLANNING + DESIGN, INC. THIS AGREEMENT is made and entered into as of the ______________ day of _________________________, 2022, by and between the City of Carlsbad, a municipal corporation, ("City"), and Alta Planning + Design, Inc. a California corporation, ("Contractor"). RECITALS A. City requires the professional services of a consultant that is experienced in the preparation of safe routes to school plans and related programming activities. B. Contractor has the necessary experience in providing professional services and advice related to the preparation of safe routes to school plans and related programming activities. C. Contractor has submitted a proposal to City and has affirmed its willingness and ability to perform such work. NOW, THEREFORE, in consideration of these recitals and the mutual covenants contained herein, City and Contractor agree as follows: 1. SCOPE OF WORK City retains Contractor to perform, and Contractor agrees to render, those services (the "Services") that are defined in attached Exhibit "A", which is incorporated by this reference in accordance with this Agreement’s terms and conditions. 2. STANDARD OF PERFORMANCE While performing the Services, Contractor will exercise the reasonable professional care and skill customarily exercised by reputable members of Contractor's profession practicing in the Metropolitan Southern California Area, and will use reasonable diligence and best judgment while exercising its professional skill and expertise. 3. TERM The term of this Agreement will be effective for a period of one (1) year from the date first above written. 4. TIME IS OF THE ESSENCE Time is of the essence for each and every provision of this Agreement. 5. COMPENSATION The total fee payable for the Services to be performed during the initial Agreement term shall not exceed thirty-three thousand dollars ($33,000). No other compensation for the Services will be allowed except for items covered by subsequent amendments to this Agreement. The City reserves the right to withhold a ten percent (10%) retention until City has accepted the work and/or Services specified in Exhibit "A". Incremental payments, if applicable, should be made as outlined in attached Exhibit "A". 6. STATUS OF CONTRACTOR Contractor will perform the Services in Contractor's own way as an independent contractor and in pursuit of Contractor's independent calling, and not as an employee of City. Contractor will be under control of City only as to the result to be accomplished but will consult with City as DocuSign Envelope ID: B51FAD29-2B49-4227-B868-77D88E1C9CFB 18th March PSA22-1777TRAN City Attorney Approved Version 6/12/18 2 necessary. The persons used by Contractor to provide services under this Agreement will not be considered employees of City for any purposes. The payment made to Contractor pursuant to the Agreement will be the full and complete compensation to which Contractor is entitled. City will not make any federal or state tax withholdings on behalf of Contractor or its agents, employees or subcontractors. City will not be required to pay any workers' compensation insurance or unemployment contributions on behalf of Contractor or its employees or subcontractors. Contractor agrees to indemnify City within thirty (30) days for any tax, retirement contribution, social security, overtime payment, unemployment payment or workers' compensation payment which City may be required to make on behalf of Contractor or any agent, employee, or subcontractor of Contractor for work done under this Agreement. At the City’s election, City may deduct the indemnification amount from any balance owing to Contractor. 7. SUBCONTRACTING Contractor will not subcontract any portion of the Services without prior written approval of City. If Contractor subcontracts any of the Services, Contractor will be fully responsible to City for the acts and omissions of Contractor's subcontractor and of the persons either directly or indirectly employed by the subcontractor, as Contractor is for the acts and omissions of persons directly employed by Contractor. Nothing contained in this Agreement will create any contractual relationship between any subcontractor of Contractor and City. Contractor will be responsible for payment of subcontractors. Contractor will bind every subcontractor and every subcontractor of a subcontractor by the terms of this Agreement applicable to Contractor's work unless specifically noted to the contrary in the subcontract and approved in writing by City. 8. OTHER CONTRACTORS The City reserves the right to employ other Contractors in connection with the Services. 9. INDEMNIFICATION Contractor agrees to indemnify and hold harmless the City and its officers, officials, employees and volunteers from and against all claims, damages, losses and expenses including attorneys’ fees arising out of the performance of the work described herein caused by any negligence, recklessness, or willful misconduct of the Contractor, any subcontractor, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable. The parties expressly agree that any payment, attorney’s fee, costs or expense City incurs or makes to or on behalf of an injured employee under the City’s self-administered workers’ compensation is included as a loss, expense or cost for the purposes of this section, and that this section will survive the expiration or early termination of this Agreement. 10. INSURANCE Contractor will obtain and maintain for the duration of the Agreement and any and all amendments, insurance against claims for injuries to persons or damage to property which may arise out of or in connection with performance of the services by Contractor or Contractor’s agents, representatives, employees or subcontractors. The insurance will be obtained from an insurance carrier admitted and authorized to do business in the State of California. The insurance carrier is required to have a current Best's Key Rating of not less than "A-:VII"; OR with a surplus line insurer on the State of California’s List of Approved Surplus Line Insurers (LASLI) with a rating in the latest Best’s Key Rating Guide of at least “A:X”; OR an alien non-admitted insurer listed by the National Association of Insurance Commissioners (NAIC) latest quarterly listings report. DocuSign Envelope ID: B51FAD29-2B49-4227-B868-77D88E1C9CFB PSA22-1777TRAN City Attorney Approved Version 6/12/18 3 10.1 Coverage and Limits. Contractor will maintain the types of coverage and minimum limits indicated below, unless the Risk Manager or City Manager approves a lower amount. These minimum amounts of coverage will not constitute any limitations or cap on Contractor's indemnification obligations under this Agreement. City, its officers, agents and employees make no representation that the limits of the insurance specified to be carried by Contractor pursuant to this Agreement are adequate to protect Contractor. If Contractor believes that any required insurance coverage is inadequate, Contractor will obtain such additional insurance coverage, as Contractor deems adequate, at Contractor's sole expense. The full limits available to the named insured shall also be available and applicable to the City as an additional insured. 10.1.1 Commercial General Liability (CGL) Insurance. Insurance written on an “occurrence” basis, including personal & advertising injury, with limits no less than $2,000,000 per occurrence. If a general aggregate limit applies, either the general aggregate limit shall apply separately to this project/location or the general aggregate limit shall be twice the required occurrence limit. 10.1.2 Automobile Liability. (if the use of an automobile is involved for Contractor's work for City). $2,000,000 combined single-limit per accident for bodily injury and property damage. 10.1.3 Workers' Compensation and Employer's Liability. Workers' Compensation limits as required by the California Labor Code. Workers' Compensation will not be required if Contractor has no employees and provides, to City's satisfaction, a declaration stating this. 10.1.4 Professional Liability. Errors and omissions liability appropriate to Contractor’s profession with limits of not less than $1,000,000 per claim. Coverage must be maintained for a period of five years following the date of completion of the work. 10.2 Additional Provisions. Contractor will ensure that the policies of insurance required under this Agreement contain, or are endorsed to contain, the following provisions: 10.2.1 The City will be named as an additional insured on Commercial General Liability which shall provide primary coverage to the City. 10.2.2 Contractor will obtain occurrence coverage, excluding Professional Liability, which will be written as claims-made coverage. 10.2.3 This insurance will be in force during the life of the Agreement and any extensions of it and will not be canceled without thirty (30) days prior written notice to City sent by certified mail pursuant to the Notice provisions of this Agreement. 10.3 Providing Certificates of Insurance and Endorsements. Prior to City's execution of this Agreement, Contractor will furnish certificates of insurance and endorsements to City. 10.4 Failure to Maintain Coverage. If Contractor fails to maintain any of these insurance coverages, then City will have the option to declare Contractor in breach, or may purchase replacement insurance or pay the premiums that are due on existing policies in order to maintain the required coverages. Contractor is responsible for any payments made by City to obtain or maintain insurance and City may collect these payments from Contractor or deduct the amount paid from any sums due Contractor under this Agreement. DocuSign Envelope ID: B51FAD29-2B49-4227-B868-77D88E1C9CFB PSA22-1777TRAN City Attorney Approved Version 6/12/18 4 10.5 Submission of Insurance Policies. City reserves the right to require, at any time, complete and certified copies of any or all required insurance policies and endorsements. 11. BUSINESS LICENSE Contractor will obtain and maintain a City of Carlsbad Business License for the term of the Agreement, as may be amended from time-to-time. 12. ACCOUNTING RECORDS Contractor will maintain complete and accurate records with respect to costs incurred under this Agreement. All records will be clearly identifiable. Contractor will allow a representative of City during normal business hours to examine, audit, and make transcripts or copies of records and any other documents created pursuant to this Agreement. Contractor will allow inspection of all work, data, documents, proceedings, and activities related to the Agreement for a period of three (3) years from the date of final payment under this Agreement. 13. OWNERSHIP OF DOCUMENTS All work product produced by Contractor or its agents, employees, and subcontractors pursuant to this Agreement is the property of City. In the event this Agreement is terminated, all work product produced by Contractor or its agents, employees and subcontractors pursuant to this Agreement will be delivered at once to City. Contractor will have the right to make one (1) copy of the work product for Contractor’s records. 14. COPYRIGHTS Contractor agrees that all copyrights that arise from the services will be vested in City and Contractor relinquishes all claims to the copyrights in favor of City. 15. NOTICES The name of the persons who are authorized to give written notice or to receive written notice on behalf of City and on behalf of Contractor under this Agreement. For City For Contractor Name Nathan Schmidt Name Kristin Haukum Title Transportation Planning & Mobility Manager Title Project Manager Department Public Works Address 711 SE Grand Avenue City of Carlsbad Portland, OR 97214 Address 1635 Faraday Ave Phone No. 619-987-7977 Carlsbad, CA 92008 Email contracts@altago.com Phone No. 442-339-2734 Each party will notify the other immediately of any changes of address that would require any notice or delivery to be directed to another address. DocuSign Envelope ID: B51FAD29-2B49-4227-B868-77D88E1C9CFB PSA22-1777TRAN City Attorney Approved Version 6/12/18 5 16. CONFLICT OF INTEREST Contractor shall file a Conflict of Interest Statement with the City Clerk in accordance with the requirements of the City of Carlsbad Conflict of Interest Code. The Contractor shall report investments or interests in all categories. Yes ☐ No ☒ 17. GENERAL COMPLIANCE WITH LAWS Contractor will keep fully informed of federal, state and local laws and ordinances and regulations which in any manner affect those employed by Contractor, or in any way affect the performance of the Services by Contractor. Contractor will at all times observe and comply with these laws, ordinances, and regulations and will be responsible for the compliance of Contractor's services with all applicable laws, ordinances and regulations. Contractor will be aware of the requirements of the Immigration Reform and Control Act of 1986 and will comply with those requirements, including, but not limited to, verifying the eligibility for employment of all agents, employees, subcontractors and consultants whose services are required by this Agreement. 18. DISCRIMINATION AND HARASSMENT PROHIBITED Contractor will comply with all applicable local, state and federal laws and regulations prohibiting discrimination and harassment. 19. DISPUTE RESOLUTION If a dispute should arise regarding the performance of the Services the following procedure will be used to resolve any questions of fact or interpretation not otherwise settled by agreement between the parties. Representatives of Contractor or City will reduce such questions, and their respective views, to writing. A copy of such documented dispute will be forwarded to both parties involved along with recommended methods of resolution, which would be of benefit to both parties. The representative receiving the letter will reply to the letter along with a recommended method of resolution within ten (10) business days. If the resolution thus obtained is unsatisfactory to the aggrieved party, a letter outlining the disputes will be forwarded to the City Manager. The City Manager will consider the facts and solutions recommended by each party and may then opt to direct a solution to the problem. In such cases, the action of the City Manager will be binding upon the parties involved, although nothing in this procedure will prohibit the parties from seeking remedies available to them at law. 20. TERMINATION In the event of the Contractor's failure to prosecute, deliver, or perform the Services, City may terminate this Agreement for nonperformance by notifying Contractor by certified mail of the termination. If City decides to abandon or indefinitely postpone the work or services contemplated by this Agreement, City may terminate this Agreement upon written notice to Contractor. Upon notification of termination, Contractor has five (5) business days to deliver any documents owned by City and all work in progress to City address contained in this Agreement. City will make a determination of fact based upon the work product delivered to City and of the percentage of work that Contractor has performed which is usable and of worth to City in having the Agreement completed. Based upon that finding City will determine the final payment of the Agreement. Either party upon tendering thirty (30) days written notice to the other party may terminate this Agreement. In this event and upon request of City, Contractor will assemble the work product and put it in order for proper filing and closing and deliver it to City. Contractor will be paid for work DocuSign Envelope ID: B51FAD29-2B49-4227-B868-77D88E1C9CFB PSA22-1777TRAN City Attorney Approved Version 6/12/18 6 performed to the termination date; however, the total will not exceed the lump sum fee payable under this Agreement. City will make the final determination as to the portions of tasks completed and the compensation to be made. 21. COVENANTS AGAINST CONTINGENT FEES Contractor warrants that Contractor has not employed or retained any company or person, other than a bona fide employee working for Contractor, to solicit or secure this Agreement, and that Contractor has not paid or agreed to pay any company or person, other than a bona fide employee, any fee, commission, percentage, brokerage fee, gift, or any other consideration contingent upon, or resulting from, the award or making of this Agreement. For breach or violation of this warranty, City will have the right to annul this Agreement without liability, or, in its discretion, to deduct from the Agreement price or consideration, or otherwise recover, the full amount of the fee, commission, percentage, brokerage fees, gift, or contingent fee. 22. CLAIMS AND LAWSUITS By signing this Agreement, Contractor agrees that any Agreement claim submitted to City must be asserted as part of the Agreement process as set forth in this Agreement and not in anticipation of litigation or in conjunction with litigation. Contractor acknowledges that if a false claim is submitted to City, it may be considered fraud and Contractor may be subject to criminal prosecution. Contractor acknowledges that California Government Code sections 12650 et seq., the False Claims Act applies to this Agreement and, provides for civil penalties where a person knowingly submits a false claim to a public entity. These provisions include false claims made with deliberate ignorance of the false information or in reckless disregard of the truth or falsity of information. If City seeks to recover penalties pursuant to the False Claims Act, it is entitled to recover its litigation costs, including attorney's fees. Contractor acknowledges that the filing of a false claim may subject Contractor to an administrative debarment proceeding as the result of which Contractor may be prevented to act as a Contractor on any public work or improvement for a period of up to five (5) years. Contractor acknowledges debarment by another jurisdiction is grounds for City to terminate this Agreement. 23. JURISDICTION AND VENUE Any action at law or in equity brought by either of the parties for the purpose of enforcing a right or rights provided for by this Agreement will be tried in a court of competent jurisdiction in the County of San Diego, State of California, and the parties waive all provisions of law providing for a change of venue in these proceedings to any other county. 24. SUCCESSORS AND ASSIGNS It is mutually understood and agreed that this Agreement will be binding upon City and Contractor and their respective successors. Neither this Agreement nor any part of it nor any monies due or to become due under it may be assigned by Contractor without the prior consent of City, which shall not be unreasonably withheld. 25. ENTIRE AGREEMENT This Agreement, together with any other written document referred to or contemplated by it, along with the purchase order for this Agreement and its provisions, embody the entire Agreement and understanding between the parties relating to the subject matter of it. In case of conflict, the terms of the Agreement supersede the purchase order. Neither this Agreement nor any of its provisions may be amended, modified, waived or discharged except in a writing signed by both parties. /// DocuSign Envelope ID: B51FAD29-2B49-4227-B868-77D88E1C9CFB PSA22-1777TRAN City Attorney Approved Version 6/12/18 7 26. AUTHORITY The individuals executing this Agreement and the instruments referenced in it on behalf of Contractor each represent and warrant that they have the legal power, right and actual authority to bind Contractor to the terms and conditions of this Agreement. CONTRACTOR CITY OF CARLSBAD, a municipal corporation of the State of California ALTA PLANNING + DESIGN, INC. a California corporation By: By: (sign here) Paz Gomez, Deputy City Manager, Public Works, as authorized by the City Manager Natalie Lozano, Corporate Secretary (print name/title) By: (sign here) Deven Young, Vice-President (print name/title) If required by City, proper notarial acknowledgment of execution by contractor must be attached. If a corporation, Agreement must be signed by one corporate officer from each of the following two groups. Group A Group B Chairman, Secretary, President, or Assistant Secretary, Vice-President CFO or Assistant Treasurer Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM: CELIA A. BREWER, City Attorney BY: _____________________________ Assistant City Attorney DocuSign Envelope ID: B51FAD29-2B49-4227-B868-77D88E1C9CFB PSA22-1777TRAN City Attorney Approved Version 6/12/18 8 EXHIBIT “A” SCOPE OF SERVICES DocuSign Envelope ID: B51FAD29-2B49-4227-B868-77D88E1C9CFB City of Carlsbad SRTS Services | 1 Scope of Work and Budget Task 1. SRTS Recommendations for Priority Schools Alta will facilitate up to three (3) listening sessions with Hope Elementary School to understand school, parent, and student safety concerns and learn about ways to promote active travel to school. These listening sessions will be complemented by a walking assessment around the school. Alta will use input from the school community, walking assessment information, collision data, and best practices to create site plans with design recommendations (which may include quick build), programmatic recommendations, AutoCAD files, and planning level cost estimates. The goals of this task are to: continue building a relationship with Hope Elementary School in order to create a culture of safe walking and biking to and from school; set the City up for a scalable SRTS program; provide opportunities for the Carlsbad Police Department and the City in general to participate in SRTS strategies; connect students to the City’s trail system, as appropriate; and supply City staff with information that can be presented to the Traffic and Mobility Commission. Task 1 Deliverables •Up to three (3) listening sessions with Hope Elementary School stakeholders •One (1) walking assessment •One (1) school site assessment summary memo •One (1) school site plans and planning level cost estimates Task 2. Short-Term, Low-Cost SRTS Recommendations Alta will conduct a desktop scan of all twenty-three (23) Carlsbad public schools, represented by Carlsbad Unified, Encinitas Union, and San Dieguito Union High, and San Marcos Unified School Districts, and will review existing information contained in Carlsbad’s Sustainable Mobility Plan. Alta will compile a list of short-term, low-cost and high- priority recommendations such as signage and striping that the City can use to create work orders for public works staff. This ‘signs and lines’ project list would enable the City to quickly improve traffic circulation and safety for all users, while visibly demonstrating their commitment to SRTS to school families. Task 2 Deliverables •List of short-term, low-cost recommendations TOTAL PROJECT BUDGET = $33,000 www.altago.com The Services will be billed on a Percent Complete basis. Invoices will be submitted monthly showing progress toward milestones or current percent complete for each task. DocuSign Envelope ID: B51FAD29-2B49-4227-B868-77D88E1C9CFB 1 of 19 (DLD01) CERTIFICATE HOLDER © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE LOCJECTPRO-POLICY GEN'L AGGREGATE LIMIT APPLIES PER: OCCURCLAIMS-MADE COMMERCIAL GENERAL LIABILITY GENERAL LIABILITY PREMISES (Ea occurrence)$DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $RETENTIONDED CLAIMS-MADE OCCUR $ AGGREGATE $ EACH OCCURRENCE $UMBRELLA LIAB EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) INSRLTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)LIMITS WC STATU-TORY LIMITS OTH-ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE If yes, describe underDESCRIPTION OF OPERATIONS below (Mandatory in NH)OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON-OWNEDAUTOSAUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE $ $ $ $ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATE 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 ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). The ACORD name and logo are registered marks of ACORD COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: INSURED PHONE(A/C, No, Ext): PRODUCER ADDRESS:E-MAIL FAX(A/C, No): CONTACTNAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S) AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 03/02/2022 Parker, Smith & Feek, Inc. 16201 E Indiana Ave, Suite 1000 Spokane Valley, WA 99216 509-789-8350 509-931-0794 Hartford Casualty Ins. Co. Alta Planning + Design, Inc. 711 SE Grand Ave Portland, OR 97214 Trumbull Insurance Company Twin City Fire Ins. Co. Continental Casualty Company A X 1,000,000 8 8 8 8 52UUNOL5120 09/01/2021 09/01/2022 1,000,000 10,000 1,000,000 2,000,000 2,000,000 B 1,000,000 8 52UENOL5676 09/01/2021 09/01/2022 A 8 3,000,000 8 3,000,000 8 10,000 52XHUOL5121 09/01/2021 09/01/2022 C X 809/01/2021 09/01/2022 1,000,000 52WEOL6H1T ** WA Stop Gap 1,000,000 1,000,000 D Professional Liability MCH114135257 09/01/2021 09/01/2022 $1,000,000 All Projects on file. City of Carlsbad/CMWD is an additional insured on the general liability policy per the attached endorsement/form... (See Attached Description) City of Carlsbad/CMWD 1635 Faraday Ave Carlsbad, CA 92008-7314 2 of 19 (DLD01) DESCRIPTIONS (Continued from Page ) 1 . Coverage is primary and non-contributory on the general liability policy per the attached endorsement/form. Waiver of subrogation applies on the workers compensation policy per the attached endorsement/form. Notice of cancellation for the general liability, workers compensation, and excess liability policies per the attached forms. CANCELS AND REPLACES PREVIOUSLY ISSUED CERTIFICATE. 3 of 19 (DLD01) SECTION II -WHO IS AN INSURED 1. Ifyou are designated in the Declarations as: a. An individual, you and your spouse are insureds, but oniy with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture, you are an insured. Your members, your partners, and their spouses are also insureds, but oniy wilh respect to the conduct of your business. c. A limited liability company, you are an insured. Your members are also insureds, but only with respect to the conduct of your business. Your managers are insureds, bul only with respect to their dufies as your managers, d. An organization other than a partnership, joinl venture or limited liability company, you are an insured. Your "executive officers" and directors are insureds, bul only with respect to their dufies as your offlcers or directors. Your stockholders are also insureds, but only wilh respecl to their liability as stockholders. e. A trust, you are an insured. Your trustees are also insureds, bul only with respect to their dufies as trustees. 2. Each ofthe following Is also an insured: a. Employees And Volunteer Workers Your "volunteer workers" only while performing dufies reiated to the conduct of your business, or your "employees", other than either your "execufive offlcers" (if you are an organization other lhan a partnership, joint venture or limiled liabilily company) or your managers (if you are a limiled liability company), bul only for acts wiihin the scope of their employment by you or while performing duties related to the conduct of your business. However, none of these "employees" or "volunteer workers" are insureds for: (1) "Bodily Injury" or "personal and advertising injury": (a) To you, lo your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co-"employee" while In the course of his or her employment or performing dufies related to the conduct of your business, or to your olher "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of lhat co-"employee" or that "volunteer worker" as a consequence of Paragraph (1)(a) above; (c) For which there is any obligation lo share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1)(a) or (1)(b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. If you are not in the business of providing professional heallh care services; (a) Subparagraphs (1)(a), (1)(b) and (1)(c) above do not apply to any "employee" or "volunteer worker" providing flrst aid services; and (b) Subparagraph (1)(d) above does not apply to any nurse, emergency medical technician or paramedic employed by you lo provide such services. (2) "Property damage" to property: (a) Owned, occupied or used by, (b) Renled to, in the care, custody or conlrol of, or over which physical conlrol is being exercised for any purpose by you, any of your "employees", "volunteer workers", any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability company). b. Real Estate Manager Any person (other lhan your "employee" or 'Volunteer worker"), or any organization while acfing as your real estate manager. c. Temporary Custodians Of Your Property Any person or organizafion having proper temporary custody of your property if you die, but only: (1) With respect to liability arising out of the maintenance or use of lhal property; and (2) Until your legal representafive has been appointed. d. Legal Representative If You Die Your legal representative if you die, but only wilh respecl lo duties as such. That representafive will have all your rights and dufies under this Coverage Part. e. Unnamed Subsidiary Any subsidiary, and subsidiary Ihereof, of yours which is a legally incorporated enlity of which you own a financial interest of more than 50% of the voting stock on the effeclive dale of the Coverage Part. HG00 01 09 16 Page 11 of 21 4 of 19 (DLD01) The Insurance afforded herein for any subsidiary not named in this Coverage Part as a named insured does not apply lo injury or damage with respecl to which such insured is also a named insured under another policy or would be a named insured under such policy bul for its lermination or the exhaustion of ils limits of insurance, 3. Newly Acquired Or Formed Organization Any organization you newly acquire or form, other than a partnership, joinl venture or limited liability company, and over which you maintain financial interest of more than 50% of the voting stock, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only unfil the 180lh day after you acquire or form the organization or the end of the policy period, whichever is eariier; b. Coverage A does nol apply lo "bodily Injury" or "property damage" that occurred before you acquired or formed the organizafion; and c. Coverage B does nol apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. 4. Nonowned Watercraft With respect lo watercraft you do not own that is less lhan 51 feet long and is not being used to carry persons for a charge, any person is an insured while operating such watercraft with your permission. Any olher person or organization responsible for the conduct of such person is also an Insured, bul only wilh respect lo liability arising out of the operafion of the watercraft, and only if no olher insurance of any kind Is available lo that person or organization for this liability. However, no person or organization is an insured with respect lo: a. "Bodily Injury" to a co-"employee" of the person operafing the watercraft; or b. "Property damage" lo property owned by, rented to. In the charge of or occupied by you or the employer of any person who is an insured under this provision, 5. Additional Insureds When Required By Written Contract, Written Agreement Or Permit The following person(s) or organization{s) are an addilional insured when you have agreed, in a written contraci, written agreement or because of a permil issued by a state or political subdivision, that such person or organization be added as an addilional insured on your policy, provided the injury or damage occurs subsequent lo the execufion of the contract or agreement. A person or organization is an additional insured under this provision only for that period of time required by the contraci or agreement. However, no such person or organization is an insured under this provision if such person or organization is included as an insured by an endorsemenl issued by us and made a part of this Coverage Part a. Vendors Any person(s) or organization(s) (referred to beiow as vendor), but only wilh respect to "bodily Injury" or "property damage" arising oul of "your products" which are distributed or sold in the regular course of the vendor's business and only if this Coverage Part provides coverage for "bodily injury" or "property damage" included within the "products-completed operations hazard". (1) The insurance afforded the vendor is subjecl lo the following addilional exclusions; This insurance does nol apply lo: (a) "Bodily injury" or "property damage" for which the vendor is obligated lo pay damages by reason of the assumpfion 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 agreemenl; (b) Any express warranty unauthorized by you; (c) Any physical or chemical change in the product made intenfionally by the vendor: (d) Repackaging, except when unpacked solely for the purpose of inspecfion, demonstrafion, testing, or the subsfilution of parts under instruclions from the manufacturer, and then repackaged in the original container; (e) 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 producls; (f) Demonstrafion, installation, servicing or repair operafions, excepi such operations performed al the vendor's premises in connection with the sale of the product; (g) 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; or Page 12 of 21 HG 00 01 09 16 5 of 19 (DLD01) (h) "Bodiiy injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acfing on ils behalf. However, this exclusion does not appiy lo; (i) The exceptions contained in Sub- paragraphs (d) or (f); or (li) 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 connecfion wilh the distribution or sale of the producls, (2) This insurance does nol 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, b. Lessors Of Equipment (1) Any person(s) or organlzafion(s) from whom you lease equipment; bul only with respecl to their liability for "bodiiy injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operafion or use of equipment leased lo you by such person{s) or organizalion(s). (2) Wilh respecl to the insurance afforded to these additional insureds this insurance does not appiy lo any "occurrence" which takes place after the equipment lease expires. c. Lessors Of Land Or Premises Any person or organization from whom you lease land or premises, but only with respect lo liability arising out of the ownership, maintenance or use of that part of the land or premises leased lo you. With respecl to the insurance afforded these additional insureds the following addifional exclusions appiy: This insurance does not apply to: 1. Any "occurrence" which takes place after you cease to lease that land; or 2. Structural alterafions, new consiruction or demolition operalions performed by or on behalf of such person or organization. d. Architects, Engineers Or Surveyors Any archilecl, engineer, or surveyor, but only wilh respecl to liabiiity for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalt (1) In connection wilh your premises; or (2) In the performance of your ongoing operafions performed by you or on your behalt With respecl to the insurance afforded these additional insureds, the following addifional exclusion applies: This insurance does not apply to "bodily injury", "property damage" or "personal and adverfising injury" arising oul of the rendering of or the failure to render any professional services by or for you, including; 1. The preparing, approving, or falling to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and speciflcafions; or 2. Supervisory, Inspection, architectural or engineering acfivifies. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employmenl, training or monitoring of olhers by that insured, if the "occurrence" which caused the "bodily injury'* or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional services by or for you. e. Permits Issued By State Or Political Subdivisions Any state or polifical subdivision, but only with respecl to operafions performed by you or on your behalf for which the stale or political subdivision has issued a permit. With respect lo the insurance afforded these addilional Insureds, this insurance does not apply to; (1) "Bodily Injury", "property damage" or "personal and advertising injury" arising out of operations performed for the stale or municipality; or (2) "Bodily injury" or "property damage" included within the "products-completed operalions hazard". f. Any Other Party Any olher person or organization who Is not an addilional insured under Paragraphs a. through e. above, bul only with respecl to liabilily for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part by your acts or omissions or the acts or omissions of those acfing on your behalt (1) In the performance of your ongoing operalions; HG 00 01 09 16 Page 13 of 21 6 of 19 (DLD01) (2) In connection with your premises owned by or rented to you; or (3) In connecfion with "your work" and included wiihin the "products-completed operafions hazard", but only if (a) The written conlract or agreemenl requires you lo provide such coverage to such additional insured; and (b) This Coverage Part provides coverage for "bodily injury" or "property damage" Included within the "products- completed operations hazard". However; (1) The insurance afforded to such additional insured only applies to the extenl permilled by law; and (2) If coverage provided lo the additional insured is required by a contract or agreemenl, the insurance afforded to such addifional insured will not be broader than that which you are required by the contract or agreement to provide for such addifional insured. With respect lo the insurance afforded lo these additional Insureds, this insurance does not apply to; "Bodily injury", "property damage" or "personal and advertising injury" arising oul of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including; (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering acfivities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure lo render any professional services by or for you. The limils of insurance lhat appiy to additional Insureds is described in Section III - Limils Of Insurance. How this Insurance applies when olher insurance is available lo the addifional insured is described in the Other Insurance Condition in Section IV - Commercial General Liability Condifions. No person or organization is an Insured with respecl lo the conduct of any current or past partnership, joinl venture or iimited liability company lhat is not shown as a Named Insured in the Declarafions. SECTION III - LIMITS OF INSURANCE 1. The Most We Will Pay The Limils of Insurance shown in the Deciarations and the rules below fix the most we will pay regardless oflhe number of; a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 2. General Aggregate Limit The General Aggregate Limil is the most we wiil pay for the sum of: a. Medical expenses under Coverage C; b. Damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products- completed operalions hazard"; and c. Damages under Coverage 8. 3. Products-Completed Operations Aggregate Limit The Products-Completed Operafions Aggregate Limit Is the most we will pay under Coverage A for damages because of "bodily injury" and "property damage" included in the "products- completed operalions hazard". 4. Personal And Advertising Injury Limit Subjecl lo 2. above, the Personal and Advertising Injury Limil Is the most we will pay under Coverage 8 for the sum of all damages because of all "personal and advertising injury" sustained by any one person or organizafion. 5. Each Occurrence Limit Subject to 2. or 3. above, whichever applies, the Each Occurrence Limil is the most we will pay for the sum of: a. Damages under Coverage A; and b. Medical expenses under Coverage C because of all "bodily injury" and "property damage" arising out of any one "occurrence". 6. Damage To Premises Rented To You Limit Subject to 5. above, the Damage To Premises Renled To You Limit is the most we will pay under Coverage A for damages because of "property damage" lo any one premises, while renled to you, or in the case of damage by flre, lightning or explosion, while rented to you or temporarily occupied by you with permission of the owner. Page 14 of 21 HG 00 01 09 16 7 of 19 (DLD01) ABCDEFGHIJ THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO CERTIFICATE HOLDER(S) This policy is subject to the following additional If notice is mailed,proof of mailing to the last known Conditions:mailing address of the certificate holder(s)on file with A.If this policy is cancelled by the Company,other the agent of record or the Company will be sufficient than for nonpayment of premium,notice of such proof of notice. cancellation will be provided at least thirty (30) Any notification rights provided by this endorsement days in advance of the cancellation effective date apply only to active certificate holder(s)who were to the certificate holder(s)with mailing addresses issued a certificate of insurance applicable to this on file with the agent of record or the Company.policy's term. B.If this policy is cancelled by the Company for Failure to provide such notice to the certificate nonpayment of premium,or by the insured,notice holder(s)will not amend or extend the date the of such cancellation will be provided within (10) cancellation becomes effective,nor will it negate days of the cancellation effective date to the cancellation of the policy.Failure to send notice shall certificate holder(s)with mailing addresses on file impose no liability of any kind upon the Company or itswith the agent of record or the Company.agents or representatives. Form IH 03 13 06 11 Page 1 of 1 © 2011, The Hartford 8 of 19 (DLD01) (3) Any manager, if you or the addilional insured is a limited liability company; (4) Any "executive officer" or Insurance manager, if you or the additional insured Is a corporafion; (5) Any trustee, If you or the additional insured Is a trust; or (6) Any elected or appointed official, if you or the additional insured is a political subdivision or public enlity. This duty applies separately to you and any additional insured. 3. Legal Action Against Us No person or organization has a right under this Coverage Part; a. To join us as a party or otherwise bring us into a "suit" asking for damages from an insured; or b. To sue us on this Coverage Part unless all of its lerms have been fully complied wilh. A person or organization may sue us lo recover on an agreed settlement or on a final judgment against an insured; but we will nol be liable for damages that are not payable underthe lerms of this Coverage Part or that are in excess of the applicable limit of insurance. An agreed setfiement means a setfiement and release of liability signed by us, the insured and the claimant or the claimants legal representafive, 4. Other Insurance If other valid and collecfible insurance is available to the insured for a loss we cover under Coverages A or 8 of this Coverage Part, our obligafions are limited as follows; a. Primary Insurance This insurance Is primary excepi when b. below applies. If olher insurance is also primary, we will share with all lhat olher insurance by the method described in c. below. b. Excess Insurance This insurance is excess over any of the olher insurance, whether primary, excess, confingent or on any olher basis; (1) YourWork Thai is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work"; (2) Premises Rented To You That is fire, lightning or explosion insurance for premises rented to you or temporarily occupied by you with permission ofthe owner; (3) Tenant Liability That is insurance purchased by you lo cover your Iiabilily as a tenant for "property damage" to premises rented to you or temporarily occupied by you wilh permission of the owner; (4) Aircraft, Auto Or Watercraft If the loss arises out of the maintenance or use of aircraft "aulos" or watercraft lo the extent not subject to Exclusion g. of Section I - Coverage A - Bodily Injury And Property Damage Liability; (5) Property Damage To Borrowed Equipment Or Use Of Elevators If the loss arises out of "property damage" to borrowed equipment or the use of elevators to the extent nol subject to Exclusion j. of Section I - Coverage A - Bodily Injury And Property Damage Liability; (6) When You Are Added As An Additional Insured To Other Insurance Any olher insurance available to you covering liabiiity for damages arising out of the premises or operafions, or products and completed operations, for which you have been added as an addifional insured by lhat insurance; or (7) When You Add Others As An Additional Insured To This Insurance Any other Insurance available lo an addifional insured. However, the following provisions apply lo olher insurance available to any person or organization who is an addifional insured underthis coverage part. (a) Primary Insurance When Required By Contract This insurance is primary if you have agreed in a writien conlract or wrirten agreement thai this Insurance be primary. If other insurance is also primary, we will share with all that olher insurance by the method described in c. below. (b) Primary And Non-Contributory To Other Insurance When Required By Contract If you have agreed in a writien conlract, writien agreement, or permit that this insurance Is primary and non- contributory wilh the addilional insured's own insurance, this insurance is primary and we will nol seek contribufion from that olher insurance. Page 16 of 21 HG 00 01 09 16 9 of 19 (DLD01) Paragraphs (a) and (b) do nol apply lo olher insurance to which the addifional insured has been added as an addilional Insured. 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 duly lo defend the insured against that "suit". If no olher insurer defends, we will undertake to do so, but we will be entified to the insured's rights against all those olher insurers. When this insurance Is excess over other insurance, we will pay only our share of the amount of the loss, If any, that exceeds the sum of: (1) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (2) The lotal of all deducfible and self-insured amounts under all thai other insurance. We will share the remaining loss, if any, with any other insurance lhat Is not described in this Excess Insurance provision and was not bought specifically to apply In excess of the Limits of Insurance shown In the Declarafions of this Coverage Part, c. Method Of Sharing If all of the other insurance permits contribufion by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts unfil il has paid its applicable limit of insurance or none ofthe loss remains, whichever comes firsl. If any of the other insurance does nol permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the rafio of its applicable limil of insurance to the tolal applicable limils of insurance of all insurers. 5. Premium Audit a. We will compute all premiums for this Coverage Part In accordance with our rules and rates. b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audil period we will compute the earned premium for lhat period and send notice to the first Named Insured. The due date for audil and relrospecfive premiums is the date shown as the due date on the bill, if the sum of the advance and audit premiums paid for the pollcy period Is greater than the earned premium, we will return the excess to the flrst Named insured. c. The flrst Named Insured must keep records of the informafion we need for premium computation, and send us copies al such fimes as we may request. 6. Representations a. When You Accept This Policy By accepfing this policy, you agree: (1) The statements in the Declarafions are accurate and complete; (2) Those statements are based upon representafions you made lo us; and (3) We have issued this policy in reliance upon your representations. b. Unintentional Failure To Disclose Hazards If unintenfionally you should fail lo disclose all hazards relating to the conduct of your business lhat exist at the inception date of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure. 7. Separation Of Insureds Excepi with respect lo the Limits of Insurance, and any rights or dufies speciflcally assigned in this Coverage Part lo the flrst Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured againsi whom claim Is made or "suit" Is brought. 8. Transfer Of Rights Of Recovery Against Others To Us a. Transfer Of Rights Of Recovery If the insured has rights lo recover all or part of any paymenl, Including Supplementary Payments, we have made under this Coverage Part, those rights are transferred lo us. The insured musl do nothing after loss lo impair them. At our request, the insured will bring "suit" or transfer those righls lo us and help us enforce them. b. Waiver Of Rights Of Recovery (Waiver Of Subrogation) If the insured has waived any rights of recovery againsi any person or organizafion for all or part of any paymenl, including Supplementary Payments, we have made under this Coverage Part, we also waive lhat right, provided the insured waived their righls of recovery againsi such person or organization in a contraci. agreement or permil lhat was executed prior lo the injury or damage. 9. When We Do Not Renew If we decide nol lo renew this Coverage Part, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the HG 00 01 09 16 Page 17 of 21 10 of 19 (DLD01) CJIrA Professional Liability and Pollution incident Liability Insurance Poiicyholder Notice NOTIFICATION OF CANCELLATION TO CERTIFICATE HOLDERS • In the event this Policy is cancelled prior to its expiration date, for any reason other than non payment of premium, the Insurer shall provide to the broker of record, a blank schedule to be completed by the Insured or such broker, with the names and email addresses of any and all certificate holders to whom the Insured requests the Insurer provide notification of such cancellation ("notification"). Such schedule must be completed and returned to the Insurer within 5 business days of the broker's receipt. Upon the Insurer's receipt of the completed schedule, the Insurer shall endeavor to provide notification to those entities set out In such schedule. If the schedule is not returned to the Insurer within 5 business days the Insurer wiil not provide notification. The Insurer will assume that the schedule provided to the Insurer by the Insured or the broker is a complete and accurate list of certificate holders. Only those persons or entities listed on the schedule will receive notification. The Insurer will keep no other record of any certificate holders In the Insurer's file. • There will be no schedule provided and, consequently, no notification provided. If such cancellation is for non payment of premium. • Any notification by the Insurer to any party that is not the first Named Insured on the Policy is intended as a courtesy only. The Insurer's failure to provide such notification will not extend the Policy cancellation date, or negate cancellation of the Policy or be cause for legal action against the Insurer. All other terms and conditions of the policy remain unchanged. This endorsement, which forms a part of and is for attachment to the policy Issued by the designated Insurers, takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy. Form No, CNA79045XX (09-2014) Endorsemenl Effective Date: 10/31/2019 Endorsement No: 8 ; Page 1 of 1 Underwriting Company: Continental Casually Company 151 North Franklin Streel, Chicago, IL 60606 ~ " ~ ' ^ ~ CO Copyright CMA All Rights Reserved Policy No: MCH114135257 Policy Effective Date 10/31/2019 Policy Page: 30 of 36 11 of 19 (DLD01) Policy: 52WEOL6H1T Term: 09/01/2021-09/01/2022 States per carrier: Twin City Fire Ins Co (NAIC 29459) AK, AL, AR, AZ, CO, FL, GA, ID, KS, KY, LA, MA, MD, MI, MN, MT, NM, NV, PA, SC, TN, UT, VA, WA Stop Gap Hartford Casualty Ins Co (NAIC 29424) Hartford Accident and Indemnity Ins Co (NAIC 22357) CT, NY Trumbull Ins Co (NAIC 27120) IL, CA Hartford Underwriters Ins Co (NAIC 30104) MO, NC, HI, TX Hartford Fire Ins Co (NAIC 19682) OR 12 of 19 (DLD01) a THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO CERTIFICATE HOLDER(S) Policy Number:52 WE OL6H1T Effective Date:09/01/21 Endorsement Number: Effective hour is the same as stated on the Information Page of the policy.Named Insured and Address:ALTA PLANNING &DESIGN,INC. 711 SE GRAND AVE PORTLAND OR 97214 This policy is subject to the following additional Conditions: A.If this policy is cancelled by the Company,other than for non-payment of premium,notice of such cancellation will be provided at least thirty (30)days in advance of the cancellation effective date to the certificate holder(s)with mailing addresses on file with the agent of record or the Company. B.If this policy is cancelled by the Company for non-payment of premium,or by the insured,notice of such cancellation will be provided within ten (10) days of the cancellation effective date to the certificate holder(s)with mailing addresses on file with the agent of record or the Company. Form WC 99 03 94 Printed in USA. Process Date:08/27/21 If notice is mailed,proof of mailing to the last known mailing address of the certificate holder(s)on file with the agent of record or the Company will be sufficient proof of notice. Any notification rights provided by this endorsement apply only to active certificate holder(s)who were issued a certificate of insurance applicable to this policy's term. Failure to provide such notice to the certificate holder(s) will not amend or extend the date the cancellation becomes effective,nor will it negate cancellation of the policy.Failure to send notice shall impose no liability of any kind upon the Company or its agents or representatives. Policy Expiration Date:09/01/22 ©2011,The Hartford 13 of 19 (DLD01) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM 0THERS ENDORSEMENT -CALIFORNIA Endorsement Number: Policy Number: 52WEOL6H1TEffective Date: Named Insured.and Address: Effective hour is the same as slated on the Information Page of the policy. ALTA PLANNING_& DESIGN, INC. 711 SE GRAND AVE PORTLAND OR 97214 We have the right to recover our payments from anyone liable for an injury covered by this policy. We will notenforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain. payroll records accurately segregating the remuneration of your employees while engaged in the workdescribed in the Schedule. · · The additional premium for this endorsement:shall be·2 % of the California workers' compensation premium otherwise due on _such remuneration. SCHEDULE Person or Organization Job Description Any person or organization from whom you are required by written contract or agreement to obtain this waiver of rights from us Countersigned by Authorized Representative Form WC 04 03.06 (1) Printed in U.S.A. 14 of 19 (DLD01) UMBRELLA LIABILITY POLICY DECLARATIONS INSURER: HARTFORD CASUALTY INSURANCE COMPANY ONE HARTFORD PLAZA, HARTFORD , CT 06155 POLICY NUMBER: 52 XHUOL5121 P4 RENEWAL OF : 52 XHU HBllBO Items 1. Named Insured and Mailing Address: ALTA PLANNING & DESIGN I INC .. SEE IH1204 711 SE GRAND AVE PORTLAND 2. Policy Period: From 09/01/20 To 12:01 A.M., Standard Time at mailing address shown above. 3. Agent/Broker Name: PARKER SMITH & FEEK INC 9. This policy consists of: (a) This Declarations; (b) The Schedule of Underlying Insurance Policies; (c) The Policy Provisions; XL00030916 (d) The Polity Cover; XL00070314 (e) Any Endorsements shown below. XL00050502 Endorsements forming part of this policy when issued: OR 97214 09/01/21 XL700012 06 HM99011185 IH09850115 IH1204 0312 IH994 004 09 IH994104 09 XL02260487 XLD4151088 XL21130914 XL21241100 XL21320919 XL21670914 XL23170204 XL23280605 XL23300115 XL2364 0616 XL237 60317 XL23800618 XL24 011217 XL24 021210 XL24480406 XL24551210 Countersigned by (Where required by law) Form XL 00 01 01 07 Qu~an £ C ao?Z.rz .... .:r~ Authorized Representative 09/03/20 Date 15 of 19 (DLD01) ABCDEFGHIJ THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO CERTIFICATE HOLDER(S) This policy is subject to the following additional If notice is mailed,proof of mailing to the last known Conditions:mailing address of the certificate holder(s)on file with A.If this policy is cancelled by the Company,other the agent of record or the Company will be sufficient than for nonpayment of premium,notice of such proof of notice. cancellation will be provided at least thirty (30) Any notification rights provided by this endorsement days in advance of the cancellation effective date apply only to active certificate holder(s)who were to the certificate holder(s)with mailing addresses issued a certificate of insurance applicable to this on file with the agent of record or the Company.policy's term. B.If this policy is cancelled by the Company for Failure to provide such notice to the certificate nonpayment of premium,or by the insured,notice holder(s)will not amend or extend the date the of such cancellation will be provided within (10) cancellation becomes effective,nor will it negate days of the cancellation effective date to the cancellation of the policy.Failure to send notice shall certificate holder(s)with mailing addresses on file impose no liability of any kind upon the Company or itswith the agent of record or the Company.agents or representatives. Form IH 03 13 06 11 Page 1 of 1 © 2011, The Hartford 16 of 19 (DLD01) SCHEDULE OF UNDERLYING INSURANCE POLICIES POLICY NUMBER:52 xHU OL5121 This schedule forms a part of the policy designated herein. Named Insured and Mailing Address: Insurer,Policy Number and Period ALTA PLANNING &DESIGN ,INC. SEE IH1204 711 SE GRAND AVE PORTLAND Type of Coverage (A)TWIN CITY FIRE INSURANCE COMPANY 52 WE OL6H1T 09/01/21 TO 09/01/22 (B)TRUMBULL INSURANCE COMPANY 52 UEN OL5676 09/01/21 TO 09/01/22 Employers’Liability Commercial Auto Liability written to include all owned, non-owned and hired autos, except as listed below: (C)HARTFORD CASUALTY INSURANCE COMPANY 52 UUN OL5120 09/01/21 TO 09/01/22 Form XL 00 05 05 02 Commercial General Liability OR 97214 Applicable Limits Bodily Injury Limit $1,000,000 $1,000,000 $1,000,000 Single Liability Limit $1,000,000 Split Liability Limits $1,000,000 written to include ail coverages of CG0001 or HGO001,except as listed below: $1,000,000 $2,000,000 $2,000,000 Each accident (by accident") Policy limit (by disease”) Each employee (by disease*) Each accident Bodily injury each person Bodily injury each accident Property damage each accident Each occurrence limit Persona!and advertising injury limit General aggregate limit (other than products- completed operations) Products-completed Operations aggregate limit PAGE 1 (CONTINUED ON NEXT PAGE) 17 of 19 (DLD01) SCHEDULE OF UNDERLYING INSURANCE POLICIES (Continued) POLICY NUMBER:52 XHU OL5121 Insurer,Policy Number and Period Type of Coverage (D)Other (Specify) HARTFORD FIRE INSURANCE COMPANY 52 CPG CD4779 09/01/21 TO 09/01/22 FOREIGN EMPLOYERS RESPONSIBILITY (D)HARTFORD CASUALTY INSURANCE COMPANY 52 UUN OL5120 09/01/21 TO 09/01/22 OTHER (SPECIFY) EMPLOYEE BENEFITS LIABILITY (D)HARTFORD FIRE INSURANCE COMPANY 52 CPG CD4779 09/01/21 TO 09/01/22 OTHER (SPECIFY) FOREIGN GENERAL LIABILITY Note Maintenance of Underlying Insurance Condition Applicable Limits $1,000,000 $1,000,000 $1,000,000 $1,000,000 $2,000,000 $1,000,000 $1,000,000 $2,000,000 $2,000,000 EACH ACCIDENT (BY ACCIDENT*) POLICY LIMIT (BY DISEASE*) EACH EMPLOYEE (BY DISEASE*) EACH CLAIM LIMIT AGGREGATE LIMIT EACH OCCURRENCE LIMIT PERSONAL AND ADVERTISING INJURY LIMIT GENERAL AGGREGATE LIMIT (OTHER THAN PRODUCTS-COMPLETED OPERATIONS) PRODUCTS-COMPLETED OPERATIONS AGGREGATE LIMIT *Except that in any jurisdiction where the amount of Employers’Liability Coverage afforded by the underlying insurer is by law unlimited,the limit stated does not apply and the policy of which this schedule forms a part shall afford no insurance with respect to Employers’Liability in such jurisdiction. Form XL 00 05 05 02 PAGE 2 (CONTINUED ON NEXT PAGE) 18 of 19 (DLD01) SCHEDULE OF UNDERLYING INSURANCE POLICIES (Continued) POLICY NUMBER:52 XHU 0L5121 Insurer,Policy Number and Period Type of Coverage Applicable Limits (D)HARTFORD FIRE INSURANCE COMPANY 52 CPG CD4779 09/01/21 TO 09/01/22 OTHER (SPECIFY) FOREIGN AUTOMOBILE LIABILITY $1,000,000 EACH ACCIDENT (D)HARTFORD FIRE INSURANCE COMPANY 52 CPG CD4779 09/01/21 TO 09/01/22 OTHER (SPECIFY) FOREIGN EMPLOYEE BENEFITS $1,000,000 EACH CLAIM LIABILITY LIMIT $2,000,000 AGGREGATE LIMIT Form XL 00 05 05 02 PAGE 3 19 of 19 (DLD01)